F.D.A. Chief Details ‘Shocking’ Conditions at Baby Formula Plant

The Abbott Nutrition plant in Michigan that was shut down in February, sparking a widespread baby formula shortage crisis, had a leaking roof, water pooled on the floor and cracks in key production equipment that allowed bacteria to get in and persist, Dr. Robert Califf, the head of the Food and Drug Administration, told a House panel on Wednesday.

He detailed “egregiously unsanitary” conditions in the Sturgis, Mich., plant to lawmakers during a hearing, but he also acknowledged that his agency was too slow in response.

“Frankly, the inspection results were shocking,” Dr. Califf said. “We had no confidence in integrity of the quality program at the facility,” noting the agency worked with Justice Department officials to dictate steps the company needed to take to turn the facility around.

That effort is expected to result in the facility reopening on June 4, Jonathon Hamilton, an Abbott spokesman, said, with some formula expected to begin rolling out June 20. Officials hope new shipments will reach store shelves within six to eight weeks, although resumption of full production at the plant will take longer.

Abbott has replaced the leaking roof at the plant as well as the floor, Dr. Califf said.

Members of the House Energy and Commerce Subcommittee on Oversight and Investigations pushed back against the agency’s assertions that it was difficult to recognize in real time the extent of the contamination and the resulting nationwide breakdown in supplies. The Abbott plant had produced one-fourth of the nation’s infant formula, including tailored formulas for people with specialized nutritional needs.

“There was a life-and-death crisis in front of the F.D.A., but they failed to see the severity of the situations,” said Representative Cathy McMorris Rodgers, a Republican of Washington. “We must solve the immediate issue and also ensure that we are taking action so this situation never happens again.”

In opening remarks, Christopher Calamari, an Abbott Nutrition senior vice president, said little about conditions at the Michigan factory but said he was “deeply, deeply sorry” about the shortages. He said the company was coordinating 50 flights per week from its formula plant in Ireland to a dozen U.S. airports to help bolster supplies.

“We are committed to ensuring that this never happens again,” Mr. Calamari said, noting that the company will add redundancy to its operations.

He later said the company is currently verifying that every step is in place to ensure the quality checks are working throughout the 700,000 square-foot facility in a sustainable way.

The agency discovered a battery of problems at the plant last fall. At the same time, reports began emerging of babies who had been hospitalized with a rare bacteria. Cronobacter sakazakii, which can be deadly to infants, was found in four babies who had consumed formula from the plant, according to the Centers for Disease Control and Prevention.

Testimony during the hearing made it clear that the F.D.A. took months to try to match the bacteria that sickened the first baby to bacteria that was later found throughout the plant.

Cronobacter strains related to two of the babies did not match samples of the bacteria later taken at the plant, although Dr. Califf said the agency considers those results “inconclusive” given shortcomings with genome sequencing.

The illnesses set the recall in the motion. The plant shutdown began Feb. 17 and led to shortages that have left parents struggling, driving hundreds of miles to find baby formula and, at times, improvising to feed hungry infants.

Dr. Califf also acknowledged that the F.D.A. erred: Its follow-up inspection in January should have started sooner, and, he said, the agency took too long to circulate a whistleblower report that arrived in October but did not reach top officials until February.

“It was too slow and there were decisions that were suboptimal along the way,” Dr. Califf said.

He told lawmakers that the agency did not receive an immediate notice when a formula plant found the deadly Cronobacter bacteria. Nor does the agency have access to the supply chain information that each of the three main U.S. baby formula manufacturers have in-house.

The report of an anonymous whistleblower who said he worked in the Sturgis plant came up repeatedly during the hearing. The whistleblower alleged that safety staff there “celebrated” the F.D.A. overlooking problems after a 2019 inspection and did not destroy enough product when it found Cronobacter in finished products. That top agency leaders did not see those claims until February “is stunning to me,” said Representative Gary Palmer, a Republican of Alabama.

Details in the report suggested there was “corruption” at the plant, Representative Kim Schrier, Democrat of Washington, charged. Dr. Califf said he could neither confirm nor deny whether there might be criminal proceedings in the future.

Last week, the Justice Department announced a consent decree with Abbott on the conditions required to reopen the Sturgis plant, and the company could face heavy fines if it does not comply. In a complaint supporting the decree, officials described contamination with Cronobacter bacteria in finished baby powdered formula lots as long ago as 2019 and 2020.

Abbott officials “have been unwilling or unable to implement sustainable corrective actions to ensure the safety and quality of food manufactured for infants,” the complaint concluded.

Cronobacter sakazakii bacteria thrive in dry conditions, like powdered foodmaking. Only one state, Minnesota, requires doctors or labs to report cases of food-borne illness from the bacteria to public health authorities, who, in turn, are supposed to alert the C.D.C., The New York Times has reported.

Senator Tammy Duckworth, Democrat of Illinois, urged the C.D.C. to change the protocols. “Our nation’s inadequate reporting system results in critical data gaps that undermine our ability to understand the true scope of Cronobacter infections in infants,” according to the letter she sent on Wednesday.

At the subcommittee hearing, Dr. Califf agreed that reporting should be required of cases involving the bacteria.

Last week, President Biden invoked the Defense Production Act to increase formula production and authorized the use of aircraft to speed shipment of infant formula to the United States from overseas. The first military plane carrying 500,000 bottles of formula arrived in Indianapolis from Europe on Sunday, and another was expected to land in the Washington, D.C., area on Wednesday.

The F.D.A. said last week that it set up a streamlined process for foreign baby formula manufacturers to send their products to the United States. On Tuesday, it announced that it approved one company’s application to send two million cans.

Mr. Biden has also signed legislation into law broadening the types of formula that can be purchased using benefits from the federal food aid program for women and babies, which cleared both chambers of Congress with few objections. A House-passed emergency $28 million measure to boost staffing for the agency, however, has stalled as some senators question whether the money will adequately address the shortage.

“We don’t want anybody to be short of baby formula or anything,” said Senator Richard Shelby of Alabama, the top Republican on the Senate Committee on Appropriations. “Let’s see if we need it — the answer is not always money. The answer is good government and market forces.”

It is unclear what other legislative steps Congress will take. But as pleas from desperate parents searching for formula flooded Capitol Hill, lawmakers hastily scheduled hearings to interrogate both Dr. Califf and top industry executives over the failures that led to the shortage. Two more hearings are scheduled for this week, with House Appropriations subcommittees summoning a panel of experts on Wednesday and Dr. Califf set to appear before the Senate’s Health, Education, Labor and Pensions Committee on Thursday.

Emily Cochrane contributed to this report.