The following story was reported by The Utah Investigative Journalism Project in partnership with The Salt Lake Tribune.
Salt Lake City pharmacist Richard Rasmuson remembers the frantic call from an Idaho prison official seeking a lethal dose of a drug for an execution in his state. A death warrant had been served and the clock was ticking.
“He said, ‘We have a scheduled date, and we’ve spent all this money getting it ready, and we’re under the gun because we don’t have any way to do it,’” Rasmuson recalled in one of several interviews with The Utah Investigative Journalism Project.
Rasmuson said the prison official offered a large amount of cash upfront and promised that no one would ever reveal who had provided the drug.
In a decision he said he instantly regretted, the 74-year-old Rasmuson, owner and chief pharmacist of University Compounding Drug Pharmacy, agreed to sell Idaho 240 milliliters (a little over 8 ounces) of pentobarbital sodium, a potent central nervous system depressant commonly used in state executions (and, in different forms not approved for humans, pet euthanasia). Since major drug manufacturers stopped supplying execution drugs a decade ago, states have increasingly turned to specialty, or “compounding drug” pharmacies for made-to-order supplies.
On Nov. 18, 2011, at 8:53 a.m., the pentobarbital from University Pharmacy was injected into Paul Ezra Rhoades, a 54-year-old serial killer who had been on death row since 1988. He was pronounced dead 22 minutes later.
“It appeared to go according to protocol, witnesses said,” according to The Oregonian.
A TV reporter who witnessed the execution described it as “incredibly sterile,” reported The Spokesman-Review.
Rhoades was well known to Utah police. He had for several years been the leading suspect in the serial murders of three young women along the Wasatch Front not long before he went on a four-week killing spree in Idaho that left two women and one man dead.
Public’s right to know
Details of his execution, including the role of the Salt Lake City pharmacy, have only recently emerged because of a public records lawsuit filed by the American Civil Liberties Union of Idaho filed on behalf of University of Idaho law professor Aliza Cover. In a decision that has national implications in capital punishment cases, the Idaho Supreme Court ruled Nov. 20 that the public has a right to know both the source of the drugs used in state executions and the money used to pay for them.
“It is significant to have the recognition of public interest here,” Cover said in a recent interview. “Even people who may support the death penalty might still think it is really important to know what the government is doing in order to carry it out.”
Rhoades’ execution was the first in Idaho in 17 years.
Documents obtained under the ACLU lawsuit and through public document requests by the federal public defenders’ office in Boise provide rare details of the desperate and potentially dangerous measures that capital punishment states sometimes undertake to get their hands on the drug — primarily pentobarbital sodium and sodium thiopental — used in lethal injection executions.
For the Rhoades execution, email strings show that Idaho prison officials began their quest for drugs nearly a year before the execution itself, at one point even negotiating with a notorious supplier in Kolkata (formerly Calcutta), India, who also purveyed sexual enhancement potions. They ended up looking elsewhere because the department insisted they come from an American source.
The India-based supplier, Chris Harris of Harris Pharma, was shut down and his illegal shipments seized by the Food and Drug Administration in 2015 after he had sold sodium thiopental to Texas, Arizona, Nebraska, Ohio and South Dakota.
“It was almost impossible to find the necessary drugs that were considered acceptable by the U.S. Supreme Court,” recalled Brent Reinke, head of Idaho corrections at the time. “It was very, very difficult. We looked all over the country and visited every state that uses this same form of execution, to see if anybody had a surplus.”
The search grew even more intense as Rhoades’ execution date approached.
Email records show that on Nov. 1 of that year, Reinke asked the Idaho attorney general for a final deadline to issue a stay of execution if the necessary drug could not be found. On Nov. 4, Idaho Gov. Butch Otter was informed of the possibility that the execution would have to be delayed.
After months of effort and hundreds of calls, the Department of Corrections finally got a verbal commitment Nov. 7, 2011, from Rasmuson that his Salt Lake City pharmacy would supply the drug.
Once prison officials found a source for the drug, they had to find a way to make it legal. In an unorthodox move, the officials submitted a form signed by a then-junior pharmacist, Brady Dowding, at Idaho State Hospital South, a state mental facility in Blackfoot. The state hospital is under the Idaho Department of Health and Welfare and not part of the criminal justice system. Pentobarbital is not on the hospital’s formulary of approved drugs.
Contacted by phone, Dowding, whose current state salary is listed as $128,960, said he could not discuss the case because the decision “is above my pay grade.” He referred the reporter to Niki Forbing-Orr, media spokesperson for the Department of Health and Welfare. Forbing-Orr and several of her co-workers, including Health and Welfare chief David Jeppesen, did not respond to repeated telephone, email and text messages.
The main unanswered question: How did the state agency charged with maintaining the health and welfare of Idahoans become involved in buying the drug used in a state execution?
“We used every bit of creativity we could because of the importance of what we were charged to carry out,” said Reinke, the former Corrections director who is now a county commissioner in Twin Falls. Reinke said he was aware of the state hospital’s involvement but could not recall the details.
Finding lethal injection drugs has become increasingly difficult after leading pharmaceutical companies, including Pfizer Inc. and Abbott Laboratories, refused to provide them for executions, saying that they were intended for curing, not killing. More recently, in 2015, the American Pharmacists Association and the International Academy of Compounding Pharmacists, the two biggest pharmacist professional organizations, came out in opposition to their members’ providing lethal injection drugs.
The American Pharmacists Association, with 62,000 members, said in a statement that participation in executions is “fundamentally contrary to the role of pharmacists as providers of health care.” The compounding pharmacy association issued a similar statement discouraging its members from “participating in the preparation, dispensing, or distribution of compounded medications for use in legally authorized executions.”
As legitimate sources of lethal injection vanished, officials in several states — including Idaho, Arizona, Texas, Nebraska and Oklahoma — have resorted to dubious, dangerous and often illegal methods to obtain them.
To address the drug supply problem, Utah in 2015 reinstated use of a firing squad in state executions if lethal injection drugs are not available. Signing the revised execution bill into law, then-Gov. Gary Herbert said he found firing squads “a little bit gruesome,” but said the state needed an alternate method of execution.
The last Utah execution was that of two-time killer Ronnie Lee Gardner on June 18, 2010. Gardner, sentenced to death after killing Salt Lake City lawyer Michael Burdell while attempting to escape from the downtown courthouse in 1985, chose the firing squad at a time when death row inmates had the option.
Idaho state prison officials conducted their search for the drugs with extraordinary stealth and secrecy. For example, the documents detail how Idaho prison officials — including current Corrections chief Josh Tewalt — in 2012 secretly traveled on a state airplane to Tacoma, Wash., where they met a representative of Union Avenue Compounding Pharmacy of Tacoma in a Walmart parking lot. In exchange for a suitcase of more than $10,000 cash, the Idaho officials obtained the pentobarbital used in the July 12, 2012, execution of Richard A. Leavitt, condemned for the stabbing and mutilation of Danette Jean Elg in Blackfoot, Idaho.
The transaction in Salt Lake City was a bit less cloak-and-dagger.
On Nov. 10, 2011 — eight days before Rhoades’ scheduled execution — an Idaho Department of Corrections representative showed up at Rasmuson’s storefront shop across the street from the University of Utah with the cash. Rasmuson recalls it was $5,000, perhaps as much as $6,000. But Ross Castleton, deputy director of prisons, later testified in a deposition that records showed more than $10,000 was used to buy the drug for Rhoades’ lethal injection.
In addition to the cash, the Idaho official carried the Drug Enforcement Administration controlled substance form signed by Dowding. The form had been improperly filled out, in grams instead of metric milliliters, so Rasmuson corrected the error and handed over the drug that he had mixed in his own sterile basement laboratory.
Rhoades suspected in Utah murders
More than 20 years earlier, Rhoades was publicly named as the leading suspect in the deaths of three young women: Christine Gallegos, 18, and Lisa Strong, 25, in Salt Lake City and 20-year-old Carla Maxwell in Layton. All three were murdered with the same gun in 1985-1986.
Then-Salt Lake Police Detective Jim F.G. Bell was part of a special homicide task force that spent at least two years collecting evidence on Rhoades.
“Myself, I’m 100% sure Rhoades is the man,” Bell told the Desert News and other news outlets in 1989. “We’ve been trying since day one to eliminate Paul Rhoades as a suspect, and we can’t do it.”
“We have some very, very, very, very good circumstantial evidence,” he said.
Rhoades, who denied ever setting foot in Salt Lake City, was never charged in the crimes. And the theory of his involvement crumbled when a known gang associate with no ties to Rhoades was convicted in the murder of Lisa Strong. The other two murders were never solved.
At the center of the lethal injection debate in the United States are compounding drug pharmacies like Union Avenue in Tacoma and University Compounding Pharmacy in Salt Lake City. Texas, which leads the country with 570 executions since 1976, has for years obtained its lethal drugs from a small compounding drug pharmacy in a Houston strip mall.
Reuters news agency detailed the compounding pharmacies’ important role in a July 2020 special investigative report:
“The difficulty in procuring execution drugs has forced states and the U.S. government to get their supplies of the drug from compounding pharmacies, which operate differently from large pharmaceutical companies — and with less oversight. Such pharmacies typically mix tailored versions of drugs suited to individual patients, for example by turning a pill into a liquid form for a patient who has trouble swallowing. Their products have short shelf-lives and do not require FDA approval, making them more prone to problems with potency or contamination that could lead to a needlessly painful death, health experts say.”
It’s unclear why Idaho prison officials finally reached out to Rasmuson and University Pharmacy, which had been in operation since 1954. But the Salt Lake City pharmacist’s agreement to supply the needed pentobarbital in 2011 caused a flurry of email exchanges inside the corrections department announcing, if not celebrating, the breakthrough after what former Idaho corrections chief Reinke called a “monumental” effort.
“I guess they just caught me when I had my problem-solver’s hat on,” Rasmuson explained in a recent interview. “And then, almost immediately after I had already committed, I decided it wasn’t a good idea and I wouldn’t do it again. It’s not that it wasn’t legal, but I just wouldn’t do it.”
Rone Tempest, a writer and former longtime national and foreign correspondent for the Los Angeles Times, reported this story for the nonprofit Utah Investigative Journalism Project utahinvestigative.org.