A five-month state investigation of a mysterious hepatitis C outbreak has failed to determine conclusively how a Timonium pharmacy infected 16 people with the disease.
However, a summary of the findings released yesterday by the Maryland Department of Health and Mental Hygiene did cast suspicion on a tainted blood sample.
The probe focused on a single contaminated vial of radioactive tracer prepared by the Timonium pharmacy Oct. 15. The tracer was sent out to three area clinics for use in routine cardiac stress tests. The tracer is typically injected into the patient's bloodstream, where doctors can chart its flow.
All 16 people who received the tracer later tested positive for hepatitis C. One recipient, a 79-year-old retired Brooklyn Park ironworker, died. His death certificate listed the virus as the cause of death, family members said.
State health officials said yesterday that no other cases of hepatitis C are expected to be linked to the contaminated tracer, which was prepared at a so-called nuclear pharmacy operated by Ohio-based Cardinal Health. After a request from state officials, the pharmacy voluntarily closed in December.
A Cardinal spokesman said yesterday that the company is reviewing the state's report and has not decided whether to reopen the pharmacy.
While they could not determine exactly how the tracer became contaminated with hepatitis C, state epidemiologists noted in their report that the day before the tracer was prepared, technicians at the pharmacy processed a blood sample that contained hepatitis B, hepatitis C and the human immunodeficiency virus. The pharmacy had been unaware that the blood was infected. According to the investigation report, genetic tests conducted by the Centers for Disease Control and Prevention in Atlanta showed that the hepatitis C virus in the blood sample was similar to the virus found in the tracer.
However, state investigators said yesterday that because nearly a month had elapsed between the preparation of the radioactive tracer and the onset of the hepatitis C outbreak, all the materials used to process the tracer had been discarded.
Investigators, therefore, cannot say conclusively that the infected blood contaminated the tracer. According to the report, the 16 people who became infected with the virus included 14 men and two women. They ranged in age from 45 to 81 years old and lived in Anne Arundel, Harford, Cecil and Baltimore counties.