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Compounding Disaster - July 2016 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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1-year probation contingent on an independent evaluator's assessment of its compliance. As NECC and the board bantered back and forth, an FDA inspector showed up at NECC, along with 2 representatives from the state phar- macy board, prompted by a complaint from a competing manufactur- er about a substance called Trypan Blue, a dye used in cataract and heart procedures. The inspectors confirmed that NECC did have a new set of written procedures for compounding. However, when the FDA inspector asked Mr. Cadden questions about compounding Trypan Blue, he "became indignant" and said he didn't have time to answer questions. When asked whether he had Trypan Blue in stock, Mr. Cadden said no. The investigators then discovered 189 vials of the substance in a drawer in the clean room. In all, the Massachusetts board investigated 8 complaints against NECC between 1999 and 2004 for unprofessional conduct, unethical conduct and failure to adhere to the standards of practice. Never did the board deliver more than a slap on the wrist. The agency did not return phone calls for this story. In a 2006 report, the independent evaluator the board hired wrote that NECC had made "significant improvements" but still had a long way to go to be in compliance with USP standards. The firm needed better documentation, needed to actually follow procedure, needed to do adequate sterility testing and needed to do a total redesign of Clean Room 1 (floor, ceiling, HVAC). Mr. Cadden agreed to replace the HVAC, but suggested the other improvements weren't needed. Apparently that was enough for the state pharmacy board. It agreed that he had satisfied the terms of the consent agreement. Meanwhile, the FDA continued its pursuit. A 2004 inspection revealed that NECC was manufacturing drugs in volume, without indi- 1 4 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 6

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