At least 10 local pain patients who were unknowingly injected with a tainted steroid medicine have gone through often-painful spinal taps since Friday in Columbus and Greenwood to check for deadly fungal meningitis, according to Dr. Drew Robertson.
Robertson, of Columbus’ Wellspring Pain Solutions, spoke with The Republic on Monday evening about the local component of a national outbreak that federal health officials say has killed 11 people and sickened 119 across 10 states. Wellspring is among six clinics in Indiana that got a shipment of the tainted medicine.
All of the local tests have come back negative, but Robertson said physicians will continue to follow patients closely with strict instructions of signs to watch for in coming weeks. Fungal meningitis can appear up to 90 days after an infection.
“They probably are in the clear,” Robertson said. “The vast majority of our patients so far are not having any symptoms that are worrisome.”
Robertson said 309 patients, about one-fourth of Wellspring’s total number of regularly scheduled patients, were given shots from a tainted batch of methylprednisolone acetate — a common pain medicine — shipped from the specialty New England Compounding Center Inc. in Framingham, Mass.
The Wellspring staff in Columbus began contacting patients Friday for follow-up visits and to make sure patients knew the signs of fungal meningitis: severe headaches, nausea, sensitivity to light, and severe neck stiffness.
“We have seen no one yet that we believe actually has fungal meningitis,” Robertson said after he, Dr. Arman Borhan and a physician’s assistant had seen 77 patients Monday. On a normal day, Wellspring medical professionals see 45 to 50 people, he said.
After getting two painkiller shots of tainted steroid medicine this summer, Stephanie Nienaber figures her health is in someone else’s hands: God’s.
And because of her Christian faith, the 40-year-old Elizabethtown resident said she cannot be angry with doctors at Wellspring who gave her the shots, unaware the medicine could have contained a fungus known as aspergillus.
Nienaber got a shot in her spine in July and again in September to fight back pain she thinks could be the beginning of rheumatoid arthritis, which runs in her family. She said she feels as badly for her doctors as anyone in this situation.
“I could see the worry in their eyes,” she said, referring to Robertson and Borhan during a free office visit Monday. “You could tell they were very concerned.”
Nienaber and her husband, David, have followed the news — and prayed.
“I’d be lying if I said I wasn’t a little worried,” said Nienaber, off on fall break from her job in the cafeteria at White Creek Lutheran School. “But my faith has kept me from being a basket case.”
She said she could tell some other patients in the Wellspring waiting room on Monday were angry. She said she understood their emotion but added that she cannot afford such.
“I have to set an example for my three kids,” she said, referring to Sammy, 7; Holly, 11; and 17-year-old Austin. “If I’m mean and vindictive and all mad about this, what’s that going to teach them?
“At this point, it’s certainly not going to help anything.”
Nienaber said she already thought of every possibility and is at peace as much as can be expected.
“If I die,” Nienaber said, “I know I’ll be going to a better place.”
Robertson said fungal meningitis is rare enough that listing a cure rate with antibiotics is difficult. He also said he’s uncertain that additional regulations could have prevented the infection at the pharmacy that has since stopped production.
“The truth is, now that we’re very aware of it, we should be able to see it stopped,” Robertson said. “But it’s kind of like firefighters fighting a wildfire. You’ve got to get it encircled before you can stop it. And I think we’re getting it encircled.”
On Monday, Wellspring still was giving shots of methylprednisolone acetate, but they were manufactured by a different pharmacy. He said those new-shot patients didn’t seem worried, “but they were more careful to ask more questions.”
Robertson said he could not recall how much unused medicine was returned to the compound pharmacy but added: “We had used a fair amount.”
Robertson said the heavy patient load probably would continue through next week, until all 309 patients who got the medicine have been seen. Some of them got injections in the spine while others got shots in various joints.
“I believe this is simply a fluke,” Robertson said. “I don’t know how else to say it. I think any knowledgeable person will come to the same conclusion.”
Bartholomew County Health Officer Dr. Brian Niedbalski said he will get involved only if a meningitis case is diagnosed and the Indiana Department of Health brings him into the matter.
- Fungal meningitis is treated with long courses of high-dose antifungal medications, usually given through an intravenous line in the hospital.
- The length of treatment depends on the status of the immune system and the type of fungus that caused the infection.
- For people with immune systems that do not function well because of other conditions, such as diabetes or cancer, treatment is often longer.
Source: U.S. Centers for Disease Control and Prevention