Tornado Rips Through North Carolina Pfizer Site, Damaging Drug Supplies

A tornado caused extensive damage to a Pfizer drug manufacturing site in Rocky Mount, N.C., on Wednesday, threatening critical supplies for hospitals across the country.

The company estimated that one-fourth of the injectable medications it supplies to U.S. hospitals were made at the Rocky Mount property, including drugs used during surgeries and other procedures to help block pain, keep patients sedated and fight infections.

Though the company has yet to disclose the extent of the storm’s impact, video footage of the site and interviews with the Nash County sheriff and with people briefed on the damage indicated that the tornado caused the worst damage at the company’s warehouse.

On Thursday, Pfizer declined to comment on the drugs affected or the proportion of its supply destroyed in the tornado, which could be considerable given that a lot of these medications required careful production and handling to ensure sterility.

It was also unclear how deeply the destruction would exacerbate existing national drug shortages, which have reached a 10-year high in recent months. Hospitals are on high alert because low-cost generic products manufactured at the site, such as the sedative propofol, are already among the most shortage-prone on the market.

“From a health care practitioner point of view, I’m just holding my breath,” said Michael Ganio, a senior director at the American Society of Health-System Pharmacists.

The tornado ripped through a 16-mile strip of the Rocky Mount area, about 50 miles east of Raleigh, at about 12:30 p.m. on Wednesday. It snapped trees at the base and tossed homes 20 yards from their foundations, according to a summary by the National Weather Service. The tornado reached wind speeds up to 150 miles per hour before it ripped off large pieces of the metal roof of a Pfizer building and flipped big-rig trucks in the parking lot. Sixteen people were injured, but no deaths were reported.

Several people said the tornado caused the most damage to a company warehouse; the impact to the manufacturing plant — and its ability to continue producing medicines — is not yet clear, according to Mittal Sutaria, a senior vice president of pharmacy contracts at Vizient, which provides contracting for medications to hospitals.

She said Pfizer and the Food and Drug Administration had teams on-site to assess the damage.

Dr. Sutaria, who said Vizient had been in touch with Pfizer, added that the Rocky Mount site made anesthesia products including propofol, used to sedate patients during surgery, as well as fentanyl and morphine, which are used in IVs for pain management. It also makes vancomycin, an antibiotic administered to fight severe infections, and muscle blockers including succinylcholine, also used in surgery.

Keith Stone, the sheriff of Nash County, where Rocky Mount is situated, told local news reporters on Wednesday that much of the Pfizer building was splintered, the roof was crushed and as many as 50,000 pallets of medicine were destroyed.

About 100 vehicles were also damaged, including forklift trucks that were strewn across nearby railroad tracks, Sheriff Stone said in an interview on Thursday. “It’s just amazing what can come up so quick and have so much damage and be gone so fast,” he said.

Steve Danehy, a spokesman for Pfizer, said on Thursday that the company’s Rocky Mount team was “working very hard to address and assess the situation,” but did not provide any details. The company said its staff survived the tornado without serious injuries.

Pfizer is expected to report its findings to the Food and Drug Administration, which tracks shortages.

“We are following the situation closely as it evolves and are working with the company to understand the extent of the damage and any potential impact to the nation’s drug supply,” said Chanapa Tantibanchachai, a spokeswoman for the agency.

The Rocky Mount facility, established in 1968, employs 4,500 people and has 24 filling lines and 22 packing lines. Though not as large as Pfizer’s manufacturing complex in Kalamazoo, Mich., the North Carolina site spans 1.4 million square feet of manufacturing space. The medicines made at the site are also shipped to Japan, Canada, Brazil and other countries.

The specific products made at the Pfizer plant — and the share of the market they comprise — is not typically public information. However, the company sells dozens of injectable items, including I.V. antibiotics, anti-seizure drugs used in brain surgery and even an antidote to coral snake venom.

Many Pfizer medicines were already in short supply before the tornado: About 130 products marketed to hospitals were listed as “depleted” and about 100 more were in “limited supply,” according to the company’s list of 660 products.

Pfizer has other manufacturing plants in Kansas, New York, Massachusetts and Wisconsin where the company could possibly shift some production to ease any shortages resulting from the Rocky Mount destruction.

Soumi Saha, a senior vice president with Premier, a company that provides contracting services for medications to hospitals, said that Pfizer had a strong track record for building in some redundancy so that products were manufactured at more than one site.

If the storm damage is limited to the warehouse and does not affect production schedules at the manufacturing plants, that could mitigate potential shortages, she said.

Dr. Ganio recalled other drug shortages caused by disasters in production zones.

Hurricane Maria struck Puerto Rico in 2017, leaving hospitals scrambling for IV bags. Another occurred last year when a region of China that was hard-hit by Covid had a lapse in producing contrast dye for CT scans and other medical images. And in recent months, doctors have warned that survival rates for some cancer patients are in jeopardy because of a halt in production at a manufacturing plant in India after the F.D.A. cited major quality lapses.

Given the worrisome shortages that affect so many lives — and that have resulted in hoarding of certain drugs and bartering among advocates who trade and find scarce drugs for the most desperate — policy experts, lawmakers and federal officials have been discussing solutions in recent weeks.

On Thursday, Senate lawmakers passed a pandemic preparedness bill out of a key health committee. It had provisions aimed at stemming shortages and increasing reports by drugmakers to alert the F.D.A. to circumstances that might lead to shortages so the agency could help head them off.

The bill would also require a report from the F.D.A. within 90 days of the legislation’s passage on the agency’s ability to deal with shortages and whether it needs more help from lawmakers.

Still, the natural occurrence of a tornado provided a stark reminder of the need to better manage shortages.

“This reinforces the need for resiliency in our supply chain and a true focus on preparedness, not only for the next pandemic,” Dr. Saha said, “but for any unforeseen circumstance that creates shocks in our supply chain.”