House staff report recounts decade of problems with New England Compounding Center

In response to these problems, the state pharmacy board filed complaints against NECC and Cadden. The company made changes and in February 2004 passed an inspection by the state. In the meantime, however, the FDA was looking into new reports of infection linked to NECC-made steroids.

Two people in Rochester, N.Y., had developed bacterial meningitis after being injected with methylprednisolone acetate — the same drug implicated in the current outbreak. FDA’s New York district office sampled 14 vials provided by the hospital in Rochester. Four tested positive for bacteria.

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On Oct. 26, the Food and Drug Administration announced that it had tested 50 vials linked to the meningitis outbreak and found all 50 vials to be contaminated with mold or fungus.

On Oct. 26, the Food and Drug Administration announced that it had tested 50 vials linked to the meningitis outbreak and found all 50 vials to be contaminated with mold or fungus.

Drugs made at compounding phramacies aren’t FDA-approved

Drugs made at compounding phramacies aren’t FDA-approved

Fatal meningitis outbreak will go down as one of the biggest drug disasters in American history.

Officials say they lacked authority over pharmacy in meningitis outbreak

Officials say they lacked authority over pharmacy in meningitis outbreak

They describe an archaic regulatory apparatus that hampered their ability to keep pace with changes.

Deadly meningitis outbreak ‘just the tip of an industry iceberg,’ report says

Deadly meningitis outbreak ‘just the tip of an industry iceberg,’ report says

State boards failed to regulate safety at specialty pharmacies, congressional report finds.

Little-regulated pharmacies that mix drugs for individuals stir up concerns

Little-regulated pharmacies that mix drugs for individuals stir up concerns

Hospitals and doctors increasingly depend on the growing number of drug compounding facilities.

Although NECC often cooperated with authorities, it was surprisingly defiant at times, too.

In an inspection in late 2004 involving questions about NECC’s production of a dye called Trypan blue, state and FDA inspectors attempted to interview Gregory Conigliaro, who co-owns the company. According to the FDA report, Conigliaro “became indignant [and] he said that he does not really have time to sit with us [and] answer all those questions.” Cadden then told his partner: “Don’t answer any more questions!”

In the same investigation, an FDA inspector asked Cadden whether he had any Trypan blue in stock. Cadden reportedly said “no, because he just compounds the drug if he receives the prescriptions for certain patients.” In the clean room, however, the inspector saw a drawer labeled “Trypan Blue” and asked Cadden to open it. It contained 189 vials of the dye.

The FDA ultimately deferred to the state pharmacy board to make Cadden clean up his operation. That’s because, despite evidence of small-scale mass production at the Framingham plant, FDA concluded that NECC was a compounder, not a drug manufacturer, and, therefore, fell under state regulations.

In a separate development, FDA inspectors found more than a dozen sterility problems at Ameridose, a sister drugmaking facility of which Cadden is also a co-owner.

According to a report released Monday, inspectors found that Ameridose repeatedly failed to perform adequate sterility tests, to investigate more than 53 instances of microbiological contamination in pain medications, and to clean bacteria and mold found in its equipment. A company spokesman said Ameridose has not had “any instance of contaminated products” over the past six years and was preparing a full response to the FDA’s report.

Both NECC and Ameridose have closed in. Cadden’s attorney, Bruce Singal, did not respond to a telephone call and e-mail request for comment.

Lena H. Sun contributed to this report.

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