Title: An open letter to Michael Ball, Chief Executive of Hospira Pharmaceuticals
Abstract: 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.1Stein R Lethal injection drug being phased out.Washington Post. Jan 22, 2011; (accessed Nov 9, 2011).http://www.washingtonpost.com/national/lethal-injection-drug-being-phased-out/2011/01/21/ABjYPtD_story.htmlGoogle Scholar 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,2Nicholl DJ Siddiqui KA Dam M Thomas G Sofair AN on behalf of 58 othersAn open letter to Ulf Wiinberg, chief executive of Lundbeck Pharmaceuticals.Lancet. 2011; 377: 2079Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar 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's response 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”.3Pilkington E Florida execution: drug firm protests to governor over lethal injection.The Guardian. Sept 27, 2011; (accessed Nov 9, 2011).http://www.guardian.co.uk/world/2011/sep/27/death-penalty-florida-pentobarbital-lethal-injection?newsfeed=trueGoogle ScholarHospira 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 relaxant when 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.4State of Massachusetts County of SuffolkAffidavit of David B Waisel, MD.http://www.reprieve.org.uk/media/downloads/2011_06_28_PUB_Waisel_Affidavit_FINAL_DRAFT.pdf?utm_source=Press+mailing+list&utm_campaign=26dcb1127c-2011_06_30_Waisel_pentobarbital&utm_medium=emailGoogle Scholar 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”.5HospiraCode of business conduct: integrity begins with you.http://www.hospira.com/files/CodeofConduct_English.pdfGoogle Scholar 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.I hold stock in Lundbeck. For the full list of signatories see webappendix. 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.1Stein R Lethal injection drug being phased out.Washington Post. Jan 22, 2011; (accessed Nov 9, 2011).http://www.washingtonpost.com/national/lethal-injection-drug-being-phased-out/2011/01/21/ABjYPtD_story.htmlGoogle Scholar 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,2Nicholl DJ Siddiqui KA Dam M Thomas G Sofair AN on behalf of 58 othersAn open letter to Ulf Wiinberg, chief executive of Lundbeck Pharmaceuticals.Lancet. 2011; 377: 2079Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar 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's response 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”.3Pilkington E Florida execution: drug firm protests to governor over lethal injection.The Guardian. Sept 27, 2011; (accessed Nov 9, 2011).http://www.guardian.co.uk/world/2011/sep/27/death-penalty-florida-pentobarbital-lethal-injection?newsfeed=trueGoogle Scholar 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 relaxant when 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.4State of Massachusetts County of SuffolkAffidavit of David B Waisel, MD.http://www.reprieve.org.uk/media/downloads/2011_06_28_PUB_Waisel_Affidavit_FINAL_DRAFT.pdf?utm_source=Press+mailing+list&utm_campaign=26dcb1127c-2011_06_30_Waisel_pentobarbital&utm_medium=emailGoogle Scholar 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”.5HospiraCode of business conduct: integrity begins with you.http://www.hospira.com/files/CodeofConduct_English.pdfGoogle Scholar 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. I hold stock in Lundbeck. For the full list of signatories see webappendix. Supplementary Material Download .pdf (.09 MB) Help with pdf files Supplementary appendix Download .pdf (.09 MB) Help with pdf files Supplementary appendix An open letter to Michael Ball, Chief Executive of Hospira Pharmaceuticals – Response from HospiraHospira shares the concern over improper use of our drugs in US executions. Hospira has long communicated that we do not support the use of any of our products in lethal injections—a use that is clearly outside the licensing approved by the Food and Drug Administration and completely counter to our company vision of advancing wellness. In fact, over the years, Hospira has regularly written to every US state to make clear that we oppose the use of our drugs, including pancuronium bromide, in executions, and we have stated our opposition publicly through the media innumerable times. Full-Text PDF