Second Meningitis Death Linked To Contaminated Shots WALNUT CREEK, Calif. (AP) --

A second death has been linked to a batch of shots contaminated with meningitis, and officials say up to 60 people may have been injected with the tainted cortisone solution.

An elderly man who received a shot mixed at Doc's Pharmacy in Walnut Creek died last week after contracting meningitis. Autopsy results reveal the man died from the spinal injection, said Dr. Wendel Brunner, director of public health for Contra Costa County.

A 47-year-old Concord man also died from meningitis, a swelling of the brain and spinal cord, May 30, 24 hours after receiving a shot for lower back pain.

Health officials have said the medicine was contaminated with the bacteria that causes meningitis when Doc's Pharmacy prepared it in less than sterile conditions.

Twelve people have been hospitalized for serratia infections linked to the tainted medication. Four of those patients contracted serratia meningitis, including the two who died, and a fifth patient contracted a serratia infection of the blood.

-- PHO (owennos@bigfoot.com), June 13, 2001

Answers

[Comment: Just to clarify, the bacteria involved in this product- contamination problem are _Serratia_, an unusual cause of meningitis and in this case spread directly by injection of the tainted medication. This is totally different from, say, the over-reaction in Ohio recently which involved _Neisseria menigitidis_ bacteria which is spread from person to person. It is unfortunate that the press reports are not making this distinction clear. --Andre]

Headline: Pittsburg [California] clinic also got contaminated medicine

Source: Contra Costa Times, 13 June 2001

URL: http://www.contracostatimes.com/news/leads/stories_one/meningitis_2001 0613.htm

A widening investigation of cortisone contamination spread to a Pittsburg clinic Tuesday as Contra Costa health officials said as many as 60 people may have been treated with the bad medicine.

Meanwhile, health officials linked a second death to the cortisone solution, which was mixed at Doc's Pharmacy in Walnut Creek. Test results showed the elderly man contracted meningitis from an epidural injection he received from the tainted batch of betamethasone, said Dr. Wendel Brunner, director of public health for Contra Costa County.

Brunner said the scope of the investigation grew Tuesday after lab tests showed vials of contaminated medicine were recovered from a Pittsburg orthopedic clinic and a Concord surgery center.

None of the medicine recovered in Concord was administered to patients, but Brunner said health officials are concerned additional exposures could have occurred at Diablo Orthopedics in Pittsburg, where eight vials of the steroid medication were removed from shelves last week.

Officials are in the process of contacting 22 people who received injections at the clinic from May 17 to June 4. Although it's likely that only a few, if any, of these patients were administered contaminated drugs, Brunner said all will be given antibiotics as a precaution.

Twelve people have been hospitalized so far for serratia infections linked to the tainted medication. Four of these patients contracted serratia meningitis, including the two who died, and a fifth person has a serratia infection of the blood.

Investigators think all the infections are linked to a batch of medicine that was compounded by a pharmacy technician at Doc's on May 17, Brunner said.

The infections all occurred in patients who received injections at the Sierra SurgiCenter in Walnut Creek.

Brunner said 10 vials of betamethasone were taken from the Diablo Surgery Center in Concord from the center's shelves before they were used.

In all, investigators have grown serratia bacteria from 12 unopened vials taken from the three facilities, a fact that Brunner said leaves little doubt as to the source of the contamination.

"We are now sure that the source of the contamination is Doc's Pharmacy," Brunner said.

Robert Horwitz, the owner and chief pharmacist at Doc's, declined comment Tuesday. Last week, he suggested that his business was being made a scapegoat for the serratia outbreak.

The state Board of Pharmacy, which licenses about 6,000 pharmacies in California, is continuing its probe of Doc's. Spokeswoman Virginia Herold said the board has asked Doc's to stop compounding all sterile medications, a request the pharmacy is honoring.

Herold said the probe could result in action against Horwitz' pharmacy license.

-- Andre Weltman, M.D. (aweltman@state.pa.us), June 13, 2001.