Kill Shot

Starred review from August 15, 2020
A disturbing dive into a barely regulated area of the pharmaceutical industry. If you like fast-paced forensic thrillers � la Kathy Reichs, you'll love this tale of death and mayhem, from the opening exhumation to the final courtroom drama. But in this story, rendered with panache by Associated Press investigative journalist Dearen, the culprit is not a fictitious evil genius but rather an ambitious and greedy entrepreneur named Barry Cadden, who ran the daily operations at New England Compounding Center, which customized "medicines for special-needs patients." Such companies face little regulation, which can lead to tainted medications. In 2012, the NECC's fungus-laced drugs led to the awful deaths of 100 people and made another 693 terribly ill. Cadden and his pharmacist sidekick, Glenn Chin, cut every conceivable corner in their dirty "clean rooms" and worked all the loopholes that allow compounders to sell drugs under the regulatory radar. Then they went well beyond mere loopholes. To add famed Mass General Hospital to their client list, they paid a $5,000-per-month bribe to a pharmacy staff member, who "steered orders for a variety of drugs NECC's way." The business was humming along until a fungus called Exserohilum rostratum contaminated 17,675 vials of a powerful pain-killing steroid shipped to 76 hospitals and clinics around the nation--and patients started dying. Dearen crafts a tight, vivid narrative based on thousands of public documents and transcripts, 150 interview sources, and reporting in eight states. He swings the spotlight among the drug makers, the victims, the Center for Disease Control and Prevention's medical detectives, and the federal attorneys who finally charged Cadden and Chin with racketeering and homicide. The climax of the trial proves anticlimactic: not guilty on the more serious charges. However, if a case in Michigan "is allowed to proceed to trial, both pharmacists could be back in court facing life sentences in late 2020." A harrowing, fast-paced tale of blind greed and sloppy science.

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August 31, 2020
In this sobering debut, investigative journalist Dearen charts the 2012 fungal meningitis outbreak that killed 100 people across America. Barry Cadden was the corrupt president of the New England Compounding Center, a company that created drugs for individual patients per doctor prescriptions. By taking illegal shortcuts, putting fake names on fake prescriptions, and selling mass amounts to hospitals and pain clinics, he was able to take the company from $5 million in profits to $50 million in under a decade. In 2012, NECC shipped 17,675 vials of an infected steroid to 23 states. The steroid was mostly used for patients with back pain and injected into the spinal cord. There the fungus would grow and cause devastating symptoms and usually death. As the CDC raced to find the cause of the outbreak, Cadden lied to investigators and was later charged, along with the company’s chief pharmacist, with racketeering and murder by the U.S. Attorney’s office. They were convicted of racketeering but not murder, with Cadden getting a nine year sentence, and the chief pharmacist eight. Dearen lays out the facts in straightforward prose. This detailed account of how greed led to widespread suffering and death grips to the end. Agent: Danielle Svetcov, Levine Greenberg Rostan Literary.

Starred review from December 1, 2020

Tom Rybinski, a 55-year-old father of three from Tennessee, was diagnosed with fungal meningitis in 2012. Dr. April Pettit of Vanderbilt University Medical Center identified the potential cause as originating from an epidural steroid injection. Rybinski was patient zero in what turned out to be the worst public health crisis caused by a pharmaceutical drug in U.S. history, as 76 facilities received contaminated drugs resulting in 793 infected people and a final death tally of over 100--the result of contaminated medication produced and distributed by the New England Compounding Company (NECC). Award-winning investigative journalist Dearen's exploration of the tragic events takes readers on a gripping journey, with patient narratives interspersed with stories of those who work at the NECC. Dearen also examines the largely unregulated pharmaceutical industry, showing how the challenge of ensuring the safety of these drugs has escaped federal oversight, and fallen to individual states. VERDICT Informative and engrossing, this book is a page-turner about a deadly outbreak and a reckless compounding pharmacy. Recommended for fans of true-life medical thrillers.--Ragan O'Malley, Saint Ann's Sch., Brooklyn

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