Hurricane Maria devastation affects Clark County hospital

Puerto Rico facilities can’t send usual amount of medications, supplies

By Marissa Harshman, Columbian Health Reporter

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The devastation Hurricane Maria inflicted on Puerto Rico late last month sent ripples that have reached a Clark County hospital.

Puerto Rico is home to dozens of drug and device manufacturing facilities for large companies — such as Pfizer, Merck, AstraZeneca and Baxter — that supply the world with medical products. In the hurricane’s aftermath, federal officials and drugmakers are working to prevent national shortages of critical drugs.

Locally, hospital officials are working behind the scenes to piece together shipments of medications and medical supplies to ensure patients and providers have everything they need.

One of the big suppliers of intravenous products, Baxter, has placed limitations on how much product they’ll distribute to each organization. That move has affected a major supplier for PeaceHealth Southwest Medical Center, said Victoria Tamis, director of pharmacy services for PeaceHealth’s Columbia Network.

“It leaves us with smaller allocations than we need,” Tamis said.

In response, PeaceHealth staff has had to get creative, looking for different ways to administer the same drugs. For example, with ready-to-use bags of antibiotics for IVs in limited supply, pharmacy staff are hand-mixing antibiotics. The practice is more-time-consuming and the drug has a shorter shelf life, but it ensures patients get what was prescribed, Tamis said.

“Our primary goal is providing safe care for our patients and providing the products they need,” she said.

Hurricanes have also slowed down shipping of products, particularly those coming from the southern United States, Tamis said.

“That’s really impacted us on some of our pain medications,” she said.

But, Tamis said, the hospital has been able to patch together shipments. With past shortages, the hospital has had to use different drugs with the same therapeutic benefits. Fortunately, that hasn’t yet been necessary, Tamis said.

Shipping delays did, however, cause the hospital to cancel some of its flu immunization clinics for staff. Some hospital employees were able to get vaccinated from supplies in the first shipment. The rest of the hospital staff, however, will have to wait until the delayed second shipment arrives, Tamis said.

The hospital does, however, have flu vaccine to provide to patients, she said.

Legacy Salmon Creek Medical Center is not currently experiencing problems obtaining necessary supplies from its wholesalers, but the supply chain for hospital drugs can often be unpredictable, said Ryan Erlewine, Legacy Salmon Creek director of hospital pharmacy.

“Things change quickly because we’re dealing with manufacturers around the world,” Erlewine said. “There might be a shortage due to production or weather. This year has been challenging long before the hurricane. We have to be vigilant about maintaining our supplies at all times.”

Drug shortages and supply disruptions occur often, Tamis agreed. Typically, though, weather isn’t the culprit, she said.

More often disruptions are caused when drug manufacturers merge, Tamis said. And sometimes, other world events lead to shortages.

When the U.S. went to war with Iraq, for example, there was a limited supply of blood products used to treat traumatic injuries because they were being sent overseas for soldiers, Tamis said.

“It’s always different things,” she said. “But drug shortages are just a normal part of our life, unfortunately.”