KANSAS CITY, Mo. - Several US states are turning to lightly regulated pharmacies for lethal injection drugs, prompting a host of court battles and at least one stay of execution because of concern tainted or impure drugs could inflict cruel and unusual punishment on inmates.
The scramble for alternative supplies comes as major pharmaceutical companies, especially based in Europe, have clamped down on sales of drugs for executions in recent years in order to avoid association with the punishment.
Missouri on Friday abandoned a plan to use the anesthetic propofol to put an inmate to death after the German maker of the drug, Fresenius Kabi, discovered that some had been sold to the state for executions, and suspended shipments to a US distributor in retaliation.
Cut off from traditional sources of drugs, at least five states where the death penalty is legal - South Dakota, Texas, Ohio, Georgia and Colorado - are looking to "compounding"pharmacies, which typically mix drugs for prescriptions and are mostly exempt from federal oversight and face widely varying scrutiny from states.
Tainted drugs from a Massachusetts compounding pharmacy caused an outbreak last year of a rare type of meningitis that killed more than 50 people and sickened more than 700 in 20 states, according to the US Centers for Disease Control and Prevention. The resulting outcry has sparked a drive in Congress for a larger role by the US Food and Drug Administration, which has warned of "special risks" from compounding pharmacies.
No judge appears to have ruled that an execution was botched from compounded drugs. But death penalty opponents have filed a flurry of lawsuits seeking to halt executions using them.
They say the use of compounded drugs runs the risk of violating the 14th Amendment to the US Constitution, which forbids states from inflicting "cruel and unusual punishment."
"You don't have a high level of assurance that the drug is pure and potent," said Sarah Sellers, a pharmaceutical consultant who testified twice about the risks of compounders before the Massachusetts Legislature after the meningitis outbreak. "When used in executions, they are a real concern. It could take longer to die, there could be unnecessary suffering."
Compounders and prison officials reject that view, saying the industry does good work, and that executions happen too fast for tainted drugs to mar the process.
A spokesman for the compounding industry, David Ball, said he was aware of only three pharmacies that had supplied compounded drugs for lethal injections, and that the industry in general was of "high quality."