Hurricane Damage To Manufacturers In Puerto Rico Influences Mainland Hospitals, Too
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At MedStar Washington Medical center Middle, doctors and nurses are moving as much patients as they may from intravenous medications to the same drugs in pill form.
If the patients are getting common antibiotics like ampicillin, and they can swallow, they’re apt to be switched to pills, says Bonnie Levin, assistant vice president of pharmacy services for MedStar Health, which includes 10 hospitals in the Washington, D.C. region.
That’s because MedStar, want many hospitals across the U.S., is usually working low on IV handbags, specifically the minibags that are used to deliver certain types of treatments. Some of these handbags contain saline alternative when delivered, and a nurse or hospital pharmacist provides in the drug if it is ready to be utilized. Other handbags arrive pre-mixed with typically used medicines.
“The basic bags, the combined bags. There will be shortages of all sorts of small-volume medicines,” Levin says.
The shortage is a direct result of the hurricane damage in Puerto Rico. It’s been eight weeks since Hurricane Maria struck the island, knocking out energy and wreaking havoc on many roads, homes and other buildings.
The storm damaged most of the island’s a lot more than 100 drug and medical device producers. Puerto Rico produces about $40 billion well worth of pharmaceuticals for the U.S. market, in line with the Food and Medication Administration – a lot more than any other talk about or territory.
Three of those plants participate in Baxter, one of the primary suppliers of IV bags to U.S. hospitals. All three of Baxter’s plants shut down temporarily, the business says, and at least two remain running on generators.
Among Baxter’s factories that makes the minibags for intravenous drugs is very remote.
“It’s atop a mountain, and the roads have already been extremely compromised. They remain working on generators the last we knew, plus they are at partial potential,” says Kristi Guest, who runs the disaster response team for Vizient, a provider that, among other activities, sources medical products for hospitals all around the U.S.
And Baxter isn’t the sole provider on the island struggling to meet up demand.
“The production environment in Puerto Rico, so far as we will be informed, is largely still functioning on generators – compromised potential,” Guest says.
Dr. Scott Gottlieb, commissioner of the Food and Drug Administration, explained in a speech at the National Press Golf club on Nov. 3 that most of the plant life are operational.
But getting back to normal “is a monumental process given the logistical difficulties they encounter,” he told reporters.
So the producers are rationing the medicines and supplies that they do have the ability to make. The theory is to prevent any one hospital from obtaining up the complete supply.
For instance Baxter has restricted distribution of IV handbags to 50 percent of a hospital customer’s normal order, according to Vizient and MedStar.
And Levin says the hospital isn’t even receiving that much.
“I don’t believe we’re getting 50 percent, but we’re getting sporadic shipments,” she says. “We utilized to get shipments weekly. Among our hospitals got five situations of IV handbags yesterday, and it was an order that they had placed per month ago.”
The shortage has become severe enough that the FDA is allowing Baxter to import minibags, amino acids and other products from its plants in Ireland, Australia, Canada, Mexico and England.
The FDA updates its set of medication shortages regularly and several products have already been added since Maria hit Puerto Rico. But you can’t really know accurately which shortages are associated with disruptions on the island.
Stephanie Hale also functions at Vizient, supporting the company’s hospital clients manage how they make use of products that are an issue
She says she and her colleagues are trying to change how hospital crisis rooms think about the use of IVs.
“Every patient that came into the emergency department, that was admitted to a unit, automatically was put on fluids to maintain hydration,” she says. “But what we’ve been suggesting to our members more recently and is usually that they evaluate using the need and determine patients more specifically and effectively for IV solutions.”
In Washington, D.C., Medstar’s Levin says her hospital has been able to manage the shortages, so far.
“We’re really fortunate in that we haven’t disrupted individual attention,” Levin says. “If this went on for two years, I’d involve some concerns. We expect source to come back in three to half a year.”