A critical shortage of intravenous (IV) fluid supplies has emerged, primarily due to significant damage inflicted by Hurricane Helene on one of the leading manufacturers, prompting hospitals across the United States to defer elective surgeries and nonemergency procedures in an effort to preserve their limited stock.
The hurricane caused catastrophic flooding that led to the temporary closure of Baxter International’s facility in North Carolina, the largest producer of IV fluids in the country. This disruption has drastically reduced the supply of IV fluids available to hospitals nationwide. Furthermore, as concerns mount over the availability of IV fluids, B. Braun Medical, the second-largest IV fluid manufacturer, announced it would close two facilities in Daytona Beach, Florida, in anticipation of Hurricane Milton.
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In Minnesota, the Minnesota Hospital Association, representing over 140 hospitals and health systems in the state, has been holding daily meetings with hundreds of healthcare providers since last week. They are discussing strategies and timelines regarding the reopening of Baxter’s facility in North Carolina, according to a spokesperson.
Impact on Hospitals and Surgeries
UVA Health University Medical Center in Charlottesville, Virginia, is postponing several elective surgeries on Wednesday, Thursday, and Friday to conserve its IV fluid supply, as confirmed by spokesperson Eric Swensen. Similar postponements are taking place at UVA Health hospitals in Culpeper, Haymarket, and Manassas, with hospital officials closely monitoring schedules to determine which procedures may need to be rescheduled.
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Baxter accounts for approximately 60% of the IV fluid market in the U.S., and hospitals across the nation depend on its products, which are crucial for delivering medications and hydration to patients directly through their bloodstream. IV fluids play an essential role during surgical procedures by keeping patients hydrated, regulating blood pressure, and compensating for fluid loss, such as blood. Due to long-term contracts with suppliers, hospitals face challenges when attempting to switch to alternative manufacturers.
To mitigate the shortage, hospitals are beginning to postpone nonemergency operations, including tumor removals that are not urgent and heart ablation procedures for patients with arrhythmias, according to the Minnesota Hospital Association. Additionally, a “gray market” for IV fluid bags has emerged on social media platforms, where individuals are attempting to sell IV fluids; however, hospitals are not engaging in these transactions, describing the situation as “the wild, wild West.”
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Hennepin Healthcare in Minneapolis has also been compelled to cancel or reschedule surgical procedures, as reported by spokesperson Christine Hill, who noted that patients are being kept informed. Hennepin Healthcare is collaborating with other healthcare systems to coordinate resources and support during this challenging period.
On Monday, the American Hospital Association, representing around 5,000 hospitals and healthcare systems, sent a letter to President Joe Biden requesting a national emergency declaration in response to the limited supply of IV fluids. While certain IV products like sodium chloride, dextrose, and sterile water have already been in short supply, the FDA stated that the Baxter facility shutdown had not yet led to new shortages of IV fluids.
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The Department of Health and Human Services has indicated that the closure of Baxter’s facility will likely lead to further constraints on IV fluid supplies. In the meantime, the FDA has allowed for the use of compounded alternatives to the IV products that are currently in short supply.
Baxter is working with the Administration for Strategic Preparedness and Response (ASPR) to expedite the reopening of its North Carolina facility. Flooding from Hurricane Helene caused damage to access bridges leading to the plant, but efforts to restore operations are reportedly progressing. Baxter has stated its objective is to achieve “90% to 100% allocation” of certain IV solution products by the end of the year. As of Wednesday, the company announced it would increase the allocation of its most demanded IV fluids to direct customers from 40% to 60%, and to distributors from 10% to 60%.
The company also clarified that its supply assessment is partly based on anticipated timing for incoming products and shipments. On Wednesday evening, the FDA announced it would temporarily permit the importation of IV fluids from Baxter facilities located in Canada, China, Ireland, and the United Kingdom.
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Hospital Preparations and Conservation Strategies
Zachary Dembner, a spokesperson for ASPR, emphasized that the agency is encouraging manufacturers and distributors to evaluate their inventories while urging healthcare providers to implement conservation strategies to preserve their supplies. On Tuesday, ASPR assisted in safely relocating IV products from B. Braun Medical’s Daytona Beach facilities to avoid damage from Hurricane Milton. B. Braun Medical’s facilities are expected to resume regular operations on Friday after the temporary closure.
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With the situation evolving, hospitals are keeping a close watch on their IV fluid supplies. A spokesperson for Enloe Health, a medical center in Chico, California, stated that the facility is closely monitoring its IV fluid inventory to ensure enough supply for patients in need. Initially, Enloe Health had paused elective surgeries, but it has since resumed operations within specific clinical parameters.
RWJBarnabas Health in New Jersey reported that it has decided to pause a limited number of elective procedures but has not established a definitive timeline for when they might resume. Meanwhile, Shea Siegert, a spokesperson for the Alaska Native Tribal Health Consortium, indicated that no surgical procedures are being postponed, but the organization is proactively implementing strategies to conserve IV fluid supplies.
Navigating the Crisis
As hospitals across the country grapple with the ongoing IV fluid shortage resulting from natural disasters and manufacturing disruptions, they are forced to make difficult decisions regarding elective surgeries and patient care. The gravity of the situation has prompted a nationwide response from healthcare organizations, advocating for emergency measures and increased support to ensure that vital medical supplies can be restored and made available to those who need them most.
The response to this crisis highlights the delicate balance between providing necessary healthcare services and safeguarding essential resources. As Baxter and other manufacturers work to resume full operations, healthcare providers remain on high alert, implementing conservation strategies and navigating the complexities of a rapidly changing environment in order to protect the health and well-being of their patients.
