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Med Shop Total Care, Inc., a compounding pharmacy in Texas, was cited for producing adulterated sterile drug products that violated federal manufacturing standards and put patients at risk. During a July 2021 inspection, FDA investigators identified serious deficiencies including inadequate product evaluation after microbial contamination was detected in the ISO 5 aseptic processing area, improper hand sanitization procedures by operators, and failure to establish sufficient contact time for disinfecting agents. These violations indicated the drug products were prepared under insanitary conditions that could have resulted in contamination with filth or rendered them injurious to health.