Power outages continue and the cleanup is underway in Puerto Rico and the Dominican Republic after Hurricane Fiona slammed the islands that are home to many plastics processors serving the medical market.

The Category I storm made landfall Sept. 18 in southwest Puerto Rico, bringing strong winds and torrential rain that toppled power lines and flooded parts of the U.S. territory before blowing over to the Dominican Republic on Sept. 19.

As much as 30 inches of rain fell in some places and at one point, some 1.3 million of Puerto Rico's 1.4 million electrical customers had no power.

Puerto Rico hadn't fully recovered from the beating by Hurricane Maria, a Category 4 storm that struck five years ago almost to the day. The power grid still was vulnerable and some houses still have had blue tarp-covered roofs since 2017.

Businesses in the plastics industry seemed to have fared well, including a 67,250-square-foot Nelipak Healthcare Packaging facility in Humacao, Puerto Rico.

The thermoforming operation, which manufactures packaging for medical devices and pharmaceuticals, had been upgraded in 2018 with a new control room and a Class 8 cleanroom.

"The plant had no major damage. They have backup power on site and expect to be back up quickly," a spokesman for the Cranston, R.I.-based company said in a Sept. 20 email.

Nelipak is still assessing the situation for employees, he added.

The floodwaters have receded in most neighborhoods and water-logged sofas, mattresses and other soggy household goods that were pushed into streets were being cleared by clean-up crews. Many roadways also are flooded and littered with downed power lines and tree limbs.

Puerto Rico is home to more than 70 medical device manufacturing plants and thousands of the industry's employees. Lured by tax incentives and a skilled workforce, dozens of plastics-related medical brands operate there, such as Johnson & Johnson, Abbott Medical Optics, Pfizer and Stryker.

Many of the businesses were prepared with backup power, including Minneapolis,-based Medtronic, which has facilities in Humacao, Juncos, San Juan and Villalba.

Medtronic has 7,100 employees in Puerto Rico and 4,300 in the Dominican Republic that produce pacemakers and other medical devices.

"No significant damage to facilities in Puerto Rico has been reported," according to a Medtronic statement issued Sept. 19. "All Puerto Rico sites are currently operating on generator power and capable of full operations. Facilities expect to restart operations today, provided employees are safe and can report to work."

The Medtronic Foundation is donating $100,000 to support storm relief.

A Boston Scientific plant in Dorado that manufactures medical devices for its neuromodulation and rhythm management businesses also is operating, but employees are having trouble getting there.

"Our first priority is the well-being of our local team, who are all safe and accounted for," Boston Scientific spokesperson Kate Haranis told Medical Design & Outsourcing. "We took proactive steps to prepare for the storm and our site remains fully functional, though we've scaled back some shifts in light of travel advisories. We expect operations to resume at normal levels once the storm subsides and travel advisories in the area are lifted."

Johnson & Johnson said most of its sites in Puerto Rico started operating again Sept. 19 "with full production resuming in the coming days."

Stryker, which makes disposable medical devices in Arroyo, Puerto Rico, said Sept. 20 that its facility is "running normal operations as of today."

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By the afternoon on Sept. 20, power was restored to about 299,000 of Puerto Rico's 1.4 million electrical customers, according to Luma, a Puerto Rican company that has been operating the system since June 2021. About 20 percent of customers had power by Wednesday morning.

Some 2,000 utility workers are assessing the damage and making repairs to reenergize the grid as quickly and safely as possible, according to Luma Public Safety Manager Abner Gómez.

"All of us at Luma are deeply aware of the painful memories from Hurricane Maria, and the lasting effect it has had on the electric grid and the incredible people of Puerto Rico. Hurricane Fiona has, tragically, brought back many of these painful memories. While challenges exist and there is much more work to do to restore power, Luma and all our partners will not stop until every customer is restored and the entire grid is reenergized," Gomez said in a news release.

Hurricane Fiona escalated into a Category 4 storm on Sept. 21 with winds at 130 miles per hour and gusts to 155 miles per hour, according to the National Hurricane Center, which expects the storm to strengthen as it moves away from Turks and Caicos and heads toward Bermuda.

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