NSW Health warns of critical IV fluid shortages days before TGA issues alert

MedTech & Diagnostics News: Australia is currently facing critical shortages of multiple intravenous (IV) fluid products from all three of its suppliers: Baxter Healthcare, B.Braun, and Fresenius Kabi. This issue has raised significant concerns across the healthcare sector.

NSW Health urgently alerted its Chief Executives, Directors of Clinical Governance, and the Director of the Regulation and Compliance Unit to the “critical” IV fluid shortages on July 16. However, the Therapeutic Goods Administration (TGA) waited an additional ten days before formally issuing an alert on July 26.

According to the NSW Health communication, “There is an ongoing disruption to supply (with intermittent stock available) of intravenous fluid bags due to manufacturing issues and increases in demand. This is expected to be critical in the coming 2-3 weeks.”

It warned that “Supply of alternative crystalloid solutions (such as Plasma-Lyte 148) are not expected to fulfil the shortfall in supply of Hartmann’s solution” and recommended “a Local Health Districts/Specialty Health Networks-wide review of intravenous fluid bag stock holding must be conducted, ensuring all locations of stock are identified.”

Australian Medical Association (AMA) President Professor Steve Robson emphasised the potential nationwide impact of the shortage.

“That would affect every surgeon, every anaesthetist, and every patient awaiting surgery in the country; that has potentially bigger implications than the COVID restrictions,” he said. “COVID restrictions were around staffing and preserving protective equipment, there was no shortage initially of supplies, but this kind of supply constraint is unprecedented.”

Professor Robson added, “It would affect anaesthesia, surgery, chemotherapy, emergency departments, managing people with acute infectious illness in hospital, paediatric intensive care, the number of patients potentially affected would be unbelievable.”

A letter issued by Baxter to wholesalers on 22 July did not indicate when their normal supply will resume. It said, “There are no new updates regarding the supply of IV fluid products. 1 or 2 back orders for each product code is preferable. When we come into some allocation of stock, we will release the stock against those back orders. Allocation quantity and product code will be unpredictable.”

In its delayed alert, the TGA stated, “We continue to collaborate with jurisdiction health departments, and suppliers of Australian-registered IV fluid products to monitor the situation and address any regulatory barriers to supply. Suppliers have advised us that supply will continue to be constrained throughout 2024.”

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