RX Tech May Have Forgotten Key Ingredient

By Walter F. Roche Jr.

Boston- A former pharmacy technician acknowledged in court testimony today that he may have forgotten to include a key ingredient, a pain killer, in drugs he prepared for injection into the eyeballs of patients under treatment at a famed treatment facility.
"I assume I made a mistake," Cory Fletcher told jurors hearing the criminal case against six of his former colleagues at the New England Compounding Center, the company blamed for a deadly nationwide 2012 fungal meningitis outbreak.
Testifying in U.S. District Court as a prosecution witness under an immunity agreement, Fletcher said that as the outbreak approached he and his colleagues were told the emphasis was on getting drugs out while safety and sanitation concerns were secondary.
Fletcher said that the problem with the eye block came just months before the meningitis outbreak, when patients at the Massachusetts Eye and Ear Infirmary complained of a burning sensation in their eyes following injections. The shots preceded cataract surgery or other eye treatments.
Fletcher said that when word first surfaced a few weeks later that a Tennessee patient, who had been injected with an NECC steroid, had been diagnosed with fungal meningitis production abruptly stopped.
All employees were ordered to begin a clean up, especially in the clean room where Fletcher worked preparing the suspect spinal steroid, methylprednisolone acetate.
Under questioning by Assistant U.S. Attorney Amanda Strachan, Fletcher said that the cleanup was just as suddenly halted and production began again. But it was shortly after that when all NECC employees were summoned to a meeting where a temporary closure was announced. It soon became permanent.
Clean out your lockers, Fletcher said he and other employees were told at the meeting in early October.
Strachan led Fletcher through a series of NECC internal documents, including those for the preparation of a cancer treatment drug that had expired in 2007, but was relabeled to indicate it had yet to expire.
He said that less than the normal amount of fluid was added to the methotrexate powder to make it appear more potent than it actually was.
He said when another expired drug was about to be used, someone went into the company compounder and changed the expiration date.
One by one, Strachan led Fletcher through documents showing some of the defendants were involved in approving expired or untested drugs. One document even showed the initials of two defendants on paperwork approving the same drug.
The drugs were then shipped to health providers from Massachusetts to Illinois, the records showed.
Asked what happened when environmental tests showed bacteria or mold in his clean room, Fletcher said nothing was done.
Under cross examination by defense lawyer Mark Pearlstein, Fletcher acknowledged that after the mistake with the eye block was discovered, he went right back to producing more of the same drug.
Fletcher acknowledged that he had little to do with Pearlstein's client, Joseph Evanosky, a pharmacist who worked alone in a clean room corner producing parenteral drugs containing controlled substances.
He also agreed that he did not recall discussing the use of expired drugs with Evanosky or defendants Christopher Leary or Gene Svirskiy.
Fletcher acknowledged that Evanosky was quiet, did not participate in the verbal and physical horseplay with other clean room workers and was "a good guy."
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