SURGICAL/CTRITICAL CARE


The dripping, ticking time-bomb of IV shortages


by Kara Nadeau I Photo 132693431 / Care © Sudok1 | Dreamstime.com


t seems like healthcare facilities have been struggling with intravenous () therapy supply shortages forever and


there is no end in sight. t was fi ve years ago that Hurricane aria devastated pro- duction of  bags in Puerto ico, causing widespread shortages of sodium chloride . inection bags also known as saline. Even before that event,  saline bags long faced supply issues, as noted by the .. Food and Drug dministration (FD) in a February  press release.1 irtually all hospitalized patients require saline, whether it is part of a medication infusion, hydration, resuscitation, or as an irrigation fl uid.2 Despite efforts to diversify production


and increase capacity, here we are in  facing the same challenges. o how did we get to another place of widespread  sup- ply shortages, how is it impacting care, and what can healthcare industry stakeholders to do fi x it


How did we get here? While Hurricane aria in  was one of the most publicized causes for  solution shortages in recent years, the problems began long before that storm. s the FD stated at the time, lthough Hurricane aria affected Baxters facilities in Puerto ico, there have been limited supplies of  fl uids since .3 Throughout , the .. experienced a nationwide shortage of  solutions,


specifi cally saline large volume intravenous solution. anufacturers blamed supply dis- ruptions on plant shutdowns for routine inspection and upgrades.


 worse than


average fl u season placed strain on already limited supplies. Hospitals reported a sig- nifi cant ump in price  with bags costing fi x or six times more than they had prior to the shortage.


The FDA acts To help alleviate the  shortage, the FD announced that it was working with the three .. manufacturers, Baxter Healthcare, B. Braun edical and Hospira, to increase supply.5


The agency also approved


Fresenius abi  to temporarily import its European sodium chloride . Freefl ex nection olution for ntravenous nfusion into the .. market in late . Then in ay , the FD approved


Baxters abinanigo, pain facility as a manu- facturing site for . sodium chloride inec- tion, P, for the .. market.7 Even with these interventions, the merican ociety of Health-ystem Pharmacists (HP) reported shortages of . sodium chloride irrigation and . sodium chloride inection bags throughout  across multiple manufacturers, includ- ing B. Braun, Baxter, Hospira and Pfi zer.8


Market changes and challenges n February , C edical announced that it had completed acquisition of Hospira


14 November 2022 • HEALTHCARE PURCHASING NEWS • hpnonline.com


nfusion ystems from Pfi zer, including  pumps, solutions and devices. The marriage of the companies established C edical as one of the worlds leading pure-play infusion therapy companies.9 But the honeymoon was soon over. n uly


, C announced that it was voluntarily recalling one lot of saline inection that had been manufactured in the .. by Hospira on February , , and was distributed nationwide to Hospira customers between pril , , and February , . The recall was prompted by, a confi rmed cus- tomer complaint of particulate matter identi- fi ed as stainless steel within a single fl exible container.10 The following month, ugust , B.


Braun announced a double whammy to the market, with a press release stating unplanned production interruptions have resulted in signifi cant decreases in supply of product necessary to meet cur- rent demands of our customers and the company was planning a plant shutdown to do critical maintenance work at the end of the year, which would further strain its inventory levels.11 Then came Hurricane aria one month


later in eptember , knocking Baxters  saline production facilities off the grid.


Off shore supplies to address the shortages The FD and manufacturers recognized the domestic challenges and the opportunity


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60