Missouri execution to effect YOUR health

Discussion in 'Too Hot for Swamp Gas' started by mastoidbone, Oct 9, 2013.

  1. mastoidbone
    Offline

    mastoidbone VIP Member

    Joined:
    Apr 3, 2007
    Messages:
    7,239
    Likes Received:
    8
    Trophy Points:
    38
    Ratings Received:
    +18
    I have mixed feelings about death penalty---I feel many deserve it but that current process with delays, jury manipulation, corrupt labs, etc makes me skeptical government can carry them out in a manner I approve of.

    THAT SAID---we use propofol in 99% of all anesthetics performed--either in general anesthesia or in sedation.
    After state of MO changed their law to allow propofol use in executions due to shortage of any barbiturates, we expect SEVERE shortages.

    We have issued the following statement to inform public.
    ASA and State Societies Work to Avert Severe Propofol Shortage

    Many of you have been made aware that Missouri plans to use propofol in an execution, which could result in a dangerous shortage of propofol. ASA has been actively tracking and working on this important public health issue for several months. Below is a summary of the issue and ASA's actions to raise awareness about the dangers of a propofol shortage.

    Missouri plans to execute two inmates on October 23 and November 20 using propofol. Propofol has not previously been used in executions, but Missouri changed its lethal injection protocol due to market unavailability of a barbiturate that had been part of Missouri's previous protocol.

    European Union Council Regulation 1236/2005 prohibits "trade in certain goods which could be used for capital punishment..." Annex III contains a list of restricted products covered by this Regulation, and these products are subject to a case-by-case assessment for export. Should Missouri be the first state to use propofol in its lethal injection protocol, it is expected that propofol will be placed on the Annex III list of restricted products.

    Subsequently, for every shipment, the drug manufacturer would be required to apply to an export authority for an export license. Without a license, an export shipment would be blocked from leaving the European Union. It reportedly takes at least three to six months to obtain an export license because the export authority must determine that the end-user will not use the propofol for executions.

    For the first three to six months after propofol is listed on Annex III, it is possible that no propofol will be imported into the United States from Europe while drug companies apply for export licenses. Once valid licenses are obtained, shortages of propofol are expected to continue due to the strict export controls.

    This could be extremely problematic because the vast majority of propofol used in the United States is manufactured in Europe. Fresenius Kabi currently supplies 89 percent of all propofol infusions in the United States. Hospira is the only company that manufactures propofol in the United States, but does not have the capacity to meet demand during a shortage.

    Over the past several months, ASA has communicated extensively with Fresenius Kabi and other drug shortage stakeholders to learn more about the European Union's distribution controls and how they will affect the manufacturer's ability to supply propofol to the United States. Fresenius Kabi has launched a website that addresses the consequences of using propofol in an execution.

    ASA is actively monitoring this situation throughout the country and is working with the Missouri Society of Anesthesiologists to educate lawmakers on how a propofol shortage will jeopardize patient safety.

    ASA, over the past several years, has spoken regularly to the Food and Drug Administration (FDA) about drug shortages, and continues to speak to the Agency about the importance of preventing another propofol shortage.

    ASA will continue to work closely with the drug manufacturers, the state societies and the FDA to emphasize the importance of propofol to safe administration of anesthesia to patients.
  2. ThePlayer
    Offline

    ThePlayer Well-Known Member

    Joined:
    Apr 3, 2007
    Messages:
    27,195
    Likes Received:
    379
    Trophy Points:
    83
    Ratings Received:
    +1,704
    Fascinating developments, Mastoid.
    The rest of the world does not like our capricious use of the death penalty.
    Just curious, what ingredients are used in Propofol that makes it unique to Europe?

    Is the use of this drug viewed differently over there?
    Would Conrad Murray have had an easier time fighting misuse charges in Europe?
  3. G8trGr8t
    Online

    G8trGr8t Premium Member

    Joined:
    Aug 26, 2008
    Messages:
    13,629
    Likes Received:
    925
    Trophy Points:
    113
    Location:
    SW Florida
    Ratings Received:
    +1,716
    law of unintended consequences. put a bullet in their head and dump em in the ditch
  4. WESGATORS
    Offline

    WESGATORS Well-Known Member

    Joined:
    Apr 3, 2007
    Messages:
    21,073
    Likes Received:
    159
    Trophy Points:
    63
    Ratings Received:
    +521
    Is the patent creating an artificial barrier to entry?
    Is it not cost effective to license out production further and charge more for the medicine? Or are there actual physical limitations to its production?

    What do we do with the illegal drugs that we confiscate, and why can't we use something like heroin to OD inmates with?

    Go GATORS!
    ,WESGATORS
  5. mastoidbone
    Offline

    mastoidbone VIP Member

    Joined:
    Apr 3, 2007
    Messages:
    7,239
    Likes Received:
    8
    Trophy Points:
    38
    Ratings Received:
    +18
    Ingredients are not the issues----it is STRICT cleaning and sterility that causes issues---propofol preservatives are not as robust, and it has properties that promote bacterial growth.

    Once a facility is contaminated---it will be MANY months before it can go on line again----and being generic---hard to get your profits out of it.....we have already cancelled many cases during last shortage, and this one could be worse....
  6. gatornana
    Offline

    gatornana Administrator

    Joined:
    Apr 3, 2007
    Messages:
    22,822
    Likes Received:
    203
    Trophy Points:
    63
    Ratings Received:
    +676
    Yup.....a bullet in the head.
  7. WESGATORS
    Offline

    WESGATORS Well-Known Member

    Joined:
    Apr 3, 2007
    Messages:
    21,073
    Likes Received:
    159
    Trophy Points:
    63
    Ratings Received:
    +521
    So maybe it's the other way around, maybe an exclusive right to produce would entice a manufacturer to produce it at a cost which gives them sufficient profit?

    Go GATORS!
    ,WESGATORS
  8. mastoidbone
    Offline

    mastoidbone VIP Member

    Joined:
    Apr 3, 2007
    Messages:
    7,239
    Likes Received:
    8
    Trophy Points:
    38
    Ratings Received:
    +18
    giving a profit motive would likely spur more production----but we import 89% of propfol---it would take YEARS to develop the capacity to produce that much....this is happening NOW.

    And while propofol is NOT protected, the process to preserve and make it is IS.

    Entry into the propofol market requires lengthy development efforts because of the product's unique characteristics. Propofol is considered to be one of the most difficult injectable products to develop. Indeed, only one company has been able to introduce a generic propofol product. Propofol is manufactured using a complex process, and it requires the use of a preservative. The preserved formulation used for Diprivan® and the preserved formulation used for the generic propofol marketed by Baxter are both protected by patents. For this reason, any new entrant would have to develop a propofol product using a different preservative that does not infringe existing patents. Once a company has developed a viable product, it is also required to conduct studies and obtain approval from the FDA to market propofol. Clinical development and FDA approval for this particular generic drug takes several years.

    http://www.ftc.gov/os/2002/12/baxter_wyethanalysis.htm
  9. PSGator66
    Online

    PSGator66 Well-Known Member

    Joined:
    Apr 29, 2011
    Messages:
    6,231
    Likes Received:
    146
    Trophy Points:
    63
    Ratings Received:
    +614
    That is what they used on me for a colonoscopy and it works.
  10. mastoidbone
    Offline

    mastoidbone VIP Member

    Joined:
    Apr 3, 2007
    Messages:
    7,239
    Likes Received:
    8
    Trophy Points:
    38
    Ratings Received:
    +18
    I cant convey how important this drug is---if you have had a general anesthetic in last 15 years---99.99% of the time we use THIS drug. There are few to NO alternatives----those available are limited in supply and have more undesired effects----ketamine, etomidate, are the main ones....

    If you have had sedation for a medical procedure----more often then not this is used---there are alternatives---but they all have much longer half-lives.

    THIS is it.
  11. gatorpa
    Offline

    gatorpa Well-Known Member

    Joined:
    Sep 5, 2010
    Messages:
    6,965
    Likes Received:
    71
    Trophy Points:
    48
    Location:
    East Coast of FL
    Ratings Received:
    +296
    Etomidate is great for procedural sedation, but has such a short half life not so good for general anesthesia.
  12. mastoidbone
    Offline

    mastoidbone VIP Member

    Joined:
    Apr 3, 2007
    Messages:
    7,239
    Likes Received:
    8
    Trophy Points:
    38
    Ratings Received:
    +18
    Problem #1--etomidate is also experiencing a shortage---supplies could be exhausted in days if we switched.

    #2--more nausea and vomit compared to propofol

    #3--etomidate 5-10x more expensive

    #4--etomidate depresses adrenal gland--even after a single dose.
  13. Bushmaster
    Offline

    Bushmaster Well-Known Member

    Joined:
    Apr 9, 2007
    Messages:
    2,594
    Likes Received:
    114
    Trophy Points:
    63
    Ratings Received:
    +484
    Are we really putting that many inmates to death in a given year that is affects the supply of this drug??

    If that is the case, a .45 caliber bullet costs about $1.00.
  14. gatorpa
    Offline

    gatorpa Well-Known Member

    Joined:
    Sep 5, 2010
    Messages:
    6,965
    Likes Received:
    71
    Trophy Points:
    48
    Location:
    East Coast of FL
    Ratings Received:
    +296
    Its not that so much is used it has to do with it being declared a drug used for capital punishment in which export is hindered by some anti-death penalty laws from the EU. (General summation, may not be exactly right).
  15. gatorpa
    Offline

    gatorpa Well-Known Member

    Joined:
    Sep 5, 2010
    Messages:
    6,965
    Likes Received:
    71
    Trophy Points:
    48
    Location:
    East Coast of FL
    Ratings Received:
    +296
    Not saying it should be used instead, just based on my own experience a pretty good drug for reducing dislocations, etc in ED.

    BTW never seen someone vomit after etomidate. Just my experience.
  16. mastoidbone
    Offline

    mastoidbone VIP Member

    Joined:
    Apr 3, 2007
    Messages:
    7,239
    Likes Received:
    8
    Trophy Points:
    38
    Ratings Received:
    +18
    correct--89% is imported---if we used it for executions, those imports might be halted---and then no drugs for anesthesia....we'll go old school

    [​IMG]
  17. Gatormb
    Offline

    Gatormb Well-Known Member

    Joined:
    Apr 3, 2007
    Messages:
    8,736
    Likes Received:
    246
    Trophy Points:
    63
    Location:
    Bradenton, Fl
    Ratings Received:
    +760
    Might suggest Missouri use whatever my Vet used to put down Miss Josie last week.

    Very peaceful, 30 seconds. Was grateful.

    Might be the same drug? Doc?
  18. Gatorrick22
    Offline

    Gatorrick22 Well-Known Member

    Joined:
    Apr 3, 2007
    Messages:
    32,555
    Likes Received:
    2,455
    Trophy Points:
    113
    Ratings Received:
    +4,274
    Why can't we make a generic version of what we need? Or just out right make it here? Screw the Euros.
  19. gatorpa
    Offline

    gatorpa Well-Known Member

    Joined:
    Sep 5, 2010
    Messages:
    6,965
    Likes Received:
    71
    Trophy Points:
    48
    Location:
    East Coast of FL
    Ratings Received:
    +296
    Take years to get thru bring manufacturing on line, get FDA approval.
  20. mastoidbone
    Offline

    mastoidbone VIP Member

    Joined:
    Apr 3, 2007
    Messages:
    7,239
    Likes Received:
    8
    Trophy Points:
    38
    Ratings Received:
    +18
    Its already generic---but this is a VERY VERY difficult drug to make and baxter has a patent on on HOW it makes it-----few others have figured out a way to do it---
    Then it would have to be approved.

    Then a GIANT sterile facility would have to be built-----5-10 years IMO to get there.

Share This Page