U.S. IV Fluid Production Threatened by Back-to-Back Hurricanes

The U.S. faces a critical IV fluid shortage after Hurricane Helene disrupted production, and with Hurricane Milton looming, the healthcare supply chain is at even greater risk.

By Genni Burkhart

In the aftermath of Hurricane Helene, the U.S. faces a critical shortage of intravenous (IV) fluids, particularly saline solutions, due to significant damage at Baxter International’s North Cove facility in Marion, North Carolina.

Baxter's North Cove facility, the country's largest producer of IV solutions, was temporarily shut down due to flooding and infrastructure damage, leading to widespread shortages across U.S. hospitals and healthcare facilities. The situation is further complicated by the arrival of Hurricane Milton, which now threatens to impact B. Braun’s Florida facility, another key player in the nation's IV fluid production.

These two back-to-back hurricanes underscore critical vulnerabilities in the U.S. IV fluid supply chain and have prompted the American Hospital Association (AHA) to call for immediate government intervention.

Hurricane Helene’s Disruption

Hurricane Helene caused extensive flooding and power outages at Baxter's North Cove facility in Marion, North Carolina. This plant, which produces a significant portion of the U.S. supply of saline and dextrose solutions, has been offline for weeks, severely impacting national supplies. As a result, hospitals nationwide have had to ration IV fluids, delaying necessary treatments and procedures. Here's some of the latest updates in the aftermath of Hurricane Helene regarding Baxter production:

Federal agencies, including the U.S. Food & Drug Administration (FDA) and the Federal Emergency Management Agency (FEMA), are working with Baxter to expedite recovery efforts at North Cove. However, the plant's downtime has already caused significant supply chain disruptions. Here's a link to the current status of CDER-regulated drugs and biologic products: FDA Updates—Drugs in Shortage.
From Baxter's most recent Hurricane Helene Updates: "We are increasing the current U.S. allocation levels of our highest-demand IV fluids for direct customers from 40% to 60% and for distributors from 10% to 60%, effective Wednesday, Oct. 9."

Hurricane Milton's Disruption

B. Braun Medical recently expanded its U.S. production capabilities to address previous shortage problems. The company’s new saline production facility in Florida is seen as a critical source of stabilizing the national supply of IV fluids. However, Hurricane Milton now threatens this facility, which could lead to even further disruptions in the already strained supply chain.

According to Politico, B. Braun is taking preventive measures to safeguard the facility from Hurricane Milton, including relocating inventory and reinforcing critical infrastructure. The company is also leveraging its global supply chain to provide additional inventory if needed, though the potential damage from Milton could still be significant.

ICU Medical: A Potential Lifeline?

While Baxter and B. Braun face immediate threats from natural disasters, ICU Medical remains critical in maintaining a steady supply of IV fluids.

ICU Medical, Inc., headquartered in San Clemente, California, specializes in developing, manufacturing, and selling medical devices and systems for infusion therapy, oncology, and critical care applications. The company gained attention in 2017 when it acquired the Hospira Infusion Systems business from Pfizer, expanding its production capabilities and market share of IV fluid systems and related medical devices.

While ICU Medical is headquartered in California, its main manufacturing facility is in Austin, Texas. It isn't in the path of any current natural disasters or hurricanes, keeping production secure (for now). This facility can potentially mitigate the current shortage by ramping up production, though it is unlikely to fully compensate for the losses at Baxter and B. Braun's facilities.

ICU Medical’s 600,000-square foot "Super Hub" highlights its logistical capacity to fill the supply gap from a "geographically stable, low-risk area."

Broader Challenges Facing the IV Fluid Industry

The U.S. IV fluid supply chain faces significant challenges despite recent logistical efforts. Natural disasters like Hurricanes Helene and Milton have exposed vulnerabilities in the production process, mainly because large portions of the IV supply chain are concentrated in hurricane-prone regions of the Southeast.

The growing frequency and intensity of climate disasters highlight the risks of relying on facilities in these areas. Additionally, regulatory hurdles, high production costs, and limited profit margins complicate efforts to increase production during shortages.

The industry’s reliance on a small number of production facilities further exacerbates the problem. The disruption of Baxter’s North Cove facility during Hurricane Maria in 2017 caused a similar nationwide shortage. Seven years later, despite efforts to diversify production, the industry remains vulnerable to localized disruptions, highlighting the ongoing risks faced by facilities in regions prone to extreme weather events.

The Road Ahead

As Hurricane Milton threatens to disrupt production at B. Braun’s Florida facility, ICU Medical’s operational capacity in Texas may provide a crucial lifeline for U.S. hospitals. However, the scale of the disruption caused by Hurricanes Helene and Milton underscores the need for a more decentralized and resilient supply chain. For dental and oral health professionals, maintaining awareness of these supply chain challenges is critical, especially as IV fluids play an essential role in patient care during sedation and complex dental procedures.

For the most current information on how B. Braun and Baxter are handling the supply chain situation, check out the embedded links in this article, which provide direct access to their latest updates and developments.

Author: With 14 years as a published journalist, editor, and writer, Genni Burkhart's career has spanned politics, healthcare, law, business finance, technology, and news. She resides in Northern Colorado, where she works as the editor-in-chief of the Incisor at DOCS Education.

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