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Archive July 2016 XVII, No. 7

Compounding Disaster

How the deadliest medication contamination case in U.S. history happened — and how it could happen again.

Outpatient Surgery Editors

BIO

contaminated steroid injection MAN-MADE EPIDEMIC A nationwide outbreak of a rare and deadly form of meningitis killed 64 people and sickened more than 750 who received contaminated steroid injections from the New England Compounding Center.

A note from the editor

While we interviewed several experts for this story, most of the details derive from more than 100 documents related to the case. They included reports from FDA and the Massachusetts Board of Pharmacy, the results of Congressional investigations, the grand jury indictment, the testimony of FBI Special Agent Clayton Phelps, bankruptcy documents, numerous lawsuits, news stories and much more. It's important to note that most of the information came from people who were adversaries of the principals of NECC. While Outpatient Surgery made every effort to report fairly, the truth is that we know very little about the perspectives of Barry Cadden, Glenn Chin, the Conigliaro family and others involved in the compounding disaster. Their side of the story has not been told. We may learn more about that starting next month, when the first of the NECC trials begins.

From the Boston Strangler to the Marathon Bombings, Beantown has had its share of spectacular killings. But the deadliest, most chilling of them all may turn out to be the medication contamination case going on trial this winter. At least 76 surgery centers, hospitals and pain clinics injected the hips, joints and backs of patients with steroids they'd bought from a family-run compounding pharmacy in a suburban Boston strip mall. Little did they know that a deadly fungus growing in many of the vials would spark a meningitis outbreak that would kill 64 people and sicken more than 750 others. All right under the government's nose. You may think you know the New England Compounding Center story, but you probably don't. And you should. Because without the vigilance of people like you, it can — and some think probably will — happen again, maybe on an even larger scale.

A family affair
The worst human-induced epidemic of the 20th century had its beginnings on an East Coast college campus in the '80s, the day Lisa Conigliaro met Barry Cadden at the University of Rhode Island College of Pharmacy. They would fall in love, marry, have 3 children, move into a charming converted barn and work as retail pharmacists in Rhode Island. Perhaps they'd still be living a quiet life today — perhaps 800-plus patients would, too — if Lisa had been an only child. But she wasn't.

The year the Caddens graduated, Lisa's entrepreneurial brother, Gregory Conigliaro, opened Conigliaro Engineering in a run-down building in Framingham, Mass. In 1991, Greg's company began recycling materials. It converted plastic, metal, glass and paper into recycling bins, flowerpots and pothole repair material. The go-getting Tufts University civil engineering grad decided to start the company on Earth Day 1990, and in just a few years had a growing business.

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