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In addition, mats on which people wiped their shoes to remove contamination before entering a sterile environment were “visibly dirty and soiled with assorted debris,” she said. And a leaking boiler adjacent to a pharmacy clean room left an unsanitary pool of water around it and the adjacent walls, she said.

As the investigation continues, Patrick’s moves to increase oversight at the state’s 25 compounding pharmacies have started.

The first of the unannounced inspections, to take place at least annually, was done on Tuesday, health department spokesman Alec Loftus said. He wouldn’t give the inspected facility’s name and said the results are being reviewed.

Patrick also said compounding pharmacies will now be required to file annual compliance reports that could help regulators determine if they are acting as manufacturers.

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Associated Press reporter Bob Salsberg contributed to this report.