KANSAS CITY, Mo. — 100 days after Hurricane Maria hit Puerto Rico, the IV fluid shortage is just now starting to get better in the U.S.
"Puerto Rico is where about 70 percent of the United States' manufacturing of IV fluids existed and the island was wiped out," said Rick Couldry, the Vice President of Pharmacy at the University of Kansas Hospital.
The shortage was at its worst before the holidays.
"Things have gotten a little bit better. There are still a couple of items that are day to day," Couldry said.
The FDA Commissioner recently sent out an update to the problem. The statement states this is a "key focus" for the administration.
"Just before the holidays, Baxter — a leading producer of IV saline fluids — announced that all their facilities on the island have returned to the commercial power grid."
The statement goes on to acknowledge the power grid is unstable and could still pose problems, but that the hope is production will get better in early 2018.
41 Action News reached out to a handful of area hospitals: University of Kansas Hospital, Truman Medical Centers, Overland Park Regional, Children's Mercy, and Shawnee Mission Health.
They all tell us the same thing — that the situation is better now than it was a few weeks ago and that they've learned ways to work around shortages so patient care isn't affected.
But some also told us shortages on medical supplies year round is a problem that needs attention. More on that in a moment.
As for the IV fluid shortage, larger hospitals have weathered the storm better than some smaller hospitals and clinics.
Lester McRae, Pharmacy Purchasing Coordinator for the University of Kansas Hospital, said people in his role have to get creative, and sometimes work together.
"We've actually loaned out a few cases to some hospitals here and there because we had a little excess just to help them out," said McRae.
Increased demand, as is usually the case, increases prices.
"Everyone’s trying to get it so of course, they're going to sell it at like 10 times or higher your normal cost," said McRae.
KU Hospital said they are absorbing this price and not passing it on to customers.
McRae adds one shortage can often lead to other shortages as hospitals and clinics find workarounds. For instance, the IV fluid shortage led to some pharmacy’s dividing larger IV fluid bags into smaller bags to serve more patients. That led to a shortage of the smaller, empty bags.
Another example is sterile water. There’s been a run on sterile water as medical professionals across the country work to find alternatives to the IV fluid shortage, which has led to a shortage of sterile water.
As for the larger issue of ongoing shortages, Couldry explained what he said has been a problem for about a decade.
"It's a matter of economics. The simple way to explain the shortage issue is, there are a number of low-cost, high-need products that are only really used in hospitals or acute or procedural settings," said Couldry. "So when you have a product that has a very low price and it's only used in acute settings, from a manufacturing perspective, there's not very many units you can sell and the price is very low so manufacturers started exiting the low-volume price products. But, they're really critical for acute and procedural health care."
Basically, Couldry suggests manufacturers don't make enough money — or aren't interested in — doing business in inexpensive products that are only sold to hospitals, clinics and doctor’s offices. He explained companies willing to produce these vital products for those who do buy them, have found the most cost-effective place to make them is Puerto Rico.
"Since new health care laws have gone into effect, a lot more people are going to hospitals, so the demand for things has gone way up," said Couldry, as he explained what he says is the basis of shortages that now happen year round.
41 Action News will continue to follow this story as long as the shortage lasts.