Bigby: Pharmacy, Lower-Level Staffers To Blame For Public Health Debacles

Dr. JudyAnn Bigby, Mass. secretary of health and human services

As hearings on the meningitis outbreak get under way today on both Beacon Hill and Capitol Hill, WBUR’s Deborah Becker aired an incisive interview on Morning Edition today with Dr. JudyAnn Bigby, the Massachusetts Health and Human Services Secretary.

The full sound file is here, but let me highlight one of the sharper moments. Toward the end, Deborah Becker asked the same essential question in several ways: Who, really, is responsible for these two major recent public health debacles in Massachusetts, the state crime drug lab scandal and the meningitis outbreak that emanated from a Framingham pharmacy that fell so incredibly through the state regulatory cracks?

What Deborah didn’t ask explicitly, but that I hear some people wondering sotto voce, is: Are you responsible, Secretary Bigby? If the widely respected public health commissioner, John Auerbach, had to resign over the state crime lab scandal, at what point does the buck stop with you?

In the interview, Dr. Bigby notes that the state board of pharmacy was the only entity that was truly responsible for overseeing the Framingham compounding pharmacy that produced the tainted drugs, and she says efforts are under way to improve the board and its inspections.

“Right now, we are in the field doing unannounced inspections of pharmacies, and we believe that in the future, that this is a necessary step to make sure that there is further oversight of the pharmacies.”

DB: And what would you say to the folks who say, ‘Yes, now you’re doing inspections but did it take 32 deaths and several complaints against this compounding pharmacy?’

JB: I think that is a very appropriate question. This travesty is one of the worst disasters in health care that I can remember that was preventable, and I do believe the NECC operated under conditions where they not only violated state and federal laws but they also violated their own practices. and we need to make sure that this never happens again.

DB: So if you’re looking at this, who’s responsible for the failure here? Is it a systemic failure?

JB: Well, I think we need to remember that NECC is responsible for these deaths, and for producing these contaminated medications. There does need to be a stronger system of oversight of these compounding pharmacies, and we will be developing recommendations to build on the emergency regulations that we have already passed here on Nov. 1 to make sure that we have an appropriate system in place so that this will never happen again.

DB: At the same time, there was the state drug lab scandal, which the Department of Public Health was also involved with. Some are suggesting that both of these huge scandals show an agency in trouble…

JB: The drug lab scandal is still under investigation and more information will come to light about that. [Chemist] Annie Dukhan clearly acted in an irresponsible way and that is without question. I do believe that the supervision of the lab and her actions was inadequate, and the people responsible for that lack of supervision have been relieved of their duties.

DB: So in both of these instances, the responsibility really was with lower-level staff members and they and their supervisors have been disciplined, and the state is taking corrective action in both cases. That would that be correct to say?

JB: That is correct.

 

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