Full Speed Ahead

For a few months in late 2024, if you looked up in the sky and caught sight of a 747, there was no guarantee people would be sitting in its seats. Instead, what you may have witnessed was a plane with unique passengers: thousands of bags of IV fluid, being flown into the United States.

Those planes were being flown in by Baxter International as it worked to offset a shortage of IV fluids after its North Cove manufacturing facility in Marion, North Carolina was damaged by Hurricane Helene in September 2024. A once-in-a-lifetime storm, the hurricane notoriously traveled deeper into North Carolina than most experts anticipated, causing enormous damage to Baxter’s facility and the surrounding community. One year later, Baxter’s operations and supply levels have returned to normal and the story is now familiar to most who work in healthcare, but it’s worth remembering the recovery efforts that took place at the nation’s largest IV fluids manufacturing plant, and how Baxter has prepared for the future.

The immediate aftermath

Because of the severity of Hurricane Helene, Baxter implemented its hurricane preparedness plan prior to the storm reaching Marion, including evacuating employees to support their safety, relocating finished product and loaded trailers to higher ground, and installing a floodgate for the onsite automated warehouse to mitigate the deluge of water about to hit the plant.

“There were a lot of things we did as the storm was approaching that really helped our recovery coming out of it,” said David Stone, senior director of business resiliency for Baxter. “And I don’t want to gloss over the fact that it’s not just the production lines that are vital in this facility, but also our warehouses.”

Baxter shut down and discharged residual electricity from machinery and robotics across the site, a key move that allowed them to preserve and support their eventual restart of equipment.

As the storm approached

The Baxter leadership team started to meet the evening of the storm, quickly implementing a governance structure to manage the company’s comprehensive response and recovery efforts. Once the hurricane passed, that team activated to tackle the storm’s aftermath on a number of fronts and set clear priorities: locate, ensure the safety of and support the plant’s 2,500+ employees (an endeavor lasting weeks in some cases due to limited connectivity and access for residents in the affected region), assess the state of the facility and determine how best to help maintain supply for customers and patients..

“From a facility and supply perspective, we needed to know what happened, what we lost, and try to estimate how long it was going to take to get back up,” said Stone. “Based on information we downloaded before the storm hit, we were able to do an assessment of everything we make in the plant: Where physically is the inventory of those products? How much do we have on hand? Not knowing when we might recover production, what’s our plan B, plan C and plan D?”

Baxter put a temporary, 48-hour ship hold on product. They also immediately engaged with government agencies, knowing that beyond the state of the plant, they would have to access washed out roads, a stressed power grid and other critical infrastructure to even move any existing product out of the facility.

Partners through the storm

As news spread about Helene and its impact to the community, the country’s medical facilities that rely on IV fluids from North Cove knew there could be a shortage. Medline, one of the company’s distribution partners, began working closely with Baxter to ensure the product went out to customers in a fair and reasonable manner.

“We found out about the flooding on a Sunday, and we were able to lock down all of our inventory by Monday, so people weren’t able to take a run on it,” said Erin Meredith, vendor relations manager at Medline. “So that was probably the most important thing we did right away, to be able to give Baxter time to react, to see how much inventory they had in their branches once things cleared up. But that, in itself, probably took two weeks.”

Locking the inventory down so customers can’t buy it all up, leaving others wanting for IV fluids, was key in those early hours.

“We were able to let it trickle out, so customers were still able to get some kind of supply, but they weren’t able to go buy our entire branch worth of inventory,” said Ryan Haley, Medline director of vendor relations. “Baxter moved mountains for what they were able to do with their own facility. From our vantage point, Medline moved mountains and absorbed cost to get product from them as quickly as possible and push it around our network.”

Haley noted that when a manufacturer suffers a disruption like this, you don’t see the level of transparency and quick action as Medline experienced with Baxter. Baxter and Medline teams talked several times a day to decide together how to best get the IV fluids out to their shared customers, who were the thousands of awaiting hospitals.

“Medline’s network helped us support patient need throughout the country, particularly in the first several weeks following the storm,” said Mary Henson, general manager of Baxter’s infusion therapies and technologies business in the U.S. and Canada. “Different parts of the country felt the impact at different times, and to varying degrees. Medline’s network helps move product across the country where and when it’s needed most.”

Shortening the supply chain

Baxter continually looks for ways to improve the resiliency of its supply chain. One recent example is its work with Medline to offer more direct deliveries, effectively “shortening” the supply chain. Typically, Baxter product flows from a manufacturing facility to a Baxter distribution center, and is then shipped to channel partners for further distribution. As a result of the hurricane, Baxter and Medline are working together to further expand Baxter’s Customer Direct program. By participating in Customer Direct, Medline can load pallets of product straight off the docks of manufacturing facilities and take it to their own distribution centers, removing one link of the supply chain.

“The more you shorten supply chain, the fewer opportunities for disruption,” said Stone.

Key takeaways

While Hurricane Helene was a once-in-a-lifetime storm in that region of North Carolina, both Baxter and Medline representatives said prior planning and coordination helped enable supply for patients and customers. But once-in-a-lifetime events seem to be happening more often in our lifetimes. So, what can others learn from Helene?

1. Communication. After a seismic disruption like a massive hurricane, information is both incomplete and ever-changing. It’s not enough to simply update internal stakeholders as the situation evolves. As Baxter highlighted, having a regular cadence of two-way communication with external stakeholders — sometimes several times a day — meant everyone stayed up to date. For one, Baxter established a dedicated webpage where it published regular and public updates, starting with two times a week following the storm.
2. Allocation. The last thing anyone needs is a run on a product after a supply line has been disrupted. Having an established allocation protocol and clear communication means available product can be distributed fairly to all parties. Baxter gradually increased allocations in the weeks and months following the storm, and removed allocations for all IV solutions product codes manufactured at North Cove in the summer of 2025.
3. Resilience investments. Baxter’s prior investments in supply chain technology, such as its Control Tower and Rapid Response tools, proved invaluable during the crisis. Having these systems in place helped provide visibility for inventory planning and tracking. Baxter’s ongoing investments in its supply chain were also critical in their ability to quickly mobilize their global manufacturing network (hence the planes flying IV fluids).
4. Collaboration. Baxter worked closely with several key stakeholders throughout the crisis, including government agencies and customers, and the collaboration between Medline and Baxter is an example of how crucial working together can be to mitigate the impact of a supply chain disruption. In this case, collaboration meant Baxter and Medline could both tackle the impact on several fronts, including managing inventory, optimizing logistics, and frequently communicating with customers across the country.

By May of 2025, less than eight months after the storm’s initial devastation, Baxter had restored inventory levels out of North Cove and has since removed all allocations — empowering healthcare facilities across the country to return to normal practices.