DEPARTMENT OF HEALTH AND HUMAN SERVICE Food and Drug Admlnlslratlon New Orleans District Import Operallons 959 Ridgeway Loop, Sulle 100 Memphis, Tn. 38120 Telephone: (901) 333·3520 FAX: (901)333-3579 Jauuary 7, 2011 UNITED PARCEL SERVICE Delivery Signature Requested RE: Entry Number 112-9938358-2 This letter provides the status of Elltry Number 112-9938358-2, consisting packets, each vial containing 500 mg of Thiopental Sodium. FDA received documentation for this shipment and verified it is destined fo1' a state correctional facility. FDA releases this shipment, which is being imported by or on behalf of state correctional authorities. In keeping with established practice, FDA does not review or approve products for the purpose of lethal injection. FDA has not reviewed the products in this shipment to determine their identity, safety, effectiveness, purity or any other characteristics. Sincerely, Patricia K. Schafei· J- Acting District Director New Orleans District Office FDA000029
9
Embed
~~K.~~ J · port 2095 5. single trans. bond 4. entry number 112-9938358-2 15. u.s. port of unlading 17. manifest number 18. go. number 19. lotalvawe 2095 20. description of merchandise
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
DEPARTMENT OF HEALTH AND HUMAN SERVICE
Food and Drug AdmlnlslratlonNew Orleans DistrictImport Operallons959 Ridgeway Loop, Sulle 100Memphis, Tn. 38120
Telephone: (901) 333·3520FAX: (901)333-3579
Jauuary 7, 2011
UNITED PARCEL SERVICEDelivery Signature Requested
RE: Entry Number 112-9938358-2
This letter provides the status ofElltry Number 112-9938358-2, consisting ofl(b)f(~)lvialpackets, each vial containing 500 mg ofThiopental Sodium. FDA received documentationfor this shipment and verified it is destined fo1' a state correctional facility.
FDA releases this shipment, which is being imported by or on behalf of state correctionalauthorities. In keeping with established practice, FDA does not review or approve productsfor the purpose of lethal injection. FDA has not reviewed the products in this shipment todetermine their identity, safety, effectiveness, purity or any other characteristics.
Sincerely,
~~K.~~Patricia K. Schafei· JActing District DirectorNew Orleans District Office
FDA000029
Page 1 of1
alpenny, Susan M; Dixon, Ruth Pentry item # 112-99-38358-2
From: Boulmay, ChristopherSent; Tuesda November 3Q, 2010 4:00 PMTo:Ce:Sub.leet:~~iltr~~',;~;3'
- "", "... 'If-y·o~r~~~~. a~~i~~~~~~~~~:~70dn ~~e!~~~;8~ff~~~~~~~~j;~~n:'jDixon at 901-333-3522. I am not authorized to make an
admissibility decision on the entry.
Thank you,
~~Consumer Safety OfficerUS Food & Drug AdministrationNOL-DO: Memphis R.P.
Comments: FDA releases this shipment, which is being imported by or on beha'lf of state correctionalauthorities. In keeping with established practice, FDA does not review or approve products for thepurpose of lethal injection. FDA has not reviewed the products in t~is shipment to determine theiridentity, safety, effectiveness, purity or any other characteristics.
Randy N. Boling, Compliance Officer (Region/District) (901) 333-3537
U S F d d D A .. . (901) 333-3579 (FAX)• • 00 an rug dmlnlstratlon [email protected]
959 Ridgeway Loop Road, Suite 100Memphis, TN 38120-4042
Randy N. Boling, Compliance Officer (Region/District) (901) 333-3537.• . (901) 333-3579 (FAX)
U.S. Food and Drug Administration [email protected] Ridgeway Loop Road, Suite 100Memphis, TN 38120-4042
These products are released. This notice does not constitute assurance that the product released complies with allprovisions of the Food, Drug, and Cosmetic Act, or other related Acts, and does not preclude action should theproduct later be found violative.
Notice Prepared For: The District Director, U.S. Food and Drug AdministrationNotice Prepared By: LPW
FDA000032
. TABS:
DEPARTMENT OF THE TREASURYUNITED STATES CUSTOMS SERVICE
Form ApJlf'MldOMS No. 1515-0069
ENTRY/IMMEDIATE DELIVERY ABI CERTIFIED
TEL:
AIR EXPRESS
1. ARRIVAL DATE
1119105. PORT
20955. SINGLE TRANS. BOND
4. ENTRY NUMBER
112-9938358-2
15. U.s. PORT OF UNLADING 17. MANIFEST NUMBER 18. Go. NUMBER 19. lOTAl VAWE
209520. DESCRIPTION OF MERCHANDISE
21. ITlBUAWB 22. mBUAWB NO.CODE
PHARMACEUTICALS NOT RESTRICTED25. COUNTRY 28. MANUFACTURER In.
OF ORIGIN
GBDREPHA176LONGBTOTAL02358560751688760418962
MH
'ZT. CERTIFICATION 28. CUSlOMS USE ONLY
I hBreby make application for entrynmmedlale delivery. I eertify thBtthe above D OTHER AGENCY ACTION REQUIRED, NAMELY:Information IB accurete, the bond Is sullielent, valid. and currant, and that allrequirements of 19 CFR Part 142 have been mst.
D CUSTOMS EXAMINATION REQUIRED.
:-=::-:=:=-=:=-=--!-::=7::=:::-:~=-=------1
-------------------------1 D ENTRY REJECTED, BECAUSE:
DELIVERYAUTHORIZED:
SIGNATURE
Customs Form 3461 (010189)
Papsrwork Reduction Act Notice: This information 18 needed to dstermlns the admissibility of imports Into the Unllsd Statae and 10 proVide the necessaryInformetlon for the examination of the cargo and to establish the liability for payment of dulleD Dnd taxeB. Your responDe Is neceBaery.
1.l(~)1raJ.jCurrency: USD - US DollarHeading: PHARMACEUTICALS NOT RESTRICTED
Name/Descri tionThiopental Injection. powder for reconstitution, thiopental sodium. 500·mg vial packs of 25's
Batch No: AW6022 EXP: 05/14
Statement Details
Discount (%):
Deli';'ery:~
Insurance:.
Shipping Details
Tariff:Declarations:We certify thallhis invoice is lrue and correct
Subtotal:""""'llL!!"""'=
VAT (World Zero):I(§Il~~
Previous Balance:.
Total: II1IDI<iJl USD • US Dollar
Pa menl Melhod: Pre a menl Thank You
Damage. shOrtage or leakage must be nollfied in writing 10 ourselves within 3 days. Non·Delivery within 14 days. GoodS remain Ihe property 0' DreamPharma Lid. Unlil fUll paymenl has been received. Subject 10 our standard conditiOns of sale. E&OE
Company Registration Number:lmIIDi VAT No. ~~~!:.!2~Director: M. Alavi
Page 1 of 1
FDA000034
lill1R}lr~"Manifest report
MPS shipment
pago·
FDA000035
FDA000036
. .
F-698
D lem"OI.US leoidenl
P.DDI/DolT-8SQ
/IppIoveeI hlooUh 121JV!IS. OMS NO joi:o-a1giSee balk of '01m III P_..kRClfocICIlAcl No~c~.
Ih..~noSIlQaI :;eclln~ No.
o ClIlll'lge Dr IICIdiess
o ;:':",,~J:,~~i:~ei=':.':~~1/fPenolDeo, ."Ll Farlllllll/ti Office
• NOTE-II. tOnln,,_ Dana Is on III... a DOIla no8\' IlhAI ;1I:campan~ 11111 crulnB" d0Clltl10nl
RETURN TO:.
AWBREF fl.:
I
12:DDpm
DEP1\R~MBN'l' OP THE TREMURYUNITED STATES CUSTOMS SERVICE