MINNESOTA, USA — Some Minnesota healthcare providers began contacting patients on Monday, notifying them that their elective and non-emergency surgeries have been canceled or postponed.
The reason? Storm damage from Hurricane Helene took our nation's largest producer of IV fluids offline last week.
Baxter International, which produces 60% of the IV fluids used across US healthcare systems sustained damage to its manufacturing facility in North Cove, North Carolina and roads connecting the supply chain have also been in disrepair following the storm.
Late last week, Baxter issued a statement saying, "We are working with the greatest urgency, but we do not yet have a timeline for when operations will be back up and running."
In response, both M Health Fairview and Hennepin Healthcare have begun cutting back non-essential surgeries to conserve those critical fluids, which are used to help patients stay hydrated during surgeries and to mix with medications - such as antibiotics - that are delivered intravenously.
On Monday, the Minnesota Hospital Association hosted a call for some 300 healthcare leaders across the state to discuss best practices to help make their current supplies go further.
"It's going to be a lot of work and a little bit of pain for us to be able to get through this," said Mike Waldt, System Director of Pharmacy for North Memorial Health.
So far, Waldt says North Memorial hasn't had to cancel any surgeries.
"We had supply on hand, which gave us a little bit of insulation," Waldt said. "But that insulation is not gonna last very long."
He said North Memorial and many others are still taking several other steps to conserve the fluids.
Mike Waldt: "Take antibiotics, for example, we've moved some of those to an IV push rather than an IV infusion. So instead of using that bag, we're just gonna add that into a syringe that can be administered slowly to a patient."
Kent Erdahl: "If you're doing a push instead of in an IV bag, is that more labor intensive?"
Waldt: "Absolutely. Instead of a nurse being able to set up an infusion pump, now they're going to need to stand there for a certain amount of time."
In order to save time - and IV fluids - elsewhere, he said they are trying to be proactive about cutting down on them in outpatient settings.
"We're trying to get patients to hydrate before they're coming in for some of those elective procedures so that we can continue to do those procedures and conserve those fluids," Waldt said.
In the meantime, the American Hospital Association sent a letter to President Biden on Monday, urging the president to take several actions to relieve the shortage:
Direct the Food and Drug Administration (FDA) to:
Declare a shortage of sterile IV solutions, which will permit the use of certain flexibilities not otherwise available to health care providers.
Provide flexibilities to allow hospitals and health systems to prepare sterile IV solutions in their own pharmacies and waive the 1-mile rule so that hospitals and health systems can distribute these products among their facilities without a patient specific order.
Identify international manufacturers capable of producing sterile IV solutions and their appropriate containers.
Extend the shelf-life of all sterile IV and peritoneal dialysis solutions that are beyond or nearing their expiration date.
Declare a national emergency under the National Emergencies Act and/or the Stafford Act and request that Department of Health and Human Services Secretary Xavier Becerra declare a national Public Health Emergency in order to create the circumstances that will allow for waivers of Medicare/Medicaid rules and regulations.
Invoke the Defense Production Act to:
Require appropriate manufacturers to prioritize and accept contracts for materials and services necessary to produce sterile IV solutions and their containers.
Incentivize appropriate manufacturers to expand the production and supply of the critical materials and goods needed to produce sterile IV solutions and their containers.
The Minnesota Hospital Association (MHA) says it is also working with state and local elected leaders toward the same goals.
"So that other manufacturing plants can come online, that Baxter can hopefully ramp its production back up and that we can have the IV supplies for our hospitals be restored," said Dr. Rahul Koranne, MHA President and CEO. "Our main message to our patients is, please be patient with your care teams at your hospitals and also do stay in touch with your providers so that they can oversee your care plan with you and make the right decisions based upon your care condition."
B. Braun, which currently produces nearly a quarter of the US supply of IV fluids, is currently trying to ramp up production, but it also has a facility in Daytona Beach, Florida that could be in the path of Hurricane Milton.
As of now, a B. Braun spokesperson said the company is monitoring the storm and taking steps to protect their employees and their IV supplies.
Full Statement from M Health Fairview:
Due to damage sustained at Baxter’s North Cove, North Carolina manufacturing facility from Hurricane Helene, our hospital system is experiencing a reduced supply of intravenous (IV) fluids.
In response to the shortage, we are taking proactive measures to manage our supply and prioritize essential patient needs. This includes modifying our inventory management, centralizing storage, and adjusting elective procedures to conserve IV fluids. We are contacting patients who may be affected by surgery schedule changes directly.
Rescheduling and delaying surgeries are decisions we do not take lightly, and we understand the impact it has on our patients. We are working closely with the Minnesota Hospital Association, state and federal officials, supply chain leaders and our clinical teams to evaluate additional relief options and to ensure the safety and quality of care remains uncompromised as we manage this temporary disruption.
We encourage patients to stay in touch with their healthcare providers and be patient as we work through these challenges. Minnesota hospitals are doing everything possible to ensure care continues, but delays and changes to some treatments may be necessary until the supply situation stabilizes.