Shortage of saline may harm patients
Hurricane disrupted Puerto Rico producers
SACRAMENTO, Calif. — Sacramento resident Charis Hill was caught off guard by the tiny bottle of saline solution hanging from the intravenous pole when she went for the latest infusion of medication that helps her avoid crippling pain. Accustomed to seeing a much larger bag of f luid, she immediately asked staff about the change.
That’s when she learned that, since Hurricane Maria devastated Puerto Rico, key U.S. pharmaceutical plants on the island are experiencing manufacturing delays and distribution holdups that have caused unprecedented shortages of the widely used and critical fluid. Intravenous infusions of saline solution are used to hydrate patients during treatment or to dilute drugs during infusions, and Hill said she’s worried about whether there will be enough of the fluids when she arrives for her next treatment in six weeks.
Perhaps the best indicator of the shortage of saline solution is that patients such as Hill have begun to take notice. Earlier this month, leaders of both the American Hospital Association and the California Hospital Association sent letters about the scarcity of supplies to the U.S. Food and Drug Administration, asking Commissioner Scott Gottlieb to take any and all steps to resolve the worsening shortages. The treatments, they said, are essential to patient care in hospitals.
“Baxter, one of the largest manufacturers of small-volume IV bags, has three plants located in Puerto Rico that continue to have issues with communications, transportation systems, and inadequate personnel during recovery efforts,” wrote Alyssa Keefe, the vice president for federal regulatory affairs at the California Hospital Association. “These continued challenges threaten not only our present supply cache, but also future inventory needs – particularly with upcoming seasonal illnesses such as influenza.”
Local health systems are taking various steps to deal with the shortage. At UC Davis Health, for instance, the medical team is now giving drugs directly rather than diluting them with a minibag, said UC Davis Health spokesman Charles Casey.
Hill snapped a picture of the little bottle of saline solution at the top of the IV pole at her station, and she posted it on Facebook, noting that usually a much larger bag typically hung there.
“I asked if they had saline in reserve and are using it up, but no, they ordered this,” she said. “It’s the second order since the hurricane, and this shipment had smaller bottles than the last.”