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88% Of Health Care Providers Short Of I.V. Fluids

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The proximate cause is Hurricane Helene's devastation around the Baxter intravenous fluids plant in North Cove, North Carolina.  The hurricane's heavy rain and storm surge breached a levee, which resulted in water flooding the site. The bridges accessing the site have also been damaged.  The other, unstated cause is massive shipments of these fluids to Ukraine.  The United States does not have a significant reserve supply of most I.V. solutions.

North Cove is Baxter’s largest manufacturing facility with more than 2,500 employees.  It is still not clear how many of those employees have been killed, injured, or displaced by Hurricane Helene. The North Cove facility is dedicated to the production of intravenous and peritoneal dialysis solutions and is the largest manufacturer of these solutions in the United States.

https://arstechnica.com/health/2024/10/over-86-of-surveyed-health-care-providers-are-short-on-iv-fluids/

Over 86% of surveyed health care providers are short on IV fluids
Providers are starting to put off elective surgeries and other procedures.
By Beth Mole – October 11, 2024

More than 86 percent of healthcare providers surveyed across the US are experiencing shortages of intravenous fluids after Hurricane Helene's rampage took out a manufacturing plant in western North Carolina that makes 60 percent of the country's supply.

IV fluids are used for everything from intravenous rehydration to drug delivery. The plant also made peritoneal dialysis fluids used to treat kidney failure.

Premier, a group purchasing organization for medical supplies that counts thousands of hospitals and health systems among its members, surveyed 257 such providers earlier this week. The poll makes clear that supplies are unsurprisingly imperiled.

In the poll, 88 percent of providers said they were receiving less than half of their requested orders, and about 54 percent said their supplies were down to 10 days or less, which is below the typical on-hand supply of 15 to 22 days. Most strikingly, nearly 17 percent said they had already begun postponing elective surgeries and other procedures. And 78 percent said they would be forced to do the same if the current situation persists over the next month.

The owner of the North Carolina plant, Baxter, is boosting production at its other global manufacturing sites and has inbound products and air shipments in the works, the company said in an announcement Wednesday. Given the incoming supplies, the company said it could increase allocation levels set immediately after the hurricane for its highest-demand IV fluids set. The increases will move allocations for direct customers from 40 percent to 60 percent and, for distributors, from 10 percent to 60 percent. Baxter hopes to reopen the plant in stages, reaching 90 percent to 100 percent production of some products by the end of the year.

Trucks and Gatorade

Federal officials, meanwhile, are working with Baxter to help support increasing supplies, setting up temporary imports, and expediting consideration of any shelf-life extension requests.

In a letter earlier this week, Department of Health and Human Services Secretary Xavier Becerra told health care leaders that the department is "working tirelessly to mitigate the sterile solutions supply chain disruptions" and, beyond the current crisis, is also working to diversify the supply chain so it is less reliant on a single plant.

For now, though, "HHS is encouraging all providers and health systems, regardless of whether they have experienced a disruption in their supply, to take measures to conserve these critical products," the letter read. Some hospitals have already reported giving patients Gatorade and Pedialyte to conserve IV fluid supplies.

In one bright spot in the current disruptions, fears that Hurricane Milton would disrupt another IV fluid manufacturing plant in Florida were not realized this week. B. Braun Medical’s manufacturing site in Daytona Beach was not seriously impacted by the storm, the company announced, and production resumed normally Friday. Prior to the storm, with the help of the federal government, B. Braun reportedly moved more than 60 truckloads of IV fluid inventory north of Florida for safekeeping. That inventory will be returned to the Daytona facility, according to reporting by the Associated Press.


   
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Baxter's latest update on North Cove:

https://www.baxter.com/baxter-newsroom/hurricane-helene-updates

Hurricane Helene Updates
DEERFIELD, Ill. - 2024-10-09

Baxter’s North Cove manufacturing site was significantly impacted by the rain and storm surge from Hurricane Helene, which was unprecedented in Western North Carolina and resulted in water flooding the facility.

Supporting our employees in the impacted communities, bringing the North Cove facility back online and helping to ensure ongoing supply to patients are our top priorities.

Below is an update on supply continuity:

Allocations: As previously shared, Baxter is advancing multiple paths to help ensure we are appropriately managing inventory and minimizing disruption to patient care as we work to fully restore our North Cove manufacturing operations. This includes implementing allocations, which limit what a customer can order based on historical purchases and medical necessity as well as available and projected inventory. Allocations help limit stockpiling and increase the likelihood of equitable access to available products.

Based on Baxter’s efforts to increase manufacturing capacity at its other sites and our current assessment of anticipated timing of inbound products and air shipments, we are increasing the current U.S. allocation levels of our highest demand IV fluids for direct customers from 40% to 60%, and for distributors from 10% to 60%, effective Wednesday, Oct. 9. We are also increasing high concentration dextrose and sterile water for injection allocations and expect to be in a position to make additional increases for certain product codes by early November. Due to the vulnerable patient population they serve, allocations for IV solutions and nutrition products for designated children’s hospitals were increased to 100%.

We continue to actively deliver supplies to current peritoneal dialysis (PD) patients. The allocations for PD solutions remain as communicated, and we are working with our partners to conserve and identify alternate sources of supply across all PD product categories. In addition, we are closely monitoring stock levels and working with partners and professional bodies to optimize utilization of PD supplies.

Our goal continues to be to restore customers to 100% allocation levels as soon as possible. This would be achieved through a combination of importing product from other Baxter facilities and the resumption of operations and scale up of production at our North Cove facility.

Site Status: As shared in our Oct. 7 update, Baxter continues to scale production across its global locations and is working closely with FDA on temporary importation of products to increase available inventory. Based on 1) the current status of our remediation efforts, 2) our expectations regarding our ability to reallocate capacity from other Baxter facilities, and 3) initiation of temporary importation on certain products, our goal is to restart North Cove production in phases and return to 90% to 100% allocation of certain IV solution product codes by the end of 2024.

As our CEO, Joe Almeida, reiterated, “We will spare no resource — human or financial — to restart operations and help ensure patients and providers have the products they need.”

We are aware that there is a tremendous amount of misinformation circulating in the marketplace, and we are disheartened to see blatant speculation fueling patient and customer concerns. As always, prioritizing patient care is our goal, and it is our sincere hope that everyone works to uphold this standard.

We are appreciative of and grateful for the ongoing support and patience of our customers and partners as we work diligently to fulfill our Mission to Save and Sustain Lives for our employees, patients and communities.


   
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https://www.upi.com/Health_News/2024/10/31/IV-solutions-shortage/6781730416400/

Biden invokes wartime powers to address IV fluids shortage
By Mike Heuer - 31 October 2024

Oct. 31 (UPI) -- A North Carolina facility is leading efforts to restore the nation's depleted supply of IV solutions after Hurricane Helene temporarily put it out of business.

The shortage of IV solutions has prompted President Joe Biden to invoke the Defense Production Act to rapidly rebuild a North Carolina manufacturing facility that was damaged by the hurricane.

The Baxter medical supplies manufacturing plant in North Cove, N.C., supplied about 60% of the nation's IV solutions but has been closed since Hurricane Helene made landfall on Sept. 26 and saturated much of the southeastern United States with excessive rainfall.

"In a matter of weeks, our team has advanced from the depths of Hurricane Helene's impact to restarting our highest-throughput manufacturing line," Baxter Chief Executive Officer Jose Almeida said Thursday in a prepared statement.

"This is a pivotal milestone, but more hard work remains as we work to return the plant to full production," he added.

Resuming production will help alleviate the shortage of IV solutions, but other measures are in place to help ensure a suitable supply.

"Baxter has now restarted manufacturing of some IV solutions," Health and Human Services Secretary Xavier Becerra said in a statement on Thursday. "The output from the restarted line ... will supplement product that is being imported from abroad."

Becerra said steps are being take to ensure the imported IV solutions are safe while ensuring access to the solutions for those who need them.

Steps also are being taken to conserve the IV solutions, so they are available when needed.

"Whether they have experienced a supply disruption or not, we encourage manufacturers, wholesalers, distributors and providers to continue to take measures to conserve these important products," Becerra said.

Biden and former President Donald Trump each invoked the wartime powers of the Defense Production Act to produce COVID-19 vaccines, test swabs and access ventilators during the pandemic.

Meanwhile, 97 people are still missing in the vicinity of the Baxter facility.


   
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