BOSTON – In the biggest criminal case ever brought in the U.S. over contaminated medicine, 14 former owners or employees of a Massachusetts pharmacy were charged Wednesday in connection with a 2012 meningitis outbreak that killed 64 people.

The nationwide outbreak was traced to tainted drug injections manufactured by the now-closed New England Compounding Center (NECC) of Framingham.

Barry Cadden, a co-founder of the business, and Glenn Adam Chin, a pharmacist who was in charge of the sterile room, were hit with the most serious charges, accused in a federal racketeering indictment of causing the deaths of 25 patients in seven states by "acting in wanton and willful disregard of the likelihood" of death or great bodily harm.

Among other things, Cadden, Chin and others are accused of using expired ingredients, failing to properly sterilize drugs and failing to test them to make sure they were pure. The other defendants, including Douglas and Carla Conigliaro, were charged with such crimes as criminal contempt, fraud and interstate sale of adulterated drugs.

U.S. Attorney Carmen Ortiz said NECC was "filthy" and failed to comply with even basic health standards, and employees falsified logs on when labs were cleaned.

"Production and profit were prioritized over safety," Ortiz said.

Conigliaro

More than 750 people in 20 states were sickened — about half of them with a rare fungal form of meningitis, the rest with joint or spinal infections — and 64 died. The steroids given were for medical purposes, not for bodybuilding; most patients received the injections for back pain.

Roughly 1,000 Minnesotans received steroids from the contaminated lots. Twelve Minnesotans suffered fungal infections after receiving NECC's contaminated steroids at pain clinics in the Twin Cities, according to the Minnesota Department of Health. Ten consequently contracted meningitis, while two others suffered infections in their bones or bone marrow. All survived but reported a variety of lingering complications including pain, dizziness and flu-like symptoms.

A lawsuit filed by one of the victims, Traci Maccoux, 24, is scheduled for a jury trial in March. Maccoux sued Medical Advanced Pain Specialists, or MAPS, where she received two injections of tainted steroids in 2012 that caused her to be hospitalized for 10 days. Her hospital bills reportedly exceeded $110,000 and she dropped out of college.

In reaction to the outbreak, Congress last year increased federal oversight of so-called compounding pharmacies like NECC, which custom-mix medications in bulk and supply them directly to hospitals and doctors.

Linda Nedroscik of Howell, Mich., said her husband, John, survived the tainted injection, but the 64-year-old "still struggles, has nightmares."

Chin's lawyer, Stephen Weymouth, said he was stunned that prosecutors charged his client with second-degree murder under the racketeering law. "He feels hugely remorseful for everything that's happened — for the injuries and the deaths — but he never intended to cause harm to anybody," Weymouth said.

After the outbreak came to light, regulators found a host of potential contaminants at the pharmacy, including standing water, mold and dirty equipment. NECC filed for bankruptcy after it was bombarded with hundreds of lawsuits.

Assistant U.S. Attorney Stuart Delery said the defendants showed "not only a reckless disregard for federal health and safety regulations, but also an extreme and appalling disregard for human life."

Staff writer Jeremy Olson contributed to this report