News Releases

Multipronged Strategy Underway to Address IV Solution Shortage Resulting from Hurricane Helene

Due to the devasting impact of Hurricane Helene’s flooding in North Carolina, Baxter International’s North Cove IV fluid manufacturing plant — responsible for producing approximately 60% of the IV fluid in the United States — hospitals in Northeast Ohio, and across the nation, are currently facing shortages of IV fluids, irrigation fluids and certain types of dialysis solutions.

In a joint statement, Cleveland Clinic, The MetroHealth System, University Hospitals and Summa Health announced that steps have been taken to deal with the shortage: “We have developed mitigation strategies to address the shortage and remain committed to providing care to all patients. Our pharmacy and supply chain teams are monitoring our supply of these products and are working closely with other manufacturers.”

The Center for Health Affairs’ Emergency Preparedness Program has been actively participating in meetings at the local, state and federal level and coordinating information sharing regarding the IV fluid shortage within Region II. These meetings have revolved around mitigating gaps in the supply chain, minimizing disruption to patient care, and the best practices related to conservation measures, employee stewardship over supplies, and the evaluation of alternate solutions.

According to a letter from the Ohio Department of Health’s (ODH) Director Bruce Vanderhoff, ODH is coordinating closely with hospital zone leads, regional healthcare coordinators, the Ohio Hospital Association, and the Ohio Pharmacy Services Center, among others, to ensure a statewide approach for situational awareness and information sharing, data collection and strategy development.

ODH launched a data-reporting initiative via EMResource — a web-based, near-real-time resource management system used by Ohio hospitals and ODH to monitor critical hospital needs during incidents — to track IV fluid usage. This data is then used to support data-driven decision-making and strategies at the state, regional, and local levels. The initiative went live on October 4, with all Ohio hospitals required to report their IV fluid data daily.

“We have seen our hospitals engaging in more efficient methods of delivery and conservation measures aimed at responsibly managing IV fluid volume use, while maintaining the same level of care,” said Vanderhoff. “The partnership has also assisted regional healthcare coalitions to maintain situational awareness and to support individual facilities’ requests for critical resources, including resource sharing between hospitals when necessary.”

On Oct. 14, Baxter reported significant facility remediation is occurring with the help of more than 2,000 individuals contributing to cleanup efforts. Baxter stated their plan is to restart North Cove production in phases by the end of 2024; there is no expected date for complete restoration of pre-hurricane Helene levels.

The damage to the facility isn’t the only factor affecting the production and distribution of IV fluid. Intense flooding has destroyed roadways and bridges in the area. A temporary bridge has been installed and has allowed the transporting of over 350 truckloads of produce off-site. A second temporary bridge is currently being installed.

Baxter announced a goal of reaching 90-100% allocation for certain IV solutions by the end of 2024. Currently, high demand IV fluids stand at 60% of direct customers’ orders — up from 40% — while distributors can expect to also receive 60% — a significant increase from 10% in recent weeks.

To continue the necessary supply continuity, Baxter secured FDA authorization for temporary importation from five additional manufacturing facilities. The authorization allows facilities in Ireland, United Kingdom, Canada and China to produce 19 different IV solution and dialysis products to bolster domestic supply. In the U.S., other manufacturers, including B Braun and ICU Medical are increasing their production to fill the gaps.

The U.S. Department of Health and Human Services (HHS) is urging manufacturers, wholesalers, and distributors to assess their product allocation and postpone certain elective surgeries, while healthcare providers are encouraged to implement conservation strategies to ensure the continued delivery of safe, high-quality patient care and to optimize the available supply. Even if they have not yet experienced supply disruptions, HHS recommends that all providers and health systems take proactive steps to conserve critical products.

“HHS is coordinating a U.S. government-wide response to address supply chain disruptions. HHS is also working with public and private partners to support the supply chain while the Baxter facility is brought back to full operational capacity,” said HHS Secretary Xavier Becerra in a letter to healthcare leaders and stakeholders. “Food and Drug Administration (FDA) will continue working with Baxter to identify both potential products already in their system and alternative manufacturing sites, including for potential temporary imports.”

HHS has also invoked the wartime powers of the Defense Production Act to assist Baxter in sourcing the materials necessary for cleanup and rebuilding efforts. This action grants Baxter priority access to critical material required for the remediation process and the eventual resumption of production. The Administration for Strategic Preparedness and Response is collaborating with Baxter to identify additional challenges and explore further ways to leverage the Defense Production Act.

To learn more about conservation strategies and resources for product management regarding IV and peritoneal dialysis solutions, visit baxter.com.