10/09/2012

The woman who stood up to Paterno

Vicky Triponey, former head of student affairs at Penn State, is photographed on Friday, July 13, at The College of New Jersey, where she's now interim director of student affairs.Vicky Triponey, former head of student affairs at Penn State, is photographed on Friday, July 13, at The College of New Jersey, where she's now interim director of student affairs.
As the vice president who oversaw student discipline at Penn State, Triponey often clashed with head coach Joe Paterno over who should discipline football players.As the vice president who oversaw student discipline at Penn State, Triponey often clashed with head coach Joe Paterno over who should discipline football players.
Triponey experienced firsthand the clubby, jock-snapping culture, the sense of entitlement, the cloistered existence. It's what drove her from her job five years ago. She was told she was too aggressive, too confrontational, that she wasn't fitting in with "the Penn State way." Triponey experienced firsthand the clubby, jock-snapping culture, the sense of entitlement, the cloistered existence. It's what drove her from her job five years ago. She was told she was too aggressive, too confrontational, that she wasn't fitting in with "the Penn State way."
Triponey agrees with former FBI Director Louis Freeh's suggestion that the university's trustees lead an effort to "vigorously examine and understand" that culture, why it's so resistant to outside perspectives and why it places such an "excessive focus on athletics." Triponey agrees with former FBI Director Louis Freeh's suggestion that the university's trustees lead an effort to "vigorously examine and understand" that culture, why it's so resistant to outside perspectives and why it places such an "excessive focus on athletics."
"The culture is deep," she told CNN. "The culture is making decisions based on how others will react, not based on what's right and wrong." "The culture is deep," she told CNN. "The culture is making decisions based on how others will react, not based on what's right and wrong."
"It's comforting to know that others can now understand," Triponey said. "It didn't have to happen this way." "It's comforting to know that others can now understand," Triponey said. "It didn't have to happen this way."
  • Vicky Triponey spoke to investigators in their probe of the Jerry Sandusky scandal
  • She was one of few who stood up to legendary Penn State coach Joe Paterno, and she lost her job
  • She was called too aggressive, too confrontational and not a good fit with "the Penn State way"
  • She often clashed with Paterno over who should discipline football players

(CNN) -- Vicky Triponey knows all too well the power Penn State's late football coach, Joe Paterno, held for more than half a century over the insular slice of central Pennsylvania that calls itself Happy Valley.

She experienced firsthand the clubby, jock-snapping culture, the sense of entitlement, the cloistered existence. It's what drove her five years ago from her job as the vice president who oversaw student discipline.

She was told she was too aggressive, too confrontational, that she wasn't fitting in with "the Penn State way."

She clashed often with Paterno over who should discipline football players when they got into trouble. The conflict with such an iconic figure made her very unpopular around campus. For a while, it cost Triponey her peace of mind and her good name. It almost ended her 30-year academic career.

Another person might have felt vindicated, smug or self-righteous when former FBI Director Louis Freeh delivered the scathing report on his eight-month investigation of the Jerry Sandusky child abuse scandal. But Triponey sensed only a deep sadness.

Former Penn State football coach Joe Paterno died on January 22. He was 85. The legendary coach, seen here in 1988, was fired in November 2011 during his 46th season at the helm of the Nittany Lions program.Former Penn State football coach Joe Paterno died on January 22. He was 85. The legendary coach, seen here in 1988, was fired in November 2011 during his 46th season at the helm of the Nittany Lions program.
The statue of Paterno outside Beaver Stadium is among many vestiges of Paterno's years as head coach.The statue of Paterno outside Beaver Stadium is among many vestiges of Paterno's years as head coach.
Paterno sprints off the field with his team at halftime in a 1996 game.Paterno sprints off the field with his team at halftime in a 1996 game.
Paterno celebrates after winning the Fiesta Bowl against Texas in 1997. Paterno was diagnosed with a treatable form of lung cancer, his son announced in November.
Paterno celebrates after winning the Fiesta Bowl against Texas in 1997. Paterno was diagnosed with a treatable form of lung cancer, his son announced in November.
In October 2001, Paterno is honored before a game for having won the most games in Division 1-A. He continued to vie with Florida State's Bobby Bowden for the most all-time major college wins until Bowden retired in 2009.In October 2001, Paterno is honored before a game for having won the most games in Division 1-A. He continued to vie with Florida State's Bobby Bowden for the most all-time major college wins until Bowden retired in 2009.
Paterno and his Nittany Lions look on before facing Iowa at Beaver Stadium in State College, Pennsylvania, in October 2004.Paterno and his Nittany Lions look on before facing Iowa at Beaver Stadium in State College, Pennsylvania, in October 2004.
Paterno shakes hands with Lloyd Carr of Michigan before their game in 2005 in Ann Arbor, Michigan.Paterno shakes hands with Lloyd Carr of Michigan before their game in 2005 in Ann Arbor, Michigan.
Paterno celebrates a triple-overtime Orange Bowl win over Florida State in Miami on January 3, 2006. Paterno has guided his teams to more bowl victories than any other college coach.Paterno celebrates a triple-overtime Orange Bowl win over Florida State in Miami on January 3, 2006. Paterno has guided his teams to more bowl victories than any other college coach.
Paterno speaks at a post-game press conference after winning the Outback Bowl on January 1, 2007, in Tampa, Florida.Paterno speaks at a post-game press conference after winning the Outback Bowl on January 1, 2007, in Tampa, Florida.
Paterno walks the field as his players warm up before their game against the Syracuse Orangemen at Beaver Stadium in September 2009 in Pennsylvania. The coach was fired in November amid the outcry over the handling of accusations against former defensive coordinator Jerry Sandusky.Paterno walks the field as his players warm up before their game against the Syracuse Orangemen at Beaver Stadium in September 2009 in Pennsylvania. The coach was fired in November amid the outcry over the handling of accusations against former defensive coordinator Jerry Sandusky.
Paterno gives direction to his players before playing the Crimson Tide in Alabama in 2010.Paterno gives direction to his players before playing the Crimson Tide in Alabama in 2010.
Paterno walks the sidelines in October 2009 in Evanston, Illinois. In December 2011, he was admitted to a hospital after fracturing his pelvis when he slipped and fell at his home in State College.Paterno walks the sidelines in October 2009 in Evanston, Illinois. In December 2011, he was admitted to a hospital after fracturing his pelvis when he slipped and fell at his home in State College.
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
Paterno as Penn State coach
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Photos: Paterno as Penn State coachPhotos: Paterno as Penn State coach
Following the firing of Penn State's legendary football coach Joe Paterno and the school's president, hundreds of students take to the streets in State College, Pennsylvania, early Thursday, November 10.Following the firing of Penn State's legendary football coach Joe Paterno and the school's president, hundreds of students take to the streets in State College, Pennsylvania, early Thursday, November 10.
Police try to control students in the street after what started as an apparent celebration of Paterno turned raucous.Police try to control students in the street after what started as an apparent celebration of Paterno turned raucous.
The crowd tipped over a news van and decried the media.The crowd tipped over a news van and decried the media.
Pennsylvania State Police disperse students along East College Avenue in the early morning hours Thursday.Pennsylvania State Police disperse students along East College Avenue in the early morning hours Thursday.
Paterno was ousted over a child sex abuse scandal at the university. Paterno was ousted over a child sex abuse scandal at the university.
Students visit the Joe Paterno statue adjacent to Beaver Stadium to quietly honor the legendary coach following the announcement that he was fired.Students visit the Joe Paterno statue adjacent to Beaver Stadium to quietly honor the legendary coach following the announcement that he was fired.
Students pass the mural at the College Bookstore where the portrait of Jerry Sandusky, the former coach accused in the scandal, has been removed and replaced with a blue ribbon.Students pass the mural at the College Bookstore where the portrait of Jerry Sandusky, the former coach accused in the scandal, has been removed and replaced with a blue ribbon.
"What can I say, I'm no longer the coach," Paterno told about 15 students gathered outside his house late Wednesday night. "It's going to take some time to get used to. It's been 61 years.""What can I say, I'm no longer the coach," Paterno told about 15 students gathered outside his house late Wednesday night. "It's going to take some time to get used to. It's been 61 years."
Penn State students take to the streets
Penn State students take to the streets
Penn State students take to the streets
Penn State students take to the streets
Penn State students take to the streets
Penn State Paterno statue
Penn State students take to the streets
Penn State students take to the streets
Penn State students take to the streetsPenn State students take to the streets

The inquiry, commissioned by the board of trustees, exposed how the personal failings of Paterno and three other Penn State leaders -- along with the university's football-first culture -- empowered an assistant football coach who molested fatherless boys for more than a decade.

"There's no joy," Triponey told CNN as she sat down for an interview Friday, the day after the Freeh report was released. She said she found solace in the public recognition of Penn State's "culture of reverence for the football program," as the report phrased it, and that it is "ingrained at all levels of the campus community." Freeh found that the culture contributed to the Sandusky scandal.

Penn State community still admires Paterno, wants to move forward

She agrees with Freeh's suggestion that the university's trustees lead an effort to "vigorously examine and understand" Penn State's culture, why it's so resistant to outside perspectives and why it places such an "excessive focus on athletics."

"It's comforting to know that others can now understand," Triponey said. "It didn't have to happen this way."

Her former boss at Wichita State University described Triponey as "a dedicated, ethical professional" who was devastated by her experience at Penn State.

"Vicky knew that she had attempted to do the right thing in disciplining the football players, but she was unable to do so in the Penn State environment," said Gene Hughes, a president emeritus at Wichita State and Northern Arizona University.

At Penn State, Triponey was among the few who stood up to Paterno, the legendary "JoePa" who for 61 years was synonymous with a football program that pumped millions of dollars into Penn State. And she paid dearly for it. At the end, nobody at the top backed her. And it didn't seem to matter to anyone whether she was right, or even if she had a point.

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Buzz Bissinger on Joe Paterno

At the heart of the problem, the Freeh report stated, were university leaders eager to please Paterno above all else, a rubber-stamp board of trustees, a president who discouraged dissent and an administration that was preoccupied with appearances and spin.

Triponey has been saying that since 2005.

Sandusky, as the mastermind of college football's legendary "Linebacker U," enjoyed insider status and used Penn State's sporting events and athletic facilities to lure victims even after he retired in 1999. When he was indicted and arrested in November, the report said, Sandusky still had his keys to the Penn State locker room.

Triponey, a slim blonde who dresses preppie and carries herself with the reserve of an academic lifer, was always an outsider at Penn State, even though she grew up in central Pennsylvania. She was not involved in the Sandusky matter; she says she never met him. But she is keenly aware of the campus culture that allowed him to prey on boys for years, virtually unchecked.

"The culture is deep," she said. "The culture is making decisions based on how others will react, not based on what's right and wrong." It focused on the interests of those at "the top of the chain," she added. "Others at the bottom didn't matter."

Triponey was just one of the 430 witnesses who spoke with Freeh's investigators; her story, which she laid out for them over several hours in March, was supported by e-mails uncovered among the 3.5 million electronic documents the investigators examined.

"When I visited with them, that's when I started to be more hopeful," she said. "They got it, and they were determined to expose it. They found evidence of the culture that allowed Jerry Sandusky to exist.

More storms loom for Penn State in wake of Freeh report

"Now I can articulate it," she said. "That is what I was railing against."

Triponey is not named in the 267-page report; her experience is laid out in a footnote at the bottom of pages 65 and 66. The section deals with the janitors who were afraid they'd lose their jobs if they reported they'd seen Sandusky molesting a boy in the showers in 2000.

"I know Paterno has so much power that if he had wanted to get rid of someone, I would have been gone," one janitor told investigators. "Football runs this university."

"If that's the culture at the bottom," Freeh told reporters, "God help the culture at the top."

The Triponey footnote sheds some light on the top. "Some individuals interviewed identified the handling of a student disciplinary matter in 2007 as an example of Paterno's excessive influence at the university," the footnote stated. It described "perceived pressure" to "treat players in ways that would maintain their ability to play sports," including reducing disciplinary sanctions.

"I wasn't part of the evidence. I was confirmation of the evidence," Triponey told CNN. "This is not about me. This is about what Jerry Sandusky was allowed to do."

Penn State can learn from its mistakes, she believes, but needs new leadership, fresh blood -- someone from outside Happy Valley.

"It's a cocoon. It's a bubble. That's why those inside the bubble are really struggling. They're afraid; they're embarrassed; they're struggling with what to do," she said.

"Now the question is, 'do you face reality?'"

Opinion: The end of 'Joe Paterno University'

'The Penn State way'

Vicky Triponey grew up in a working-class household and was the first person in her family to attend college. Her father was a rabid Penn State football fan, but she chose to go to the University of Pittsburgh, commonly known as Pitt. She got her bachelor's degree in psychology and continued with post-graduate studies, pursuing a career in higher education. She earned her doctorate at the University of Virginia.

She worked at several colleges and universities before encountering her mentor, James Rhatigan, who developed the division of student affairs at Wichita State University. Rhatigan introduced her to Mike Meacham, a young man who had been student body president and worked for the alumni association. They married 21 years ago.

She left Wichita in 1998 for the University of Connecticut, where she helped coach Randy Edsall build up the football program. Edsall, who is now head coach at the University of Maryland, told CNN that they worked hard to ensure that football players lived by the same rules as other students.

"We always taught our guys they weren't better than somebody else," Edsall said. "My whole thing was, we told our guys up front that there was a student code of conduct they had to adhere to. If they violated it, there would be consequences."

Penn State recruited Triponey in 2003. She quickly figured out she was the leading candidate when the university brought on its A game for her interview. Her campus visit coincided with the weekend of "The Thon," a popular dance marathon that students hold to raise money for charity.

"I liked what I heard during the interview," she recalled. "It was a truly impressive place, and I considered it a fabulous next step in my career."

She also heard the expression "the Penn State way" for the first time that weekend. Had she understood its significance, she said, she would have "quickly run in the other direction."

Still, she enjoyed a long honeymoon. She felt she had the support of Penn State's president, Graham Spanier, who unabashedly sang her praises when she was hired and later at professional conferences they both attended.

"I arrived there and was supported, encouraged, and really for the first two years I thought we were doing good things," she said. "We were moving in some good directions. But that second year, in the fall, I started going home and telling Mike, 'They're not getting it. They're not embracing conversations about change.'"

There were controversies about her decisions to cut off funding to a student radio program and revamp the student government.

Spanier assured her that she was right to stick to her guns, but she was "hitting the brick wall in student discipline." Looking back, she says, "I was putting my neck out and taking a stand, but there weren't many people with me."

And then one day in late 2004, as disciplinary sanctions were being considered against a member of the football team, she received a visit from Paterno's wife, who had tutored the player.

He's a good kid, Sue Paterno said. Could they give him a break?

Triponey realized then that she wasn't in Kansas anymore. Or even Connecticut.

By the next year, 2005, she was battling Paterno himself over who controlled how football players were disciplined. Paterno also chafed over enforcing Penn State's code of conduct off campus.

Spanier called a meeting at which Paterno angrily dominated the conversation, Triponey recalled. She summarized the meeting in an e-mail to Spanier, Athletic Director Tim Curley and others, complaining that Paterno "is insistent that he knows best how to discipline his players" and that her department should back off.

Opinion: Penn State report is a warning to all of of us

She noted that Paterno preferred to keep the public in the dark about player infractions involving violence, and he pushed for not enforcing the student code of conduct off campus. She added that having "a major problem with Coach Paterno should not be our concern" in making disciplinary decisions.

"I must insist that the efforts to put pressure on us and try to influence our decisions related to specific cases ... simply MUST STOP," she wrote. "The calls and pleas from coaches, board members and others when we are considering a case are indeed putting us in a position that does treat football players differently and with greater privilege ... and it appears on our end to be a deliberate effort to use the power of the football program to sway our decisions in a way that is beneficial to the football program."

Curley, who once played for Paterno and according to the Freeh report was widely considered his "errand boy," responded to Triponey by explaining "Joe's frustrations with the system" and the "larger issues that bother him."

Triponey wrote back, complaining about Paterno's "disregard for our role and disrespect for the process." She added, "I don't see how we can continue to trust those inside the football program with confidential information if we are indeed adversaries."

She followed up with another e-mail to Spanier on September 1, 2005, stating her objection to Paterno's attitude and behavior, which she called "atrocious." She said others, including students and their parents, were mimicking him.

"I am very troubled by the manipulative, disrespectful, uncivil and abusive behavior of our football coach," she wrote. "It is quite shocking what this man -- who is idolized by people everywhere -- is teaching our students."

Paterno clearly seemed to resent "meddling" from outsiders, even if Triponey was simply doing her job. She saw the dangers of special treatment that placed football players under a softer standard than other students lived by. She said it wasn't right. But it was a battle she couldn't win.

Paterno ridiculed her on a radio show as "that lady in Old Main" who couldn't possibly know how to handle students because "she didn't have kids."

Tensions reached the breaking point in 2007 over how to discipline half a dozen players who'd been arrested at a brawl at an off-campus apartment complex. Several students were injured; one beaten unconscious.

Triponey met with Paterno and other university officials half a dozen times, although she preferred to remain neutral as the appeals hearing officer.

At the final meeting, Triponey urged the coach to advise his players to tell the truth. Paterno said angrily that he couldn't force his players to "rat" on each other since they had to practice and play together. Curley and Spanier backed him up on that point, she said.

Triponey recommended suspensions; Paterno pushed for community service that included having the team clean up the stadium for two hours after each home game.

In the end, four players were briefly suspended during the off-season. They didn't miss a game.

By then it was clear she no longer enjoyed Spanier's support. He began making noises about whether she really embraced "the Penn State way." He told her during an annual review that she was too confrontational, too aggressive. Triponey knew her days at Penn State were numbered when he advised her to think hard about whether she had a future there.

Paterno defended football, Penn State in letter before his death

Back from the ashes

When it all fell apart, Triponey felt completely alone.

She received threatening phone calls at home when her husband was traveling and was savaged on student message boards. Her house was vandalized and "For Sale" signs were staked in her front yard. By the time police installed surveillance cameras, she was already on her way out.

Spanier came to her home and sat in her living room after Paterno lost his temper at the meeting about the players involved in the brawl. She said he told her, "Well, Vicky, you are one of a handful of people, four or five people, who have seen the dark side of Joe Paterno. We're going to have to do something about it."

She shakes her head, recalling that conversation now. "'Doing something about it,'" she says, "ended with me being gone."

Citing "philosophical differences," Triponey resigned under pressure as the 2007 football season got under way. Unlike Sandusky, convicted last month of 45 counts of molesting young boys, she did not receive a $168,000 golden handshake, prime football seats for life or keys to the locker room.

She was no longer invited to events. She was shunned.

She sold her big house in State College and moved into a condo in Bellfonte, the quaint county seat where Sandusky was tried, while her husband, a Penn State professor, looked for a job at another university. It took two years, but he finally found a spot at the Medical University of South Carolina in Charleston.

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She stopped going to Wegman's, a favorite upscale supermarket outside State College, because "the Penn State people went there." They recognized her and without fail turned their backs and walked away, she recalled.

Former colleagues who did want to reach out held back. Later, they explained that they were afraid of losing their jobs, too.

That, she says, was "the Penn State way" as she knew it.

It had been corrupted by success.

"Winning became more important," she said, along with a strong desire "to avoid bad publicity." So many people were invested in the football program, they felt they had "to protect something that they had created, a grand experiment that was so perfect that they didn't dare let anybody know there were blemishes."

There was no accountability. Board meetings were scripted to avoid controversy. It was a point of pride that nobody ever argued. The leadership was "grounded in the spin, the image, the 'too big to fail.' It became a business dependent on the money and contributions," she said.

As for Paterno, who died of lung cancer in January, Triponey does not judge him harshly.

"Joe Paterno was an incredibly principled person," she said, recalling how, at the beginning, he made sure his athletes were successful students, as well. "That was at his core," she said, "but the pedestal became so high, he lost that somewhere."

She thought she had left academia forever, following her husband to Charleston and getting involved in charities and community work.

"At the time, it destroyed my career. I couldn't go back into higher education after what happened at Penn State. I had to leave the work I had done for 30 years. What enabled people to take a chance on me was when the Sandusky story broke."

Sandusky was indicted in November and accused of molesting 10 boys over 15 years. Spanier and Paterno were dismissed and Curley and another Penn State vice president, Gary Schultz, were charged with lying to a grand jury about what they knew about the Sandusky affair.

"The world of higher education started seeing me as a more credible person," Triponey said. "I did get messages and kudos."

Reporters started calling, and then so did people at other schools. Among them was R. Barbara Gitenstein, president of the College of New Jersey near Trenton. The Division III school focuses on liberal arts and had an opening in student affairs.

Triponey started in February and plans to stay at least until December as the interim director.

"Actually, she's not doing just fine," Gitenstein said. "She's doing great." She is well liked by the students, staff, trustees and other department heads, she added.

Penn State leaders 'empowered Sandusky'

"I think she's open, she accessible," Gitenstein said. "She's thoughtful, and she has knowledge about student affairs. She's also very responsible in terms of budget. She knows how to bring others along, to make them feel part of the enterprise."

Triponey says she's now working in a place where it's not just acceptable to speak truth to power, it's encouraged.

"I never though I'd be back doing work in higher education," she said. "I also never thought I'd see the day where public opinion is at the place where folks are saying Penn State's culture has got to change."

Edsall, her former colleague at UConn, says Triponey stands in contrast to the other officials at Penn State and the choices they made. "She lost her job, but she never lost her principles, her values or her morals," he said. "When you see a friend, a colleague, go through what she went through, it's good to see that things have come to light.

"I tell my players there are two things in life," he added. "You've got your name and you've got your reputation. And you know what? Vicky still has her name and she still has her reputation."

She took a stand for what she believed in, Edsall said, but the leadership at Penn State didn't want to change.

"They wanted to continue with the status quo, and look where it got them."

Triponey views the Freeh report as "my trigger that it's OK to start speaking out," she said.

"Maybe it's an opportunity for me to take the experience, take the pain, take the pain of other victims, and help change the culture," she said. "Maybe not at Penn State, but other coaches, other presidents around the country are in a position now to see the danger in a culture like this."

It has all left her "saddened, disgusted and horrified, but also hopeful," she said.

It has brought new life to the teacher in her.

Penn State review recasts story of football hero Paterno

Rare meningitis kills 8, infects 100

Bottles containing the injectable steroids, distributed by the New England Compounding Center (NECC), suspected in causing a meningitis outbreak.
Bottles containing the injectable steroids, distributed by the New England Compounding Center (NECC), suspected in causing a meningitis outbreak.
  • NEW: CDC: As many as 13,000 people may have received medicine
  • No new exposures have occurred in recent weeks, Tennesse official says
  • Patients have contracted meningitis after receiving contaminated steroid injections
  • Nine states have reports of this rare, noncontagious form of the disease

(CNN) -- Eight people have died from a rare, noncontagious form of meningitis linked to contaminated steroid injections, the Centers for Disease Control and Prevention said Monday.

In addition, 105 people in nine states have been infected with the illness as a result of the shots, the CDC said.

The number of reported cases has increased significantly in recent days as federal and state authorities continue to investigate the outbreak.

As many as 13,000 people may have received the medicine between May 21 and September 24, a spokesman for the CDC told CNN.

Tennessee is reporting the most number of overall cases, with 35 infections and four deaths, according to the CDC.

"In our state we estimate there are about 1,000 people who we believe are at risk," said Tennessee Commissioner of the Department of Health Dr. John Dreyzehner. "In other words they have potentially received some of the contaminated medication."

He told reporters Monday that because not enough was known about the incubation period for the disease, his department continues to stay in contact with people who might have been exposed.

Dreyzehner said there haven't been any new exposures since the department contacted clinics in the state two weeks ago about the contaminated injections. The number of cases grows as the state learns of more people with meningitis, he explained

The fourth death reported in Tennessee on Monday occurred in late September, he said.

The patients contracted the deadly fungal meningitis after being injected in their spines with a preservative-free steroid called methylprednisolone acetate that was contaminated by a fungus. The steroid is used to treat pain and inflammation.

What is meningitis?

The New England Compounding Center (NECC), the Massachusetts-based pharmacy that made the contaminated injections, voluntarily recalled three lots of the injected steroid last week.

On Saturday, the same pharmacy announced a voluntary nationwide recall of all its other products as well. NECC said that the new recall was being announced out of an abundance of caution and that there is no indication any of its other products are contaminated.

The Food and Drug Administration has already asked doctors, clinics and consumers to stop using any of the pharmacy's products. The pharmacy on Wednesday voluntarily surrendered its license to operate until the FDA investigation into the contamination is complete.

Health officials say 75 medical facilities in 23 states received the contaminated steroid injections from NECC.

List of medical facilities that received the contaminated injections

Other than Tennessee deaths have been reported in Maryland, Michigan and Virginia.

There are also confirmed cases in Florida, Indiana, Minnesota, North Carolina, and Ohio.

CDC: State-by-state breakdown of meningitis cases

The other states that received the contaminated products from NECC are California, Connecticut, Georgia, Idaho, Illinois, New Hampshire, New Jersey, Nevada, New York, Pennsylvania, Rhode Island, South Carolina, Texas and West Virginia.

Federal health inspectors began inspecting the NECC plant last Monday. Inspectors found foreign particles in unopened vials, and after testing one of the unopened vials, they determined the substance was a fungus.

The investigation is still under way.

Nearly 10% of drugs administered in the United States come from compound pharmacies, according to a 2003 Government Accountability Office report.

Drugs manufactured by compound pharmacies do not have to go through FDA-mandated premarket approval. Instead, state health pharmacy boards are responsible for the oversight and licensing of these pharmacies.

Compound pharmacists create customized medication solutions for patients for whom manufactured pharmaceuticals won't work, according to the International Academy of Compounding Pharmacists.

Meningitis is an inflammation of the protective membranes covering the brain and spinal cord. It is usually caused by an infection, frequently with bacteria or a virus, but it can also be caused by less common pathogens like fungi, according to the CDC.

Fungal meningitis is very rare and, unlike viral and bacterial meningitis, it is not contagious.

Symptoms of fungal meningitis are similar to symptoms from other forms of meningitis, but they often appear more gradually and can be very mild at first, the CDC says.

Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University Medical Center, told CNN that fungal infections are not usually mild. He said when a fungus invades small blood vessels, it can cause them to clot or bleed, which can lead to symptoms of small strokes.

In addition to typical meningitis symptoms like headache, fever, nausea and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness and discomfort from bright lights. Patients might just have one or two of these symptoms, the CDC says.

Health officials say any patients who received an injection at one of the facilities beginning May 21 and who began showing symptoms between one and three weeks after being injected should see their doctor right away.

The earlier a patient gets treatment, the more likely he or she will survive.

Patients are treated with anti-fungal medication, which is given intravenously, so patients have to be admitted to the hospital, the CDC said. Patients may need to be treated for months.

The FDA is urging anyone who has experienced problems following an injection with the NECC product to report it to MedWatch, the FDA's voluntary reporting program, by phone at 1-800-FDA-1088 or online at www.fda.gov/medwatch/report.htm.

CNN's Elizabeth Cohen and Miriam Falco contributed to this report.