Ambulatory surgery centers (ASCs) across the U.S. are being forced to postpone elective and non-emergent procedures due to a nationwide shortage of intravenous (IV) fluids.
Procedures like heart ablations, the removal of tumors that don’t require immediate treatment and colonoscopies are among those reported being put on pause for the time being.
This shortage stems from the impact of Hurricane Helene, which caused significant damage to Baxter International’s North Cove plant in North Carolina – a facility responsible for producing approximately 60% of the country’s IV solutions.
“We’re already seeing a shortage event at several of our facilities,” Scott Bergman, market president at ASC development company Compass Surgical Partners, told ASC News. “We are filling our stocks as much as possible – ordering as much fluid as possible and keeping it in stock. We actually had a facility that just moved a couple of cases from the ASC to the hospital for fear of a shortage.”
Health systems across the country have reported delays in surgeries and chemotherapy treatments as they conserve their limited supply of IV fluids.
One example: the University of Rochester Medical Center announced on Oct. 15 that it would pause “some elective and semi-elective surgical procedures requiring IV sterile fluids, beginning Oct. 16.”
“All cases will be reviewed daily to determine urgency and sterile fluid needs and surgeries and procedures requiring little or no IV sterile fluid use will be evaluated on a case-by-case basis,” the announcement explained.
Last week, the Ambulatory Surgery Center Association (ASCA) issued a letter to the U.S. Department of Health and Human Services (HHS), imploring officials to declare a shortage of sterile IV solutions to allow waivers to permit certain flexibilities not otherwise available to health care providers.
ASCs, which rely heavily on elective procedures, are feeling the strain of the supply chain disruptions.
Efforts are underway to address the problem.
Baxter has taken steps to increase allocation levels, particularly for high-demand IV fluids, Bill Prentice, CEO of ASCA said on a recent audio update.
“They’re increasing the current U.S. allocation levels of the highest demand IV fluids for direct customers from 40% to 60%, and for distributors from 10% to 60% effective this past Wednesday,” Prentice said.
He also noted that Baxter aims to return to 90% to 100% allocation of certain IV solutions by the end of the year.
Additionally, the federal government is working with international manufacturing plants to get more IV solutions into the U.S.
This crisis has brought to light the vulnerability of relying on one plant for such a critical supply, Prentice said.
“That single manufacturing plant is responsible for producing about 60% of all IV solutions for the entire United States,” Prentice said. “Now many are, no doubt, questioning the wisdom of having a single manufacturing facility responsible for so much of an essential medical necessity.”
Baxter has responded by implementing allocation limits on IV fluid orders to prevent stockpiling and ensure fair distribution. The company is also implementing allocations limiting what a customer can order based upon historical purchases and medical necessity, as well as available and projected inventory, Prentice said.
“These allocations help limit stockpiling and increase the likelihood of equitable access to available products,” he said.
As the industry waits for relief, Prentice said ASCA will continue to provide support.
“We’ve also created a page on the ASCA website that we’ll be updating regularly so that members can find the latest news and information related to this,” he said. “The seriousness and urgency of overcoming the situation can’t be overstated, and we do want our members to know that we will continue to do everything – including working with our federal regulators – to find ways to bridge these temporary shortages.”
