2 U. Mich. J.L. Reform A76
Compounding is the act of combining, mixing or altering ingredients
to create a drug tailored to the needs of an individual patient, such as
a child who needs a less potent dose, an elderly patient who has
trouble swallowing, or an individual with a severe allergy to a drug
component. Compounding pharmacies, which engage in large-scale drug
compounding, have come under the microscope recently because of the
ongoing deadly outbreak of fungal meningitis that began in 2012. Fungal
meningitis “occurs when the protective membranes covering the brain and
spinal cord are infected with a fungus.”1 The
recent outbreak was caused by steroid shots contaminated with so much
fungus that in some cases the fungus particles were visible to the naked
eye.2 A
single compounding pharmacy in Framingham, Massachusetts, the New
England Compounding Center, “shipped 17,676 vials of … potentially
contaminated [steroid] solution to 75 clinics in 23 states.”3 As
of March 4, 2013, the Centers for Disease Control and Prevention (CDC)
had linked 720 cases of meningitis or other complications, including
forty-eight deaths, in twenty states to the epidural steroid injections
that all originated from the New England Compounding Center.4
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