After people affected by the faulty injections told of their grim experiences before a judge on Monday, Barry J. Cadden, the former co-owner and head pharmacist of the company that produced the injections, was sentenced to nine years in prison. Mr. Cadden had been convicted this spring on federal racketeering and fraud charges related to the outbreak, which experts have described as among the worst medicine-related public health crises in recent times.

“I will die imprisoned in my body, slowly and in anguish, and he should die in prison,” Ms. Shuff, who described the grueling regimen of treatment she is still undergoing, told Richard G. Stearns, a United States District Court judge here.

For his part, Mr. Cadden stood before the judge and apologized publicly for the first time since the illnesses began to emerge in 2012. “It breaks my heart to read about how painful their deaths were,” he said.

The situation unfolded as a slow-motion disaster, first with a few unusual meningitis cases that soon piled up — particularly in Michigan, Tennessee and Indiana. Investigators linked the cases to the New England Compounding Center, housed inside a squat brick building in Framingham, Mass., and said there were untested and nonsterile drugs as well as expired ingredients. Workers told of extensive mold.

Health officials said 13,000 people could have been injected with the contaminated medication, and many were left to cope with an excruciating wait to see whether they would develop symptoms. By October 2015, the Centers for Disease Control and Prevention counted 753 cases of illness and 64 deaths; in court here on Monday, prosecutors said the death toll was even higher: 76. Among eight survivors who spoke in court on Monday, some said they still lived with pain and had received little money from a fund intended to aid the victims.