A decade ago, Dr. Carlo Musso came to then-Clayton County Sheriff Stanley Tuggle with an idea: He wanted to run the local jail’s medical service.

Musso, an emergency room doctor at the time, was energetic, ambitious and tired of overnight shifts. The work he did in the emergency room, he explained to Tuggle, was similar to what’s needed in a jail infirmary. Musso bid on and won the $2 million-a-year contract.

It’s been an ideal arrangement, Tuggle said.

“Emergency room doctors move fast, think fast and get things done,” Tuggle said. “That’s how he moves in life. He’s always moving, always thinking about how to solve problems.”

These days, Musso has more to worry about than just sick prisoners or sheriffs trying to squeeze him about contract costs. An anti-death-penalty group last week — in its most recent effort to halt executions — asked the state medical board to revoke his license, saying he illegally sold sodium thiopental, a drug used in lethal injections, to two states.

Musso didn’t respond to several requests for comment for this story. But Thursday night, after the execution of convicted murderer Roy Blankenship, Musso released a statement to the Associated Press saying he is being singled out for “political purposes.” He urged death penalty critics to target their efforts at lawmakers, not him.

The company he started, CorrectHealth, has grown to provide care to about two dozen detention centers, making it one of the largest such operations in the Southeast. Aside from providing jail health care, Musso also runs Rainbow Medical Associates, which monitors lethal injections for Georgia. It’s a business he started, he has said, because he wanted to make sure executions were carried out with “the least amount of pain and suffering.”

Sodium thiopental is a sedative used with two other drugs during executions. The drug has been hard to get in the past year because a U.S. manufacturer stopped making it.

Federal authorities maintain Georgia obtained sodium thiopental from a London company that operated in a storefront behind a driving school.

It’s unclear who purchased the drug. Earlier this year, the DEA seized the state’s supply after defense attorneys questioned whether the drug had been legally acquired.

Documents in the complaint filed by the Atlanta-based Southern Center for Human Rights include records that indicate Musso’s company has supplied Kentucky and Tennessee with the drug in the past year after buying it from the London firm. A Kentucky Department of Corrections memo said the agency bought 18 grams of the drug in February from CorrectHealth.

“This complaint is not about Dr. Musso’s role at state-sponsored executions,” Southern Center attorney Jessica Oats wrote. “It is only concerned whether the person or entity importing and distributing the drug is properly licensed and authorized. Dr. Musso was neither.”

Musso this year told the Associated Press his company sold no drugs to other states.

“We’re not the middle man,” he said then. “We’ve been asked to do that, and I’ve said, quite frankly, ‘No, we’re not going to do that.’ ”

Brad Robinson, chief deputy in Carroll County, which has done business with Musso since 2002, said the news about Musso’s firm selling the drugs to other states — for $1,551 and $1,600, according to the complaint — doesn’t sound right.

“I don’t think he’d go out and intentionally jeopardize [his career] to go out and make money on this,” Robinson said. “I’d assume he was just helping out a neighboring state.”

An attorney for the Southern Center for Human Rights said doing such favors might open doors for more business.

The Southern Center’s complaint includes an email from a CorrectHealth administrator to a Tennessee prison official after the sedative was delivered: “I enjoyed our discussion about the potential need for skilled nursing care for some of your inmates. CorrectHealth and I would be very happy to discuss this in more detail.”

The Georgia Department of Corrections said it would not release information on Musso’s company’s contract with the state without a receiving an Open Records request. Despite receiving one from the AJC, as of Friday the newspaper still had not received the records.

The medical board would not comment on the human rights group’s complaint, but an investigator said the agency would look into the matter.

Supporters say Musso, a Clayton County resident, has long been an energetic volunteer devoted to local causes such as abused children, the arts and the region’s housing crisis. In 2008, as chairman of the county’s housing authority, Musso was instrumental in creating a consortium to help keep troubled homeowners in their homes.

“He lives in this community and was trying to come up with a solution,” said Chris Wood, a public relations specialist who has worked with the housing authority. “He’s an outstanding community leader on the south side. Anyone who infers that Carlo is insensitive or not caring or is in it only for the money knows nothing about the man.”

Musso has said that he and other doctors in his company have donated some of the money earned from supervising executions to a child abuse center where he has volunteered.

In 2006, he told the New England Journal of Medicine that nurses start an IV on the condemned and prison officials administer the fatal drugs.

Georgia sheriffs who have hired Musso largely stand behind his company and talk about him as a go-getter who has advanced the field of jail health care.

Several sheriffs said Musso is accessible, quick to respond to problems and works diligently to cut costs and save taxpayers money. They noted he worked to get prisoners covered by Blue Cross Blue Shield when they are taken to hospitals, saving millions. Others noted his expertise is such that he helps design new jail facilities to improve security and workflow.

“As elected officials, we are hard clients to work for,” Clayton County Sheriff Kem Kimbrough said. “If you are successful at keeping costs down, the word will spread.

“When you find someone who gets the hang of it, then it’s called cornering the market. If you get a formula, then it’s like being Col. Sanders.”

DeKalb County Sheriff Thomas Brown said Musso is a master at generating business and is one of the largest sponsors of the Georgia Sheriffs’ Association.

“He’s a platinum sponsor, the only platinum sponsor,” Brown said. “It gives him a chance to lobby sheriffs. He gets a lot of face time and recognition when he goes to conferences. I have to give it to him, he’s quite a capitalist.”

But Brown said he cut CorrectHealth loose from an annual $8 million contract this year.

He said the firm had a hard time keeping nurses and even hiring employees who would show up, which caused a backup in the number of sick prisoners, and that became a security issue. Also, he said CorrectHealth was sending too many prisoners to the hospital, driving up costs.

The relationship between Brown and his old golfing partner became strained.

“I still like him personally,” Brown said. “But business is business.”