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Missouri Fought For Years To Hide Where It Got Its Execution Drugs. Now We Know What They Were Hiding.

Lethal injection drugs
The state of Missouri did everything it could to keep secret where it got the drugs it used to put 17 inmates to death. Now, BuzzFeed News has discovered the supplier is a pharmacy repeatedly found to engage in hazardous practices that could put patients — and convicts — at risk.

The state of Missouri has engaged in a wide-ranging scheme — involving code names and envelopes stuffed with cash — to hide the fact that it paid a troubled pharmacy for the drugs it used to execute inmates.

Procuring execution drugs has become almost impossible, as major pharmaceutical companies stopped making them or refused to provide them for capital punishment. Missouri itself faced a crisis in early 2014, when the previous pharmacy it had been using was exposed in the press and stopped providing the state with drugs. Scrambling, Missouri found a new pharmacy and stockpiled the lethal injection drug pentobarbital, enabling it to set a record pace for executions, scheduling one a month for more than a year.

To hide the identity of the new pharmacy, the state has taken extraordinary steps. It uses a code name for the pharmacy in its official documents. Only a handful of state employees know the real name. The state fought at least six lawsuits to stop death row inmates and the press from knowing the pharmacy’s identity. Even the way Missouri buys and collects the drugs is cloak-and-dagger: The state sends a high-ranking corrections officer to a clandestine meeting with a company representative, exchanging an envelope full of cash for vials of pentobarbital. Since 2014, Missouri has spent more than $135,000 in such drug deals.

But now, BuzzFeed News can reveal the supplier: Foundation Care, a 14-year-old pharmacy based in the suburbs of St. Louis that has been repeatedly found to engage in hazardous pharmaceutical procedures and whose cofounder has been been accused of regularly ordering prescription medications for himself without a doctor’s prescription. Late last year, Foundation Care was sold to a subsidiary of health care giant Centene Corporation, which declined to say whether it will allow the pharmacy to continue supplying execution drugs.

According to two sources with knowledge of the matter, Missouri used Foundation Care’s drugs for 17 executions. The sources spoke on the condition of anonymity because of strict state laws that prohibit disclosing or publishing the identity of the supplier.

Foundation Care is what is known as a compounding pharmacy, one that mixes specialty drugs that are not readily available on the market. These pharmacies are more loosely regulated than traditional manufacturers, and slipshod practices at some of them have led to tainted drugs and deadly disease outbreaks.

Death row inmates fear that drugs prepared by such pharmacies could result in a painful and protracted death.

According to more than 900 pages of court records and regulatory findings, as well as interviews with more than half a dozen people familiar with the company, Foundation Care has been accused of multiple problems.

In 2007, the Food and Drug Administration inspected the pharmacy after a patient who took a drug supplied by Foundation Care developed pneumonia. The FDA found that the pharmacy was not testing all of its drugs for sterility and bacterial contamination, and it uncovered a lab report that indicated a vial of the pharmacy’s drugs had, in fact, been contaminated with bacteria. After initially denying that the vial was tainted with bacteria, the executives later insisted that they had purposefully infected it as part of a test, a story the FDA did not accept.

In 2013, the FDA designated Foundation Care a “high-risk” pharmacy, and when FDA agents showed up to inspect it, the company’s CEO tried to block them from entering and threatened legal action. Inspectors, who ultimately gained access, found “multiple examples” of lax procedures that the agency warned “could lead to contamination of drugs, potentially putting patients at risk.”

Two former senior employees — including the head of pharmacy operations — have alleged in a lawsuit that Foundation Care violated state or federal regulations by reselling drugs returned by patients, purposefully omitting the names of ingredients in drugs it prepared, and failing to notify other states about a $300,000 settlement with Kansas over allegations of Medicaid fraud. The suit also accuses one of the pharmacy’s founders of “regularly and frequently” ordering prescription medications for himself without a prescription, a crime that carries up to a year behind bars. One of the employees alleged that during a dispute with the founders, she was held against her will and feared she would be physically struck. Foundation Care and its founders have denied the allegations, and the suit is ongoing.

A suit by another former employee, a pharmacy tech, alleges that she complained to her supervisors and the Missouri Board of Pharmacy about “serious operational violations.” The employee alleged she was fired shortly after filing her complaint. The company denied the allegations and settled with the employee out of court.

When first approached by a reporter in 2015, Foundation Care’s CEO and head pharmacist, Dan Blakeley, flatly denied that his company supplied Missouri with its execution drugs.

“I don’t know what you’re talking about,” Blakeley said. “All I can tell you is your sourcing is mistaken.”

When a reporter visited in person this month and informed Blakeley that BuzzFeed News would be publishing a story identifying the pharmacy as Missouri’s supplier, his assistant said he didn’t want to talk. The pharmacy also did not respond to a detailed list of questions sent by email.

In court papers, Foundation Care said that it sold execution drugs for political reasons. “M7’s decision to provide lethal chemicals to the Department was based on M7’s political views on the death penalty, and not based on economic reasons,” a representative for the pharmacy wrote in a 2016 affidavit, using the state’s code name for Foundation Care.

“M7’s decision to supply lethal chemicals anonymously arises out of M7’s fear of harassment and retaliation, both physical and financial, if M7’s identity is released.”

One question that remains unanswered is how Foundation Care itself obtained the pentobarbital it sold to the state — did it mix the drug on its own or somehow procure a manufactured version? Akorn Pharmaceuticals, the only manufacturer permitted to make the drug in the United States, requires its distributors to sign agreements that they will not sell its products to executioners.

➤ Click here to read the full article

Source: BuzzFeed, Chris McDaniel, February 20, 2018


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"One is absolutely sickened, not by the crimes that the wicked have committed,
but by the punishments that the good have inflicted." -- Oscar Wilde

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