Hurricane Maria plunged Puerto Rican hospitals into the dark, forcing doctors on the island to rely on outside aid, emergency supplies and prayer to keep their most vulnerable patients alive. Months later, the long-since-dissipated storm is forcing doctors in Cincinnati to get creative, too. Children's Hospital pharmacy director Mark Thomas said the decreased availability of Puerto Rico-produced supplies such as I.V. bags has created a shortage in many American hospitals. Typically, his staff would use around 1,000 such bags every day. "They're a critical part of our practice," Thomas said. "They've been around for so many years and so plentiful that we've kind of gotten used to them being around." Puerto Rico, long a manufacturing powerhouse for American companies, has historically produced more pharmaceutical products for the United States market than any other state or territory. When Maria disabled the island's factories, it snapped a crucial link in the country's medical supply chain. Factories are coming back online, but weeks or months of missed quotas mean the supply pinch could continue for some time. Facilities in the mainland United States simply aren't equipped to handle the capacity hospitals need, Thomas said. With this in mind, the FDA temporarily allowed Children's to import medical supplies from Canada, Ireland and Australia during the worst of the shortage.