Fears about an IV bag shortage have come to fruition as medical device manufacturers struggle to return to normal production in Puerto Rico more than three months after Hurricane Maria devastated the U.S. territory.
About 45 percent of electricity customers still don't have power on the island, where 30 percent of the gross domestic product comes from medical and pharmaceutical products like IV bags, sophisticated cancer drugs, glucose monitors and cardiac pacemakers.
A California man took to social media, posting on Twitter about how the medical supply shortage affected hospital care for his wife, who has an inoperable brain tumor. His Dec. 28 tweet brought public attention to the issue, a fact check from the website Snopes, and an update from the U.S. Food and Drug Administration.
The man, Ben Boyer, tweeted: "My wife's nurse had to stand for 30 mins & administer a drug slowly through a syringe because there are almost no IV bags in the continental U.S. anymore. See, they were all manufactured in a Puerto Rican factory which still isn't fixed…"
The tweet blew up, raising a lot of questions about inventories of medical supplies and rising quickly to the top of the list of claims investigated by Snopes, which rated it "true."
The FDA told Snopes in a Dec. 28 statement that it has been working closely with the industry and local and federal officials to address the shortage for IV saline bags and other products.
"This remains a key area of focus for the agency and we expect that the shortage of IV fluids will improve in early 2018 based on the information we are receiving from the manufacturers. In the meantime, we are continuing all of our efforts to increase supplies while concerns remain," FDA said.
Federal regulators began monitoring about 30 drug products and 10 medical devices to mitigate potential shortage situations soon after the hurricane swept through the center of the island on Sept. 20. To stabilize the manufacturing sector, FDA has allowed two foreign companies to import of IV saline products into the United States as it helps Puerto Rican businesses get fuel for generators and back to the electrical grid.
One of the manufacturers that got priority access to power, Baxter International, is the largest IV bag supplier in the United States. Baxter told Snopes all its facilities in Puerto Rico have electricity, plus diesel generators on standby in case of outages. The company said it expects to "return to more normal supply levels for products made in Puerto Rico in the coming weeks."
In the meantime, hospital officials are concerned. FDA has warned against hoarding products and manufacturers have set quotas based on order history. The staff at Massachusetts General Hospital is facing a "critically low" supply of the small IV bags used to dilute drugs like antibiotics so they can be administered slowly. To conserve supply, nurses are diluting drugs manually with a process known as an "IV push" and doctors are looking for oral alternatives for drugs.
"I would describe the status as deteriorating," MGH Chief Medical Officer O'Neil Britton told the Boston Herald on Dec. 30. "We're managing the situation, but the outlook remains very concerning."
At the moment, confidence in the health care supply system is suffering the most, Britton added, noting that IV bags and solutions are a major component of hospital care.
"We spend a ton of money on the national strategic oil reserves, but there's no such thing in health care, and maybe we should think about that," Britton said.