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Northland hospitals cope with supply shortage in wake of hurricane

Puerto Rico's mountainous central region was hard hit by Hurricane Maria. As authorities scramble to restore basic services to the island, residents in the sparsely populated interior are likely to be some of the last to have power and water again. (Jim Wyss / Miami Herald)

Northland hospitals, like those around the nation, are responding to a shortage of medical supplies exacerbated by a hurricane that hit Puerto Rico seven weeks ago.

"We are experiencing supply shortages due to manufacturing that was affected by the hurricane," said Mike Boeselager, vice president of support services for St. Luke's hospital, in a statement.

"We are working closely with suppliers and implementing practices internally to preserve our resources and to avoid any unnecessary interruptions in patient care," he added.

Puerto Rico is home to close to 50 manufacturers of medical supplies and drugs, said Jim Tomsche, director of pharmacy services for Essentia Health. That includes a Baxter International facility that manufactures small-bag IV solutions. Its productions were interrupted when Hurricane Maria struck the U.S. island territory of Puerto Rico.

The bags hold from 50 to 250 milliliters and typically contain saline solution or dextrose, Tomsche said. They're widely used to administer medications such as antibiotics to patients.

The continuing shortage drew a sharp call-to-action letter from Thomas P. Nickels, an executive vice president of the American Hospital Association, to Scott Gottlieb, commissioner of the Food and Drug Administration, earlier this week.

Nickels wrote that the shortage of "widely-used critical products" was "quickly becoming a crisis and looming threat to the public's health."

But although the shortage is real, patients and prospective patients shouldn't panic, Tomsche said.

"At this point, we're holding our own," he said. "We have processes and a plan in place to make sure that we're able to provide top-notch care to our patients, and at this point we're doing OK. There's no need to feel like the sky is falling."

Essentia has taken several steps to ensure there's an adequate supply, Tomsche said. They've purchased IV bags from secondary wholesalers, had nurses administer antibiotics through a syringe instead of intravenously and even stockpiled sodium chloride so they can make their own saline solution if necessary.

No patients have experience delays in care because of the shortage, he said.

It's not clear when the situation will get better.

"We don't always receive a lot of communication from the manufacturers about where they're at with the shortage," Tomsche said. "You just have to go with the flow and continue to utilize whatever contingency plan you have in place.

The shortage of IV fluid actually dates back to 2014, the FDA said in a statement responding to the hospital group's complaint, but it was exacerbated by the hurricane's impact on Baxter's plant. In response to the shortage, the FDA temporarily has allowed import of IV fluid from plants in other countries, is working with U.S. companies to increase their supply, and has recently approved applications from two companies that are expected to increase production in the coming weeks.

The FDA also is working with Baxter to help it restore its operations in Puerto Rico, the statement said.

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