The latest victim of what health officials are calling a 'rapidly evolving outbreak' of rare fungal meningitis was a dedicated child care worker who spent 20 years tending to a husband suffering from Lou Gehrig's disease.

Diana Reed died on Wednesday afternoon at St Thomas Hospital in Nashville, Tennessee, surrounded by family members.

Mrs Reed, 56, is one of thousands of patients recently treated in Tennessee hospitals for back pain with a steroid epidural - a fairly typical treatment. But since then a tainted batch of steroids released across the U.S. has been linked to dozens of cases of fungal meningitis.

The injectable steroids responsible for Reed's death were produced by New England Compounding Center, a specialized pharmacy in Framingham, Massachusetts. The company has shut down operations and said it is working with regulators to identify the source of the infection.

It is not clear how many patients received tainted injections, or even whether everyone who got one will get sick.

Officials are still investigating how the steroid resulted in fungal meningitis.

 

New England Compounding Center released a statement promising to work with heath authorities to discover what happened. But company president and licensed pharmacist Barry J. Cadden has otherwise dodged interview requests and the company web site is down. 

An archived version of the site notes the company is licensed to distribute drugs in every U.S. state. 

New England Compounding Center is among the approximately 3,000 U.S. compounding pharmacies specializing in blending, liquefying, or combining medicines customized for patients unable to swallow tablets, require specific dosages, or who have allergies. 

Such companies are regulated by the state boards of pharmacy that license them rather than facing the broader regulations traditional drug companies deal with.

The pharmacy has produced questionable products before. In 2006, New England Compounding Center was one of four companies ordered by the the Food and Drug Administration to cease producing a topical anesthetic cream that was found to cause 'grave reactions including seizures and irregular heartbeats.' 

The cream was the cause of two deaths, neither tied directly to New England Compounding Center. 

That same year the company was also cited for multiple violations of federal laws and regulations based on a 2004 review of its offices. They were charged with misbranding drugs prescribed for eye treatment, misbranding an anesthetic drug and failing to provide adequate directions for its use, and promoting the use of a cancer drug for an unapproved purpose.

An FDA warning letter admonished the company that it was 'distributing an unapproved drug in violation' of federal regulations.