Lyn Laperriere, a retired automobile industry worker living in Michigan, was having back pain in the fall of 2012 when he received a dose of steroids produced at the former New England Compounding Center in Framingham.
Lapperiere was a drag racer and was looking forward to the winter bowling season. But a week after receiving the shot he checked into a hospital. Forty-two days later, his wife Penny Laperriere agreed to take him off life support. He was 61.
“We did everything together,” Penny Laperriere recalled. “So when he passed away, life for me came to a screeching halt too.”
More than two and a half years after NECC recalled all of its products after steroids the compounding pharmacy produced were linked to a nationwide meningitis outbreak, some financial relief may finally be on its way for the relatives of the 64 who died and the 750 who were sickened as a result of receiving injections of the tainted drugs.
A federal bankruptcy judge on Tuesday indicated he would approve a $200 million settlement to compensate NECC’s creditors, including victims of the outbreak.
‘There’s Been No Financial Help’
Penny Laperriere, who’s now 58, couldn’t afford to keep the house she’d shared with her husband. She had an auction to sell off the couple’s things and moved close to her sister. She’s received lots of bills, but no money to help with what became the deadliest case of contaminated medicine the country’s history.
“That’s the hard part, there’s been no financial help for me or any of the patients who are still living with this,” she said.
Laperriere started a support group for victims of fungal meningitis who’ve had to cash in retirement funds, file bankruptcy and still face mounting medical bills. Patients and those who lost loved ones will file claims for a share of the $200 million settlement beginning next month. Laperriere has no idea what to expect.
“Anything I get will be a gift,” she said. “I’m not expecting much because there are so many hands in the pot.”
Laperriere says she’s been warned that lawyers’ fees and liens from hospitals and insurers who provided care will eat up a good deal of the settlement. But lawyers who negotiated the agreement say it’s much better than they expected after looking at just the insurance and assets of the pharmacy owners.
“Many people thought there would be no way to craft together a fund, let alone a $200 million fund that would start paying back or compensating victims for their injuries and their loss,” said David Molton, an attorney with the law firm Brown Rudnick.
Victims Want More Accountability For NECC Owners
About $50 million of the settlement comes from former pharmacy owners. The rest of the $200 million is from organizations that contributed to avoid liability, including a clinic that administered the shots and a company that cleaned the compounding pharmacy.
Many victims and survivors are angry that they have suffered while the owners of the pharmacy have not been held accountable and are, in some cases, still living in their homes.
Attorney Bruce Singal offered a statement on behalf of New England Compounding Center’s former co-owner and head pharmacist Barry Cadden.
“No such statement can convey the profound sense of sadness Barry feels about these tragic events,” Singal said. “He can only hope that the settlement confirmed today can give the victims some small measure of comfort from the terrible suffering they have endured.”
Cadden and 13 other former employees or investors in the pharmacy are awaiting trial on criminal charges. They pleaded not guilty when arraigned last year.Related:
A Massachusetts bankruptcy judge gave verbal approval for a $200 million settlement plan for victims of a national meningitis outbreak linked to the New England Compounding Center, the Boston Business Journal reports.
At least 64 people died, and over 750 were sickened due to tainted steroids from the NECC, according to the CDC.
A news release from lawyers involved in the case says that payouts to victims and other creditors could start before the end of the year:
Judge Henry J. Boroff of the United States Bankruptcy Court for the District of Massachusetts today said he would approve the Chapter 11 Plan of New England Compounding Center (“NECC”), the compounding pharmacy involved in a deadly national meningitis outbreak. Under the confirmed Plan, approximately $200 million will be available to compensate NECC’s creditors, including victims who became ill or died as the result of receiving an injection of the tainted steroid. Over 98% of creditors that voted on the Plan voted to accept the Plan…
The Plan establishes a Tort Trust for compensating those persons that have suffered personal injury and/or death due to allegedly contaminated drugs compounded by NECC.
The Tort Trust will be funded by the proceeds of the Trustee’s settlements with NECC’s shareholders, various clinics and health care providers that administered NECC drugs, and companies that had business relationships with NECC. Those parties will receive releases from NECC-related liability, as well as injunctions in aid thereof, in exchange for their substantial contributions. The Trustee and the Committee anticipate that distributions to victims from the Tort Trust may commence before the end of the year.
The Centers for Disease Control estimates that at least 751 people nation-wide have been diagnosed with fungal meningitis or other serious injuries as a result of the administration of NECC products. At least 64 deaths have been confirmed.
Paul Moore, the Chapter 11 Trustee of NECC and a partner at the law firm of Duane Morris LLP, which also serves as his counsel, said: “My principal mission since the day I was appointed was to recover as large a sum as possible for the benefit of those who died or suffered serious injuries as a result of this tragic outbreak. I am pleased to have succeeded…”
Stay tuned for a more detailed report by WBUR’s Martha Bebeinger later today.
Living in the nation’s capital can make one rather jaded. Another presidential inauguration – another day of clogged metro and closed streets! The Cherry Blossom Festival – the cherry blossoms are always beautiful – but again the traffic is horrendous. But last Friday, May 8th, I witnessed a flyover of 15 World War II aircraft formations which were organized to commemorate the 70th anniversary of end of the War in Europe. The planes flew down the Potomac River, past the Lincoln Memorial, and down Independence Avenue. Standing at the corner of C and 2nd Streets, just outside the Madison Building, I was able to witness this awe inspiring and touching sight. The drone of the airplane engines reminded me of the World War II English and American fighter pilot movies I’ve watched, but also made real for me the sounds that would have signaled destruction for so many citizens throughout Europe and the Pacific during the six years of the war.
The flyover was organized to commemorate the German surrender to the Allies. On May 8, 1945, in Reims, German General Alfred Jodl signed an instrument of unconditional surrender. The document of surrender is quite short and states in part:
We the undersigned, acting by authority of the German High Command, hereby surrender unconditionally to the Supreme Commander, Allied Expeditionary Force and simultaneously to the Soviet High Command all forces on land, sea, and in the air who are at this date under German control. The German High Command will at once issue orders to all German military … to cease active operations at 2301 hours Central European time on 8 May and to remain in the positions occupied at that time.
This surrender was followed in 1946 by the Paris Peace Conference where the Allies met and negotiated a series of treaties which readjusted the map of Europe and set monetary reparations. Jodl himself was eventually tried and executed in 1946 by the International Military Tribunal at Nuremberg.
Though there was rejoicing at the end of the War, the horrors of the Holocaust and Hitler’s extermination camps were revealed as the Allies advanced into German territories. Even as we commemorate the end of World War II each May, we are also encouraged to commemorate Jewish American Heritage Month. Although this month may provide an opportunity to celebrate the achievements of Jewish Americans, the annual presidential proclamations also remind us of the many incidents of prejudice against Jewish Americans throughout history, as well as the unparalleled suffering of those caught up during World War II.
By Dr. Isaac Chan
Hers was the face of someone defeated by cancer. Our conversation was grim. She wanted to “fight,” to continue treatment. But there were no more options.
I vaguely remember speaking, feeling hopelessly ill-equipped. I, too, felt defeated. As a young physician and aspiring oncologist, I wondered: How do we prepare ourselves and our patients for these conversations?
Thankfully, I am not alone in struggling with this question. A new theme in medicine has emerged: How to talk about dying. As a field, oncology has been at the forefront of this movement. Some suggest making exposure to end-of-life encounters mandatory during medical school. Others stress creating systems and providing more resources for patients and doctors to encourage earlier planning for death.
But in order to facilitate and advance this difficult conversation, we must first change the very words we use to discuss cancer.
When the National Cancer Act was signed in 1971, our nation’s political and social will was focused on a “war on cancer.” Our widespread use of this language is rooted in a propagandist history promoting the belief that, with enough resources, this is a conflict we will win. Consequently, victory became defined only by “defeating cancer,” or finding a cure.
A visit to the American Cancer Society website asks you to join the “fight against cancer;” and a majority of public cancer-related media is packed with more war imagery. While the war description of cancer has resulted in unprecedented attention and fundraising for cancer care, research and survivorship, a balance should be reached between these successful efforts and language that is a realistic assessment of what can be accomplished today, for the patient, right now.
Cancer is a unique disease. To take the war analogy further, cancer is not a foreign agent infiltrating our bodies, such as an infection — cancer is a coup d’état, a tumorous growth from within us. One of the great paradoxes of cancer treatment is that targeting cancer inevitably means targeting our own bodies.
Yet because we conflate cancer and conflict, physicians and patients often find themselves in the midst of an unintentional civil war, fighting for life to the very end. We have inadvertently created a culture where death is considered a failure, and life extension equals life.
It’s time we changed our rhetoric. Words affect perception, and for some patients, a “cure” is not always an achievable goal. Choosing words that no longer focus on cancer’s destruction gives patients and physicians the freedom to engage in discussions about other treatments such as palliative care, removing the suspicion that any course other than “fighting to live” somehow means “giving up.”
So how do we make this change? As with most things in medicine, it begins with the patient.
Once faced with a cancer diagnosis, the physician’s temptation is to start the patient down a pre-determined path of treatment. Instead, we should take a step back before pursuing the details of what to do next. A recommended but not often used script is to first ask the patient: What do you understand about your illness and what do you want to know? Who among your friends and family can provide support? What are your goals in life – both short- and long-term?
And while it creates a sense of camaraderie, we should avoid phrases such as “we will fight this” or offer vague hope. Rather, I caution patients with advanced cancer that therapy may be the life-saving option currently helping them achieve their goals, but there may come a time in the future when additional medical therapy will actually impede their enjoyment of life. This is akin to the technique of framing discussions in a way to hope for the best but prepare for the worst.
Physicians can guide patients through these discussions by involving palliative care specialists, whose role is to improve quality of life through symptomatic and psychosocial support. This support ranges from treating pain, insomnia, and anxiety to addressing spiritual needs and helping patients understand their disease and cope with related stress. Engaging their services soon after a cancer diagnosis has been shown to not only consistently improve survival, but also health literacy and other disease-associated outcomes, such as depression. Studies show that these effects even extend to patient caregivers.
However, a barrier to more use of palliative care is the misconception that palliative care and hospice are one and the same, that accepting palliative care means “surrendering” to the disease. While hospice focuses on end-of-life comfort, palliative care provides support throughout the spectrum of illness, from diagnosis to death. Once this concept is explained, palliative care is often more easily embraced.
The result of having these exchanges and involving palliative care early in the course of the disease is to break the false dichotomy between cure and failure. This strategy broadens the patient’s and physician’s ability to receive and provide care. But these are very difficult conversations and are filled with fear and anxiety. How does one address a patient who feels terrified when told to “prepare for the worst?” It is crucial for a physician to normalize these conversations, perhaps by saying “I discuss this with all my patients who face a serious diagnosis,” and then to provide reassurance that their patient will receive comprehensive medical care, whether it is curative, palliative, or both.
As physicians grow to embrace a more holistic view of cancer treatment, the public discourse surrounding death and disease must also evolve. Online tools such as “Let’s Have Dinner and Talk About Death” are a step in the right direction. Ending the “war on cancer” is another.
Let’s stop the talk of battles and instead raise awareness by celebrating the remarkable stories of those who succumbed to cancer and those who are currently living with cancer. As one of my patients eloquently told me, “Death is not a threat but the condition that maximizes my life.” Our medical interventions, while powerful, are not the only way to maximize life. And partnering with my patients to figure out how is the best part of my job.
Isaac Chan, MD, PhD, is a resident in General Internal Medicine at Boston Medical Center.