A former Massachusetts pharmacy executive, Barry Cadden, has been sentenced June 26 to nine years in prison for his role in a meningitis outbreak that killed 76 people in 2012. (Reuters)

The head of a now-defunct Massachusetts pharmacy was sentenced Monday to nine years in prison for his role in a 2012 meningitis outbreak that killed 76 people and left hundreds of others with debilitating infections.

Barry Cadden, the owner and head pharmacist of New England Compounding Center, was cleared earlier this year of murder charges but convicted of racketeering and fraud in connection with the outbreak, which the Department of Justice has called the largest public health crisis ever caused by a pharmaceutical product.

The 50-year-old was accused of producing drugs in dangerously unsanitary conditions and sidestepping regulations to bring in more money. Tainted steroids from the facility were distributed to patients around the country, triggering a wave of infections that sent health officials scrambling to identify the source.

U.S. District Judge Richard G. Stearns in Massachusetts ordered Cadden to serve 108 months in prison and three years of supervised release. Prosecutors had asked for the harshest sentence allowable, 35 years, arguing that Cadden showed an “unconscionable disregard for the lives of the patients.” Defense attorneys said he should serve no more than three years.

Cadden was tearful during the sentencing, according to Reuters.

“As head of a company that made drugs that killed and sickened these people, I say with full sincerity that it breaks my heart to read about how painful their deaths were,” he said.

The judge said he spent the weekend reviewing statements from the victims and their family members. He told Cadden he understood why they would have wanted the maximum sentence, Reuters reported.

“The most common word that repeats itself is pain,” the judge said.

Ahead of the sentencing, Patricia Martin told the court that her mother died after she was injected with a steroid from Cadden’s company in September 2012, according to USA Today. Up until that point, Martin said, her mother had been an active person. “Don’t let my mother’s death be in vain,” she said.

In fall 2012, an unusual number of meningitis cases and other fungal infections started popping up in Tennessee, Virginia and several other states. Health officials traced the illnesses back to a batch of preservative-free methylprednisolone aceta, a steroid used to treat lower back pain, produced by the New England Compounding Center in Framingham, Mass.

As the outbreak spread, officials around the country rushed to determine how many people were affected and where, contacting patients and family members and even making home visits to figure out who might have received a tainted injection, as The Washington Post reported at the time.

More than 17,000 vials of the steroid were shipped from the pharmacy to dozens of facilities around the country. The fungus contained in some of the vials appeared to cause a rare brain infection only curable through months of intravenous antibiotics, The Post reported. Officials said some 13,000 people may have been exposed. Cadden’s company voluntarily recalled its products and suspended operations as it sought to pinpoint the source of the infections.

Ultimately, more than 750 people in 20 states fell ill after receiving injections of the steroid, according to the U.S. Centers for Disease Control and Prevention. The agency said 64 people had died as a result of the tainted medicine as of fall 2013, but prosecutors said a dozen others had died since then, bringing the total number of deaths to 76, according to the Associated Press.

When regulators inspected Cadden’s facility, they found standing water, mold and bacteria on workers’ gloves — all potential sources of contamination.

In 2014, federal prosecutors charged Cadden and 13 others in a 131-count indictment, claiming the company operated more like a criminal enterprise than a pharmacy. They alleged Cadden, who was charged with second-degree murder, deliberately authorized shipments without knowing whether drugs were sterile, used expired ingredients, and allowed an unlicensed pharmacy technician to manufacture some of his batches. The company was also accused of dispensing drugs without valid prescriptions, in some cases using celebrity names such as “Michael Jackson” and “Diana Ross” to forge drug paperwork.

“Barry Cadden put profits over patients,” said Acting U.S. Attorney William D. Weinreb for the District of Massachusetts. “He used NECC to perpetrate a massive fraud that harmed hundreds of people.

The case brought new scrutiny to compounding pharmacies, which typically make medicines for individual patients on a custom basis and face looser regulations as a result. Medical experts told The Post after the outbreak that the New England Compounding Center was operating more like a full-blown manufacturer, producing large volumes of medicine and shipping them to many states.

In court Monday, about 20 people affected by the outbreak described how they lost loved ones or suffered through months of pain themselves.

Among them was Penny Laperriere, a Michigan woman whose husband died after receiving a steroid shot for back pain, according to the Associated Press. She asked of Cadden: “Who gave him the right to play God?”

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