Tainted Drugs and Deadly Infections
How federal prosecutor Amanda Masselam Strachan ('98) brought rogue pharmacists to justice.
Photos by Michael D. Spencer
Tainted Drugs and Deadly Infections
How federal prosecutor Amanda Masselam Strachan (’98) brought rogue pharmacists to justice.
Ideally, Amanda Masselam Strachan’s mind would be blissfully empty during her Saturday morning hot yoga classes. But it rarely is. While moving through poses, she is balancing phrases for closing arguments, weighing one against another. The overarching argument needs to be sound, but even the right words and phrases are crucial.
“When you’re trying to persuade a jury that your view of the case is the right one, it’s great if you can talk about it in really simple, straightforward ways,” she says. “People don’t like to be sold to. I think the worst thing you can do is come across as inauthentic.”
Authenticity is a Strachan hallmark, colleagues say, though her quest for plainspokenness is regularly challenged by the complexity of her work. As chief of the healthcare fraud unit for the US Attorney’s Office in Boston, Strachan (’98) oversees criminal healthcare fraud enforcement in Massachusetts.
She supervises 15 prosecutors who probe criminal wrongdoing by individuals—such as healthcare providers who fraudulently bill Medicare and hospice nurses suspected of stealing patients’ morphine—and fraudulent activity by healthcare corporations and pharmaceutical companies.
Strachan, whose work is rarely high-profile, found herself taking a star turn after scores of patients around the country became seriously ill with fungal meningitis in 2012. All had received injections of what was supposed to be a sterile steroid to relieve back and joint pain. The Centers for Disease Control and Prevention tracked the tainted drug to the New England Compounding Center (NECC) in Framingham, Mass.
Investigators from the US Food and Drug Administration found that the compounding pharmacy’s “clean room” was contaminated with bacteria and mold, and the staff had falsified records and used expired ingredients. Nearly 800 patients across 20 states who had received injections became sick, and of those, more than 100 died. The healthcare crisis prompted the passage of the Drug Quality and Security Act in 2013 to impose tighter controls over compounding pharmacies. During her two-year investigation, Strachan traveled the country to interview patients debilitated by fungal meningitis. “The awareness of the suffering of the victims throughout the investigation had a profound effect on me,” she says. “It was a case of a lifetime. It changed me forever.”
When you’re trying to persuade a jury that your view of the case is the right one, it’s great if you can talk about it in really simple, straightforward ways. People don’t like to be sold to. I think the worst thing you can do is come across as inauthentic.
‘Completely Spun Out of Control’
The US Attorney’s Office in 2014 indicted 14 former NECC employees, alleging criminal intent by knowingly producing contaminated and otherwise substandard drugs. “They were only interested in getting as much drug out as quickly as possible,” Strachan says, “and they were financially rewarded for it until the place completely spun out of control.” Six employees were charged with racketeering, which for two defendants included 25 counts of second-degree murder in seven states as predicate racketeering actions under the Racketeer Influenced and Corrupt Organizations (RICO) Act.
Strachan and her team immersed themselves in compounding pharmacy law, the exacting standards for clean rooms, regulatory issues, and the excruciating symptoms of fungal contamination. They combed more than 10 million pages of evidence and more than 1.2 million emails generated to and from the NECC’s owners and employees, as well as victims’ medical records.
Strachan and co-counsel George Varghese obtained convictions for every defendant except one through four guilty pleas and four federal trials. The first and most closely watched was a two-and-a-half-month marathon in 2017 against NECC’s former owner and head pharmacist, Barry Cadden. He was convicted of 57 counts of racketeering, racketeering conspiracy, and other crimes. But in a bizarre twist, the jury incorrectly completed the verdict form: rather than tick “guilty” or “not guilty” for 25 racketeering acts of second-degree murder, the jurors instead listed their tallies. The judge interpreted the divided votes as acquittals.
“I felt like we’d been robbed,” Strachan says. “I knew that there were some jurors who were with us. You sit in front of a jury for 10 weeks, and you know when they are with you. But you’re powerless in this situation. I felt like the victims didn’t get the benefit of a unanimous jury verdict on the murders.”
Commitment and Compassion
Varghese, who worked with Strachan for seven years at the US Attorney’s Office, says she blends a fierce commitment to justice with deep compassion for victims. Those traits were embodied in the totems she tucked in the lectern before closing arguments: a Captain America action figure from one of her sons and a small ornamental cardinal, the favorite bird of Effie Shaw, a North Carolina victim.
Strachan impressed juries by deftly weaving victims’ heartbreaking stories into a compelling narrative and “translating” microbiology and pharmacology for a lay audience, he says. The trials were the culmination of months of research and investigation, which for Strachan included “the incredibly painstaking work” of matching CDC data with records from state departments of public health to identify victims, says Varghese, a partner in WilmerHale’s Boston office.
The NECC crimes received extensive media coverage. TV host and commentator John Oliver devoted an episode of his show to NECC and the lack of oversight of compounding pharmacies. So did CNBC’s true-crime series American Greed. A book about the scandal, Kill Shot, will be published in February 2021.
Despite the prominence of the investigation, the publicity had no effect on Strachan’s down-to-earth demeanor, says Miranda Hooker, a former colleague and longtime friend. “She is an incredibly genuine, capable lawyer and just incredibly kind and competent—and a ferocious advocate,” says Hooker, a partner at Troutman Pepper in Boston.
Before working at the US Attorney’s Office, Hooker and Strachan were colleagues at Hale & Dorr (now WilmerHale). Strachan joined after law school, attracted by Hale & Dorr’s strong white-collar defense practice. In 2007, after the birth of the first of her three boys, she moved to the US Attorney’s Office to gain a different perspective.
Counterfeit Masks and Fake Ads
Recently, Strachan has been tapped to oversee investigations into coronavirus-related price gouging, financial and healthcare fraud, phony antiviral products, and counterfeit medical-grade masks. She is also a frequent panelist at compliance forums, sharing insights on enforcement trends and best practices.
She credits her background in defense and prosecution with helping her strike the right balance between enforcing the law and respecting pharmaceutical companies’ drive to innovate. “When you’re looking at corporate wrongdoing in this sector, you have to remember, maybe you find evidence of a crime here, but what else does this company do?” she says. “What drugs does this company make that are important to keep on the market? How many jobs would be lost if we bring charges against this company? With the discretion that we have as prosecutors, it’s very important that it be wielded carefully.”
