Hurricane Maria's ripple effects have reached California. When the storm destroyed much of Puerto Rico's infrastructure, it disrupted the operations of the leading manufacturer of saline solution IV bags, leading to a shortage that has affected California and other states.
The California Hospital Association confirmed the Golden State is running low on 50 cc and 100 cc saline bags, known as mini-bags, but it said the shortage is not yet a serious problem.
"There are larger sizes of these bags available so hospitals are making do," Association spokeswoman Jan Emerson-Shea said in an email. "As far as [the Association] is aware, patient care isn't being affected. At this point it's just a hassle for the hospitals."
Kaiser Permanente, which serves about 8.5 million Californians, had a similar response. "We have found alternatives and there has been no impact on patient care," it said in a statement.
The American Hospital Association sent a strongly worded letter to Food and Drug Administration Commissioner Scott Gottlieb this week expressing concern that the shortage of IV products is "quickly becoming a crisis and looming threat to the public's health."
The shortages of 50 and 100 cc saline and dextrose solutions "are unacceptable and must be resolved quickly to prevent a negative impact on patient care," wrote Thomas Nickels, the national hospital group's executive vice president for government relations and public policy.
While expressing appreciation for the FDA's efforts to find additional sources for these products, Nickels "strongly" urged the FDA "to do more by pushing current manufacturers to not only continue to produce these products at their maximum capacity but also to make investments to ensure an increasing supply for the future."
There was no immediate comment from the FDA.
Nickels also asked the federal agency to consider short-term fixes, such as allowing health systems to create their own IV solutions.
The Puerto Rico-based manufacturer affected by the hurricane is Baxter, which makes a wide variety of medical products.