Updated Feb. 21 with St. Louis on the Air conversation with reporter Chris McDaniel
Original story from Feb. 20 — A BuzzFeed News investigation has found that a St. Louis-area compounding pharmacy with a troubled safety history has provided execution drugs to the state of Missouri for the last four years.
Sources told BuzzFeed News reporter Chris McDaniel that Foundation Care, based in Earth City, supplied the drugs for 17 executions since February 2014. Foundation Care denied its participation in executions to McDaniel, and did not respond to requests for comment from St. Louis Public Radio.
State law prohibits the name of anyone on the execution team from being made public, including the pharmacies providing the drugs. Missouri officials, McDaniel said, went to great lengths to keep Foundation Care’s name secret.
“The state fought a handful of lawsuits that would try to expose the pharmacy,” McDaniel said. “They gave it a code name, M7. Only a small, small handful of people inside state government knew its identity — even the attorney representing the Department of Corrections said that he didn’t know the identity of it. And ultimately, the second-in-command for the Department of Corrections, he was paying this pharmacy envelopes full of cash each time he wanted to get execution drugs.”
The state had previously used a compounding pharmacy based in Oklahoma. That pharmacy, Apothecary Shoppe, halted its involvement in executions after McDaniel, then at St. Louis Public Radio, and another reporter discovered it was not licensed to sell drugs in Missouri. The decision to make the name of future pharmacies secret was driven in part by that story.
The current supplier, Foundation Care, opened in 2004, catering mostly to patients with cystic fibrosis, McDaniel said. His investigation found that in 2007, a patient using drugs mixed by Foundation Care contracted pneumonia and died. A lawsuit was settled out of court. Two inspections by the federal Food and Drug Administration found “questionable sterility, and potency questions,” McDaniel said.
“If drugs aren’t sterile, you can expose patients to bacteria. If they aren’t potent enough, then they won’t being doing what they’re supposed to be doing — or it could be too potent, which would put them through some pain,” McDaniel said.
Concerns about potency and sterility came up in multiple lawsuits filed by inmates on Missouri’s death row that challenged the state’s execution protocol on the grounds that it is cruel and unusual punishment, McDaniel said.
“If the drug isn’t potent enough, it could be that the inmate is left alive through an execution,” he said. “If the drug, on the other hand, is too potent, it could cause the inmate to sort of suffocate while he’s dying. And if the drug is not sterile, then it could burn while it’s going through their body.”
McDaniel said the FDA investigations found that sterility was a concern at Foundation Care.
Tony Rothert, the legal director of the ACLU of Missouri, said in a statement that BuzzFeed's investigation showed why the state had fought so hard to keep Foundation Care's identity a secret. The ACLU has several open records lawsuits pending against the Department of Corrections.
"It says a lot that the only way the state can execute people is to find a pharmacy with significant professional and ethical shortcomings willing to take part in such uncivilized work," Rothert said. "We should be ashamed that the Missouri Department of Corrections continually violates professional and ethical standards, then covers it up by denying the public’s right to know the dirty details of how it does business.”
A subsidiary of Clayton-based Centene Corporation purchased Foundation Care in 2017. The health care giant did not return calls for comment from McDaniel or from St. Louis Public Radio; neither did the Missouri Department of Corrections.
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Read Chris McDaniel’s work for BuzzFeed here.