WASHINGTON – Staffers at a pharmacy linked to the deadly meningitis outbreak documented dozens of cases of mold and bacteria growing in rooms that were supposed to be sterile, according to federal health inspectors.
In a preliminary report on conditions at the pharmacy, the Food and Drug Administration said Friday that even when the contamination at New England Compounding Center exceeded the company’s own safety levels, there is no evidence that staffers investigated or corrected the problem. The FDA uncovered some four dozen reports of potential contamination in company records, stretching back to January this year.
The report comes from an FDA inspection of the Framingham, Mass.-based company earlier this month after steroid injections made by the company were tied to an outbreak of fungal meningitis. FDA officials confirmed last week that the black fungus found in the company’s vials was the same fungus that has sickened 338 people across the United States, causing 25 deaths.
The New England Compounding Center’s attorney said Friday the pharmacy “will review this report and will continue our cooperation with the FDA.”
Compounding pharmacies like NECC traditionally fill special orders placed by doctors for individual patients, turning out a small number of customized formulas each week. They have traditionally been overseen by state pharmacy boards, although the FDA occasionally steps in when major problems arise. Some pharmacies have grown into much larger businesses in the last 20 years, supplying bulk orders of medicines to hospitals that need a steady supply of drugs on hand.
The FDA report provides new details about NECC’s conditions, which were first reported by state officials earlier this week. The drug at the center of the investigation is made without preservative, so it’s important that it be made under highly sterile conditions. Compounding pharmacies prepare their medications in clean rooms, which are supposed to be temperature-controlled and air-filtered to maintain sterility.
But FDA inspectors noted that workers at the pharmacy turned off the clean room’s air conditioning every night. FDA regulators said that could interfere with the conditions needed to prevent bacterial growth.
Inspectors said they found a host of potential contaminants in or around the pharmacy’s clean rooms, including green and yellow residues, water droplets and standing water from a leaking boiler.
Inspectors also found “greenish yellow discoloration” inside an autoclave, a piece of equipment used to sterilize vials and stoppers. In another supposedly sterile room inspectors found a “dark, hair-like discoloration” along the wall. Elsewhere, FDA staff said that dust from a nearby recycling facility appeared to be drifting into the pharmacy’s rooftop air-conditioning system.