Hospital IV fluid shortages can affect surgery for weeks

Surgery schedules across the country could be washed out for several more weeks while a key IV and sterile fluid factory remains closed Hurricane related damage.

People often plan non-emergency surgeries in the fall and early winter when their insurance coverage will take up more of the bill, but they may have to wait while the health system reserves supplies for emergencies.

“It's not great for patients, but it's kind of the best you can do with what you have,” said Erin Fox, associate chief pharmacy officer at University of Utah Health.

The federal government and medical providers have taken several steps to help ease the supply crunch Hurricane Helen, That forced Baxter International to close its North Carolina plant late last month.

But experts say supply is still fragmented, and improvements will take time. Here's a closer look at the situation.

What did Hurricane Helen do?

According to the American Hospital Association, Baxter's North Cove, North Carolina, location produces about 60% of the intravenous fluids used daily in the United States. It produces fluids used by patients in home dialysis and sterile water for cleaning patient surgical sites during operations.

But flooding caused by the storm swept away nearby bridges and flooded the factory, forcing it to close. Baxter said there was no structural damage to the site.

How has it affected patient care?

The health system began storing fluids soon after the plant was shut down. Some patients may drink fluids with Gatorade or water instead of giving them an IV.

Hospitals are also starting to postpone planned procedures that can wait, such as some orthopedic surgeries or heart procedures, said Dr. Chris DiRienzo, chief medical executive of the American Hospital Association.

Baxter has limited the supply of fluids it sends to distributors and health systems. The impact on patients will depend in part on how much a hospital or health system relies on Baxter, said Nancy Foster, vice president of the hospital association.

What is being done to improve supply?

The US Food and Drug Administration has temporarily approved imports of fluids from Baxter plants into several countries.

The agency has already begun relaxing some of the limits it had placed on supply.

Baxter's rival B. Brown Medical has increased production at its Daytona Beach, Florida, site, which is protected from harm from another hurricane, and at a location in California.

The FDA also issued new temporary guidance to make it easier for compounding pharmacies to prepare certain IV drugs that are in short supply.

Will this help with IV fluid deficiency?

Supply experts are optimistic that the situation will improve, but they could not say whether the measures would fill the void left by plant closures.

Fox said his health system is still dealing with uncertainty because the amount Baxter has allocated to them is not always available through their distributor.

Foster said hospitals want to have extra supplies sitting on their shelves so they can handle both planned surgeries and unexpected ones, but “we're not going to be there for a while.”

Another complication: Hospitals and surgery centers are heading into a busy time of year. Hospital beds fill up during cold and flu season. Patients also tend to schedule more procedures later in the previous year Their license was renewed in January, exposing their costs to tens of thousands of dollars.

When will Baxter's factory reopen?

Power and water are back on at the North Carolina plant. Employees have completed deep cleaning in production rooms and are testing and repairing equipment.

Baxter said it intends to resume production gradually by the end of the yearAnd by then it hopes to ease the limits it has placed on some customer orders.

But the company has no timeline for production to return to pre-hurricane levels.

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AP Health writer Matthew Perrone contributed to this report.

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