IV fluid supply disruption prompts Biden administration to invoke wartime powers to bolster recovery CNN

Hurricane Helen's disruptions have exacerbated critical intravenous fluid shortages in the United States, and now the Biden administration is invoking the Defense Production Act's wartime powers in the latest move to speed up recovery efforts.

As the storm swept through western North Carolina last month, it severely affected operations at the North Cove manufacturing site of Baxter International, the nation's largest manufacturer of IV fluids and dialysis solutions. After a hiatus, Baxter resumed distribution of supplies – but with significant limitations on the quantities that could be ordered. As of last week, Baxter has expanded order capacity to 60% of normal volume for the most in-demand IV fluids.

But the strain remains. The US Food and Drug Administration has declared multiple shortages as a result, and hospitals are rationing supplies — and in some cases suspending surgeries — as the national supply chain continues to suffer.

On Saturday, the US Centers for Disease Control and Prevention issued a health advisory about the shortage, warning health care providers that “supply disruptions may affect patient care and may require adjustments in clinical management of patients.”

Last week, the FDA announced it was allowing imports of products from five facilities outside the United States to help address the shortage. And other U.S. manufacturers, B. Brown Medical and ICU Medical, are ramping up production to help fill the gap.

But Baxter's North Cove facility is an important part of the supply chain; It typically produces about 60% of IV fluids for hospitals across the country.

The US Department of Health and Human Services has now invoked the Defense Production Act to help Baxter get materials for cleanup and rebuilding. Under the authority of the Act, Baxter will have priority over a particular material necessary to pursue the remedy process and prepare to resume production. The administration is working with Baxter to identify other challenges to HHS's strategic preparedness and response and will pursue other opportunities to use the Defense Production Act, an agency spokeswoman said.

“Ensuring people get the medical supplies they need is the highest priority of the administration. That is why we are working closely with Baxter to support the cleanup and restoration of the facility, including invoking the Defense Production Act to help resume production as soon as possible,” an HHS official said in a statement Tuesday.

The Defense Production Act was passed in 1950 in response to the Korean War. The act gives the government — specifically the president — more authority to direct resources to industrial production during emergencies.

It was used by the Biden and Trump administrations during the Covid-19 pandemic to boost production of supplies used in response efforts, including vaccines and ventilators. It was part of recovery efforts after Hurricane Maria hit Puerto Rico in 2017, which also affected Baxter facilities and caused a months-long shortage of IV bags used to administer and dilute drugs.

In an update Monday, Baxter said there has been “good progress in site cleanup and remediation” at the North Carolina location. A temporary rock bridge replaced one damaged by the storm, and a second bridge is being constructed to allow more goods and equipment to come and go from the facility.

“Current priorities are to complete a deep clean of the facility, including floors and equipment, as well as assessing the condition of all equipment and production lines,” the company said. It aims to resume production at the affected sites by the end of the year, but this will happen in phases and there is no specific timeline for when production levels will be fully restored.

Allocations for IV solution and nutrition products for children's hospitals have been restored to full capacity, and some other IV solution products may return to full allocation by the end of the year, the agency said.

The major disruptions in IV fluid supply after Hurricane Helen are the latest in a string of challenges that have exposed vulnerabilities in the broader US supply chain.

According to data from the American Society of Health-System Pharmacists and the University of Utah Drug Information Service, the United States had a record number of drugs in active shortage in the first three months of 2024. The situation has improved somewhat in recent months, but there have been at least 300 active shortages for the past year and a half.