STATE OF NEBRASKA DEPARTMENT OF CORRECTIONAL SERVICES Scott R. Frakes Director June 10, 2015 Governor Mr. Chris McDaniel Buzz Feed News 40 23rd St 5th Floor New York NY 10010 RE: Public Records Request Dear Mr. McDaniel This letter is in response to your email dated June 4, 2015, in which you request copies of various records from us under the Nebraska Public Records Statutes, Neb. Rev. Stat. 84-712 through 84-71209. We received your request on June 5, 2015. Your specific request is for copies of communication between the Nebraska Department of Correctional Services and the Food and Drug Administration and/or the Drug Enforcement Agency over the past month ending June 4, 2015. The public records responsive to your request are enclosed. Sincerely Kathleen A. Blum Nebraska Department of Correctional Services XC: Director?s Office File Legal Office File PO. Box 94661 Lincoln, Nebraska 68509-4661 Phone (402) 471-2654 An Equal Opportunity Employer U.S. Department ofJustice/ Drug Enforcement Administration CONTROLLED SUBSTANCES EXPORT DECLARATION Read instructions on reverse before completing) OMB APPROVAL No. 1117-0009 EXPIRATION DATE: See reverse for PrivacyI Act 1. U.S. CUSTOMS CHECK IMPORT DECLARATION Nonnarcotic Substances In Schedules IV, CERTIFICATION ONE Date of Depa rture/Arrival EXPORT DECLARATION Nonnarcotic Substances in Schedules and IVand all substances in ScheduIeV (Name and Address) Nebraska State Penitentiary 4201 14th South Street Lincoln, NE 68502 DEA REGISTRATION NO. 0414184 BROKER OR FORWARDING AGENT, IF USED (Name and Address) . Not Applicable Date of Certification Signature of Customs Official 2. CONTROLLED SUBSTANCES TO BE IMPORTED OR EXPO RTED DEA Transaction ID 2a. NAMEAND QUANTITY OF DRUG OR PREPARATION (Enter-names as shown on labels; numbers and sizes of packages; strength 0 1? tablets, capsules, etc, CSA Drug Code and NBC Namber) 2b. CONTENT OF DRUG OR PREPARATION expressed as acid, base or alkaloid. (Enter names of controlled substances contained inlthe drug, compound, or preparation) 2C. DATE IM AND ACTUAL QUANTITY (Completed by registrant at time of transaction) Sodium Thiopental 1gm Vial Quantity: 1,000 Vials GSA Drug Code: 2100 NDC Number: G21 Sodium Thiopental 1,000 Vials multiplied by 1 gram Sodium Thiopental 1,000 grams Sodium Thiopental No Conversion Factor Applies to Sodium Thiopental per DEA Instruction. 38. FOREIGN (for US. Import) I: DOMESTIC (for U.S. export) PORT OF EXPORTATION APPROX. DEPARTURE DATE KolkataI India June 15, 2015 (Approximate) 4a. MODE OF NAME OF VESSEL CARRIER (if known) Fed ex 5. NAME AND ADDRESS OF FOREIGN Harris Pharma 145 Bosepukur Road Kolkata700039_, West Bengal, India 3b. [3 FOREIGN (for us. export) DOMESTIC (forU.S. Import) PORT OF IMPORTATION AND APPROX. ARRIVAL DATE Omahal NE June 18, 2015 (Approximate) 4b. NAME OF ALL INTERMEDIATE CARRIERS I hereby certifythat the substance(s) listed in Section 2 are to be Imported (conform to 21 U.S.C. 952(b)) Exported (conform to 21 U.S.C. 953(e)) and are intended for I: Medical, Scientific, or Other legitimate uses (attach explanation for other legitimate use). The above named substances are to be Re?Exported (Attach documentation per Title 21) CFR 1312.27) to (list countries): Ifthe form is being used as an "Export Declaration?, attach documentation that the consignee is authorized under the laws and regulations of the country of destination to receive the controlled substances. If the controlled substances are being re-exported from the first country to second countries, attach documentation that the consignee in the toun'tn)I of ultimate destination is authorized under the laws and regulations ofthat country to 'r?eceive the controlled substances. SIGNATURE OF AUTHORIZED INDIVIDUAL OF DATE NAME OF FIRM AND TELEPHONE NUMBER EKPDR FRI-HACKER 0R FORWARDING AGENT 5/26/2015 State of Nebraska Department of Corrections (402) 4796630 E-mail: scott.trakes@nebraska.gov Tire/y. zap?f" STATE OF NEBRASKA DEPARTMENT OF CORRECTIONAL SERVICES Scott R. Frakes Director Governor May 26, 2015 Drug Enforcement Agency Attention: import/Export Unlt (Ms. Kara Sweeney) 8701 Morrisette Drive Springfield, Virginia 22.152 RE: Form 236 Legitimate Use Declaration To Whom It May Concern l, Scott R. Frak?es, as Director of the Nebraska Department of Correctional Services do hereby notify the United States Drug Enforcement Agency that have sought the importation of Sodium Thiopental pursuant to DEA Form 236. The shipment of 1,000 vials containing one gram each of Sodium Thiopental will solely be used for the legitimate purpose of the Nebraska Department of Correctional Services carrying out lethal injections for those persons sentenced to death in the State of Nebraska. 1 Agree or Scott .Frakes, Director Nebraska Department of Correctional Services XC: File US. Department ofJustice Drug Enforcement Administration CONTROLLED SUBSTANCES EXPORT DECLARATION Read Instructions on reverse before completing} 1. CHECK ONE IMPORT DECLARATION EXPORT DECLARATION Nonnarcotic Substances in Schedules IV, Nonnarcotic Substances in Schedules and IV and all substances in Schedule OMB APPROVAL NO. 1117?0009 EXPIRATION DATE: 9/301'2016 See reverse for Privacy Act U.S. CUSTOMS CERTIFICATION Date of Departure/Arrival (Name and Address) Nebraska State Penitentiary 4201 14th South Street Lincoln, NE 68502 DEA REGISTRATION NO. [)414184 BROKER OR FORWARDING AGENT, IF USED (Name and Address) Not Applicable Date of Certification Signature of Customs Official 2. CONTROLLED SUBSTANCES TO BE IMPORTED OR EXPORTED DEA Transaction ID 23. NAME AND QUANTITY OF DRUG OR PREPARATION {Enter names as shown on labels; numbers and sizes of packages; strength of tablets, capsules, etc, CSA Drug Code and NDC Number} 2b. CONTROLLED SUBSTANCE CONTENT OF DRUG OR PREPARATION expressed as acid, base or alkaloid. (Enter names of controlled substances contained in the drug, compound, orpreparadonj 2c. DATE AND ACTUAL QUANTITY {Completed by registrant at time of transact ion) Sodium Thiopental 1gm Vial Quantity: 1,000 vials CSA Drug Code: 2100 NDC Number: Sodium Thiopental 1,000 Vials multiplied by 1 gram Sodium Thiopental 1,000 grams Sodium Thiopental No Conversion FactorApplies to Sodium Thiopental per DEA instruction. 3a. FOREIGN (for U5. import) El DOMESTIC (for US. export) PORT OF EXPORTATION AND APPROX. DEPARTURE DATE Kolkata, India June 18, 2015 (Approximate) 3b. FOREIGN (for US. export) DOMESTIC (for US. import) PORT OF AND APPROX. ARRIVAL DATE Omaha, NE June 21, 2015 (Approximate) .48. MODE OF NAME OF CARRIER (if known) Fedex 4b. NAME OF ALL INTERMEDIATE CARRIERS 5. NAME AND ADDRESS OF FOREIGN Harris Pharma LLP Level 8, RDB Boulevard, Plot K1, Sector V, Salt Lake City Kolkata 700091, West Bengal, India I hereby certify that the substance(s) listed in Section 2 are to be Imported (conform to 21 U.S.C. 952(b)) Exported (conform to 21 U.S.C. 953(e)) and are intended for I: Medical, Scientific, or Other legitimate uses (attach explanation for other legitimate use). CI The above named substances are to be Rea?Exported (Attach documentation per Title 21, CFR 1312.27) to (list countries): Ifthe form is being used as an "Export Declaration", attach documentation that the consignee is authorized under the and regulations of the country of destination to receive the controlled substances. If the controlled substances are being re-exported from the first country to second countries, attach documentation that_the consignee in the country of ultimate destination is authorized under the laws and regulatlons Of that country to receive the controlled substances. SIGNATURE OF AUTHORIZED INDIVIDUAL OF DATE NAME OF FIRM AND TELEPHONE NUMBER EXPO 'Ru PROKER 0R FORWARPING AGENT 5/29/2015 State Of Nebraska Department Of Corrections i (402) 479-5630 E?mail: soott.frakes nebraska. ov Pn mam Sq?- meat?? 9 DEA COPY 4 STATE OF NEBRASKA DEPARTMENT OF CORRECTIONAL SERVICES Scott R. Frakes Director Pete Ricketts Governor May 29, 2015 Drug Enforcement Agency Attention: ODGI import/Export Unit (Ms. Kara Sweeney) 8701 Morrisette Drive Springfield, Virginia 22152 RE: Form 236 Legitimate Use Declaration To Whom it May Concern, l, Scott R. Frakes, as Director of the Nebraska Department of Correctional Services do hereby notify the United States Drug Enforcement Agency that I have sought the importation of Sodium Thiopental pursuant to DEA Form 236. The shipment of 1,000 Vials containing 1 gram each of Sodium Thiopental will solely be used for the legitimate purpose of the Nebraska Department of Correctional Services carrying out lethal injections for those persons sentenced to death in the State of Nebraska. Sincerely, . Frakes, Director Nebraska Department of Correctional Services PO. Box 94661 Lincoln, Nebraska 68509?4661 - Phone (402) 471-2654 An Equal Opportunity Employer 0'1? Tifng P11 e1" DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service *e RECEIVED Food and Drug Administration Rockville MD 2085? JUN 0 1 2015 May 28, 2015 NDCS Director's Of?ce Scott R. Frankes, Director Nebraska Dept. of Correctional Services PO. Box 94661 Lincoln, NE 68509?4661 (402) 471?2654 Re: Media reports about recent purchase of imported sodium thiopental Dear Mr. Frankes, I am writing you today because of media reports that the state of Nebraska has recently purchased and perhaps received sodium thiopental from an overseas source for use by the Nebraska Department of Correctional Services. On April 10, 2012, I sent a letter to your predecessor, Robert Houston, informing him of the US District Court for the District of Columbia decision in Beauty v. FDA, 853 F. Supp. 2d 30 (D.D.C. 2012), a??d inpart, rev?d in part sub nom. Cook v. FDA, 733 F.3d 1 (DC. Cir. 2013). The District Court?s June 2012 Order, which modi?ed the Court?s March 2012 Order, permanently enjoined FDA from permitting the entry of, or releasing any future shipments of, foreign manufactured sodium thiopental that appears to be misbranded or an unapproved new drug in violation of 21 U.S.C. 355. Please note that there is no FDA approved application for sodium thiopental, and it is illegal to import an unapproved new drug into the United States. A recent ABC News article indicated that Nebraska Governor, Pete Ricketts, has recently purchased sodium thiopental from an overseas source. The article also indicates that, at that time, you had not yet received any shipments of sodium thiopental. While our records do not indicate any imported shipments of sodium thiopental destined for your facility or other Nebraska state agency, we remind you of the applicable legal framework. If you have any questions, I can be reached at (301) 796?6673 or by e-mail at Domenic .Veneziano@fda.hhs . gov. Respectfully, Digitally signed by Thaddeus Puplawsk?n -5 DH: HUS, Gowrnmenl. ou=People, Th a a WS Pap 1.1m ki -5 Date: 2015.05.28 12:19:16 -04'00' CAPT Domenic J. Veneziano, Director, Division of Import Operation United States Public Health Service May 28, 2015 - Scott R. Frankes Enclosure: Order, Beaty v. FDA, N0. (RJL) (D.D.C. Mar 27, 2012) Order, Beat-y FDA, N0. Lev-00289 June 22, 2012) ABC news article dated 5/14/2015 Case Document 29 Filed 06/22/12 Page 1 of 2 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA Donald Edward BEATY, Daniel Wayne COOK, Eric J. KING, Brett Patrick and Stephen Michael WEST, Civil Action No. 1:11-cv-00289 (RJL) Plaintiffs, ECF Case v. FOOD AND DRUG ADMINISTRATION, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, Kathleen SEBELIUS, and I Mar aret A. HAMBURG, M.D., 3 JUN 22 2012 Defendants. Clerk. U.S Bankruptcy Courts for the District of Columbia gears UpOn consideration of the Unopposed Motion to Dismiss Count II, Enter Final Judgment, and Make Certain Modi?cations to the Court?s Injunction ?led by Plaintiffs in the above- captioned matter, it is this '31 day of :1 ?5?:ng 2012, ORDERED, that the Motion is GRANTED, and it is further, ORDERED, pursuant to Federal Rule of Civil Procedure 41 that Count II of Plaintiffs? First Amended Complaint is dismissed without prejudice; and it is further, ORDERED, that the sentence of the Order dated March 27, 2012 (Dkt. No. 24), stating that FDA is ?permanently enjoined from permitting the entry of, or releasing any future shipments of, foreign manufactured thiopental into interstate commerce? is hereby modi?ed to read, ?permanently enjoined from permitting the entry of, or releasing any future shipments of, foreign manufactured thiopental that appears to be misbranded or in violation of 21 U.S.C. 355,? and it is further, Case Document 29 Filed 06/22/12 Page 2 0f 2 ORDERED, pursuant to Federal Rule of Civil Procedure 54(b) that the Clerk shall enter ?nal judgment disposing of this action in its entirety. Hon'. Richarilglleon United States istriet Court Judge Case Document 24 Filed 03/27/12 Page 1 of2 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA DONALD EDWARD BEATY, et al., Plaintiffs, v. Civil Case No. 11-289 (RJL) FOOD AND DRUG ADMINISTRATION, and U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, and KATHLEEN SEBELIUS, in her official capacity as Secretary of the U.S. Department of Health and Human Services, and MARGARET A. HAMBURG, M.D., in her of?cial capacity as Commissioner of Food and Drugs, Defendants. ORDER (March Zi, 2012) For the reasons set forth in the Memorandum Opinion entered thiil day of March, 2012, it is hereby ORDERED that plaintiffs? Motion for Summary Judgment and Declaratory Relief on Counts I and is and it is further ORDERED that the defendants? Motion to Dismiss and/or for Summary Judgment is and it is further Case Document 24 Filed 03/27/12 Page 2 of 2 DECLARED, pursuant to 28 U.S.C. 2201(a), that l. the foreign manufactured thiopental (or ?thiopental?) imported by the importing States Arizona, California, South Carolina, Georgia, and Tennessee) is a misbranded drug and an unapproved new drug within the meaning of the and 2. as such, this thiopental cannot lawfully be introduced or delivered for introduction into interstate commerce or lawfully be imported into the United States; and 3. defendants? recent actions allowing such thiopental to enter the United States were each contrary to law, arbitrary, capricious, and an abuse of discretion under the and, in particular, 4. defendants? January 4, 2011 announcement that they will allow ?rture shipments of such thiopental to enter the United States is contrary to law, arbitrary, capricious, and an abuse of discretion under the accordingly IT IS HEREBY ORDERED that the FDA: 1. immediately notify any and all state correctional departments which it has reason to believe are still in possession of any foreign manufactured thiopental that the use of such drug is prohibited by law and that, that thiopental must be returned immediately to the and 2. be permanently enjoined from permitting the entry of, or releasing any future shipments of, foreign manufactured thiopental into interstate commerce; and IT IS FURTHER ORDERED that the parties are hereby directed to meet and confer to determine whether further litigation is necessary, or proper, with respect to the remaining count in this Complaint. SO ORDERED. aw RICE-IARILUJEON United States District Judge Governor says Nebraska has ordered. new death penalty drugs By GRANT SBHULTE May. 14,2015 10:25 PM EDT LINCOLN, Neb. (AP) ?Nebraska's Republican governor is taking new steps to resume executions in a state that hasn't imposed the death penalty since 1997, as lawmakers look seriously at abolishing capital punishment. Gov. Pete Ricketts said Thursday evening that state of?cials have bought all three drugs required to carry out executions. Nebraska lost its ability to execute prisoners when its supply of sodium thiopental, a required lethal injection drug, expired in December 2013. The announcement comes one day before lawmakers are scheduled to debate a death penalty repeal measure that has gained more support than usual. The bill won ?rst-round approval with a veto?proof majority in April, but two more votes are required before it goes to Ricketts, a death-penalty supporter. Some opponents haVe argued that Nebraska should abolish capital punishment because it has only wasted money and created a false promise for Victims' families. The state hasn?t executed anyone since 1997, and some prisoners have been on death row for decades. Nebraska has only carried out four executions since 1973, partly because of repeated legal challenges. Ricketts and his corrections director, Scott Frakes, said the state now possesses one of the three lethal injection drugs that state law requires for executions and will receive the other two in the near future. Nebraska Attorney General Doug Peterson has said three of Nebraska's ll death-row inmates have exhausted all of their appeals. "The functionality of the death penalty in Nebraska has been a management issue that Ihave promised to resolve,? Ricketts said. Ricketts said the department has already obtained potassium chloride, a drug that stops the heart, and has bought the other two drugs sodium thiopental and pancuronium bromide from a distributor in West Bengal, India. Sodium thiOpental serves as an anesthetic, and pancuronium bromide is a muscle relaxant that induces paralysis. Ricketts spokesman Taylor Gage said the state ordered the drugs over the past few weeks from HarrisPharma, a distributor that has sold to state officials before. The last purchase was made this week. Defense attorneys for Nebraska's death-row inmates have raised legal questions about the company before. One lawyer argued that Chris Harris, the company's owner, sold drugs that were only meant to be used as testing samples, and was not authorized to do so. Because he was not allowed do so, the defense attorney argued that the drug was stolen property and Nebraska shouldn't be allowed to use it in executions. Nebraska Solicitor General Jim Smith, who handled previous death penalty cases, said those arguments were later rejected. The Nebraska Supreme Court ruled that the argument wasn't a valid challenge in a death penalty case under state law. From: Blum, Kathy Sent: Friday, May 29, 2015 3:51 PM To: 'kara.a.sweeney@usdojgov' Subject: FW: Message from Attachments: 20150529154048846pdf Ms. Sweeney, Attached is the cancellation of DEA Form 236 previously sent to you by the Nebraska Department of Correctional Services. We have learned that the address for the foreign consignee/consignor in box #5 has changed. The Nebraska Department of Correctional Services will be sending you a new DEA Form 236 with an updated address for the foreign exporter. Kathleen A. Blum Associate Legal Counsel Nebraska Department of Correctional Services Phone: 402-479-5901 Fax: 402-479-5623 E?mail: OMB APPROVAL U.S. Department of Justice Drug EnforCement Administration No. 1117-0009 CONTROLLED SUBSTANCES IMPORT EXPORT DECLARATION EXPIRATION DATE. 9133mm Read instructions on reversebefore Completing} sea reverse for tha av IMPORT DECLARATION Nonnarcotlc Substances In ScheduIEs IV, ONE EXPORT DECLARATION Nonnarcotic Substances In Schedules Ill, and IV'and all substances In Date or DepamreyArrIVal Schedule IMPORTERIEKPDIITER (Name and Add'r?ss) BROKER OR FORWARDING AGENT, iF USED (Name and Date of Certification Address) Nebraska State Penitentiary 4201 14th South Street Not Applicable . 1 NE 68502 Signature of Customs Official DEA Transaction ID as?. Res no. 9414134 2.- To BE IMPORTED on EXPORTED 2a. NAME AND QUANTITY OF DRUG OR PREPARATION 2b. CONTROLLEDSU CONTENT OF DRUG OR 2C. DATE AND (Enter-names as shown on labels; numbers and si2es of PREPARATION expressed as acid, base or alkaloid. {Enter ACTUAL QUANTITY package?s; strength of tablets, capsules, eta, 65A Drug Code names afcontrolled substances contained in the drug, {campieted by. registrant at time of and Wm: Number} compound, or preparation) transaction) Sodium Thiopental ?igm Vial Sodium Thiop?entai QM Quantity: 1,000 Vials 1.;000 Vials multiplied by 1 gram Sodium Thiopental 1.000 grams Sodium Thibpen'tai 5 ?l CSA Drug Code: 2100 No Conversion Factor Applies to Sodium NDC Number: Thi'o?pe?ntal per DEA Instruction. 3a. FOREIGN (farU.S. Import) El DOMESTIC (for us. export) PORT OF 3b. FOREIGN (Tor U.S-. export) DOMESTIC (for U5. Ifri?p'ort) EXPORTATION AND APPROX. DEPARTURE DATE IMPORTATION AND APPROX. ARRIVAL DATE Kuikata, indie June 15. 2015 (Approximatei Omaha. NE June 18, 2015 (Approximate) 4a. MODE OF NAME OF VESSEL CARRIER [If known) 4b. NAME OF ALL INTERMEDIATE CARRIERS Fedex 5. NAME AND ADDRESSLOF FOREIGN CONSIGNEEXCUNSIGNOR Harris Pharma LLP . 1'45 Bo?sepukur Road Kolkata'700039?. West Bengal,- indie I hereby certifytha?t the substance(s) listed In Section 2 are to be [a Imported (conform to 21 U.S.C. 952(b)) Exported (conform to 2'1 U.S.C. 953(ei) and are - intended 'for Medical, El Scientific, or Other legitimate uses (attach Explanation for other legitimate use). CI The above named substan?Ces are to be (Attaah documentation per Title 21, CFR 1312.27) to (list countries); If the form Is being used as an "Export Declaration", attach documentation that the consignee is authoriZed under? the laws Grid re?gUiatiO'n?s Of'tiie country of destination to receive the controlled substances. If the controlledisubstances are being re-exported from the ?rst country to second countries, attach documentation that the? In the country of ultimate destination is authorized under the laws and regulations of that country to receive the controlled substances. SIGNATURE OF AUTHORIZED INDIVIDUAL OF IMPORTER DATE NAME OF FIRM AND TELEPHONE NUMBER EKPDR ERI-BRUKER 0R FORWNIDING AGENT 512612015 State of Nebraska Department of Corrections (402) 479E5630 - E?m?aii: scattfrake's nebraska. ov a e: ?5915?? . . DEA 4 From: Frakes, Scott Sent: Monday, June 01, 2015 7:35 AM To: Sweeney, Kara A. Cc: Boyer, Mark; Blum, Kathy Subject: RE: Cannot Process DEA 236 form Thank you we will get this resolved ASAP. From: Sweeney, Kara A. Sent: Monday, June 01, 2015 7:32 AM To: Frakes, Scott Subject: Cannot Process DEA 236 form Importance: High Mr. Frakes, We can?t process the DEA Import 236 form received for Sodium Thipoental because the DEA Registration on this form is incorrect. The DEA Registration starts with please correct this, date and initial the change, then scan and email the amendment form to me so that we may process this request. Thanks, Kara ara Sweeney Program Analyst Drug Enforcement Administration Office of Diversion Control Import/Export Unit 202?307-4989 From: Blum, Kathy Sent: Monday, June 01,2015 10:01 AM To: 'Sweeney, Kara Cc: Frakes, Scott Subject: RE: Message from Attachments: 20150601095252544pdf Kara, As you requested, attached is the corrected DEA form 236. We overnighted the original form to you on Friday May 29, 2015. The Nebraska Department of Correctional Services Director Scott Frakes has initialed the corrected DEA Registration number as you instructed. Thanks, Kathleen A. Blum Associate Legal Counsel Nebraska Department of Correctional Services Phone: 402-479-5901 Fax: 402-479-5623 E?mail: From: Sweeney, Kara A. Sent: Monday, June 01, 2015 7:34 AM To: Blum, Kathy Subject: RE: Message from Importance: High Kathy, The DEA Registration on the DEA 236 form is also incorrect. The DEA Registration starts with please correct this as well. Thanks Kara Message?-?-- From: Blum, Kathy Sent: Friday, May 29,2015 4:52 PM To: Sweeney, Kara A. Subject: FW: Message from Ms. Sweeney, Attached is the cancellation of DEA Form 236 previously sent to you by the Nebraska Department of Correctional Services. We have learned that the address for the foreign consignee/consignor in box #5 has changed. The Nebraska Department of Correctional Services will be sending you a new DEA Form 236 with an updated address for the foreign exporter. Kathleen A. Blum Associate Legal Counsel Nebraska Department of Correctional Services Phone: 402-479?5901 Fax: 402-479-5623 E-mail: kathv.biL1m@nebraskeigov OMB APPROVAL U.S. Department OfJustIce/ Drug Enforcement Administration No. 1117?0009 CONTROLLED SUBSTANCES EXPORT DECLARATION . . EXPIRATION DATE: 5l30I2016 (Read Instructions on reverse before completing} See reverse for privacy Act 1. U.5. CUSTOMS CHECK IMPORT DECLARATION Nonnarcotic Substances In Schedules IV, CERTIFICATION 0 I. . El Nonnarcotic Substances in Schedules and IV and all substances in Date Of Departure/Arrwal EXPORT DECLARATION Schedujev - IMPORTEITXEXPORTER (Name and Address) BROKER OR FORWARDING AGENT, IF USED [Name and Date of Certi?cation Address) Nebraska State Penitentiary Nat Appncable Signature of Customs Of?cial DEA Transaction ID DEA REGISTRATION nowfku??l 2. CONTROLLED 5U BSTANCES TO BE IMPORTED OR EXPORTED 23. NAMEAND QUANTITY OF DRUG OR PREPARATION 2b. CONTROLLED SUBSTANCE CONTENT OF DRUG OR 2c. DATE AND (Enter names as shown on IabeIs; numbers and sizes of PREPARATION expressed as acid, base or alkaloid. (Enter ACTUAL QUANTITY packages; strength of tablets, capsules, etc, GSA Drug Co'de names of controlled substances contained in the drug, (Completed by registrant at time of and compound, or preparation) transaction) - Sodium Thiopental 1gm Vial Sodium Thiopentai Quantity: 1,000 vials 1,000 Vials multiplied by 1 gram Sodium Thiopental 1,000 grams Sodium Thiopental CSA Drug Code: 2100 No Conversion FactorAppIies to Sodium NDC Number 621000300? - Thlopental per DEA instruction. Ba. FOREIGN (for US. Import) DOMESTIC (for U.S. export) PORT OF FOREIGN (forUS. export) DOMESTIC (for US. import) PORT OF EXPORTATION AND APPROX. DEPARTURE DATE IMPORTATIDN AND APPROX. ARRIVAL DATE Kolkata, India June 18, 2015 (Approximate) Omaha, NE June 21, 2015 (Approximate) ,4a. MODE OF NAME OF VESSEL [If known) 4b. NAME OF ALL CARRIERS Fedex 5. NAME AND ADDRESS OF FOREIGN Harris Pharma LLP Level 8, RDB Boulevard, F'Ial. K1, Sector V, Salt Lake City Kolkata 700091, West Bengal, India I hereby certifythat the substance(s) listed in Section 2 are to be Imported (conform to 21 U.S.C. 952(b)) I: (conform to 21 U.S.C. 953(e)) and are intended for CI Medical, Scientific, or Other legitimate uses (attach explanation for otheriegitimate use). The above named substances are to be FIE-Exported {Attach documentatton per Title 21, CFR 1312.27) to (list countries]: If the form Is being used as an 'fExporI: Declaration", attach documentation that the consignee Is authorized under the laws and regulations of the country of destination to receive the controlled substances. If the controlled substances are being re-exported from the ?rst country to second countries, attach documentation that the In the country of ultimate destination Is authorized under the Iaws and regulations of that cnunt?to receive the controlled substances. SIGNATURE OFAUTHORIZED INDIVIDUAL OF DATE NAME OF FIRM AND TELEPHONE NUMBER EXPO ERIEROKER 0? AGENT 512912015 State Of Nebraska Department of Corrections (402) 479-5630 E?maii: scott.frakes@nebraska.gov Pr t-Nam gx?? DEA copwr STATE OF NEBRASKA DEPARTMENT OF CORRECTIONAL SERVICES Scott R. Frakes Director Pete Ricketts Governor May 29, 2015 Drug Enforcement Agency Attention: ODGI import/Export Unit (Ms. Kara Sweeney) 8701 Morrisette Drive Springfield, Virginia 22152 RE: Form 236 Legitimate Use Declaration To Whom It May Concern, 1, Scott R. Frakes, as Director of the Nebraska Department of Correctional Services do hereby notify the United States Drug Enforcement Agency that l?have sought the importation of Sodium Thiopental pursuant to DEA Form 236. The shipment of 1,000 vials containing 1 gram each?of Sodium Thiopental will solely be used for the legitimate purpose of the Nebraska Department of Correctional Services carrying out lethal injections for those persons sentenced to death in the State of Nebraska. Sincerely, Nebraska Department of Correctional Services PO. Box 94661 Lincoln. Nebraska 63509-4661 - Phone (402) 47142654 An Equal Opportunity Employer . . i! uni?r2. ?ah-n an. From: ra kes, Scott Sent: Tuesday, June 02, 2015 2:52 PM To: Blum, Kathy Cc: Boyer, Mark Subject: Fwd: DEA Import 236 Form See if you ?gure this out. See you tomorrow. Sent from my Verizon Wireless 4G LTE smartphone Original message From: "Sweeney, Kara Date: 06/02/2015 2:39 PM To: "Frakes, Scott" Subject: DEA Imp01t 236 Form Scott, The DEA Import 236 form submitted says, ?No Conversion Factor Applies to Sodium Thiopental per DEA Instruction? please explain as our system has a 92% conversion factor for Sodium Thiopental making the base weight in grams being imported 920 grams. Thanks, Kara Kara Sweeney Program Analyst Drug Enforcement Administration Office of Diversion Control Import/Export Unit 202?307?4989 From: Boyer, Mark Sent: Tuesday, June 02, 2015 3:11 PM To: Kara.A.Sweeney@usdoj.gov Cc: Frakes, Scott; Blum, Kathy Subject: RE: DEA Import 236 Form Kara, I attempted to speak with Alan Drumheller at the phone number you provided (202) 307?8600. I was referred to another DEA staff member due to the fact Mr. Drumheller was not in the office on the day ofthe telephone call. This DEA employee advised that Sodium Thiopental did not have a conversion factor and was not a substance that was capable of being converted into its base form. Please advise on how you wish us to proceed in this matter. Mark Boyer 9955?! From: Frakes, Scott Sent: Tuesday, June 02, 2015 2:52 PM To: Blum, Kathy Cc: Boyer, Mark Subject: Fwd: DEA Import 236 Form See if you ?gure this out. See you tomorrow. Sent from my Verizon Wireless 40 LTE smartphone Original message From: "Sweeney, Kara {KaraA.Swecncy@usdoigov> Date: 06/02/2015 2:39 PM To: "Frakes, Scott" Subject: DEA Import 236 Form Scott, The DEA Import 236 form submitted says, ?No Conversion Factor Applies to Sodium Thiopental per DEA Instruction" please explain as our system has a 92% conversion factor for Sodium Thiopental making the base weight in grams being imported 920 grams. Thanks, Kara Kara Sweeney Program Analyst Drug Enforcement Administration Office of Diversion Control import/Export Unit 202-307-4989 Sweeney, Kara A. lent: Thursday, June 04,2015 6:50 AM To: Boyer, Mark Cc: Frakes, Scott; Blum, Kathy Subject: RE: DEA Import 236 Form ODE confirmed that it is 100% for Sodium Thiopental. Mark Via will coordinate this correction in our system with our IT Department. Thank you! The assigned DEA Transaction for this Import Request is #5159973. - Please write the DEA Transaction on copies 1, 2, 3, and 5 of the 236 forms (DEA Transaction ID box above box 20) - Once shipped/received please complete box 2c on the DEA 236 Form with the actual date and actual quantity received/shipped (the base in grams per line item on the declaration) - Scan and email the DEA 236 form with the completed box 20 to the DEA Controlled Substances email box: CSIMEX?usdoigov Kara Sweeney Program Analyst Drug Enforcement Administration Of?ce of Diversion Control Import/Export Unit 202-307-4989 From: Boyer, Mark Sent: Tuesday, June 02, 2015 4:11 PM To: Sweeney, Kara A. Cc: Frakes, Scott; Blum, Kathy Subject: RE: DEA Import 236 Form Kara, I attempted to speak with Alan Drumheller at the phone number you provided (202) 307-8600. was referred to another DEA staff member due to the fact Mr. Drumheller was not in the office on the day ofthe telephone call. This DEA employee advised that Sodium Thiopental did not have a conversion factor and was not a substance that was capable of being converted into its base form. Please advise on how you wish us to proceed in this matter. Mark Boyer NDCS Legalwrestn. From: Frakes, Scott Sent: Tuesday, June 02, 2015 2:52 PM To: Blum, Kathy Cc: Boyer, Mark Subject: Fwd: DEA Import 236 Form See if you ?gure this out. See you tomorrow. Sent from my Verizon Wireless 4G LTE smartphonc Original message 'om: "Sweeney, Kara {KamASwecnevr?usdoLaow ?ats: 06/02/2015 2:39 PM To: "Frakes, Scott" Subject: DEA Import 236 Form Scott, The DEA lmport 236 form submitted says, ?No Conversion Factor Applies to Sodium Thiopental per DEA Instruction? please explain as our system has a 92% conversion factor for Sodium Thiopental making the base weight in grams being imported 920 grams. Thanks, Kara Kara Sweeney Program Analyst Drug Enforcement Administration Office of Diversion Control Import/Export Unit 202-307-4989