By PAULA TRACY, InDepthNH.org

CONCORD – With some elective surgeries now being cancelled and delayed in New Hampshire due to a national shortage of intravenous fluids, Gov. Chris Sununu has sent a letter to the Biden Administration demanding more transparency and a plan to get the health care products the state needs calling it a national security issue.

Patients who need emergency IV services are being prioritized at hospitals across the state, but some hospitals are saying they are receiving less shipments than they expected as the crisis drags on following a Hurricane which hit the North Carolina manufacturing plant in late September.

Gov. Chris Sununu wrote to Dawn O’Connell, assistant secretary for preparedness and response, in relation to the crisis which damaged Baxter International in North Cove, North Carolina, which provides the fluids.

Beginning the week of Dec. 2, the company said it will provide bi-weekly updates regarding its progress to restore operations at its North Cove, N.C., site following Hurricane Helene.

According to its website, the manufacturing facility was significantly impacted by the rain and storm surge from Hurricane Helene, which was unprecedented in Western North Carolina and resulted in water flooding the facility.

Road infrastructure in and around the facility was also damaged. 

“We are making continued strong progress at our North Cove site including the initial resumption” of some IV and peritoneal dialysis solutions, the website reads.

But while production on these lines has restarted, “it will take some time for the lines to ramp up” to produce at pre-hurricane levels.

While it expects that all available production lines will be restarted by the end of the year, “we do not yet have a specific date for when we expect North Cove production to be fully restored to pre-hurricane levels.”

The facility provides products for New England hospitals and while the company said it has activated nine plants across its global network to help increase available inventory, which is contemplated in current allocation levels, conservation efforts at hospitals here are occurring.

“Conservation efforts for IV and PD solutions across the healthcare system remain essential to supplement allocation levels and help preserve supply,” the company wrote.

“We are closely partnering with the kidney community, including physicians, nurses and care teams, to enhance our support for patients,” it said.

The governor wrote to the Administration that he does not understand why the Biden 

Administration has not taken more of a leadership role in coordinating sourcing and distribution of the 

affected IV fluid and dialysis solutions. 

“Patient care is being directly impacted today because of this failure of leadership,” he stressed.

“In the past week, hospitals across New Hampshire report deliveries are in lower-than-expected quantities and are arriving late. This has impacted patient care in at least three hospitals that have had to cancel surgical procedures, particularly those procedures that require 3 Liter irrigation fluids such as 3 Liter Normal Saline Irrigation Solution and 3 Liter Glycine 1.5% Irrigation Solution. Because of the lack of transparency and consistency in deliveries, additional hospitals report plans to cancel additional surgical procedures affecting the lives of Granite Staters,” Sununu wrote. 

He said one of the state’s greatest concerns is there is no line of sight about national supplies of the various IV fluid solutions “beyond amorphous percentages of normal allocations as set by Baxter International. These allocations do not align with what hospitals are receiving. There is no transparency as to the rationale for the current distribution plans, no transparency about hard quantities of the various products and no 

certainty that the current national supply will be adequate enough to last until the manufacturing line reopening. There is no transparency as to the hard quantities of IV fluids being imported and no information regarding what products are or are not being imported,” Sununu said. 

He said the New Hampshire Department of Health and Human Services has had to intervene and assist multiple hospitals when the distributor did not deliver the quantities of IV fluid products as set forth in Baxter international’s restricted allocations.

He urged the Biden Administration to immediately provide greater transparency to the states and individual hospitals by providing timely and accurate information to allow hospitals to make more informed preparations and accurate scheduling “instead of forced last minute cancellations of procedures when supplies do not materialize.”

He also asked for it to immediately assess the current reopening timeline of the affected manufacturing lines at the plant and determine if some products will be exhausted before they can be manufactured within the United States. 

Sununu said if they are to be exhausted the administration needs to immediately source these products internationally to allow sufficient time for appropriate quality checks. 

He said that the administration needs to “become the leader of this national issue rather than outsourcing the problem to one manufacturer.”

“This is a national security issue,” Sununu stressed.