By Joseph Walker

The U.S.’s largest maker of intravenous fluids will slash shipments to hospitals after Hurricane Helene took down one of its manufacturing plants in North Carolina.

Baxter increase; green up pointing triangle sent letters to hospitals telling them that future shipments of IV fluids would be about 40% of what they normally receive after the storm flooded its facility in Marion, N.C., Dr. Paul Biddinger, chief preparedness and continuity officer at Mass General Brigham in Boston said during a conference call Thursday.

Mass General Brigham, a prestigious hospital system, said it is continuing to treat patients normally, but is conserving its fluid supplies. This includes switching to oral hydration—Gatorade or water—for patients who are healthy enough for it, and not discarding partially used IV fluid bags when patients are moved to a different part of the hospital, Biddinger said. The organization uses hundreds of thousands of liters of IV fluids each month, and a majority of patients admitted to a hospital receive fluids at some point, Biddinger said.

“Right now we’re continuing all of our clinical care as we normally do,” Biddinger said. “Our intent is to preserve clinical care in the face of this shortage as long as we possibly can.”

There are other fluid manufacturers in the U.S., but they tend to give priority to meeting the demand from their existing customers, Biddinger said.

Nor can the U.S. count on tapping European manufacturers because of previously existing global shortages, said Soumi Saha, senior vice president of government affairs at Premier, a group purchasing organization for hospital supplies that serves thousands of medical institutions in the U.S.

Baxter said a levee breach contributed to the flooding, and bridges leading to the plant were also damaged. The company said it is working with health, emergency and other government agencies to assess the damage to the plant and come up with a plan to restart production as quickly as possible.

Ahead of the storm, the company evacuated workers and moved products to higher ground or secure storage where possible. The company has been allocating products to customers to try to conserve supply and ensure equitable distribution.

Baxter experienced a similar disruption to supplies of its saline solutions in 2017, when a hurricane hit its plant in Puerto Rico.

Baxter, based in Deerfield, Ill., is the market leader in the U.S. for IV solutions, with more than 50% share, Wells Fargo analyst Larry Biegelsen said in a research note.

IV fluids, typically infused with substances such as salts, sugars and electrolytes, are integral to hospital care. Their uses include keeping patients hydrated before and during surgery and cleaning waste from blood during kidney dialysis.

“These are not high-dollar, lucrative products, but they are the warhorse products in a hospital,” said Premier’s Saha. “You go in for anything, and the first thing that they’re doing is hanging an IV bag.”

Biddinger said this is one of the bigger supply-chain shortages he has experienced over the past decade, and that the hospital system is still trying to estimate how long its current supplies will last.

“There are just too many unknowns right now,” Biddinger said.

The Food and Drug Administration said it is working with Baxter and could expedite its review of manufacturing lines at the plant when they are cleaned and restored. The agency also said it would work with other Baxter locations, and other suppliers, to increase supplies of the solutions.

The duration of the shortages could depend on how extensively damaged the plant is, said Premier’s Saha. If the flooding affects the plant’s ability to meet FDA standards for sterility and stability, it typically takes 90 days to receive FDA recertification.