Kill Shot: A Shadow Industry, a Deadly Disease

by Jason Dearen

Overview

Now in paperback. 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 hero's, and the perpetrators—and the legal loopholes that allowed it to occur. Kill Shot forces a powerful but unchecked industry out of the shadows.

Product Details

ISBN-13:	9780593421352
Publisher:	Penguin Publishing Group
Publication date:	02/22/2022
Pages:	272
Sales rank:	501,658
Product dimensions:	5.40(w) x 8.20(h) x 0.80(d)

About the Author

Jason Dearen is an award-winning investigative journalist for the Associated Press and was a 2018-2019 Knight Science Journalism Fellow at MIT. His work appears regularly in hundreds of newspapers and websites, including The Washington Post, The Guardian, USA Today, and The New York Times. He has twice been nominated by the Associated Press for the Pulitzer Prize. Dearen grew up in California and attended the Columbia Graduate School of Journalism. He lives with his wife, a law professor.

Table of Contents

Author's Note ix

Prologue xi

Chapter 1 Patient Zero 1

Chapter 2 The Ferrari of Compounders 13

Chapter 3 A Slow-Moving Mass-Casualty Event 33

Chapter 4 Bulletproof 53

Chapter 5 Shadow Industry 71

Chapter 6 Six Confounding Cases 87

Chapter 7 A House of Cards 93

Chapter 8 October Deluge 109

Chapter 9 An Opportunistic Killer 131

Chapter 10 The Case of a Career 141

Chapter 11 The Hail Mary 151

Chapter 12 Depraved Indifference 167

Chapter 13 Trial 179

Epilogue 207

What to Ask Your Prescriber About Compounded Drugs 221

Acknowledgments 225

Notes 229

Index 247

Editorial Reviews

"If you like fast-paced forensic thrillers á la Kathy Reichs, you’ll love this tale of death and mayhem .... A harrowing, fast-paced tale of blind greed and sloppy science." —Kirkus, starred review

"A gripping journey... 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."—Library Journal, starred review

"This detailed account of how greed led to widespread suffering and death grips to the end."—Publishers Weekly

"This unnerving true tale is a crowd-pleaser for fans of true crime and medical mysteries."—Discover Magazine's Must-Read Science Books

"In the tradition of the best medical thrillers, Kill Shot is a riveting and harrowing tale of mysterious and lethal infections. But Jason Dearen's deeply researched book is more than just a good story—in the end, it's also a must-read indictment of our flawed pharmaceutical system and our embarrassingly inadequate regulatory response."—Deborah Blum, Pulitzer-Prize-winning author of The Poison Squad: One Chemist's Single-Minded Crusade for Food Safety at the Turn of The Twentieth Century

"A shocking scientific detective story that's impossible to put down. Jason Dearen's skill at unraveling a deadly tale of greed and corruption is matched only by his storytelling chops."—Seth Mnookin, New York Times bestselling author of The Panic Virus

"Kill Shot is a chilling and thrilling yarn that reads like a Michael Crichton medical mystery. The only problem? All of this actually happened, with so many innocent people killed and maimed. This is investigative reporting at its best—poignant, sharp, and powerful enough to catalyze outrage at our sadly broken healthcare system."—James Nestor, New York Times bestselling author of Breath: The New Science of a Lost Art

"Ever wonder whether the injectable drug you get at your doctor's office is safe? You'll be certain it isn't after reading Kill Shot, a chilling and indelible portrait of human greed, pharmaceutical mayhem and regulatory failure."—Katherine Eban, New York Times bestselling author of Bottle of Lies

"This fast-moving and important story reads like a thriller but is all too true. As Jason Dearen makes clear, it could happen again—and probably will, unless we find a way to finally bring strict oversight to a dark corner of the drug industry."—Dan Fagin, author of the Pulitzer Prize-winning Toms River

"Dearen unfolds his story like the murder mystery it sadly is. Kill Shot also is a post-mortem on a medical system gone alarmingly astray, told by a writer who is as skilled at storytelling as fact-gathering, and whose journalism helped expose the perpetrators."—Larry Tye, New York Times bestselling author of Demagogue: The Life and Long Shadow of Senator Joe McCarthy

"A shocking, fascinating, edge-of-your seat thrill ride, Kill Shot exposes the dark underbelly of American medicine. It's a must-read for anyone interested in the future of healthcare."—Matt McCarthy, MD, author of Superbugs: The Race to Stop an Epidemic

"Ace investigative reporting, meticulous science writing, and Agatha Christie suspense power Kill Shot, a potent exposé on the deadly consequences of greed and lax oversight in the drug industry. Dearen’s in-depth tale of how fungal meningitis spread from one compounding pharmacy to kill and maim Americans in multiple states is an indictment of self-regulation and a call to action to protect patients from even greater harm."—Cynthia Barnett, author of Mirage, Blue Revolution, and Rain: A Natural and Cultural History

From the Publisher

08/31/2020

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. (Oct.)

Publishers Weekly

★ 12/01/2020

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

Library Journal

★ 2020-07-28
A disturbing dive into a barely regulated area of the pharmaceutical industry.

If you like fast-paced forensic thrillers à 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.

Kirkus Reviews