This photo provided Oct. 9, 2012, by the Minnesota Department of Health shows shows vials of the injectable steroid product made by New England Compounding Center implicated in a fungal meningitis outbreak that were being shipped to the Centers for Disease Control and Prevention in Atlanta from Minneapolis. (Associated Press - Ap/The Minnesota Star Tribune)

Minnesota health officials have learned that 129 clinics throughout the state purchased drugs from the Massachusetts firm linked to a deadly national meningitis outbreak.

It's not clear how many patients received drugs made by the company, New England Compounding Center (NECC), which is now under investigation for selling contaminated steroids.

But there are indications that it may involve hundreds more people, at a minimum, in Minnesota alone.

The list of clinics, which was provided by federal investigators, gives state officials the first clear picture of how widely the company's products were used throughout the state.

The Minnesota Department of Health plans to contact each clinic to warn them of "a potential risk of meningitis or other infections," Richard Danila, the deputy state epidemiologist, said Tuesday.

On Monday, the U.S. Food and Drug Administration warned that several of the company's drugs may have been contaminated, not just the batches of injectable steroids implicated in the meningitis outbreak.

Already, Minnesota clinics have begun scouring records for patients who may have been affected.

At Associated Eye Care in Stillwater, for example, officials have identified 559 patients who received NECC products since May, said spokeswoman Elizabeth Bradshaw. She said the clinic used four of the company's medications, including an injectable drug, at its Ambulatory Surgery Center. "We will be notifying all patients," Bradshaw said, and advising them to watch for possible symptoms of infection.

Big medical groups involved

Although the Health Department has not yet released the complete list of clinics, some of Minnesota's largest medical groups have acknowledged that they were customers of NECC, a specialty pharmacy that sold drugs nationwide.

Fairview Health Services said about 250 patients received one of the drugs on the latest FDA alert, a heart surgery medication called cardioplegic solution. "We are reaching out to patients who received this," said spokesman Ryan Davenport. "We apologize to patients who may be impacted by this. We'll continue to keep them informed as we learn more."

The FDA has not positively linked any of the other drugs to a specific illness, but said its investigation raised concerns about the safety of a second steroid, the heart drug, and all the company's injectable drugs, including those used in eye surgery.

Checking patient records

Essentia Health in Duluth said it had purchased two types of injectable drugs from NECC -- hyaluronidase and cardioplegia -- and plans to contact all affected patients. "We're in the process of determining how many patients that will impact," said spokeswoman Kim Kaiser.

St. Luke's Hospital in Duluth reported that it too bought injectable drugs from NECC, and removed them from stock when the products were recalled in late September. "St. Luke's is currently working to identify any patients who received these drugs," said Mary Greene, the hospital spokeswoman.

Other clinics said they were checking their records.

"If we find that any of our patients have been given any of these medications, we will follow the FDA's advice regarding patient notification and follow up," said David Kanihan, a spokesman for Allina Health.

As of Tuesday, 231 cases of meningitis, two joint infections and 15 deaths have been linked nationally to the company's steroids, which were contaminated with fungal infections. Minnesota has had five confirmed cases but no deaths.

Nearly 1,000 Minnesotans received spinal injections with the steroid linked to the infections.

Maura Lerner • 612-673-7384 Paul McEnroe • 612-673-1745