There are many lessons to be learned from the tragic death last summer of a cardiac patient at a Fredericksburg, Va., hospital, where bacterial contamination of an injected surgical solution is the suspected culprit. Paramount among these, however, is that the incident and others like it are entirely preventable (" Deaths spur debate about drugs made in pharmacies," Cover story, News, Tuesday).

Compounding by pharmacists — when best-practice standards for quality assurance, safety and efficacy are applied and adhered to — is instrumental in meeting the special needs of patients when commercially available products can't.

For more than 60 years, the American Society of Health-System Pharmacists has led medication-use improvements, including developing evidence-based practice standards and guidelines in the area of sterile and non-sterile compounding.

To further ensure the quality of compounded medications, it is imperative that pharmacists and pharmacy technicians be adequately trained and have sufficient facilities and equipment that meet technical and professional standards. When hospitals and other care settings outsource some aspects of pharmacy services, such as sterile compounding, those organizations and their pharmacy departments must share the accountability for patient outcomes stemming from all medication-related activities performed by contractors on- or off-site.

The onus should not fall solely on the hospital. The fact that Central Admixture Pharmacy Services, the business hired by the Virginia hospital to produce the cardiac surgery drug, is a Food and Drug Administration-registered facility suggests that a re-examination of the regulatory framework of commercial, large-scale operations that compound sterile products for hospitals is in order.

While the culprit in the tragic death of the cardiac patient is not yet definitively known, the merits of best practices and evidenced-based compounding are a well-established fact.