On September 29, 2024, Hurricane Helene flooded Baxter International's North Cove plant in North Carolina. The site is the company's largest in the world, and KFF Health News reported it supplied about 60 percent of the intravenous fluids used in the United States. Within days, hospitals that had never thought about saline as a supply risk were rationing it.
The FDA declared the shortage over on August 12, 2025, according to Axios. That is the end of the news story. It is not the end of the exposure, and the buyers who treat it that way will be the ones caught next time.
What actually happened
The timeline matters because it shows how long "temporary" lasts.
- Late September 2024: North Cove closes after the flood. Baxter begins allocating remaining inventory to customers.
- October 2024: A Premier survey found more than 86 percent of healthcare providers were experiencing IV fluid shortages, as reported by the South Carolina Hospital Association.
- Fall 2024: Hospitals cancel or delay elective procedures, switch patients to oral hydration where clinically appropriate, and move to alternate crystalloids. KFF Health News reported one health system cut IV fluid use by 55 percent.
- End of 2024: Eight of North Cove's ten manufacturing lines are running again, according to Axios.
- February 2025: The plant returns to pre-hurricane production, about four months after landfall.
- August 2025: FDA removes the products from the shortage list.
Almost a year of disruption from a single weather event at a single plant. The FDA and the Administration for Strategic Preparedness and Response lined up imports from Europe and Asia and expanded manufacturing capacity elsewhere while production was restored, per Axios. That federal response is not something a buyer can plan around.
The structural problem did not go away
Four manufacturers dominate the US IV saline market, and North Cove remains a large share of domestic capacity. Sterile injectable manufacturing is capital-intensive and slow to add. Nothing about that changed when the shortage ended. A second hurricane, a quality hold, or a cyberattack on one of the four producers would put hospitals back where they were in October 2024.
The Anesthesia Patient Safety Foundation's shortage update documented the clinical side of that risk: procedure delays, changed hydration protocols, and pressure on staff to conserve. For a supply chain leader, that is the cost of not having a plan.
Five lessons for the next one
1. Know your consumption in bags per day, not dollars per month. During the shortage, the hospitals that recovered fastest were the ones that could say how many 1,000 mL bags each unit used per day. Conservation only works when you can measure it.
2. Pre-approve the alternates. Different bag sizes, different manufacturers, and different crystalloids all needed pharmacy and nursing sign-off in the middle of the crisis. Get those approvals on file now, while nobody is under pressure. Keystone's post on approving a backup vendor before you need one covers the process.
3. Hold a protective par on the cheap items that stop everything. IV fluids themselves are hard for a distributor to buffer at scale because of weight, dating, and manufacturer allocation. Administration sets, extension sets, flush syringes, and IV start kits are not. Those are the items that run out when everyone switches protocols at once, and they are cheap to hold.
4. Put the buffer on paper. For hospital systems and large buyers, Keystone will hold a dedicated buffer of sets, flushes, and start kits in Edina, Minnesota under an open purchase order or standing order. The order is yours, the release schedule is yours, and the stock does not move to another customer. We do not build speculative inventory without that commitment, and you should be skeptical of any distributor who says they will.
5. Watch the signals. Weather, plant inspections, and manufacturer notices show up before the allocation letter does. Keystone's disruption monitor tracks manufacturer events by category so purchasing sees the notice early.
What Keystone supplies
Keystone quotes IV administration sets, extension sets, prefilled saline flush syringes, IV start kits, and related infusion consumables by the case, with confirmed lead times on every acknowledgment. IV fluids themselves are quoted subject to manufacturer allocation and dating, and we tell you that up front rather than after the order.
The shortage is over. The next one is not scheduled. Build the plan while the shelves are full.
Browse IV fluids, sets, and flush syringes or request a continuity review for your infusion consumables.
Sources
- Axios, "FDA says IV fluid shortage from hurricane is over" (August 12, 2025): https://www.axios.com/2025/08/12/iv-fluid-shortage-fda-ends
- KFF Health News, "Nationwide IV Fluid Shortage Could Change How Hospitals Manage Patient Hydration": https://kffhealthnews.org/news/article/iv-fluid-shortage-hospitals-conservation-bags-baxter-plant/
- South Carolina Hospital Association, "IV Fluid Shortage Update" (Premier survey figure): https://scha.org/news/iv-fluid-shortage-update/
- Anesthesia Patient Safety Foundation, "The Sterile Intravenous (IV) Fluid Shortage Crisis Update": https://www.apsf.org/article/the-sterile-intravenous-iv-fluid-shortage-crisis-update/