Stacey Barchenger

USA TODAY NETWORK – Tennessee

Joan Peay of Nashville is 76 years old, but she'll tell you she feels 86 and looks 86 because of two bouts with meningitis in 2012 and 2013.

"The whole month of October 2013 my family thought I was going to die," she said. "And I was so sick I wish I would’ve. I thought heaven would have been a better place."

Peay was one of about 750 people nationwide sickened by fungal meningitis attributed to tainted steroid injections made by a Massachusetts pharmacy in 2012. Seventy-six people died in the outbreak, according to an investigation by the U.S. Food and Drug Administration.

Now, after a lengthy federal probe and two years of legal battling, Peay and other victims are anxiously watching as the first pharmacy executive goes to trial on criminal charges.

Facing a jury is Barry J. Cadden, the director of the New England Compounding Center who is charged with 25 counts of second-degree murder connected to deaths in seven states and other crimes. He and 13 other company executives and pharmacists were indicted in 2014.

Opening statements are scheduled to begin Monday in federal court in Boston. The trial is before U.S. District Judge Richard G. Stearns. Twelve jurors who were chosen last week will decide the case, and there are three alternates who also will hear the evidence. Cadden's lawyer and federal prosecutors declined to comment on the trial.

Federal prosecutors say Cadden and other pharmacy executives did not follow regulation and procedure in preparing the medicine methylprednisolone acetate, leading to more than 10,000 tainted doses.

Michigan was hardest hit by the outbreak, with 264 illnesses and 19 deaths, according to the Centers for Disease Control and Prevention. Tennessee was the second-hardest hit state, with 153 illnesses and 16 deaths. The CDC's data was last updated in October 2015.

Among the violations alleged by prosecutors that led to that toll: using expired ingredients, failing to sterilize the medicine and ignoring indications there was mold in the rooms where medicines were made. Prosecutors say the pharmacy executives knew the potential consequence of those actions was death.

Want more details? Read the full indictment at the end of this story.

Not surprisingly, Peay agrees.

"We just feel like they knew what they were doing, and they just went ahead and did it," she said. "They knew tainted shots would hurt people, if not kill them. They just turned their backs because they were in it for the money.

"We hope they go to jail for the rest of their lives."

If convicted on all counts, Cadden could face a life term, according to a 2014 news release announcing the indictment from the U.S. Department of Justice.

It's likely the defense will focus on Cadden's role in the outbreak, on his job as an administrator and distancing him from other executives facing charges. Court records show that Cadden does not dispute that the outbreak was caused by NECC's medications.

As recently as December, Cadden was supposed to go to trial with another defendant, Glenn Chin. Chin was the company's supervisory pharmacist who oversaw the rooms where the drugs were compounded, court documents say. The judge's Dec. 15 order says the joint trial could not happen because their defenses might infringe on the other's right to a fair trial, indicating perhaps they might try to blame the other person. Chin will now stand trial after Cadden.

While there have been delays in the criminal case, most of the flurry of civil cases filed against the pharmacy have been resolved as part of a $200 million settlement. A few cases against medical facilities that prescribed the tainted steroids also are pending.

"This is the deadliest catastrophe in the history of modern medicine," said Mark Chalos, a lawyer at Lieff, Cabraser, Heimann & Bernstein in Nashville who has represented the victims.

"The stricken patients and families who lost loved ones take some comfort in knowing that those responsible for making the contaminated medication will be held accountable by a jury," he said. "The criminal trials are an important step. There remains more work to be done to hold all the wrongdoers accountable, by juries in civil and criminal courts."

Peay suffered hearing loss as a result of the second infection, and still deals with the back pain that led her to seek medical treatment in the first place.

She considered attending the trial but will not because of her back, which she said cannot withstand the punishing hard courtroom benches for hours, let alone days or weeks.

In a grandmotherly soft tone, her voice shatters into sobs when she describes the lasting impact of the infections. Still, she also perkily describes how life has gotten back to normal after her illness: her involvement in church, volunteering as a chaplain and at a food bank and a gig answering phones for the American Red Cross' disaster assistance.

"I just feel that you should do what you can in life to help people," she said. "This fungal meningitis has curtailed that, but it hasn't stopped me."

READ MORE:

Patients told of partial payments in meningitis outbreak (March 2016)

Fungal meningitis victims to share $200 million (May 2015)

Lawsuit: Bargain shopping allowed meningitis tragedy (Feb. 2015)

Two face murder charges in meningitis outbreak (Dec. 2014)

FBI questions meningitis victims (July 2014)

Deaths, infections tied to compounding drugs (March 2013)

FDA finds more bad drugs from Mass. company (Nov. 2012)

Chances to avert meningitis outbreak possibly missed (Nov. 2012)

Meningitis cases up to 198, deaths to 15 (October 2012)

By the numbers

More than 750 people nationwide were sickened by tainted steroids traced back to Massachusetts-based New England Compounding Center, according to the U.S. Centers for Disease Control and Prevention. The Food and Drug Administration put the death toll at 76. The CDC reported 64 deaths in the following states as of October 2015:

19: Michigan

16: Tennessee

11: Indiana

7: Florida

5: Virginia

3: Maryland

1 each in Ohio, North Carolina and Minnesota

Source: U.S. Centers for Disease Control and Prevention website

Tennessee civil cases

Several Tennessee medical centers that prescribed the steroid were sued after the outbreak. The case alleged Saint Thomas Outpatient Neurosurgical Center and other facilities in that health network negligently brought the tainted drugs to Tennessee while trying to cut costs.

Federal court records indicate a settlement was reached in the case in September. The terms of the agreement are not public. Mark Chalos, a Nashville lawyer representing the victims, and Chris Tardio, a Nashville lawyer who represented the medical facilities, each said they could not comment on the settlement.

Ten cases against another Tennessee facility, Specialty Surgery Center in Crossville, and staff there were dismissed by a judge in November, court records say, but there are still claims pending against that facility in federal court.

Reach Stacey Barchenger at 615-726-8968 or on Twitter @sbarchenger.