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Kill Shot: A Shadow Industry, a Deadly Disease

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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 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.


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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 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.

30 review for Kill Shot: A Shadow Industry, a Deadly Disease

  1. 5 out of 5

    Christina

    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. 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.

  2. 4 out of 5

    JanB

    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 receive 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.

  3. 5 out of 5

    Marialyce (absltmom, yaya)

    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 a 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.

  4. 4 out of 5

    Kirsti

    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 occasi 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.

  5. 4 out of 5

    Rick Umali

    Kill Shot is a sprawling and comprehensive recounting of a man-made fungal outbreak, a deathly illness originating from a single company in Framingham, Massachusetts. Jason Dearen explores multiple angles on this nation-wide medical disaster and it is riveting. It is frightening that compounding pharmacies are out there producing medicines largely unregulated. The sections of the book interviewing advocates for more regulation is compelling to me, especially because if compounders make mistakes Kill Shot is a sprawling and comprehensive recounting of a man-made fungal outbreak, a deathly illness originating from a single company in Framingham, Massachusetts. Jason Dearen explores multiple angles on this nation-wide medical disaster and it is riveting. It is frightening that compounding pharmacies are out there producing medicines largely unregulated. The sections of the book interviewing advocates for more regulation is compelling to me, especially because if compounders make mistakes or cut corners, people die. I can easily picture the type of non-descript corporate building that the New England Compounding Center (NECC) operates from. The author explains the history and economics of the compounding pharmacy industry. There is real demand for specialized drugs not made by Big Pharma that must be made from scratch by a pharamcist's hand. The motivation for NECC's unchecked production: lavish lifestyles by owners and executives, which translated into producing drugs at all costs. Some of the shortcuts taken by management to meet safety requirements and fulfill orders is incredible. There were over 100 people who died because of the fungal-contaminated drugs from NECC. These drugs caused fungal meningitis, which rendered patients gravely ill and at death's door in a matter of days. Dearen explain fungal science and why it's so virulent if it enters the body. The potential for more deaths was always present. Urgent and methodical detective work identified NECC as the source for the bad drugs. The sections describing the work of the CDC and local agencies charged with keeping people safe is inspiring. The book culminates in a courtroom in Boston. Dearen reveals how a complicated case is built step-by-step, from both the prosecutor's and defendant's point of view. Fans of "A Civil Action" (Jonathan Harr) will have much to absorb and enjoy here. His presentation in this section is even-handed, which heightened the suspense for the verdict. There's a crime here, but Dearen's book convinces me that the real crime is compounding drug companies still operate as a shadow industry.

  6. 5 out of 5

    Pakinam

    An immensely powerful and terrifying story of how two pharmacists compounded a drug that unleashed a deadly fungal microbe and ended up killing over 100 Americans. Jason Dearen spotlights the tragedy and the people at the heart of it in this incredible and eye-opening investigation. The storytelling is intense, intriguing, disturbing and the reporting thorough and masterful. The book skillfully tracks the complex web of failures and loopholes that allowed this to happen (showing, in my opinion, h An immensely powerful and terrifying story of how two pharmacists compounded a drug that unleashed a deadly fungal microbe and ended up killing over 100 Americans. Jason Dearen spotlights the tragedy and the people at the heart of it in this incredible and eye-opening investigation. The storytelling is intense, intriguing, disturbing and the reporting thorough and masterful. The book skillfully tracks the complex web of failures and loopholes that allowed this to happen (showing, in my opinion, how this tragedy was in many ways, almost inevitable, but also repeatable). The theme has implications for this era. And the crime resonates with a post-COVID world where the lack of regulatory oversights, deeply fragile health infrastructures, corporate greed and moral failure have taken lives and profoundly altered others.

  7. 5 out of 5

    Barb

    This is the scariest book I have ever read. No contest. This about an outbreak of human fungal meningitis that was caused by a compounding pharmacy that made methylprednisolone (used in epidural steroid injections for back pain) not following standard protocols, clean room protocols, etc. So this drug was infected in the lab where it was made and then injected into the spinal column of unsuspecting patients. Since you spinal fluid is sterile, the "germs" or fungus just multiplied causing abscess, This is the scariest book I have ever read. No contest. This about an outbreak of human fungal meningitis that was caused by a compounding pharmacy that made methylprednisolone (used in epidural steroid injections for back pain) not following standard protocols, clean room protocols, etc. So this drug was infected in the lab where it was made and then injected into the spinal column of unsuspecting patients. Since you spinal fluid is sterile, the "germs" or fungus just multiplied causing abscess, strokes, paralysis, and death. There are many compounding pharmacies in the US and they are not regulated by the FDA. Some have voluntarily chosen to have the FDA to inspect them. They are probably the reputable ones. Those that have not, I would be very, very afraid.

  8. 4 out of 5

    Susan

    Are you among the millions who have been prescribed injections at a pain clinic? Do you know of any premature babies receiving IV meds? Are you anticipating cataract eye surgery? Have you watched as nurses administer meds through your or your loved ones IV tubes? This is stunning investigative reporting on a major loophole in America's pharmacy industry laws that have the public in grave danger. Greed, graft, and politicians on the take seem to be the drivers. Public Health & other scientists ha Are you among the millions who have been prescribed injections at a pain clinic? Do you know of any premature babies receiving IV meds? Are you anticipating cataract eye surgery? Have you watched as nurses administer meds through your or your loved ones IV tubes? This is stunning investigative reporting on a major loophole in America's pharmacy industry laws that have the public in grave danger. Greed, graft, and politicians on the take seem to be the drivers. Public Health & other scientists have been sounding the alarm for decades. The book provides a valuable list of question to ask YOUR health provider BEFORE you schedule procedures. To reach your US Congressional and Senate reps call: 202-224-2131

  9. 4 out of 5

    Vicki Elia

    An excellent chronicle of the compounding pharmacy disaster in 2013 by NECC of Boston. The 758 cases of rare fungal meningitis resulted in 69 deaths and lifetime disability for many others. Reading like a work of fiction, the horror of this story is all too true. Congress has typically turned a blind eye to the industry. Every member of Congress should read this story. Those that haven't been paid off by lobbyists will stand horrified and may finally act to eliminate this loophole from FDA regul An excellent chronicle of the compounding pharmacy disaster in 2013 by NECC of Boston. The 758 cases of rare fungal meningitis resulted in 69 deaths and lifetime disability for many others. Reading like a work of fiction, the horror of this story is all too true. Congress has typically turned a blind eye to the industry. Every member of Congress should read this story. Those that haven't been paid off by lobbyists will stand horrified and may finally act to eliminate this loophole from FDA regulation. The next time you are to receive a surgical injection, ask the simple question: is this medication or injectable FDA approved? If not, who did it come from?

  10. 5 out of 5

    Ngaio

    A compelling and tightly woven story about a reckless, unregulated industry. Every time I think I've become numb to the horror stories from the American health care industry, I end hear a new tale and discover that it gets worse. Yikes. Dearen's skilled prose balances the corporate cover-up and the CDC sleuthing with the real people whose lives this ruined. The book never loses sight of the human cost amongst the weeds of legal loopholes and politics. 4.5 stars. I will probably read it again. A compelling and tightly woven story about a reckless, unregulated industry. Every time I think I've become numb to the horror stories from the American health care industry, I end hear a new tale and discover that it gets worse. Yikes. Dearen's skilled prose balances the corporate cover-up and the CDC sleuthing with the real people whose lives this ruined. The book never loses sight of the human cost amongst the weeds of legal loopholes and politics. 4.5 stars. I will probably read it again.

  11. 5 out of 5

    Mjdrean

    I vaguely remember this heartbreaking event. But whoa Nellie, what a travesty. I was never aware, though, of drug compounding companies. They were and still are not under the purview of the FDA or CDC. They did and still do operate with impunity, despite killing hundreds and leaving thousands of others crippled or blind for the rest of their lives. This isn't a very long book, but it is packed to the gills. Like so many examples in life, the rich owners got away with little more than a slap on t I vaguely remember this heartbreaking event. But whoa Nellie, what a travesty. I was never aware, though, of drug compounding companies. They were and still are not under the purview of the FDA or CDC. They did and still do operate with impunity, despite killing hundreds and leaving thousands of others crippled or blind for the rest of their lives. This isn't a very long book, but it is packed to the gills. Like so many examples in life, the rich owners got away with little more than a slap on the wrist.

  12. 5 out of 5

    Mónîcā

    This book is absolutely wild. First, it’s a medical thriller. Second, it is truly. HORRIFYING. It’s gross. It’s so squicky I physically recoiled reading it. And I cried. It’s so, so awful that over a hundred people died because of such a wide variety of failures. And it was so frustrating to see at the end of the day that corrupt lawmakers chopped real change off at the waist so that this can potentially happen again.

  13. 4 out of 5

    Melanie

    I decided to read this book amidst the current pandemic we all facing. Just to have some insight as to what these big pharma companies are really upto. I am a studious kind of gal and the pros and cons matters, so i can make informed decisions basically about anything that transpires in my life. I found this book to be fascinating, interesting and most of all thought provoking.

  14. 4 out of 5

    Bob Adams

    This book frightened me more than any story written by Stephen King (or any other writer of that genre) because, not only is the horror real, but also because it is ongoing and unabated as I write this. I shudder every time I think about it. I see this book as Exhibit A of how broken our government is when it comes to protecting our well-being.

  15. 5 out of 5

    Del

    Gripping and shocking true story about compounding pharmacies. Well researched and written. Reads like a thriller. Really opened my eyes because I new nothing about these pharmacies. Everyone needs to know about this.

  16. 5 out of 5

    Martha Evans

    A must read for any pharmacist and just fascinating in general. Overall, great reporting, and I really enjoyed the human element. I did however feel it was slightly biased against the compounding pharmacist.

  17. 5 out of 5

    Alicia Mesa

    If you already mistrust the government and the medical industry this book will validate your concerns. If you don’t have time for the book then watch American Greed on CNBC Season 13 Episode 10: Painful Greed Turns Deadly.

  18. 5 out of 5

    Lori Swanson

    Very well written, I understood the characters ...thrilling sad could not put the book down

  19. 4 out of 5

    Magnus Mortensen

    This reads like a crime novel but is a true story which only makes it that much more scary!

  20. 5 out of 5

    Tad Panther

    Incredible, unbelievable story. Beautiful, fast-paced writing. Reading for second time right now. Highly recommended.

  21. 4 out of 5

    Penny

    Must read for anyone contemplating epidural steroid injections for pain. Or any procedure involving drugs made by compounding pharmacies. Beware all consumers!

  22. 4 out of 5

    S B

    Riveting story of a public health disaster told in real-time through parallel narratives. Nonfiction medical thriller meets the best of accountability journalism. Highly recommended.

  23. 5 out of 5

    UnicornMurphy

    Great but also terrifying read. I'd never heard of drug compounders before this book. Great but also terrifying read. I'd never heard of drug compounders before this book.

  24. 5 out of 5

    Richard

    you will be wary of compounded drugs and lobbyists after reading this.

  25. 4 out of 5

    Heather

    Scary as any horror novel. Great reporting.

  26. 4 out of 5

    Kevin

    highly recommended nonfiction

  27. 4 out of 5

    Justin

    Frightening.

  28. 5 out of 5

    Surika

    Recommend to any pharmacy student to understand the dangers of negligence in compounding pharmacies

  29. 5 out of 5

    Merry

    Couldn't put it down! I can't believe this is Dearen's first book. I am now in the process of checking all my prescriptions (both of them...LOL) to see where they were processed. Couldn't put it down! I can't believe this is Dearen's first book. I am now in the process of checking all my prescriptions (both of them...LOL) to see where they were processed.

  30. 5 out of 5

    Amanda

    This reads like a thriller but it’s sadly and terrifyingly real. Everyone should read this book. Up there with Bad Blood for amazing non fiction

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