Injected Meningitis

GeorgeK

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I looked but did not see a thread on this
http://www.foxnews.com/health/2012/...ath-toll-rises-to-12-with-121-cases-reported/


http://www.cnn.com/2012/10/09/health/meningitis-exposure/index.html
Tainted vials of epidural steroids resulting in fungal meningitis. There are many other articles out there about it, but I was wondering if anyone has been able to find out

1. where the drugs were made and packaged? The distributor is in Massachutes, but now days there are parts of things from all over and then finally assembled in one place, and

2. specifically what species of fungus is it?
 

Plot Device

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I'm in Massachusetts, and I also work in healthcare. So I have been watching this story in shock and awe for several days now.

The company is called NECC, New England Compounding Center. They assemble complex medical preparations (such as injectables) from pre-manufactured bulk drug packages. Yesterday, in the face of this terrible situation, they voluntarilly surrrendered their license to operate and essentially shut themselves down. Lawsuits to follow I am sure.

I do not have the details of whether the fungus originated in their pharmacy, or if they got a bad batch of something or other which caused this to happen. (Coulda gotten a bad batch of drugs, or coulda gotten a contaminated shipment of needles -- ANYTHING in the chain could have caused this. Or maybe they had one really stupid messed up day of bad infection control procedures there in the lab, so the fault could lie 100% with them.)

But no matter what happened, this is quite the horror story all around.
 
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GeorgeK

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It's going to take time for the whole picture because fungal cultures typically can take 6 weeks or more to grow. It could be aspergillus, but as far as fungal contaminants in the micro lab go, aspergillus is also among the more likely
 

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One thing I want to add:

My mom had declined enough to where she could no longer live alone, and so my brothers and I made arrangements to have her go to an assisted living facility back in 2009. (She has passed away since then.)

While making the extensitve, extensive arrangements to move her to such a place, the issue of how she would get her personal medications arose.

For three years I had been the one to purchase all her drugs for her, and then I would meticulously load up her pill-minder cartridges for her so she could find her pills every day (she was legally blind, so she could no longer drive, and she could also no longer even read the pill bottles).

558_thumbnail_image.jpg


I had naively assumed that once she was in the assisted living facility, there would be no more need for me to assist her with ... anything.

Wrong.

I still needed to go and do her laundry. If I didn't, then the facility would charge $7 per load to do it for her.

And I still needed to do all her medications for her. If not, the facility would make arrangements with a "compounding pharmacy" to load up bubble packs for her which would get shipped to the facility, placed in her room, and it was up to her to find her pills and take them every day.

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The facility told me the name of that compounding pharmacy, and while I do not recall their name now, it might very well have been NECC because I went to do some internet research on these types of facilities back in 2009 when all these options were being laid out on the table for me, and I discovered that there were, at the time, less than a dozen such compounding pharmacies in all of Massachusetts capable of doing this bubble pack service for my mom. It was a VERY expensive service and so I opted out of that whole situation and decided to just keep doing it myself for her, as well as doing her laundry.

Moral of the story: do your elderly mother's medications for her yourself, people.
 

GeorgeK

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So, laundry and medications were, "Incidental Expenses," at a care facility?

Holy Crap!
 

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So, laundry and medications were, "Incidental Expenses," at a care facility?

Holy Crap!


Specifically at an "assisted living facility." Big difference between this and a "nursing home."

Assisted living is a luxurious elderly apartment building (they try to make them look like high society hotels from another era) with lots of home health aides around who can help you to shower and get dressed, and even help walk you to the dining room for breakfast, lunch, and dinner. Lots of independence in an assisted living facility, and you have the freedom to come and go as you please. But a nursing home is loads more hands-on care, and you usually cannot leave without permission. So laundry and medicine are a given in a nursing home. Not so for laundry and medication in assisted living where it's possible for a resident to go years and do their own landry and never need any medicines at all.
 

Xelebes

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Looking as bad as the XLFoods recall here in Canada. Except more dead on your side of the border. :(
 

GeorgeK

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The thing about the tainted steroids is that they are injected into the epidural space. Part of the procedure to know that you have your needle in that space typically involves getting the needle into the cerebrospinal fluid, then backing the needle out until you can no longer draw up CSF. By definition there is now a perforation of the dura and some of the injected material can get through that perforation directly into the central nervous system crossing the blood brain barrier. Furthermore, steroids are imunosuppressive worsening the risk. Also many antifungals don't cross the blood brain barrier making it even harder to treat.
 

veinglory

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Compounding pharmacies are going to see more regulations and inspections down the line. It's the same with veterinary compounding, remember all those polo ponies that suddenly died?