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Kill Shot: A Shadow Industry, a Deadly Disease
An award-winning investigative journalist's horrifying true crime story of America's deadliest drug contamination outbreak and the greed and deception that fueled it.
Two pharmacists sit in a Boston courtroom accused of murder. The weapon: the fungus Exserohilum rostratum. The death count: 100 and rising. Kill Shot is the story of their hubris and fraud, discovered by a team of medical detectives who raced against the clock to hunt the killers and the fungal meningitis they'd unleashed.
Bloodthirsty is how doctors described the fungal microbe that contaminated thousands of drug vials produced by the New England Compounding Center (NECC). Though NECC chief Barry Cadden called his company the Ferrari of Compounders, it was a slapdash operation of unqualified staff, mold-ridden lab surfaces, and hastily made medications that were injected into approximately 14,000 people. Once inside some of its human hosts, the fungus traveled through the tough tissue around the spine and wormed upward to the deep brain, our control center for balance, breath, and the vital motor functions of life.
Now, investigative journalist Jason Dearen turns a spotlight on this tragedy--the victims, the heroes, and the perpetrators--and the legal loopholes that allowed it to occur. Kill Shot forces a powerful but unchecked industry out of the shadows.
Two pharmacists sit in a Boston courtroom accused of murder. The weapon: the fungus Exserohilum rostratum. The death count: 100 and rising. Kill Shot is the story of their hubris and fraud, discovered by a team of medical detectives who raced against the clock to hunt the killers and the fungal meningitis they'd unleashed.
Bloodthirsty is how doctors described the fungal microbe that contaminated thousands of drug vials produced by the New England Compounding Center (NECC). Though NECC chief Barry Cadden called his company the Ferrari of Compounders, it was a slapdash operation of unqualified staff, mold-ridden lab surfaces, and hastily made medications that were injected into approximately 14,000 people. Once inside some of its human hosts, the fungus traveled through the tough tissue around the spine and wormed upward to the deep brain, our control center for balance, breath, and the vital motor functions of life.
Now, investigative journalist Jason Dearen turns a spotlight on this tragedy--the victims, the heroes, and the perpetrators--and the legal loopholes that allowed it to occur. Kill Shot forces a powerful but unchecked industry out of the shadows.
272 pages, Hardcover
First published February 23, 2021
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March 17, 2021
Marialyce and I were in a slump with several disappointing fiction reads in a row. We decided to turn our attention to a few non-fiction titles. This was one of those books, one that highlighted a horrifying case of medical fraud and greed that cost lives and resulted in untold suffering.
As an RN, I’m familiar with compounding pharmacies, which makes custom mixes of medications, but little did I know that the abuses outlined in this book went unchecked for so long. As a patient who has received countless joint steroid injections, I’m even more horrified - and angry.
In 2012 there was a fungal microbe that contaminated thousands of vials of methylprednisone acetate produced by the New England Compounding Center (NECC). This is a drug injected to provide back and joint pain relief.
The CDC and FDA began investigating a multi-state series of cases of fungal meningitis that eventually sickened hundreds of patients and left countless others permanently disabled. Many died, and are still dying. The fungus was particularly lethal when injected into the epidural space of their spine where it traveled to their brain, causing devastating disabilities, and in many cases, death. In these pages we get to know many of these victims and their families, making it personal.
The investigation traced the contaminated vials to the NECC in Framingham, MA. The conditions in the lab where the drugs were made were contaminated, and failed to meet the most basic of clean conditions. Records were falsified, they failed to recall known contaminated vials, expired ingredients were used, vials were mislabeled, and the atmosphere in the lab was unprofessional and demonstrated a wanton disregard for the human lives at stake.
The pharmacists who owned the company became very wealthy from the business, making millions of dollars. When they knew they were in trouble they took great pains in moving money around and hiding their assets. One owner was arrested in the airport as he was attempting to flee the country.
There was a trial but due to some misunderstandings on the part of the jury the individuals involved were acquitted of murder and got off with light sentences considering the gravity of their crimes.
I wish I could say this was a one-off with no possibility of this happening again, but I can’t. Since this case, more compounding pharmacies have been cited for unsafe practices. This is a case of pure corporate greed combined with bureaucratic failures and a lack of oversight from the very agencies who are supposed to protect us.
The author ends his book with a list of questions for patients to ask their physician if they are prescribed injectable drugs made in a compounding pharmacy. However, as a nurse and part of a medical family, I can guarantee you that the physician would have no idea. The onus and responsibility of the safety of our drugs should not rest on the shoulders of patients and doctors. This pharmacy was licensed. Are doctors supposed to travel and independently inspect every pharmacy where the compounded drugs they use are dispensed? Obviously the fact the pharmacies are licensed is no assurance of safety.
The laws need to be changed and the agencies responsible for ensuring the safety of our drug supply needs to be fully funded to prevent this from ever happening again. The burden should be on the state and federal inspections and licensing departments, not on the patient and physician.
As an RN, I’m familiar with compounding pharmacies, which makes custom mixes of medications, but little did I know that the abuses outlined in this book went unchecked for so long. As a patient who has received countless joint steroid injections, I’m even more horrified - and angry.
In 2012 there was a fungal microbe that contaminated thousands of vials of methylprednisone acetate produced by the New England Compounding Center (NECC). This is a drug injected to provide back and joint pain relief.
The CDC and FDA began investigating a multi-state series of cases of fungal meningitis that eventually sickened hundreds of patients and left countless others permanently disabled. Many died, and are still dying. The fungus was particularly lethal when injected into the epidural space of their spine where it traveled to their brain, causing devastating disabilities, and in many cases, death. In these pages we get to know many of these victims and their families, making it personal.
The investigation traced the contaminated vials to the NECC in Framingham, MA. The conditions in the lab where the drugs were made were contaminated, and failed to meet the most basic of clean conditions. Records were falsified, they failed to recall known contaminated vials, expired ingredients were used, vials were mislabeled, and the atmosphere in the lab was unprofessional and demonstrated a wanton disregard for the human lives at stake.
The pharmacists who owned the company became very wealthy from the business, making millions of dollars. When they knew they were in trouble they took great pains in moving money around and hiding their assets. One owner was arrested in the airport as he was attempting to flee the country.
There was a trial but due to some misunderstandings on the part of the jury the individuals involved were acquitted of murder and got off with light sentences considering the gravity of their crimes.
I wish I could say this was a one-off with no possibility of this happening again, but I can’t. Since this case, more compounding pharmacies have been cited for unsafe practices. This is a case of pure corporate greed combined with bureaucratic failures and a lack of oversight from the very agencies who are supposed to protect us.
The author ends his book with a list of questions for patients to ask their physician if they are prescribed injectable drugs made in a compounding pharmacy. However, as a nurse and part of a medical family, I can guarantee you that the physician would have no idea. The onus and responsibility of the safety of our drugs should not rest on the shoulders of patients and doctors. This pharmacy was licensed. Are doctors supposed to travel and independently inspect every pharmacy where the compounded drugs they use are dispensed? Obviously the fact the pharmacies are licensed is no assurance of safety.
The laws need to be changed and the agencies responsible for ensuring the safety of our drug supply needs to be fully funded to prevent this from ever happening again. The burden should be on the state and federal inspections and licensing departments, not on the patient and physician.
March 17, 2021
Honestly, before reading this book, I didn't even know what a compounding drug factory was. Where my drugs came from never even crossed my mind. However in 2012, a deadly fungus microbe was, through negligence and unclean facilities, managed to infect hundreds of people. The bulk of these drugs were made in a facility called the New England Compounding Center, exposing some 14,000 people to a fungus that traveled up their spine creating havoc eventually entering their brains.
People became ill and the doctors were baffled. The illness resembled in a way, meningitis but that is carried by a virus and that virus was not detected in the bodies of the affected. It was a race to pinpoint the why as people were dying a horrible death, loss of motor functions, loss of the ability to breathe, and ultimately death.
Horrible as it was, once the disease was tracked to NECC, the owners, Barry Caden, Gregory Conigliaro, Glenn Chin, Robert Ronzio who had gained millions of dollars, multiple million dollar homes and the like, were both arrogant, haughty, and fraudulent The really salient and disgusting fact was that they knew their facility was unclean, harbored next to a recycling center with tons of old mattresses in their yard.
A trial was eventually held and due to misunderstanding in orders to the jury from the judge, the owners and the board got off with slightly more than a slap on the hand, even though the charge was murder. While some did serve a limited amount of time, it still didn't come close to the suffering, the misery, the loss that so many endured while these heinous people grew very wealthy. To this day, some are still dying from this fungus that for many were injected into their spine to alleviate pain.
This powerful story begs one to demand the pertinent agencies to take efficient and active involvement in the assembling of drugs. It reveled so well the deficiencies that both the federal and state governments make as they fail to take sufficient measures to ensure these life threatening drugs are not made in a careless and reckless manner. We desperately need to demand our governments look into this with regularity and pass laws that bring these negligent and greedy drug makers very stringent and fitting punishments. They do hold the lives of the people in their hands and we have always trusted their effectiveness and the manner in which they monitor drug manufacturing. It is truly a heinous crime for some to make drugs that they know may someday cause and probably do cause such horrible outcomes. In the eve of so many new drugs and new drug making procedures, this is a priority. The people have always placed their faith and trust in the drugs they take. This book is a wake up call that we should pay extreme attention to the process to monitor drug makers as it seems to be severely broken.
We need Congress and the various agencies to take a very active role in how and where are drugs are manufactured. It is of great concern to many that countless numbers of our current drugs are made in China. We are playing with people's lives and of course the cost to people and their love ones do not have a price.
Thank you to Jason Dearden for bringing this topic to light.
People became ill and the doctors were baffled. The illness resembled in a way, meningitis but that is carried by a virus and that virus was not detected in the bodies of the affected. It was a race to pinpoint the why as people were dying a horrible death, loss of motor functions, loss of the ability to breathe, and ultimately death.
Horrible as it was, once the disease was tracked to NECC, the owners, Barry Caden, Gregory Conigliaro, Glenn Chin, Robert Ronzio who had gained millions of dollars, multiple million dollar homes and the like, were both arrogant, haughty, and fraudulent The really salient and disgusting fact was that they knew their facility was unclean, harbored next to a recycling center with tons of old mattresses in their yard.
A trial was eventually held and due to misunderstanding in orders to the jury from the judge, the owners and the board got off with slightly more than a slap on the hand, even though the charge was murder. While some did serve a limited amount of time, it still didn't come close to the suffering, the misery, the loss that so many endured while these heinous people grew very wealthy. To this day, some are still dying from this fungus that for many were injected into their spine to alleviate pain.
This powerful story begs one to demand the pertinent agencies to take efficient and active involvement in the assembling of drugs. It reveled so well the deficiencies that both the federal and state governments make as they fail to take sufficient measures to ensure these life threatening drugs are not made in a careless and reckless manner. We desperately need to demand our governments look into this with regularity and pass laws that bring these negligent and greedy drug makers very stringent and fitting punishments. They do hold the lives of the people in their hands and we have always trusted their effectiveness and the manner in which they monitor drug manufacturing. It is truly a heinous crime for some to make drugs that they know may someday cause and probably do cause such horrible outcomes. In the eve of so many new drugs and new drug making procedures, this is a priority. The people have always placed their faith and trust in the drugs they take. This book is a wake up call that we should pay extreme attention to the process to monitor drug makers as it seems to be severely broken.
We need Congress and the various agencies to take a very active role in how and where are drugs are manufactured. It is of great concern to many that countless numbers of our current drugs are made in China. We are playing with people's lives and of course the cost to people and their love ones do not have a price.
Thank you to Jason Dearden for bringing this topic to light.
November 30, 2025
Body Horror: Nonfiction Edition. 😱
But seriously, this was terrifying.
I read this as part of a very silly reading challenge that somehow turned out to be successful.
Click here to hear more of my thoughts on this book over on my Booktube channel, abookolive.
But seriously, this was terrifying.
I read this as part of a very silly reading challenge that somehow turned out to be successful.
Click here to hear more of my thoughts on this book over on my Booktube channel, abookolive.
August 4, 2023
* how have i not heard about this case 🤯
* it follows the deadliest outbreak of fungal meningitis in the United States, caused by faulty medication made by a compound pharmacy
* if you have no idea what this is, it's okay, i didn't either 😅
* the short explanation is that it's different from a drug manufacturer (like those pertaining to Big Pharma) and it theoretically should work on a much smaller scale - thus it's not regulated by the FDA, or subject to FDA rules and policies, so people do shady shit and end up killing patients because of gross negligence and greed
* it reads like a medical thriller, but the fucked up thing is that it actually happened
* it's short, but packs a punch and i genuinely gasped in disbelief every other page
* 5/5 ⭐️ with an added shudder on top, because just omg 🤯
* it follows the deadliest outbreak of fungal meningitis in the United States, caused by faulty medication made by a compound pharmacy
* if you have no idea what this is, it's okay, i didn't either 😅
* the short explanation is that it's different from a drug manufacturer (like those pertaining to Big Pharma) and it theoretically should work on a much smaller scale - thus it's not regulated by the FDA, or subject to FDA rules and policies, so people do shady shit and end up killing patients because of gross negligence and greed
* it reads like a medical thriller, but the fucked up thing is that it actually happened
* it's short, but packs a punch and i genuinely gasped in disbelief every other page
* 5/5 ⭐️ with an added shudder on top, because just omg 🤯
October 19, 2021
In high school, I had a job at a pharmacy where they compounded their own drugs so this story hits kind of close to home for me.
Another crazy, maddening and disgusting account on what an absolute cluster medical corporations are—a real life nightmare.
Another crazy, maddening and disgusting account on what an absolute cluster medical corporations are—a real life nightmare.
March 13, 2021
Знаете ли какво е магистрални (екстемпорални) рецепти? Именно те стават причина за смъртта на над 100 души в САЩ през 2012 г.
Сега всички сме свикнали да купуваме медикаменти директно от аптеките като търговски продукт. Но все още съществува и друга възможност - приготвяне на лекарство от отделните му съставки в аптеката по указания, дадени в магистрална рецепта. В миналото подобна практика е била често срещана, докато днес, поне в България, е по-скоро изключение. До магистрална рецепта се прибягва, когато пациент е алергичен към някое от помощните вещества в търговския продукт, но и често по чисто шарлатански причини. Например, нашумялото лекарство ивермектин първоначално се "приготвяше" само с магистрална рецепта, на място в аптека, преди да бъде одобрен търговския продукт. Напомням, че ивермектин НЕ се препоръчва за лечение на COVID-19 и може да ви навреди.
В САЩ приготвянето на магистрални (екстемпорални) лекарства изглежда все още е популярно. Някои аптеки доставят стотици опаковки от определени продукти, защото предоставят по-ниски цени и по-бързо изпълнение на поръчките. Постепенно те започват да изпълняват функциите по-скоро на производители на лекарства. Предимството им пред фармацевтичните фирми е огромно - не подлежат на строг контрол и имат множество законови вратички за занижаване на стандартите. Докато през 2012 г. не се случва огромна трагедия.
Метилпреднизолон е лекарство, което често се използва за лечение на различен вид ставни болки. Понякога се инжектира директно в гръбначномозъчната течност (ликвора). Клиники, лекуващи болка, правят огромни печалби, инжектирайки по-евтин "магистрален" метилпреднизолон на своите пациенти. Но през 2012 г. няколко партиди от лекарството, произведени в нестерилни условия, се оказват замърсени с рядък вид гъбичка. Инжектирането на контаминирания метилпреднизолон в пространството около гръбначния мозък води до изключително тежки случаи на менингит и причинява смъртта на над 100 човека, като оставя поне толкова инвалиди за цял живот. Американските регулаторни институции се задействат незабавно, установяват причината и прекратяват дейността на компанията. Но вредата вече е нанесена.
Прочетете книгата, за да разберете как стремежът към печалби води до смъртоносни компромиси в лечението и какво може да се случи, когато определени играчи не са подложени на строг регулаторен контрол.
Сега всички сме свикнали да купуваме медикаменти директно от аптеките като търговски продукт. Но все още съществува и друга възможност - приготвяне на лекарство от отделните му съставки в аптеката по указания, дадени в магистрална рецепта. В миналото подобна практика е била често срещана, докато днес, поне в България, е по-скоро изключение. До магистрална рецепта се прибягва, когато пациент е алергичен към някое от помощните вещества в търговския продукт, но и често по чисто шарлатански причини. Например, нашумялото лекарство ивермектин първоначално се "приготвяше" само с магистрална рецепта, на място в аптека, преди да бъде одобрен търговския продукт. Напомням, че ивермектин НЕ се препоръчва за лечение на COVID-19 и може да ви навреди.
В САЩ приготвянето на магистрални (екстемпорални) лекарства изглежда все още е популярно. Някои аптеки доставят стотици опаковки от определени продукти, защото предоставят по-ниски цени и по-бързо изпълнение на поръчките. Постепенно те започват да изпълняват функциите по-скоро на производители на лекарства. Предимството им пред фармацевтичните фирми е огромно - не подлежат на строг контрол и имат множество законови вратички за занижаване на стандартите. Докато през 2012 г. не се случва огромна трагедия.
Метилпреднизолон е лекарство, което често се използва за лечение на различен вид ставни болки. Понякога се инжектира директно в гръбначномозъчната течност (ликвора). Клиники, лекуващи болка, правят огромни печалби, инжектирайки по-евтин "магистрален" метилпреднизолон на своите пациенти. Но през 2012 г. няколко партиди от лекарството, произведени в нестерилни условия, се оказват замърсени с рядък вид гъбичка. Инжектирането на контаминирания метилпреднизолон в пространството около гръбначния мозък води до изключително тежки случаи на менингит и причинява смъртта на над 100 човека, като оставя поне толкова инвалиди за цял живот. Американските регулаторни институции се задействат незабавно, установяват причината и прекратяват дейността на компанията. Но вредата вече е нанесена.
Прочетете книгата, за да разберете как стремежът към печалби води до смъртоносни компромиси в лечението и какво може да се случи, когато определени играчи не са подложени на строг регулаторен контрол.
September 17, 2022
Highly recommended for anyone involved in compounding drugs. This was a great reminder of how the steps we take everyday to assure sterility and integrity of drugs have a substantial and critical role in patient safety and outcomes. It also highlights the disappointing reality of cracks in the system and that individuals in the profession of pharmacy exist who lack morals and integrity and function on greed.
August 18, 2021
Investigative journalist Jason Dearen puts a thriller spin on the hunt to find the source of a deadly outbreak of meningitis, which he eventually traces back to a high-production lab with little regard for safety protocols. Not much is known to regular folks about the business of pharmaceutical compounding, but after reading this, you will want to question the origin of every shot and needle that is stuck into your body. Lots of legal loopholes and hurdles challenge the investigation, and Dearen tells the story with just the right touch of sensationalism.
March 27, 2021
Imagine you are a businessperson. You find a cheap warehouse on what used to be a toxic waste dump. In the parking lot, there's an enormous pile of rotting mattresses and old furniture that you leave there for years. You decide that this is the perfect place to formulate sterile drugs that humans will swallow or have injected into them. Inside the "clean room" of the lab itself, oil bubbles up through cracks in the floor. Your employees cover the cracks and oil with trash cans on the rare occasions that officials carry out inspections. The employees kill bugs in the clean room fairly often.
Imagine you are a pharmacy tech working in this filthy clean room. It's always really busy because your company cuts corners and sells drugs it's not supposed to sell and doesn't worry about keeping the clean room clean. And it keeps its prices low. When a work surface tests positive for mold, nobody gets punished. Nobody cleans it up, either. Anyway, you work in a big room with a lot of other guys, and one day you get into an argument about what's going to play on the radio. You want to listen to music, but most of the others want to listen to sports talk radio. You get so mad you quit on the spot. The company replaces you with a less experienced tech. He is supposed to be trained and supervised, but nobody bothers. Months later, people all over the country start dying because they were injected with steroids that contain mold. It's a mold that normally eats plants, but it develops a taste for blood, probably because blood and leaves both contain iron. The steroid suppressed each patient's immune response and dulled the pain so that no symptoms emerge until about a month after the injection. People die of meningitis. They suffer horribly. A doctor who works for the CDC testifies in court that it is the worst medical emergency he has seen in 15 years except for Ebola. And this emergency was entirely preventable. And it happened, in part, because you got mad when you couldn't pick the radio station.
Imagine you are the safety officer at this company. At the trial, the prosecutor hands you a document that describes the standard operating procedure for vetting medication orders against individual patients' prescriptions, as the law requires. You say that you've never seen this document before and you don't know what vetting means.
Imagine you are a pharmacist, and you do your job so badly that the government brings dozens of murder charges against you.
Imagine you are a pharmacy tech working in this filthy clean room. It's always really busy because your company cuts corners and sells drugs it's not supposed to sell and doesn't worry about keeping the clean room clean. And it keeps its prices low. When a work surface tests positive for mold, nobody gets punished. Nobody cleans it up, either. Anyway, you work in a big room with a lot of other guys, and one day you get into an argument about what's going to play on the radio. You want to listen to music, but most of the others want to listen to sports talk radio. You get so mad you quit on the spot. The company replaces you with a less experienced tech. He is supposed to be trained and supervised, but nobody bothers. Months later, people all over the country start dying because they were injected with steroids that contain mold. It's a mold that normally eats plants, but it develops a taste for blood, probably because blood and leaves both contain iron. The steroid suppressed each patient's immune response and dulled the pain so that no symptoms emerge until about a month after the injection. People die of meningitis. They suffer horribly. A doctor who works for the CDC testifies in court that it is the worst medical emergency he has seen in 15 years except for Ebola. And this emergency was entirely preventable. And it happened, in part, because you got mad when you couldn't pick the radio station.
Imagine you are the safety officer at this company. At the trial, the prosecutor hands you a document that describes the standard operating procedure for vetting medication orders against individual patients' prescriptions, as the law requires. You say that you've never seen this document before and you don't know what vetting means.
Imagine you are a pharmacist, and you do your job so badly that the government brings dozens of murder charges against you.
November 27, 2021
Incredible, unfortunately true horror story about recklessness of pharma industry. I'm sure there are honest individuals, all hooked on idealistic humanity saving ideals, working in those labs somewhere, but what say do they even have? As a whole, big pharma is blood thirsty chain of parties, each of them in glaring conflicts of interest in their efforts to grab their share of profit.
In this book, we find out that "small pharma" is actually no better, even worse in many regards. Big pharma at least produces somewhat "clean" poison. However, these small criminals with big, life threatening impact won't blink twice selling you concoctions produced in cock roach infested environments, kept outside of all temperature limits just so they can save a few bucks on electricity. How about making "sterile" drugs in what was previous no more than a train maintenance shed, with ground underneath so soaked with train fluids and oils that workers spent significant amount of their time just scooping that vomit that gets squeezed out of the earth every 1-2 hours?
And then back to their work of preparing those life saving medicines for you. Maybe only stopping to kill huge centipedes lurking around. Granted, they do it quite medically, by drowning them in alcohol. If this sounds like B rated movie, unfortunately it isn't. This is really what happened and caused the biggest drug contamination scandal in history.
So many lives lost to human greed... Do we ever get off?
In this book, we find out that "small pharma" is actually no better, even worse in many regards. Big pharma at least produces somewhat "clean" poison. However, these small criminals with big, life threatening impact won't blink twice selling you concoctions produced in cock roach infested environments, kept outside of all temperature limits just so they can save a few bucks on electricity. How about making "sterile" drugs in what was previous no more than a train maintenance shed, with ground underneath so soaked with train fluids and oils that workers spent significant amount of their time just scooping that vomit that gets squeezed out of the earth every 1-2 hours?
And then back to their work of preparing those life saving medicines for you. Maybe only stopping to kill huge centipedes lurking around. Granted, they do it quite medically, by drowning them in alcohol. If this sounds like B rated movie, unfortunately it isn't. This is really what happened and caused the biggest drug contamination scandal in history.
So many lives lost to human greed... Do we ever get off?
December 2, 2024
This book is devastating and so engaging and I couldn’t put it down. I’m terrified for the state of compounded medications in the US. I hate how much pharma can lobby simply because they have so much money.
This author did a great job looking into the lives of those affected and also those at the CDC and EIS doing the investigations.
This author did a great job looking into the lives of those affected and also those at the CDC and EIS doing the investigations.
November 9, 2022
As a pharmacist, it is so disheartening to read stories like this. Stories of other pharmacists who blatantly disregard and disrespect the oath that we took to do no harm. I applaud the writing and dedication to telling such a harrowing and heartbreaking story. I am saddened for the families who suffered because of this incredible disregard for patient safety.
I normally find investigative reporting very hard to get through because of how dry and legal it can be, but this book was a quick and fascinating read. This writing is sharp, powerful, and to the point. Dearen does a fantastic job of taking very complicated subject matter (FDA Jurisdiction in compounding pharmacies, pharmacy law, 503A/B, the Drug Quality and Security Act, etc) breaking it down, and making it digestible for those who may not have medical background. Dearen showcases how our healthcare system is deeply broken and that legislation and clear cut laws are needed to prevent a tragedy like this from happening to any future patient.
All pharmacists or future pharmacists should consider reading this to understand the deep impact that laws, regulations, standards of practice, etc. etc. have on our daily work.
Also, I hope Barry Cadden never knows another day of peace again in his life.
I normally find investigative reporting very hard to get through because of how dry and legal it can be, but this book was a quick and fascinating read. This writing is sharp, powerful, and to the point. Dearen does a fantastic job of taking very complicated subject matter (FDA Jurisdiction in compounding pharmacies, pharmacy law, 503A/B, the Drug Quality and Security Act, etc) breaking it down, and making it digestible for those who may not have medical background. Dearen showcases how our healthcare system is deeply broken and that legislation and clear cut laws are needed to prevent a tragedy like this from happening to any future patient.
All pharmacists or future pharmacists should consider reading this to understand the deep impact that laws, regulations, standards of practice, etc. etc. have on our daily work.
Also, I hope Barry Cadden never knows another day of peace again in his life.
May 3, 2024
I didn’t know what a compounding pharmacy was until I read this book. I found the story informative and scary. Especially galling is that members of Congress can be bought by lobbyists for the IACP (International Academy of Compounding Pharmacists), today known as the Alliance for Pharmacy Compounding. Theses politicians do not put the health of Americans ahead of their political ambitions. Many Americans died an awful death, or some continue to suffer the consequences of a compounded injectable steroid drug intended for pain relief that introduced a fungus directly into their spinal fluid.
July 11, 2022
A crazy tale of greed & lack of regulation that will make you hate evil humans even more
June 10, 2022
A classic American tale involving corporate greed, corruption, and government failure.
language: some (when quoting others)
language: some (when quoting others)
August 4, 2021
This was one of the best thrillers I've read in years. As far as narrative non-fiction goes it's right up there with Into Thin Air, The Perfect Storm and Seabiscuit. You have the villain, a melomaniac who chases money at the risk of people's health and ultimately their lives. Barry Cadden uses loopholes in the compounding pharmacy industry to turn a pharmacy into a drug manufacturer, which is not exactly the premise of a compound pharmacy to begin with. Yet Cadden builds an empire of wealth convincing clinics around the country to purchase their injectables at a savings. Of course without FDA approval needed, all kind of shortcuts are taken and you can guess what happens next. A fungus gets into several lots of Methylprednisolone, a steroid, and the fungus eats away blood vessels right into peoples brains. It's the stuff of science fiction, yet it's all true.
The good guys finally do get a win in the end, but is it enough? And at what cost? The real kicker is that the FDA still has no jurisdiction over any compounding pharmacies and mistakes are made daily. Scary, thrilling and well researched. I can't say enough good thing about this book. Read it.
The good guys finally do get a win in the end, but is it enough? And at what cost? The real kicker is that the FDA still has no jurisdiction over any compounding pharmacies and mistakes are made daily. Scary, thrilling and well researched. I can't say enough good thing about this book. Read it.
January 7, 2025
Wow!! This was such a good read (or, listen in my case). It was a fast-paced, blistering indictment of the compounding industry, and went deep into the background of how and why the fungal meningitis epidemic of 2012 was so damning. Not only does it make me very fearful of the lack of administration and oversight into these kind of pharmacies, it’s also extremely critical of the law makers who continue to accept money from compounding lobbyists and predatory pharmaceutical practices. Additionally, I appreciated that victims stories were shared tactfully & that they were remembered for how they lived, and hopefully this book serves as one step towards justice for their families. Overall, a great read for anyone interested in healthcare.
May 26, 2021
This is a true crime book about a pharmacy that produced a steroid that becomes a breeding ground for a deadly fungus that kills over 100 people. It is a story I never heard of before reading this book. It outlines the way the tragedy unfolded and the subsequent court proceedings and murder trial for the pharmacists. I don't want to give anything away, in case you haven't heard the story (I hadn't). The author does a great job of bringing each character to life and also explaining the story from a birds eye view so as we don't lose sight of the major tragedy. I ONLY recommend this book if you are a real true crime fanatic that even likes boring, white collar, crime stories.
June 18, 2021
This was a well-researched book with many interviews and heart-breaking personal stories. It makes me pause now when I'm planning to go to the doctors. If the disease doesn't kill you, the doctor/pharmacist/treatment will. I appreciate the questions the author listed at the end of the book, questions which we should ask our doctors about compounded medications. Unfortunately, the same sloppy and careless compounding seems to be happening with other companies. A scary situation for us patients .
November 29, 2022
Anyone that works for a compounding pharmacy should read this book to fully appreciate the magnitude of responsibility that lies on their shoulders. When a system and it’s staff fails to do their jobs, innocent lives are impacted with heartbreaking consequences. I was shocked to read the level of negligence that took place and how long it was allowed to go on. We as patients trust our doctors and the sources of our medications. This story sheds light on this industry and the standards it should be held to so that such an event never happens again.
February 7, 2023
As a medical mycologist, I appreciate the intensive research (and hours) that made this book so wonderful. From pathogen description to patient testimonies to intricacies of the justice system, the book was well thought out and credible. This story reveals the horrors of some of drug companies, the heroism of our epidemiologists and researchers (I am biased), and the limitations of the government and its agencies. A great non-fiction read!
August 8, 2024
This is a horrifying reality in health care where the bottom line is not "do no harm."
And as much as this book focuses on one pharmaceutical drug compounder; the research shows just how endemic and wide spread this issue is; from hospital and pain clinic well through to lobbyists and bought politicians who know not what they speak on.
And as much as this book focuses on one pharmaceutical drug compounder; the research shows just how endemic and wide spread this issue is; from hospital and pain clinic well through to lobbyists and bought politicians who know not what they speak on.
April 28, 2025
A pharmacist friend of mine recommended this book and wow am I glad she did!! This book tells the true story of the largest fungal meningitis outbreak in the history of the United States and the compounding pharmacy responsible. My jaw was on the floor. This book is hard to put down. I was worried I would have a tough time because I’m an attorney with no science background but I understood this book and followed along easily. It’s a quick read but it will stick with you.
March 1, 2021
A lot to unpack with this fast-paced medical thriller. For those unfamiliar with the event, this reads like a fiction murder mystery (spoiler: it is non-fiction). For those familiar with the 2012+ case, it is a sobering reminder of profit greed over patient care. Read it, then let's discuss it.
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March 22, 2023Literally closed this book and turned on the news to see eye drops across 10 different brands were recalled and shook my fist to the sky and screamed “COMPOUNDING CLINICS!” Anyway ask where the drugs you’re taking come from yall
June 29, 2025
Shoutout work for loaning me this enthralling book! An educational, horrifying, captivating (binge-read in two days), and unfortunately true story that happened locally. I will be deep cleaning my bathroom as the concept of mold is now terrifying for me.
March 30, 2021
Recommend to any pharmacy student to understand the dangers of negligence in compounding pharmacies
August 8, 2024
This was such an incredible book that was so well written and well researched. I was hooked from the moment I started.
June 28, 2025
As someone who works in this particular industry, I’ve heard a lot about this case but wow there was still so much I didn’t know. A very complex and scary issue that no one is talking about!!!
September 22, 2021
Disturbing.
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