propofol

Healthcare firm Fresenius Kabi receives award for action to prevent use of drug in executions

A pharmaceutical company which has taken steps to prevent its product from being used in executions by lethal injection will today receive an award recognising its ethical leadership in the industry.

Fresenius Kabi announced last September that it had put in place controls designed to ensure that its propofol product would not be sold or distributed to correctional facilities where it could be used to carry out the death penalty. Fresenius Kabi, which at the time was the sole US supplier of the anesthesia drug, acted after US states started considering the use of propofol as supplies of previously-used execution drugs became scarce.

John Ducker, the CEO of Fresenius Kabi USA, will today receive the Corporate Social Responsibility Award for Ethical Leadership in the Pharmaceutical Industry on behalf of the company. The award is presented by human rights charity Reprieve.

Mr Ducker said: “Everything we do at Fresenius Kabi is to help assure the safety and availability of therapies for patients and those who care for them,” Mr. Ducker said. “We are pleased to accept this award on behalf of our employees and customers.”

Maya Foa, Deputy Director of Reprieve’s Death Penalty Team said: “Fresenius Kabi has shown unwavering commitment to the core values of the Hippocratic Oath, taking unprecedented steps to ensure their products are used to advance the health and wellbeing of patients all over the world, and are not put to ill use. In so doing, they have shown themselves to be a true leader in ethical business.”

MISSOURI – 19 Missouri Death Row Inmates Awaiting High Court Ruling

June 15, 2012 Source : http://stlouis.cbslocal.com

St. LOUIS (KMOX) – Missouri Attorney General Chris Koster is prodding the state supreme court to set some execution dates for 19 individuals.

Koster said  it’s been more than a year since Missouri carried out an execution, largely due to concerns over whether the old three drug system was cruel and unusual punishment.

“We have a law in the state of Missouri, the death penalty law is very clear and our filing  was a recognition that the Supreme Court can not simply be silent on this issue.”

“It needs to answer these questions one way or another, and so the single drug protocol that has been developed by the department of corrections,  will probably come under scrutiny over the enxt several months but it is time to move this process forward and silence on this issue is really not an option.”

Last month, Missouri became the first state in the nation to adopt, Propofol, a surgical anesthetic as its execution drug. After Koster asked the high court to set execution dates, it filed orders in six cases, asking inmates to “show cause” why they shouldn’t be executed. They have until June 29 to respond.

Propofol,  is  the same anesthetic that caused the overdose death of pop star Michael Jackson.  Critics question how the state can guarantee a drug untested for lethal injection won’t cause pain and suffering for the condemned.

Propofol, made by AstraZeneca and marketed as Diprivan, gained notoriety following Jackson’s death in 2009. Spokespeople for AstraZeneca and its U.S. marketer, APP, declined comment on its use in executions. But Dieter questioned if enough research has been done.

“Any drug used for a new purpose on human subjects should certainly be tested very, very carefully,” Dieter said. “I can only imagine the things that might go wrong.”

Adding to the concern, some say, is Missouri’s written protocol which, like the one it replaced, does not require a physician to be part of the execution team. It states that a “physician, nurse, or pharmacist” prepares the chemicals, and a “physician, nurse or emergency medical technician … inserts intravenous lines, monitors the prisoner, and supervises the injection of lethal chemicals by nonmedical members of the execution team.”

Jonathan Groner, an Ohio State University surgeon who has studied lethal injection extensively, said propofol is typically administered by either an anesthesiologist, who is a physician, or a nurse anesthetist under the physician’s direct supervision. Improper administration could cause a burning sensation or pain at the injection site, he said.

Groner said high doses of propofol will kill by causing respiratory arrest. But the dosage must be accurate and the process must move swiftly because propofol typically wears off in just a few minutes.

“If they start breathing before the heart stops, they might not die,” Groner said. That would force the process to be restarted.

Critics also question the safety of the single-drug method. Missouri becomes the third state with a single-drug protocol, along with Arizona and Ohio. Three others — South Dakota, Idaho and Washington — have options for single- or multiple-drug executions, according to the Death Penalty Information Center. California and Kentucky are exploring a switch to the one-drug method.

German drug company faces involvement in US executions

June 8, 2012 Source : http://www.reprieve.org.uk

A German drug company, Fresenius Kabi, may become the prime supplier of execution drugsto US death rows following the move by the State of Missouri to use propofol in lethal injections last month.

The switch to propofol, which was announced by Missouri prison on the 17th May, is a response to the unavailability of the previously used execution drugs, sodium thiopental and pentobarbital. Other States, also unable to procure the old execution drugs, are now likely to follow suit.

Propofol, a widely used anaesthetic agent, is manufactured by two companies in the US: German pharmaceutical company, Fresenius Kabi (under the tradename, Diprivan), and Hospira. Ongoing problems at Hospira’s plant mean that Fresenius Kabi has been the principle supplier of the drug to the US for over 18 months.

Missouri was forced to change its protocol following action by European pharmaceutical manufacturer, Lundbeck, and the European Commission to prevent the use of European medicines in executions.

Reprieve is in dialogue with the CEO of Fresenius Kabi, Rainer Baule, on this issue. Reprieve worked closely with Lundbeck on the distribution controls put in place to prevent the use of Lundbeck’s pentobarbital in executions and propose that Fresenius Kabi take similar steps to prevent the use of their medicines in lethal injections in the US.

Reprieve is also in contact with the German government on this issue. The German government is vigorously opposed to capital punishment and has previously refused an official request from US authorities for sodium thiopental for use in executions.

Following the protocol change, Missouri DOC requested that execution dates be set for nine death row prisoners.

Maya Foa, Head of Reprieve’s Lethal Injection Project, says: “This is an extremely disturbing development for any pharmaceutical company, but particularly one based in Europe. Fresenius Kabi’s motto is ‘Caring For Life’; it would be disastrous for the company if involvement in executions were to make a mockery of this noble commitment.

No one wants to see German drugs used to execute people. Fortunately for Fresenius, there are simple and effective ways that the company could prevent prisons from using their drugs in executions. Fresenius must act quickly, however, otherwise they risk becoming the primary facilitator of capital punishment in the USA.”

MISSOURI : Missouri finds a drug option for executions: Propofol

May 18, source : http://www.pennlive.com

KANSAS CITY, Mo. _ The state of Missouri is back in the execution business with a drug that’s never been used to put prisoners to death in the United States.

Stymied by a chemical shortage affecting every death-penalty state, the Missouri Department of Corrections said this week that it now will carry out death sentences with propofol, a widely used surgical anesthetic that also played a factor in singer Michael Jackson’s death.

Attorneys representing some of the state’s death row inmates learned of the plan Thursday, after corrections officials met with some inmates and informed them of the new protocol.

Defense attorneys said it’s too early to say what, if any, legal challenges might be mounted in regard to the new one-drug execution protocol that replaces Missouri’s previous three-drug cocktail.

“It’s something we will have to look at very carefully,” said Joseph Luby, an attorney with the Death Penalty Litigation Clinic in Kansas City. “Propofol has no track record in executions.”

Missouri is the first state to formally adopt the use of propofol, also known by the brand name Diprivan, for use in lethal injections, said Richard Dieter, executive director of the Death Penalty Information Center in Washington, D.C.

“No one has used it yet,” Dieter said. “Other states may have considered it.”

Deborah Denno, a law professor at Fordham University in New York and nationally known expert on lethal injection issues, called it a “pretty extraordinary development” that raises many questions.

“I would anticipate legal challenges,” she said.

Missouri’s last execution took place in February 2011. Since shortly after that, the state has been unable to obtain the anesthetic that put inmates to sleep before they are injected with two other chemicals that stop the lungs and heart. Officials also had been unable to obtain an alternative drug that some states had adopted to take its place.

With news that the corrections department had obtained a different drug, Missouri Attorney General Chris Koster on Thursday asked the state Supreme Court to set execution dates for 19 inmates. They include Michael Taylor, one of the killers of Ann Harrison, a Kansas City teenager kidnapped in 1989 while waiting for the school bus in front of her house, and Allen Nicklasson, convicted of kidnapping and killing Excelsior Springs businessman Richard Drummond in 1994 after Drummond stopped to help Nicklasson and a co-defendant when their car broke down.

Koster said in his motion that there are no legal impediments or stays now in place to stop the executions.

“Unless this court sets an execution date after a capital murder defendant’s legal process is exhausted, the people of Missouri are without legal remedy,” Koster said in his motion.

According to Supreme Court procedures, lawyers for the inmates must be given the opportunity to file responses before the Supreme Court sets execution dates.

“There is no timetable as far as when the court would rule (on dates),” said spokeswoman Beth Riggert. “The court rules when it deems it appropriate.”

Missouri and every other state using lethal injection once used the same three-drug mixture that employed sodium thiopental to anesthetize prisoners. The drug has been employed in all 68 executions Missouri has carried out since 1989.

Inmates in Missouri and across the country had filed numerous legal challenges to the method, alleging that it created the risk of inflicting cruel and unusual punishment if not administered properly. However, the U.S. Supreme Court ruled in 2008 that the method was not unconstitutional.

In early 2010, shortages of sodium thiopental began cropping up, and in early 2011 the only domestic supplier announced it would no longer manufacture the drug.

States also had difficulty obtaining it from foreign sources, and on March 27, a federal court in Washington, D.C., banned any importation of sodium thiopental and ordered the Food and Drug Administration to contact every state that it believed had any foreign-manufactured thiopental and instruct them to surrender it to the FDA. It also permanently prohibited importation of the drug.

With thiopental in short supply, some states began to substitute another anesthetic, pentobarbital, for use in the three-drug method.

In February 2011, Ohio began using pentobarbital by itself to execute prisoners. Earlier this year, Arizona became the second state to switch to one-drug executions using pentobarbital.

Dieter, with the death penalty information center, said pentobarbital has been used, either by itself or in combination with other drugs, in the last 45 executions in the United States.

But last July, its Danish manufacturer announced that it was imposing restrictions on how pentobarbital was distributed to prevent its use in executions.

Since its on-hand supply of thiopental expired in March 2011, Missouri had been unsuccessful in finding it or pentobarbital.

In announcing its new protocol this week, Missouri Department of Corrections officials did not comment on when they obtained the new drug or where it was obtained.

According to Missouri’s new written protocol, inmates will be injected with 2 grams of propofol. A Kansas City anesthesiologist said that amount is 10 times the dosage that would be used in a surgical setting for a 220-pound patient.

According to Missouri’s new protocol, the chemical will be prepared by a doctor, nurse or pharmacist. An intravenous line will be inserted and monitored by a doctor, nurse or emergency medical technician. Department employees will inject the chemicals.

Doctors say the drug is used widely in medical settings and does not have some of the side effects, like post-operative nausea and vomiting, of previously used anesthetics. It was developed in England in the late 1970s.

Currently, only one execution date is pending in Missouri. Michael Tisius, convicted of killing two jailers in Randolph County, is scheduled to be put to death Aug. 3.

An attorney representing Tisius could not be reached for comment Friday.

Related articles