If it is good enough to kill Michael Jackson then it must be good enough to kill Missouri’s death row inmates. At least that is the first thought that comes to mind when the state of Mo. announced that due to the discontinuation of the lethal injection mainstay anesthetic drug Pentothal it will begin killing its condemned prisoners with Propofol.
Back in August of 2010, a nationwide shortage of the drug sodium thiopental (Pentothal) caused a number of states to postpone their lethal injections. At the time, Hospira Pharmaceuticals, based outside of Chicago, the sole U.S. manufacturer of the drug, said manufacturing problems had hindered production of the drug. A few months later they announced they would not resume its production. Overnight the most used IV anesthesia induction agent of the last 70 years was no more.
And for death houses across the country the essential drug which put the condemned to sleep was gone. Most states were using a 3 drug cocktail which included Pentothal, a muscle paralyzing drug like Curare (a long acting ‘muscle relaxant’ used in the operating room to keep patients from moving, and which also stops breathing, though it has been mostly replaced by newer drugs. It is also the ‘poison arrow’ substance famously used by various tribes of the jungle in lore.), and to stop the heart in its tracks, Potassium Chloride (the same drug used to stop the heart during open heart surgery). State’s scrambled to obtain supplies to kill their criminals. But the international community refused to send them any and Italy refused to allow Hospira to move their manufacturing to one of their plants there citing the use of the drug for capital punishment. Thus, Hospira stopped production permanently rather than overhaul their production facility in the U.S. to cure deficiencies found by the FDA.
Most states replaced the discontinued agent with a shorter acting drug in the same family as Pentothal, pentobarbital (Nembutal) and in July of 2011 the Ohio Supreme Court ordered, for the first time in history, an execution be video taped. They were evaluating the use of pentobarbital for the first time to determine whether it caused any discomfort. It was administered as part of the traditional 3 drug recipe. Apparently they were satisfied with it in Ohio.
Now what makes the MO decision interesting is that Propofol has a VERY short half-life (duration of action), and they are removing the use of the drugs that will actually guarantee death in any individual the first drug puts to sleep. Propofol’s lethality is dose dependent, meaning one has to administer an overdose of the drug so that respirations are suppressed for at least 10 minutes, or more, since death by Propofol will be cause by respiratory arrest leading to cardiac arrest one oxygen levels fall low enough. Just what that appropriate dose per body weight for this purpose is, is anybodies guess. So someone did. Missouri has settled on 2 Grams in a single bolus which can be repeated once if needed. It sounds like a good lethal dose, and it should be remembered that someone who is familiar with propofol administration for general anesthesia pulled this number out of their behind as a good, round, 10x the normal dose, figure. It should do the trick and may be double the amount actually needed. see the official Mo. Department of Corrections Protocol below.
But don’t expect the first body to hit the floor any time soon. There is little doubt that death row inmates will be challenging this new idea in court, claiming that Propofol is an untried drug, very different from the old 3 drug regimen. And they will have an excellent point.
On a final note, 101 death row inmates have been exonerated in the last two decades. Yes, one hundred and one people sentenced to death were let out of prison, which is a far cry from being out to death as the system had ordered, because they were proven not to have committed the crime beyond a reasonable doubt after all.
Tags: ohio supreme court
, potassium chloride