Certified pharmacy technician Elizabeth Davis makes flavored troche pills at the Medical Center Compounding Pharmacy in Cleveland, Tenn., one of three in the state that is nationally certified.

When inspectors described what they found inside a Massachusetts compounding pharmacy linked to a national fungal meningitis outbreak, Cindy Smith made her pharmacy staff read the report.

They read about mold and bacteria in two "clean rooms" that were supposed to be sterile. They read about labeling errors that made it difficult to tell sterile and nonsterile ingredients apart. They read details about "yellow residue" and "green residue" and other unknown foreign substances on various pieces of equipment.

The U.S. Food and Drug Administration report made for a difficult read, but one that Smith felt was necessary.

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