In the two weeks since Hurricane Maria devastated the island of Puerto Rico, federal officials and medical supply companies have been working hard to prevent shortages of lifesaving and life-extending products manufactured on the island.

But that's tough to do without a functioning power grid.

About 23 medical device companies including Medtronic PLC and Boston Scientific Corp. have facilities on the island, including manufacturing sites that churn out everything from pacemakers to trauma-surgery products. As of Friday, some of the factories are up and running again on generator power, but none is working at full capacity, according to an assessment from Washington-based industry trade group AdvaMed.

AdvaMed said in an Oct. 4 letter to federal officials that once the island's immediate humanitarian needs are met, federal officials should consider prioritizing the re-establishment of power and phone service to med-tech companies on the island, given their importance to the island's economy and to patients in the region and around the world who need the health products produced there.

"This storm has been so destructive across the entire island and the work that our companies do so directly impacts the health care system and the patients who need access to these products," AdvaMed CEO Scott Whitaker said Friday. "If we're not prioritized, we're concerned that patients won't get the products they need and the supply chain will be negatively impacted by that."

It wasn't clear specifically which medical devices made on the island would be vulnerable to shortages.

After Hurricane Maria hit Puerto Rico on Sept. 20 and knocked out the power grid, some factories are running on generator power, but none at full capacity.

Dr. Scott Gottlieb, commissioner of the Food and Drug Administration, said in a statement Friday that the drugs, biologics and medical devices manufactured on the island account for about 30 percent of Puerto Rico's entire gross domestic product. And more than three-quarters of the pharmaceuticals made on the island are consumed by U.S. citizens in Puerto Rico and in the 50 states.

"Securing this manufacturing base is vital to maintaining access to many important medical products," Gottlieb's statement said. "We're keeping a close watch on the most critical medical products."

Medical device maker Boston Scientific, which has business operations around the Twin Cities, was able to restart operations at its plant in the Puerto Rican municipality of Dorado the week after the storm hit the island. The Dorado plant is the site of manufacturing for most of the thin implantable wires called leads that are used to connect Boston Scientific's pacemakers and implantable defibrillators to a patient's heart.

"The plant is operational and all commercial product lines were re-established, with a focus on high volume products," company spokeswoman Kate Haranis said in an e-mailed statement. "Full [production] volume will also require restoration of the electric grid, but we are able to run production on our backup generators and are optimistic we can minimize customer impact."

Abbott Laboratories, which makes some of its cardiovascular products on the island, said its manufacturing and other facilities there are "largely functional" at this point. "Our goal is to maintain supply of our products for the people who need them. No inventory was lost due to the storm. We continue to closely monitor the situation," spokesman Scott Stoffel said in an e-mail Friday.

Medtronic, which makes products for all of its major divisions at four different facilities on the island, said it partly restarted production on Oct. 2 at all of its sites using backup power generators. Manufacturing is expected to gradually ramp up in coming weeks.

"The impact to lives and the devastation to property in Puerto Rico is unprecedented and indescribable. And yet, the resiliency and spirit of our Medtronic colleagues in Puerto Rico remains strong," Chief Executive Omar Ishrak said in a statement. "We are eternally grateful for the commitment of our Puerto Rican colleagues who have returned to work to restore our operations — many of whom have lost everything in this storm."

Medtronic estimated it would see a revenue impact of up to $250 million in the quarter that ends Oct. 27, but it was too soon to estimate longer-term financial impacts. Medtronic had $7.3 billion in revenue in the same quarter last year.

"We are extremely focused on restoring our manufacturing operations in Puerto Rico as quickly as possible, as well as prioritizing our available inventory to patient surgeries over large volume orders from customers," Ishrak said in the statement.

Joe Carlson • 612-673-4779