Drug shortages in the aftermath of Hurricane Maria are now threatening the lives of premature babies. Months after Hurricane Maria brought destruction through Puerto Rico, the island is still mostly without power, running water, and is now experiencing a diminishing amount of medical supplies.
According to the Food and Drug Administration, the island’s power outages are affecting not only the production of saline solution but also the supply of amino acids.
“It’s devastating for pediatrics and babies because hospitals were telling us they were down to just a few days’ supply and they were really getting extremely concerned,” said Captain Valerie Jensen to NBC News. Jensen is the Associate Director of the Drug Shortages Program with the FDA. “This is their protein source. It is absolutely critical.”
Amino acids are used to feed patients who are unable to eat or use a stomach tube. These patients include premature babies, who are unable to breastfeed. The administration of amino acid solutions to premature babies, or preemies, improves infant weight as well as overall nutrition.
However, for amino acids to properly deliver nutrition to preemies, who sleep between 10.5 to 18 hours a day, the solution must be pure and free of contaminants. This is because newborns babies, preemies especially, are susceptible to infection by contaminants such as aluminum.
The FDA announced just recently that, due to the shortage, the pediatric formulation would need to be imported. Baxter, a major supplier of saline and amino acids throughout the United States, hosted its main facilities in Puerto Rico.
“In order to help mitigate this shortage,” said FDA director Dr. Scott Gottlieb, “the FDA has worked with Baxter to facilitate the temporary importation of amino acids for pediatric and adult formulations of IV amino acids from Baxter facilities in the United Kingdom and Italy.”
The FDA is also working with ICU Medical, B. Braun, and other manufacturers to increase supplies. The goal, said Jensen, is to encourage manufacturers and speed up inspections to provide critical supplies of saline.
Shortages of saline solution have been a problem since 2014 after a sudden increase in demand. However, Hurricane Maria has now made this shortage far worse and far more noticeable.
Dick Stapleton, a New Jersey Cancer patient, said a nurse has to deliver his chemotherapy treatment manually when just the month before his chemo was infused over several hours from a large bag of saline. The shortage of saline requires the need for specialized staff, which raises medical costs.
“We’ve been putting strategies into place that result in better conservation of the bags we have and get,” said Chris Fortier, the chief pharmacy officer at Massachusetts General Hospital. “From a fluid perspective, we’re telling our physicians to think if a patient really needs that fluid.”
The FDA has been urging medical centers and hospitals to fight the temptation to stock up on saline. Hoarding saline and amino acids prevent other medical centers from getting the solutions they need for their patients.
This includes those in Puerto Rico whose hospitals and clinics are still largely without power. To prevent medical catastrophes, the FDA has made deals with Puerto Rico to ensure electricity is restored to medical manufacturers first.