Ohio’s lack of access to lethal drug could force change in executions

E.U. companies block states from purchases

9/30/2013
BY JIM PROVANCE
BLADE COLUMBUS BUREAU CHIEF
The death chamber of the new lethal injection facility at San Quentin State Prison in San Quentin, Calif.
The death chamber of the new lethal injection facility at San Quentin State Prison in San Quentin, Calif.

COLUMBUS — Ohio is preparing to possibly overhaul its execution procedure for the third time in four years after its access to a lethal drug at the center of its injection process has been blocked again by its manufacturer.

Barring some way the state can acquire more doses of the powerful sedative pentobarbital, as Texas apparently did at the last minute last week, Ohio will tell a federal court by Friday how it plans to carry out lethal injections.

“There will be controversies with each drug,” said Richard Dieter, executive director of the Death Penalty Information Center. The center does not take a position on capital punishment or the methods used to carry it out.

“Some of these are international companies that want to distance themselves from anything that will result in death,” he said. “They want to make drugs that keep people alive. Even a compounding pharmacy [on-demand drug maker] wants to make clean, pure, reliable drugs that will help you. Although they are not quite as subject to public shaming, they are not in the business of killing people.”

Last week, Ohio was believed to have used the last of its supply of pentobarbital to execute Harry Mitts, Jr., who killed two people, including a Cleveland area police officer, 19 years ago.

But when asked before the execution whether a change in drug is definite for the next execution, Gary Mohr, director of the Ohio Department of Rehabilitation and Correction, said, “Not necessarily.” He declined to discuss the state’s options.

“We have been talking pretty extensively,” he said. “We are looking at whether we need to change the protocol or not, quite frankly. We anticipate finalizing that in about a week.”

Ohio is just one of a number of states making moves as the Danish manufacturer of pentobarbital has worked to cut off access to it for execution purposes. The drug, which can be used to induce coma in heart-surgery patients, is also used in another variation to euthanize animals.

“[Veterinarians] are not in the business of selling a drug,” Mr. Dieter said. “It would be like trying to buy a drug from your doctor. You might check with a vet to see what their source is, but whatever was obtained has expiration dates. And even if they have it, will they be able to get it the next time?

“The manufacturer has put these restrictions on, so it may be harder to get,” he said, adding that he knows of no state that’s been able to acquire the drug through veterinarians.

It already has a backup plan in place in case a usable vein for the intravenous drug can’t be found. It’s never been used. It would involve the injection of two drugs — the sedative midazolam and morphine-derivative hydromorphone — directly into muscle. Florida just announced it will substitute midazolam for pentobarbital in the drugs it uses.

Ohio, like other states, could also try to acquire pentobarbital through a compounding pharmacy that manufactures them from raw ingredients on demand, a move that likely would increase the cost of the drug.

“Texas, like Ohio, said it was running out, but it did carry [Thursday’s] one out,” Mr. Dieter said. “It did not announce where it got it. It could have gotten it from a compounding pharmacy, which is where Georgia obtained pentobarbital.”

Or Ohio could go with a completely different drug, such as propofol, breaking ground as it did four years ago when it announced that it would become the first state to execute inmates using a single drug instead of a combination of drugs.

The state in 2009 scrapped its three-drug process after the highly publicized failed execution of Romell Broom when the execution team struggled for two hours to insert intravenous shunts into his arms to administer the drugs. Then Gov. Ted Strickland took the unprecedented step of calling a halt to an execution after the process had already begun.

In early 2011, the state had to make another change when the Italian manufacturer of a single drug, the powerful sedative sodium thiopental, made the drug unavailable for executions. Italy doesn’t have the death penalty.

Now essentially the same thing has happened with Danish manufacturer Lundbeck and pentobarbital.

Whatever the substitute for the drug may be, its first use would be on Ronald R. Phillip, convicted of sexually assaulting and murdering his Akron girlfriend’s 3-year-old daughter in 1993. His execution is set for Nov. 14.

The state of Missouri recently announced that it will switch to propofol, best known as the drug that killed Michael Jackson.

But the planned use of the common anesthetic in an upcoming Missouri execution is raising concerns that the anti-death penalty European Union could limit export of the drug, endangering the supply of a medication used every day in thousands of American hospitals and clinics.

The Missouri execution scheduled for Oct. 23 would be the first to use propofol, which is by far the nation’s most popular anesthetic.

About 50 million vials are administered annually in some 15,000 locations. That’s about four-fifths of all anesthetic procedures, according to the American Society of Anesthesiologists. Propofol is popular because it works quickly and patients wake up faster with fewer side effects such as post-operative nausea.

Roughly 85 percent of the U.S. supply of propofol is made in Europe, where capital punishment is outlawed, by the German company Fresenius Kabi. Export is controlled by the European Union, which prohibits trade in goods that could be used for executions. The European Union is reviewing whether to subject propofol to that rule.

Information from The Blade's news services was used in this report.

Contact Jim Provance at: jprovance@theblade.com or 614-221-0496.