Doctors call on pharma firm Hospira to stop supply of execution drugs

January 6, 2012

Image of drugs

A coalition of medical professionals from around the world has today called on pharmaceuticals company Hospira to prevent their products from being used in US executions.

Hospira is the sole supplier to the US of pancuronium bromide, a paralysing agent used as the second part of a three-drug ‘cocktail’ by most states which carry out lethal injections.

In an open letter to Hospira’s Chief Executive, published in the Lancet, the doctors warn of the very real possibility that the use of pancuronium could result in “extreme pain and suffering” for the prisoner, and emphasise that “no responsible pharmaceutical company should have anything to do with executions.”

They call on Hospira to put in place a restricted distribution system – following the example of another pharma company, Lundbeck – which would prevent the drugs from falling into the hands of execution chambers, whilst ensuring that they reach legitimate medical users.

The letter concludes: “As your own code of business conduct states, Hospira has an ‘ethical compass’ to ‘accept the responsibility of being an ethical global citizen’. It is time for Hospira to live up to those fine words, without affecting patients’ care, by putting in place a restricted distribution system for pancuronium.”

Dr David Nicholl, Consultant Neurologist and signatory to the letter, said: “Although we all want to see Pancuronium available for legitimate clinical use, it is disappointing to see that, to date, Hospira have not used the experience of other manufacturers to effectively block the use of their drug in executions. Hospira have yet to show the leadership and willingness to take action that other drug companies, such as Lundbeck, have managed to take by the use of a restricted distribution system . I would be intrigued to know how many ill US inmates, who are not on death row, have had Pancuronium as it is a very potent drug that should only be used in a critical care setting by a certified anaesthetist (or anaesthesologist if in the US). There is thus no legitimate use for clinical care that I am aware of in a US prison.”


Notes to editors

1. For further information, please contact Donald Campbell in Reprieve’s press office: +44 (0) 207 427 1082

2. The full text of the letter and list of signatories is as follows:

An open letter to Michael Ball, Chief Executive of Hospira Pharmaceuticals

Earlier this year, your company determined that you could not prevent the diversion of the use of your company’s product, thiopental, for use in capital punishment, so you stopped producing it completely. This resulted in US states that carry out the death penalty ultimately switching to pentobarbital, manufactured by Lundbeck. Lundbeck, initially, were hesitant to act, but, after a critical letter, they took decisive action in the form of a restricted distribution system to tighten up their supply chain to ensure that pentobarbital was used only for legitimate clinical purposes.

Lundbeck’sresponse has truly been exemplary (to the extent that some of us even bought shares in the company). The company even wrote to the Governor of Florida warning of the risks of using pentobarbital for executions, which drew one legal commentator to state: “I don’t know how you could cast more doubt on the use of a drug than when you have the condemnation of it by its own maker”.

Hospira is now the sole supplier of pancuronium, which is also used for executions in the USA. To date, Hospira has refused to comment on what, if any, action it will take to stop the abuse of this drug. Pancuronium is an extremely effective muscle relaxantwhen used in an appropriate hospital setting, but when used for executions, there is the very real possibility of causing extreme pain and suffering in a paralysed prisoner. No responsible pharmaceutical company should have anything to do with executions.

As your own code of business conduct states, Hospira has an “ethical compass” to “accept the responsibility of being an ethical global citizen”. It is time for Hospirato live up to those fine words, without affecting patients’ care, by putting in place a restricted distribution system for pancuronium.

David J Nicholl, Consultant Neurologist, City Hospital, Birmingham Richard Grünewald, Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK Prabir Chatterjee, Physician, Kolkata, India Michael Hutchinson, Dept of Neurology, St Vincent’s University Hospital, Dublin, Ireland Carlo Colosimo, Neurologist, University of Rome “La Sapienza”, Italy Khurram A Siddiqui, Department of Neurology, Neuroscience Centre, King Fahad Medical City, Riyadh, Saudia Arabia Pete Deveson, GP, Derby Medical Centre, Epsom, Surrey Michael Douglas, Consultant Neurologist, University Hospital Birmingham, Birmingham Peter Hall, MBBS, MRCPI, DGM, Chair, Doctors for Human Rights, Abbots Langley, Herts, UK Amanda Burls, Department of Primary Health Care, University of Oxford, UK Andrew Rouse, Public Health, Birmingham, UK Wasim Hanif, Consultant Physician, University Hospital Birmingham Jonathan Frankel, Dept of Neurology, Wessex Neurological Centre, Southampton University Hospitals NHS Trust, UK Anna Cummin, NHS Breast Screening Service, Guildford Barry Dale, Retired Haematologist, Bowral, Australia Margaret McCartney, GP, Fulton Street Medical Centre, Glasgow Carl Counsell, Dept of Neurology, Aberdeen Royal Infirmary, Aberdeen, Scotland Biba Stanton, Neurologist, London, UK Rhodri Huws, Psychiatrist, Sheffield, UK Saket Singhal, Gastroenterologist, Sandwell General Hospital, Sandwell, UK Tom Marshall, Senior Lecturer in Public Health, University of Birmingham, Birmingham, UK Judith Cook, GP, London Dr Faisal Goni, GPVTS ST3, North East Thames, London Deanery S Ahmed Sadiq, Consultant Ophthalmic Surgeon, Manchester Royal Eye Hospital, Manchester, UK Brendan O’Reilly, GP, Brynsadler, Wales

3. For a factsheet on Lundbeck’s distribution system, detailing the transition beween old and new distribution models, see this link or download the PDF below:

4. Reprieve, a legal action charity, uses the law to deliver justice and save lives, from death row to Guantánamo Bay. Reprieve investigates, litigates and educates, working on the frontline, to provide legal support to prisoners unable to pay for it themselves. Reprieve promotes the rule of law around the world, securing each person’s right to a fair trial and saving lives.  Clive Stafford Smith is the founder of Reprieve and has spent 25 years working on behalf of people facing the death penalty in the USA.

Reprieve’s current casework involves representing 15 prisoners in the US prison at Guantánamo Bay, assisting over 70 prisoners facing the death penalty around the world, and conducting ongoing investigations into the rendition and the secret detention of ‘ghost prisoners’ in the so-called ‘war on terror.’ Follow Reprieve on twitter: @ReprieveUK; if you were forwarded this release, sign up to join our press mailing list.