Join Date: Feb 2006
US death penalty AND operations under threat as EU considers banning export of drug
Last Nov. 1, a drug company representative spent all day sitting outside the warden’s office at the Missouri Corrections Department’s prison in Bonne Terre. She was trying to retrieve a package that her company, Morris & Dickson LLC, of Shreveport, La., had shipped to the prison by mistake.
The warden wouldn’t give it back; his bosses told him not to. At this point, the only way Morris & Dickson is going to get it back is if Gov. Jay Nixon orders it returned. He should do so immediately. Thousands of lives could depend on it.
The package contained 20 50-milliliter vials of a drug called Diprivan, a trade name for the anesthetic known generically as propofol. It is the most common general anesthetic in use today. “We use it in 90 to 95 percent of our cases,” said Dr. Elizabeth Cavanagh of Creve Coeur, past president of the Missouri Society of Anesthesiologists.
In correct doses, propofol can put patients into deep sleep or sedate them for procedures like colonoscopies. When the procedure is finished, patients wake up quickly with few side effects.
Waking up quickly with few side effects is not what the state of Missouri has in mind.
On Oct. 23, the Department of Corrections intends to administer a massive dose to Allen Nicklasson, 41. He was convicted in Lafayette County of the 1994 “Good Samaritan” killing of Richard Drummond, 47, of Excelsior Springs.
In Arizona two days later, Nicklasson fatally shot Joseph and Charlene Babcock, who like Mr. Drummond, also had stopped to offer roadside assistance. Nicklasson was the trigger man, but an accomplice, Dennis J. Skillicorn, also was convicted of capital murder in the Missouri case. He was executed in 2009 under Missouri’s now-abandoned three-drug execution protocol.
Nobody has ever been executed with propofol. Because manufacturers have stopped supplying other drugs previously used in executions, states have looked for alternatives. Missouri and Texas have announced their intention to use propofol.
Though propofol is widely available, 89 percent of it is manufactured in Europe. The European Union strongly opposes capital punishment and is considering putting export controls on propofol if either Missouri or Texas uses it to kill people.
In a letter written Monday to Gov. Nixon, Markus Löning, Germany’s Human Rights Commissioner, warned, “The use of propofol would almost certainly lead to strict export controls. Subsequently there would also be a severe shortage of propofol in the United States for medical purposes.”
A German company, Fresenius Kabi, manufactured the propofol that wound up at the Bonne Terre prison, the site of Missouri’s execution chamber. Fresenius had sold it to Morris & Dickson, one of 14 U.S. companies that it licensed to sell it. The distributors were warned not to sell it to corrections departments.
But on Sept. 26 and 27 last year, Morris & Dickson suffered what it called a “system failure.” It realized its mistake in late October.
On Nov. 2, in a desperately worded email to Missouri Corrections Director George Lombardi, Dale Kelley, a Morris & Dickson executive, pleaded for the drug’s return. The email was misaddressed and may not have been received.
“Please — Please — Please HELP …,” Mr. Kelley wrote. “This system failure a mistake — 1 carton of 20 vials — is going to affect thousands of Americans.”
The state and national chapters of the Anesthesiologists Association have pleaded for Mr. Nixon’s intercession, as have other medical groups. An EU restriction on exports would affect millions of U.S. hospital patients. Fresenius estimates that each day, propofol is administered about 140,000 times in more than 35,000 U.S. hospitals and medical facilities.
Surgeries would have to be postponed or less effective anesthetics employed. Recovery times could take longer, with potentially more dangerous side effects. That would mean longer hospital stays and more uncertain outcomes. There is no good substitute for propofol.
Said one St. Louis anesthesiologist: “This could be like capital punishment for a lot of surgical patients.”
In five years as governor and 16 as the state attorney general, Mr. Nixon has been a hard-liner on capital punishment. He has signed death warrants for two men, Skillicorn in 2009 and Martin Link, executed in 2011, and commuted one sentence to life in prison. Currently Missouri has 47 condemned inmates.
The state capital punishment system has been so plagued with problems that governors over the past decade have been spared at least a few tough decisions. Lately there have been shortages of execution drugs. In 2006, the state had to rewrite its execution protocol after a federal judge found that the doctor in charge of preparing the drugs was dyslexic and may have been winging it on dosages.
Missouri now has enough propofol for at least two executions. After Nicklasson on Oct. 23, the next in line is the notorious serial killer Joseph Paul Franklin, 63, scheduled for execution Nov. 20. He has confessed to eight murders and is suspected in another eight. He has confessed to the nonfatal shootings of civil rights leader Vernon Jordan and Hustler magazine publisher Larry Flynt. He was sentenced to death in 1997 for the 1977 sniper killing of Gerald Gordon, 42, outside of a Richmond Heights synagogue.
There continues to be a federal court challenge to the use of propofol in lethal injections. Lawyers for several Missouri inmates argue that the drug, which can burn if not administered correctly, would cause unconstitutional pain and suffering to condemned men.
Nonetheless, Missouri Attorney General Chris Koster pushed the state Supreme Court to set execution dates. He has grown impatient with various court challenges and gone so far as to suggest the state might have to bring back the gas chamber to carry out capital punishment.
This would be absurd if the underlying issues weren’t so serious. Mr. Nixon has some decisions to make. Should he hope the U.S. Trade Commission will take him off the hook by talking the European Union out of restricting propofol exports? Does he hope the federal courts take him off the hook by upholding the Eighth Amendment challenge?
Or does he do the right thing? Propofol is too valuable to too many people to play games with it. The governor should return the box of drugs which the state wasn’t supposed to have in the first place.
Above post is my opinion unless it's a quote.