Missouri Gov. Jay Nixon halts what was to have been first U.S. execution by propofol

ST. LOUIS - Missouri Gov. Jay Nixon on Friday halted what was to have been the first U.S. execution to use the popular anesthetic propofol, following threats from the European Union to limit the drug's export if it were used for that purpose.

Nixon also ordered the Missouri Department of Corrections to come up with a different way to perform lethal injections without propofol, the leading anesthetic used in America's hospitals and clinics. Nearly 90 percent of the nation's propofol is imported from Europe.

"As governor, my interest is in making sure justice is served and public health is protected," Nixon said in a statement. "That is why, in light of the issues that have been raised surrounding the use of propofol in executions, I have directed the Department of Corrections that the execution of Allen Nicklasson, as set for October 23, will not proceed."

Nixon, a Democrat and staunch supporter of the death penalty, did not specifically mention the EU threat in his brief statement. Nixon was Missouri's longtime attorney general before he was first elected governor in 2008. During his 16 years as attorney general, 59 men were executed.

The leading propofol maker, Germany-based Fresenius Kabi, and anesthesiologists had warned of a possible propofol shortage that could impact millions of Americans if any executions took place.

In a statement, Fresenius Kabi applauded Nixon's move.

"This is a decision that will be welcomed by the medical community and patients nationwide who were deeply concerned about the potential of a drug shortage," said John Ducker, CEO of Fresenius Kabi USA. The company said propofol is administered about 50 million times annually in the U.S.

Source: NY Daily News, October 13, 2013

State Executions Threaten Propofol Supply

Oct. 13, 2013 — Propofol has never been used for executions, but some states are considering changes to their lethal injection protocols due to market unavailability of barbiturates that have been previously used. The American Society of Anesthesiologists commends Missouri Governor Jay Nixon on his recent decision to not use propofol in a manner that may have significantly affected the availability of this medication for the anesthetic care of patients in the United States.

Propofol's wide-spread patient acceptance and tolerance in procedures requiring anesthesia make this medicine critically important to providing the most optimal outcomes for patients.

The vast majority of propofol used in the United States is manufactured in Europe and the European Union (EU) places export restrictions on products being traded with countries that use those products for capital punishment. Fresenius Kabi, based in Germany, currently supplies 89 percent of all propofol infusions in the United States. There have been critical shortages of propofol over the last several years. Recently, the FDA placed propofol on the list of resolved drug shortages. Drug shortages have led to less optimal outcomes (e.g. post-op vomiting and nausea), longer operating room and recovery times, medication errors, and even death.

Source: Science Daily, October 13, 2013

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