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Wholesalers, Distributors Overcome Logistic Obstacles After Terrorist Attacks

Donna Young

When terrorists attacked the World Trade Center and the Pentagon on September 11, New York City and Washington-area hospitals were thrust into disaster-response status.

Pharmacists at St. Vincents Hospital and New York University Hospital in Manhattan, Washington Hospital Center and Walter Reed Army Medical Center in Washington, D.C., and Virginia Hospital Center—Arlington in Northern Virginia suddenly found themselves placing and receiving a rapid succession of phone calls to and from drug wholesalers and distributors.

With no one knowing how many casualties there would be—about 50,000 people were estimated to be in the World Trade Center towers, and the Pentagon houses about 23,000 military and civilian employees—it was difficult to determine the amounts of drug products that would be needed.

Hospitals needed critical supplies of plasma products, i.v. solutions, pain medications, tetanus toxoid, and silver sulfadiazine and other burn-care products for the anticipated casualties.

But wholesalers and distributors were faced with several logistic nightmares in getting their deliveries to the hospitals. The Federal Aviation Administration (FAA) had immediately grounded all air traffic. Roads to and from New York City and Washington were heavily congested with traffic. Telecommunications circuits were jammed with high volumes of panicked callers trying to reach relatives and friends. And officials from the federal Defense and Justice departments could not guarantee that morning that the attacks were over.

One product in high demand was human albumin, a plasma-volume expander that stabilizes a body in shock by regulating the distribution of fluids and maintaining proper osmotic pressure and blood volume.

Chris Ground, sales and marketing vice president for FFF Enterprises of Temecula, California—a drug and biological products distributor that reportedly supplies about 60% of the nation’s hospitals with albumin products—said his West Coast company generally could provide same-day delivery of albumin to the East Coast through the use of air transport. But when the FAA shut down the nation’s airports, it sent Ground’s company scrambling to find other sources of transportation.

"We didn’t know how long that lockdown was going to be," Ground said. "But our hospitals needed to have their orders right away."

Ground said he soon connected with FedEx Custom Critical Inc. of Akron, Ohio, a subsidiary of transport giant FedEx Corp. of Memphis, Tennessee, that specializes in controlled distribution and emergency transports.

Joel Childs, FedEx Custom Critical spokesman, said his company received special "lifeguard" flight approval from the FAA the week of September 11 to transport life-saving products and rescue supplies to the New York and Washington areas.

"We are the ones people call when they can’t get it done the normal way," Childs said. "We never close."

Ground said his company chartered a FedEx Boeing 747 freight jetliner. The flight carried 74 pallets of albumin vials, enough for 25,000 treatments. An American Red Cross shipment of human tissue supplies was also on the flight.

The FedEx jetliner arrived in Philadelphia at 8:45 the morning after the attack, Childs said. The albumin vials were immediately distributed to 54 hospitals by FedEx delivery trucks. Police vehicles escorted the trucks to the New York hospitals.

FFF Enterprises also made an agreement with Coram Healthcare Corp. of Denver to store some of the albumin in facilities located in New York and New Jersey until it was needed. Unused vials were returned to California the week after September 11.

Geoffrey D. Fenton, spokesman for Cardinal Health Inc. of Dublin, Ohio, said his company received lifeguard flight approval from FAA to use a corporate jet to transport plasma products from Nashville to New York. Cardinal also received FAA’s approval to use helicopters to transport deliveries to hospitals that urgently needed life-saving products.

Fenton said Cardinal received the help of 20 police escorts—totaling more than 50 police vehicles—to transport 130 tractor-trailer loads of drug products and other medical supplies.

About 20 of the loads were orders for the Federal Emergency Management Agency, Fenton said.

Michael N. Kilpatric, vice president of corporate and investor relations for AmerisourceBergen Corp. of Valley Forge, Pennsylvania, said his company is used to handling emergency deliveries across the country.

AmerisourceBergen delivers most of its orders by ground transportation.

"The fact that planes couldn’t fly that day did not impact us," Kilpatric said. "We have 51 warehouses located a day’s trucking distance from any of our customers—all within about 300 to 400 miles away. We generally have any order delivered by noon the next day as long as it is placed before 5 p.m. We were able to have supplies to St. Vincents and New York University Hospital by 2 a.m. that morning."

Kilpatric said his company’s trucks also received police escorts.

"I have to commend the New York Police Department," Kilpatric said. "The same goes for the [Washington] DC police. They were able to help us get our trucks and vans where they needed to go."

Kilpatric said his company also received "great" support from pharmaceutical companies during the crisis.

"They cooperated with us to deliver some products a little early to make sure we had plenty in stock for our customers," he said. "The pharmaceutical supply chain is in good shape. Even in this crisis, we were able to move products between distribution centers across the country."

Patrice Smith, spokeswoman for McKesson Corp. of San Francisco agreed that having warehouse distribution centers located near her company’s customers helped McKesson quickly deliver essential drug products to the hospitals.

McKesson was able to supply Walter Reed Army Medical Center with a van full of drug products from the company’s Landover, Maryland, warehouse immediately after the Pentagon had been attacked, said a military pharmacist.

Smith said McKesson also has warehouses near New York in Rocky Hill, Connecticut; Delran, New Jersey; and New Castle, Pennsylvania.

"Everyone rallied to get supplies to the hospitals," she said.

Smith said most of the products her company supplied were typical orders, but in larger amounts.

Few hospitals, Smith said, requested additional supplies of drug products used as antidotes in case of chemical or biological attacks.

"Most of the questions about drugs, such as [Bayer Corp.’s] Cipro, have come from the media," she said. "The hospitals don’t seem to be as concerned about it."