State News

July 12, 2013

State to use compounding pharmacy for execution drug

ATLANTA — The state of Georgia plans to use a compounding pharmacy to obtain an execution drug for an inmate scheduled to die next week, making it one of the first states to acknowledge using these pharmacies as execution drugs become increasingly difficult to get.

The Department of Corrections will get pentobarbital from a compounding pharmacy for the execution of Warren Lee Hill, which is set for Monday, spokeswoman Gwendolyn Hogan said in an email Thursday. The state’s supply of pentobarbital expired in March. It has become tough for states to get the drug because the manufacturer has said it doesn’t want it used in executions.

Compounding pharmacies custom-mix small batches of a drug for specific clients. They’ve come under scrutiny after a deadly meningitis outbreak was linked to contaminated injections made by a Massachusetts compounding pharmacy. The FDA considers compounding pharmacy products unapproved drugs and does not verify their safety or effectiveness.  

It’s hard to tell how many states have used or are planning to use compounding pharmacies for execution drugs because states frequently resist disclosing the source of the drugs, death penalty experts said.

South Dakota has confirmed that it used compounded pentobarbital in an execution in October. A handful of other states that had acknowledged execution drug shortages have begun scheduling executions months into the future, suggesting they’ve found a stable supply, said Richard Dieter, executive director of the Death Penalty Information Center in Washington.

Georgia Department of Corrections emails obtained by The Associated Press through an open records request make it clear that the state is using a compounding pharmacy to mix a doctor-prescribed dose of pentobarbital for Hill. The names of the sender and recipient of the emails are redacted, but it is clear from an email signature that one person is a corrections employee and the other person appears to be a doctor.

“I spoke with the compounding pharmacist earlier today and I wanted to relay some instructions he gave regarding the prescription,” the corrections employee wrote in an email dated Monday. “Along with the patient name, he also needs their birthday and social security number. I will be happy to forward this information along to you when you are preparing to write the prescription.”

Another email from Tuesday provides the relevant information for Hill and says the Department will need six 50-milliliter syringes of pentobarbital.

In response to questions about the emails, Hogan confirmed that the department would use a compounding pharmacy.

Brian Kammer, an attorney for Hill, said the use of a compounding pharmacy raises concerns.

“I think it’s a violation of the Hippocratic Oath on the part of whatever physician prescribes it,” Kammer said.

He pointed out that the American Medical Association Code of Medical Ethics says doctors should not prescribe drugs for use in an execution. But a Georgia state law says that medical professionals cannot have their licenses challenged or suspended for participating in a court-ordered execution.

It is not clear what doctor is writing the prescription for the pentobarbital for Hill’s execution, and it’s not clear what pharmacy or pharmacist will mix it. A law passed by the Georgia Legislature classifies the name of any person or entity who participates in an execution as a “confidential state secret,” off-limits for release to the public. That includes any company that “manufactures, supplies, compounds, or prescribes the drugs.”

Supporters of the law have said it’s necessary to protect people and companies involved in court-ordered executions from retaliation by angry families of the condemned or opponents of capital punishment. The law’s sponsor, Republican state Rep. Kevin Tanner, also said in an interview before the law passed that it would help the state obtain execution drugs from companies or pharmacies that might not want people to know they were involved in executions.

That secrecy is worrisome when it comes to compounding pharmacies, Dieter said.

“I don’t think automatically that compounding pharmacies are disreputable but some have had problems. And this is sort of a new area where the dosage would be sort of unusual. It wouldn’t be their normal production,” he said. “You’d want to know what the history is and if they have expertise and knowledge in prescribing or manufacturing the right amount and the right strength.”

Kammer declined to say whether he planned to file a challenge to Hill’s execution based on the new law or the fact that the state is using an unidentified compounding pharmacy to produce the drug. He’s already filed a request with the U.S. Supreme Court asking the court to consider new expert statements he submitted in Hill’s case. The high court has yet to weigh in.

Hill was sentenced to death for the 1990 beating death of fellow inmate Joseph Handspike. Hill bludgeoned Handspike with a nail-studded board while his victim slept, authorities said. At the time, Hill was already serving a life sentence for the 1986 slaying of his girlfriend, Myra Wright, who was shot 11 times.        

His lawyers have long said he is mentally disabled and therefore shouldn’t be executed because the execution of mentally disabled offenders is prohibited by state law and a 2002 U.S. Supreme Court decision.


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