Meningitis Linked to Infected Steroid Shots

Lethal medicine linked to meningitis outbreak, CBS News, March 10th, 2013

Many are still fighting meningitis they contracted from contaminated steroid shots. A special episode on CBS aired on Sunday about the victims of this outbreak.

As of November 16, the U.S. Centers for Disease Control and Prevention (CDC) had identified 469 cases of fungal meningitis, stroke due to presumed fungal meningitis or other central nervous system-related infection and 11 cases of peripheral joint infections (such as knee, hip, shoulder or elbow) as part of a nationwide outbreak of illness linked to contaminated steroid shots from a Massachusetts pharmacy, the New England Compounding Center (NECC). The CDC reports 33 deaths in the outbreak.

According to the CDC, there have been two cases reported in Illinois.

The CDC and U.S. Food and Drug Administration (FDA) have confirmed the presence of a fungus known as Exserohilum rostratum in unopened medication vials of the steroid methylprednisolone acetate (MPA) from two of three lots that were shipped across the U.S. prior to September 26 by the Massachusetts-based specialty pharmacy. According to news reports, the majority of meningitis cases in this outbreak have been linked to Exserohilum rostratum. The fungus appears to aggressively attack tissues in the spine and brain.

Additionally, on November 1, the CDC and FDA said that bacteria had been found in two additional NECC-supplied products: Preservative-free injectable betamethasone and NECC cardioplegia solution. The products have not been linked to any illnesses. However, the FDA said that the finding does “reinforce the FDA’s concern about the lack of sterility in products produced at NECC’s compounding facility and serve to underscore that hospitals, clinics, and health care providers should not use any NECC-supplied products.”

The CDC and U.S. Food and Drug Administration (FDA) have confirmed the presence of a fungus known as Exserohilum rostratum in unopened medication vials of the steroid methylprednisolone acetate from two of three lots that were shipped across the U.S. prior to September 26 by the Massachusetts-based specialty pharmacy. According to news reports, the majority of meningitis cases in this outbreak have been linked to Exserohilum rostratum. The fungus appears to aggressively attack tissues in the spine and brain.

The CDC says as many as 14,000 patients received the contaminated steroid injection that was shipped to 76 clinics in 23 states. The shots were mainly used as epidural (spinal) injections for back pain, but some patients received the steroid for pain in such joints as knees, ankles and shoulders.

On October 4, the FDA advised physicians to not use any NECC products, which was followed by the NECC voluntarily recalling all of its products on October 6.

The FDA has urged physicians across the country to follow up with patients when the following three conditions have been met:

  • They received an injectable product purchased from or produced by NECC, including an injectable ophthalmic drug used in conjunction with eye surgery, or a cardioplegic solution,
  • The medication was shipped by NECC on or after May 21, 2012, and
  • The medication was administered to patients on or after May 21, 2012.

The FDA is providing a list of customers who received NECC products that were shipped on or after May 21, 2012.

There are currently three known locations in Illinois that received the steroid methylprednisolone acetate from the NECC that is at the center of the current outbreak:

  • APAC Centers For Pain Management
    708-483-7007
    Westchester, IL
  • APAC Centers For Pain Management
    773-935-2760
    Chicago, IL
  • Thorek Memorial Hospital
    773 975-6734
    Chicago, IL

The FDA has announced that the NECC sister company, Ameridose, LLC, has issued a voluntary recall of all of its unexpired products in circulation. According to the FDA, although an inspection of Ameridose’s facility is ongoing, “the FDA’s preliminary findings have raised concerns about a lack of sterility assurance for products produced at and distributed by this facility.” The recall is not based on reports of patients with infections associated with any of Ameridose’s products but was recommended by the FDA “out of an abundance of caution.”

Multistate Fungal Meningitis Outbreak Investigation

The CDC is currently conducting an investigation into the outbreak and tracking confirmed cases of fungal meningitis, stroke due to presumed fungal meningitis, other central nervous system-related infection and peripheral joint infections.

As of November 16, the CDC reported there were confirmed cases in the following states:

State Case Count Deaths
Florida (FL) 23 3
Georgia (GA) 1 0
Idaho (ID) 1 0
Illinois (IL) 2 0
Indiana (IN) 55 5
Maryland (MD) 23 1
Michigan (MI) 158 8
Minnesota (MN) 13 0
North Carolina (NC) 3 1
New Hampshire (NH) 13 0
New Jersey (NJ) 31 0
New York (NY) 1 0
Ohio (OH) 17 0
Pennsylvania (PA) 1 0
Rhode Island (RI) 3 0
South Carolina (SC) 1 0
Tennessee (TN) 82 13
Texas (TX) 2 0
Virginia (VA) 50 2
TOTALS 480 33

The CDC said tainted steroid shots from the New England Compounding Center had also been distributed in California, Connecticut, Nevada and West Virginia.

Fungal Meningitis Symptoms

Meningitis is a life-threatening infection that has a number of causes, but which is usually caused by bacteria or a virus, the CDC says. Meningitis infections cause inflammation of the protective membranes covering the brain and spinal cord.

Fungal meningitis can develop after a fungus spreads through the bloodstream from somewhere else in the body, such after it is introduced directly into the central nervous system (i.e., via epidural injections). (It should be noted that these types of epidural shots are not the same as epidurals given to women in childbirth.)

Fungal meningitis cannot be transmitted from person to person. It is not contagious.

Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis, however they often appear more gradually and can be very mild at first, the CDC says.

Meningitis is characterized by sudden fever, headache and a stiff neck. It is often accompanied by additional symptoms, such as:

  • Nausea
  • Vomiting
  • Photophobia (sensitivity to light)
  • Altered mental status
  • People with fungal meningitis may also experience:
  • Confusion or other changes in mental status
  • Hallucinations
  • Personality changes

Fungal meningitis patients may suffer from only one or two of these symptoms, the CDC says.

Fungal meningitis is treated with lengthy courses of high-dose antifungal medications. Treatment is usually delivered by intravenous solution (IV) at a hospital.

Let Our Experienced Chicago Drug Injury Lawyers Help

The drug injury attorneys of Salvi, Schostok & Pritchard P.C., in Chicago are collecting evidence of patient injuries, including contracting fungal meningitis, after receiving tainted steroid injections manufactured and distributed by the New England Compounding Center of Framington, Mass., for back pain.

When a patient is harmed by faulty medications, a case of pharmacist malpractice, medical negligence or medical malpractice may exist. Depending on the circumstances, a pharmacy or pharmacist, clinicians, or other medical care providers are potential defendants in medical malpractice or medication error lawsuits that seek damages on behalf of patients harmed by medication errors or the family members of deceased victims.

Salvi, Schostok & Pritchard P.C., can evaluate the circumstances of your or your loved one’s injury or death if it followed a steroid injection administered for back pain between July and September 2012. Our medical negligence attorneys work with accredited medical experts to determine whether pharmacological and healthcare standards have been met, and will be able to advise you about the legal options available to you.

Please contact the medication error attorneys of Salvi, Schostok & Pritchard P.C., for a free, no-obligation consultation. Call our toll-free number or use our online contact form.

There are strict deadlines for filing medical malpractice lawsuits in Illinois and other states, so it is important to get a start on your case as soon as possible.

For nearly three decades, the attorneys of Salvi, Schostok & Pritchard P.C., have represented medication error victims from across Illinois, the Midwest and elsewhere across the country.