Hospitals in Massachusetts are facing a shortage of IV fluids after Hurricane Helene disrupted production at a key facility in North Carolina.
Baxter International Inc., which supplies about 60% of IV fluids used in the United States, shut down its facility in Marion, North Carolina, because of extensive flooding.
“Remediation efforts are already underway, and we will spare no resource — human or financial — to resume production and help ensure patients and providers have the products they need,” Baxter’s chair, president and CEO, José E. Almeida, said in a Sunday statement announcing the closure.
The fluids are a critical tool for hydrating patients. They are used for a wide range of reasons, including to support patients during surgery and for people with kidney failure to use at home.
Mass General Brigham received a letter from Baxter earlier this week saying the hospital system would receive just 40% of their usual supply of IV fluids, said MGB Chief Preparedness and Continuity Officer Dr. Paul Biddinger. The shortage has led MGB hospitals to take steps to conserve the supply they have on hand in order to continue providing standard clinical care as long “as long as we possibly can.”
“We use in the area of hundreds of thousands of liters of these fluids across our entire system each month,” Biddinger said. “And so even little bits of conservation make a big difference in terms of of preserving our supply.”
Those conservation efforts include encouraging oral hydration with drinks like Gatorade when possible, and not preparing IV fluid bags if health care teams are not certain they’ll need them.
Other hospitals in the region are also trying to conserve their supplies.
“Our fear is that if we don’t plan proactively now, that we might get into a situation where we don’t have enough supply on hand,” said Dr. Kimi Kobayashi, chief quality officer for UMass Memorial Medical Center in Worcester.
Kobayashi said he’s concerned the disruption could last months, which affects how the medical center is thinking about the shortage.
“It’s hard to put a number on it,” he said, “but if this goes into a couple of weeks, I am sure that this will become very challenging if we cannot get, you know, meaningful replacement of supply.”
UMass Memorial doesn’t want to find itself forced into pausing certain treatments or canceling surgeries, but planning isn’t the only factor. Still, Kobayashi said the very nature of the business means they can’t plan for everything.
“We have patients in emergencies that come in all the time that we just simply can’t control,” he said. “And we need to have the treatments available on hand to care for those patients.”
A spokesperson for Tufts Medical Center said in a written statement that they are closely monitoring the issue.
“Our Supply Chain team is being proactive to secure additional product and we continue to maintain safe patient care and meet our patients’ needs,” the statement reads.
It’s not the first time a storm has led to a shortage like this. In 2017, Hurricane Maria struck Puerto Rico, causing a shortage of IV fluids that lasted months. Biddinger, from Mass General Brigham, said conservation measures taken then were effective.
“We did not have to cancel any surgical procedures [in 2017]. We did not have to change care,” he said. “So I think my message to patients and their families is that we are continuing care as normal. I think people should have a lot of confidence that we are delivering care as normal and people who need fluids and need resuscitation will absolutely get it.”
It’s not easy to simply switch to another supplier during supply chain problems like this, Biddinger said.
“What happens historically is that the other manufacturers tend to limit their distribution of their products to their existing customers to make sure they can support their customers,” he said. “So we are certainly reaching out and looking for all other channels. But historically, it’s been a little hard to switch distributors or manufacturers in the middle of an emergency because of our experience with the supply chain challenges.”
The shortage comes as ports up and down the east coast are closed because of a national dockworkers strike. It’s not clear yet what impact that strike might have on securing more IV fluids, Biddinger said.
“It’s our understanding that the alternative manufacturing facilities for Baxter are in Spain and in Mexico, and so there’s a possibility of of a double impact there,” he said. “But it’s our understanding that the fluid may have other ways to come to the United States.”
