The Greatest Public Health Disaster

The recent national Meningitis outbreak is being called “the worst public health disaster since the 1930’s.” The outbreak was due to poor practices at a compounding pharmacy located in Massachusetts. The pharmacy had been manufacturing and supplying major hospitals with tainted vials of methylprednisolone acetate. This pain medication was manufactured in a plant that simply did not practice basic clean room technique.

Recent reports indicate that the air conditioning was switched off nightly in a sterile room where medications were compounded. This gross oversight lead to unmaintained temperature and humidity, fostering the growth of microbes. Bacteria and mold was found in numerous clean rooms where sterile drugs were manufactured. In fact, the vials containing methylprednisolone acetate had visible green and black matter floating in them. In addition, tarnished surfaces coated with green and yellow matter were found on much of the machinery used in sterilization.

The other important piece of this story is that the company failed to operate in a context appropriate for a compounding pharmacy. The pharmacy should have been supplying customers on a small scale, creating custom products that might not be available at a traditional pharmacy. Instead, they were supplying many major hospitals affiliated with prestigious schools like Harvard, Yale as well as the Mayo Clinic.

Compounding pharmacies serve a distinct purpose for medical practitioners; they produce products that are tailored to individual needs that aren’t available in the mass market. This event has undoubtedly tarnished the reputation of compounding pharmacies that are operating under the correct sanctions. This worries me because many of the patients I have seen as a student clinician have benefited from the work of local compounding pharmacies. These types of pharmacies serve our community in a way that is uniquely important, and hopefully that will shine through this terrible oversight.

NY Times, FDA Details Contamination at Compounding Pharmacy

Washington Post, Compounding Pharmacy Linked to Meningitis


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