Hurricane Maria causes shortages at hospitals for IV fluids

One medical facility in Cape Girardeau reports a shortage concerning medical-grade saline solution for intravenous medication systems.

It's an issue hospitals are facing across the country because of disrupted manufacturing in Puerto Rico after Hurricane Maria.

"Saint Francis has had some interruption in our delivery of IV fluids, but it has not interrupted any services," Saint Francis Medical Center spokeswoman Emily Blattel said in an email Friday.

"We have reached out to other suppliers and are getting the fluids we need to treat our patients. We have also implemented some process changes based on our standards of care to help us conserve our supply," Blattel added.

Hospitals across the United States are experiencing shortages of smaller-volume bags of sodium chloride, or saline, and dextrose, according to several national reports. Normally, these solutions are used to rehydrate patients and dilute intravenous medications.

The Washington Post and other news outlets said Baxter International lost "multiple production days" in the wake of Hurricane Maria, "and it has set up an allocation system for hospitals based on past purchases," the newspaper reported.

Baxter International is based in Puerto Rico, which was hit by Hurricane Maria in September. The island's pharmaceutical-manufacturing sector was damaged during the storm, according to the Post.

When reached by phone late Friday, a Southeast Hospital spokeswoman said she could not immediately provide a response on whether the hospital was having such supply issues.

Food and Drug Administration commissioner Scott Gottlieb stated Oct. 24 that the FDA has been working closely with Baxter and other affected companies to reduce the risk and potential impact of shortages.

The FDA helped facilitate imports of the mini-bags from Baxter's Ireland and Australia facilities, according to the statement.

"The FDA and Baxter will continue to keep in close consultation as we monitor the challenging situation on the island," Gottlieb said in the statement.

The FDA also is providing logistical support to move critical products off the island.

Gottlieb also testified Oct. 24 before the House subcommittee on oversight and investigations, committee on energy and commerce about the agency's response to the disaster in Puerto Rico.

In that testimony, Gottlieb said the tragedy in Puerto Rico challenged the FDA in unique ways the agency has not confronted with other storms.

"At least 33 percent of Puerto Rico's gross domestic product is from its pharmaceutical sector," Gottlieb testified. "About 8 percent of the medicines consumed by Americans (based on the dollar value of pharmaceuticals) are manufactured in Puerto Rico, with major categories including blood fraction products, cardiovascular drugs, and treatments for cancer and HIV."

About 50 medical device manufacturing facilities on the island supply products to Americans, Gottlieb said.

"The impact of Puerto Rican manufactured medical products to the public health of all Americans is significant, and we will continue to monitor all pharmaceutical manufacturers on the island to identify other opportunities where the agency can assist, such as additional imports," Gottlieb said.

Traditionally, shortages have been handled internally by the FDA, but given the magnitude of the crisis, Gottlieb testified, a larger response had to be organized.

"In all, FDA has hundreds of staff working full or part time in response to these tragic storms," Gottlieb testified.

The FDA's goal is to meet patients' needs with imports until approved U.S. versions can cover market demand, Gottlieb said.

Gottlieb said FDA leadership is committed to getting manufacturing firms back up and running.

"We stand with the people of Puerto Rico," Gottlieb said.

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