Hurricane Helene Disrupts IV Fluid Supply Chain
By Phil West

The Texas Medical Association has heard from Texas physicians and the North Carolina Medical Society that hospitals and practices are facing shortages of IV fluids following Hurricane Helene’s damage to Baxter International’s North Cove manufacturing site in Marion, N.C.  

The facility supplies an estimated 60% of IV solutions in North America.  

Some Texas hospitals are currently assessing and planning conservation strategies, in alignment with guidance from the U.S. Department of Health and Human Services.  

“We have been asked to start looking at ways to conserve our IV fluids so we don’t have a situation where elective surgeries would need to be postponed,” said Shaina Drummond, MD, president-elect of the Dallas County Medical Society and an anesthesiologist at Parkland Health and UT Southwestern Medical Center. “Leadership is aware and trying to be proactive. Much of this depends upon where health care facilities receive their IV fluids [from] and how quickly manufacturers can pivot their supply chain.” 

HHS issued a letter on Wednesday announcing it is working with Baxter and the Food and Drug Administration to identify alternative manufacturing sites, including for potential temporary imports, at an expedited rate.  

“In the coming weeks, supply may continue to be constrained, and we understand that certain products are on allocation,” HHS Secretary Xavier Becerra said. “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 inventory will be used to support current allocations in the short term, and they note that several of their global plants are scaling and ramping production to help meet U.S. needs,” Secretary Becerra added. “Other producers are expected to be able to continue to fulfill domestic orders within their allocation.”  

As of this writing, HHS planned to host a virtual briefing on Oct. 10 with Baxter leaders on the status of the manufacturing facility and supply disruptions. 

HHS says there are currently shortages of “normal saline IV fluids, normal saline irrigation fluid, sterile water irrigation, and dextrose 5% IV fluids that pre-date Hurricane Helene. The hurricane-related supply disruption at the Baxter facility will likely lead to further constraints for IV fluids.” 

Baxter has released a statement with updates on its road to recovery, following its release of product codes affected.  

“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,” the company wrote. “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.”  

Since the initial disruption, Baxter has announced plans to increase current U.S. allocation levels of its highest-demand IV fluids for direct customers from 40% to 60%, and for distributors from 10% to 60%. The company also says it is upping allocations of high-concentration dextrose and sterile water for injections, anticipating additional increases for certain product codes by early November.  

Baxter is also increasing allocations for IV solutions and nutrition products for designated children’s hospitals to 100%. 

HHS is also aware of and preparing for the potential impact of Hurricane Milton, which may disrupt operations of another IV product manufacturer, Braun. 

The North Carolina Medical Society offers clinical practice guidance to aid in local conservation efforts.  

TMA continues to monitor the supply disruption and its effect on physicians. Read Texas Medicine Today for updates.