The Aum Shinrikyo Executions: Why Now?

With the execution of Aum Shinrikyo leader and six of his followers, Japan looks to leave behind an era of tragedy. 
On July 6, 2018, Japanese authorities executed seven members of the religious movement Aum Shinrikyo (Aum true religion, or supreme truth), which carried out the 1995 Tokyo subway sarin attack and a series of other atrocities. None of the seven of the executed men were directly involved in releasing the gas on that tragic day; four of those who did remain under a death sentence, and their executions may be imminent.
The seven executed were involved in planning and organizing the various crimes committed by Aum. Asahara Shoko (born Matsumoto Chizuo), was the founder and leader of the movement, having developed the doctrinal system instrumental to Aum’s violence and its concept of a final cosmic war of good (Aum) against evil (the corrupt material world and everyone — from the Japanese government to the general public — who lived in it). Asahara is believed to have given …

Not In My Name

A painstaking reconstruction of a real-time execution by lethal injection that highlights some of the very specific issues relating to the USA’s preferred execution method.

Over the last few years, executions have been on the decline in the US, the practice has been fraught with pragmatic, fiscal, and constitutional problems. This hasn’t stopped the country from continuing to be one of the top executing nations in the world.

#DeathPenaltyFail is a campaign to promote the facts, highlight the inefficiencies, and push for the repeal of the death penalty in the United States. Using films, visuals, and the stories of exonerees, victim’s families, and law enforcement, we are committed to educating people about the social, emotional, and financial burdens of the death penalty.

Whether you support the death penalty or not, there can be no doubt that the death penalty is riddled with problems, and when that system leads to the taking of a life, the stakes are simply too high to ignore.

Source: DeathPenaltyFail.org, August 2016

We can no longer mask the barbarity of the death penalty

Ronald B. Smith
Ronald B. Smith
(CNN) The United States is bumbling its way toward the bitter end of the death penalty. As the numbers of executions fall every year, the state-ordered deaths that we do commit become that much more unusual, freakish and unfair applications of the law. As states scramble to implement arbitrary new lethal injection protocols, the cruelty of the procedure only worsens. The way Alabama killed the convicted murderer Ronald B. Smith on Thursday is only the latest example.

According to Birmingham News reporter Kent Faulk, Smith moved his lips after receiving an injection of midazolam, the third-choice sedative that most death penalty states are using in the absence of stronger barbiturate drugs. Besides moving his lips, Faulk reported the man was gasping for breath, heaving and coughing, for 13 minutes, stating that Smith "clenched his left fist after apparently being administered the first drug in the three-drug combination."

Faulk also said Smith's left eye appeared slightly open at times during the procedure and said Smith moved his right arm and hand after a prison official poked and prodded him a second time to check whether he was still conscious.

After the midazolam, which is the same twilight-inducing benzodiazepine that many people experience in lower doses for common procedures like a colonoscopy, prison staff next injected Smith with the paralytic pancuronium bromide and finally potassium chloride (which causes the lethal cardiac arrest).

The medicalization of capital punishment began in 1982 with the first lethal injection in Texas, and for most of the time we've relied on this method, states first injected the condemned with sodium thiopental, a strong barbiturate sedative (in general, barbiturates are stronger than benzodiazepines like midazolam).

But death penalty states lost their access to sodium thiopental when the pharmaceutical company Hospira stopped making it following European pressure. The European Union even specifically blocks the export of drugs that could potentially be used in executions to the United States.

Executioners next turned to pentobarbital, another barbiturate that can induce a deep medical coma, but its Danish manufacturer Lundbeck then cut off our supply of that drug, too. Now, prison officials are relegated to partnering with local compounding pharmacies whose skills in drug synthesis aren't ready for prime time. Or, they can get creative and use a drug so common its supply can't be cut off by the EU or a single manufacturer -- a drug like midazolam.

The only problem with that is that midazolam's a lousy drug for lethal injection. Besides the fact that there are stronger sedatives that it makes more sense to use, we know it's not very soluble, meaning it can easily become a solid in the vial or IV tubing, especially the higher the dose gets. Moreover, potassium chloride only makes its solubility worse, precipitating more of the drug out of solution, enough that trying to force in the injection through the precipitate can break the vein, spilling the drugs out into the arm tissue where they're not going to have their intended effects.

We know that consciousness is a continuum, and from the descriptions of Smith's execution, he was likely in a semi-conscious state for some of his execution. He could have been more fully conscious, but we'd be unaware because the paralytic he got would have prevented him from speaking.

We can't run experiments determining what prisoners really experience with any of the cocktails. After all, the experimental subject would be dead, one way or another, following the procedure. But the evidence we've got -- a number of botched executions using midazolam with subjects moving and attempting to speak after they're supposed to have been rendered unconscious, makes it clear this method is unacceptable.

To compound matters, decent physicians aren't willing to participate. Relevant specialties like anesthesiology will kick out a member who facilitates executions. The resulting procedure is archaic. Medics are fumbling around in the middle of the night trying to place peripheral IV lines right before the execution, having difficulty finding veins, when larger central or PICC lines could have been placed beforehand with imaging guidance.

We certainly can't trust the neurological examination skills of these executioners, so they'd be better off using a more objective EEG monitoring protocol to assess the how deeply unconscious their subjects are. But setting up one of the commercially available systems would require the help of companies and vendors that probably have ethical standards that wouldn't allow them to participate in executions.

We've just elected a new president who has embraced torture in the fight against terrorism. So perhaps quibbles about how humane lethal injection procedures may or may not be as means of exiting condemned murders seem a little quaint.

But the Constitution hasn't changed. The Eighth Amendment still prohibits cruel and unusual punishment. Yet lethal injection is only becoming more cruel and unusual. If we want to efficiently dispatch these murderous criminals into a deep coma and then stop their hearts, we've got a lot of work to do devising a better protocol.

However, no good medical professionals want to do that work. No modern, well-run company that wants any kind of international standing for itself will assist. That suggests that it's time for America to take a cue from the rest of the world. Our options just ran out. We can no longer mask the barbarity of what we are doing.

Source: CNN, Opinion, Ford Vox, December 10, 2016. Ford Vox is a physician specializing in rehabilitation medicine and a journalist. He is a medical analyst for NPR station WABE-FM 90.1 in Atlanta. He writes frequently for CNN Opinion. Follow him on Twitter @FordVox.

Doing Harm: Medical Professionals and the Death Penalty

Romell Broom
Romell Broom: 18 attempts to insert an IV
"Doctors who do participate in executions are not always the best of the best -- in part because the pay is low and many of these doctors have had little success elsewhere."

It's a brutal photo. Romell Broom holds his arms in front of him, palms out. Dozens of white adhesive squares mark the locations of all 18 attempts to insert an IV by members of an Ohio Department of Rehabilitation and Correction execution team in 2009. Broom had been sentenced to die for the 1984 rape and murder of 14-year-old Tryna Middleton. After two hours, during which eyewitnesses claim Broom showed signs of pain and distress, the execution was called off.

It was the 1st time a state had attempted an execution but failed to kill the condemned person since lethal injection was first used by Texas in 1982. This past March, the Ohio Supreme Court ruled that attempting to execute Broom again would not constitute cruel and unusual punishment or double jeopardy.

With Pfizer's announcement last Friday that it would impose tighter regulations on drugs that can be used for executions, the last open-market source for those drugs has been closed. State-sanctioned killing will continue, but states must now buy drugs from under-regulated compounding pharmacies.

For years, death penalty states have worked on the margins of medicine. During Broom's attempted execution, the fact that medical professionals (including nurses and a phlebotomist) failed to insert IVs properly is a case in point. When the execution team failed, Ohio corrections officials solicited the last minute assistance of physician Dr. Carmelita Bautista, who was working in the prison at the time. Bautista later told The Associated Press that she was asked to help locate an IV site.

The Ohio Supreme Court's green light to the state to attempt to kill Broom again should raise another concern regarding state execution protocols: the ongoing participation of medical professionals in state-sanctioned killing.

In spite of the injunction to "first do no harm," some doctors help maintain the US death penalty regime.

In 2014, an Oklahoma family physician named Dr. Johnny Zellmer tried to insert an IV into the femoral vein of Clayton Lockett during an attempted execution. The drugs entered the tissue under his skin and not his bloodstream, causing extreme pain. After 43 minutes, Lockett died of a heart attack. His family filed a lawsuit against Zellmer, though it was ultimately unsuccessful.

On December 9, 2015, a nurse on Georgia's execution team spent longer than an hour inserting IVs into Brian Keith Terrell's arms and also put one in his hand. Also in Georgia, on February 3, 2016, the execution team failed to insert IVs in 72-year-old Brandon Jones' arms. A physician then inserted an IV near his groin.

Doctors have also been involved in executions indirectly. Dr. Mark Dershwitz, a professor of anesthesiology at the University of Massachusetts Medical School, provided testimony in support of using a controversial drug combination for the execution of Dennis McGuire in Ohio. Dershwitz has testified in support of lethal injection protocols for 22 states and the federal government. McGuire's execution took 26 minutes, and according to witnesses he struggled and gasped for air. Months after that execution, Dershwitz announced he would be getting out of the testifying business.

In spite of the injunction to "first do no harm," some doctors help maintain the contemporary US death penalty regime directly and indirectly, and they have the support of a few doctors and lawyers who have argued that doctors should be present at executions in order to avoid needless pain and suffering.

Deborah Denno, professor of law at Fordham University and lethal injection expert, told Truthout that there should be more attention paid to the role medical professionals play in executions. "I think generally people are looking more at secrecy and drug acquisition. The Supreme Court hasn't really looked at medical professionals. But they've always been involved. They've always been there and it's ongoing."

Denno noted that doctors who do participate are not always the best of the best -- in part because the pay is low and many of these doctors have had little success elsewhere. "And then we often only find out there are doctors present when there's a problem," she said.

A Moral Slippery Slope

That photo of Romell Broom's mutilated arms, widely available online, was taken by Dr. Jonathan Groner, a pediatric surgeon at Nationwide Children's Hospital in Columbus, Ohio. Groner was asked by Broom's attorney to examine him shortly after the attempted execution.

Groner's visit to examine Broom was also his 1st visit to a prison.

"It's an otherworldly experience to be there. Everything about the institution discourages conversation," he told Truthout. "Broom was basically in a cage, and I said to the guards, 'I need to see him; I can't just look at him in this cage.' He didn't look particularly threatening to me."

The guards let him out but his wrists and ankles were shackled. They led him to a chair. Broom spoke little but would point things out to Groner -- a bruise here and there, a wound in a hard-to-reach spot. It had only been a few days and the "wounds were still fresh." He seemed shellshocked.

Groner noticed large bruises around puncture sites, suggesting the execution team worked hard to find usable veins. He added, "My assumption was that the people who did this were not people who do this often -- probably prison guards who have EMT training."

"When health care professionals use their skills to execute people, it blurs the lines between healing and killing."

After the execution the Ohio Department of Rehabilitation and Correction asserted that he had been an IV drug user, but according to Groner, Broom lacked the scars of hardcore drug abuse. "His veins looked decent to me. IV drug abusers have 'railroad tracks' on their arms from repeated injections up and down their veins. Broom had no scars. I couldn't tell why they'd had a hard time. He might have been dehydrated. Maybe a little nervous."

Groner emphasized that their inability to access a vein was evidence of their lack of skill, experience or training, arguing that an experienced medical professional would have been able to find a vein, even on a person experiencing tremendous anxiety preceding execution.

Groner wears a tightly trimmed goatee and black-rimmed glasses. His tone is fast and persistent -- he speaks in a staccato voice and barely moves his head or body. And yet he's warm and thoughtful. He said it was hard for him to work in a children's hospital at first, to take care of kids who were sick, while his own were young.

But he learned to deal with it -- though he stumbles still. Shortly after his father died, he had one such moment. The gasping sound of a mechanical ventilator assisting the breathing of a teenager dying after a car crash reminded him of his father's before he died. The sound association, the sound of the labored breathing, was too much. Groner broke down and sobbed in front of his peers. It was a sign of his empathy, the deep regard he has for the doctor-patient bond.

"People trust doctors because we don't use our powers to do bad things," he said, and that's the problem. "When health care professionals use their skills to execute people, it blurs the lines between healing and killing."

Groner opened a folder on his computer with images from various post-execution autopsies. One was of a central venous catheterization and the other something called a "cutdown." He explained that these are specialized procedures requiring skill, training and experience.

"What I remember most about Broom, about the experience, were his hands. They were smooth and soft," Groner said. And then he spoke of his father again. "You know, they reminded me of my father's at the end of his life."

"When I have to speak to families about end-of-life decisions, about all that I can really do is provide comfort. At the end of the day that's the only medicine I have. That's a doctor's role -- to provide comfort. Most patients would be willing to suffer to survive. But I don't accept that we're supposed to provide comfort at an execution. There's supposed to be a trust there and when our skills are used for the state's benefit, that's a moral slippery slope."

A Brief History of Doctors and the Death Penalty

Doctors have been involved with the death penalty since at least the 18th century, when, for example, a French surgeon named Antoine Louis proposed a device to make executions swift and, supposedly, humane. That device was ultimately named after a death penalty opponent, Dr. Joseph-Ignace Guillotin.

In 1866, an Irish doctor named Samuel Haughton proposed the use of a table of drops that accounted for a condemned person's height and weight in order to kill them more quickly.

"We do not see the inmate about to be executed as a 'patient' per se."

In an 1887 essay titled "Scientific Methods of Capital Punishment," a dentist in New York State named Julius Mount Bleyer proposed "the hypodermic injection of morphine." Bleyer suggested that any sheriff would be able to execute a condemned person with ease. He wrote, "The advantages of this method are its certainty, its painlessness, the freedom from the chance of horrible displays, the reduction of the dramatic element to a minimum, and its inexpensiveness."

In 1953, Great Britain's Royal Commission on Capital Punishment considered using lethal injection as an alternative method to hanging, but it concluded that no medical practitioner should be involved in such a process. As a result, the commission stuck with hanging.

Over 2 decades later, 2 medical professionals working in concert with two state legislators in Oklahoma concocted the first lethal injection protocol.

Jay Chapman (Oklahoma's chief medical examiner) and Stanley Deutsch (a faculty member of the University of Oklahoma College of Medicine), like Haughton and Bleyer before them, sought an effective and potentially painless way to kill people that could replace the electric chair and the gas chamber.

Their suggestion was to use a lethal cocktail of drugs. For many years, the most common drugs used were sodium thiopental or sodium pentothal (to induce sleep), pancuronium bromide (to stop breathing) and potassium chloride (to stop the heart). In Texas in 1982, Charles Brooks Jr. was the first to be executed by lethal injection.

Since 1980, the American Medical Association (AMA) has prohibited medical doctors from participating in executions, though doctors can prescribe sedatives prior to execution and sign death certificates. The AMA language is necessarily broad:

Physician participation in execution is defined generally as actions which would fall into one or more of the following categories: (1) an action which would directly cause the death of the condemned; (2) an action which would assist, supervise, or contribute to the ability of another individual to directly cause the death of the condemned; (3) an action which could automatically cause an execution to be carried out on a condemned prison.

The AMA was part of a chorus of medical professionals condemning lethal injection. Susannah Sirkin of Physicians for Human Rights said in an interview that her organization quickly understood what was happening -- that states were using physicians to sanitize the process. "We wanted to give the lie to that notion," she said

From its inception in 1986, Physicians for Human Rights has worked to expose and end situations where health professionals violate human rights -- in particular, doctor involvement in torture or cruel and unusual punishment. "Of course," Sirkin said, "the history of this goes back to Nuremberg and the Nazi doctors and the concept of doing no harm."

In 1994, Sirkin helped pen "Breach of Trust," a report that documented the roles that medical professionals play in executions. The report concluded, "State medical boards, which are responsible for licensure and discipline, should define physician participation as unethical conduct, and take appropriate action against physicians who violate ethical standards."

Furthermore, the report claimed, "Laws should not be enacted that facilitate violations of medical ethical standards (such as anonymity clauses)."

And yet, that's exactly what has happened.

"There's a reason that there's anonymity," Sirkin said. "It underscores the fact that states know this is wrong, almost an admission that it's a violation of ethics and you can't go after them. And it shows that the only way to recruit them is to shield them."

One of the issues facing medical professionals, though, is that the declarations of their professional organizations have no teeth. The best they can do is censure or revoke membership. This is clear when looking at the efforts of physicians to put a stop to other physicians participating in executions.

In a June 18, 2014, opinion piece for the Journal of the American Medical Association, three doctors from Harvard Medical School argued that protecting physicians who participate in executions is essentially an attempt by states to de-professionalize medical professionals.

One of the authors, Dr. Robert D. Truog, professor of medical ethics, anesthesiology and pediatrics and director of the Center for Bioethics at Harvard Medical School, wrote in an email exchange with Truthout that legislative attempts to de-professionalize doctors continue. The best-case scenario, Truog said, would be for medical boards to revoke the certification of doctors who participate in executions. The American Board of Anesthesiology has adopted such a policy. "In this case, the physician would not lose his/her license, but would be barred from practicing in any hospital that requires its physicians to be board certified in their specialty in order to have privileges on the hospital staff (which is most hospitals)."

But courts have asserted that licensing boards can't discipline medical professionals who participate in lethal injection. When the North Carolina Medical Board attempted to do so, the State Supreme Court prohibited it. Some states are trying to pre-empt boards from such actions. Ohio's death penalty secrecy law, HB 663, says that a licensing authority can't sanction a medical professional participating in an execution.

Health Care's Darkest Corner

An overwhelming majority of medical professionals and their attendant associations have made it clear that lethal injection executions are not the place for physicians and allied health professionals. However, there are exceptions, and death penalty states are doing their best to encourage and shield these rogues.

Jen Moreno, an attorney with the Berkeley School of Law Death Penalty Clinic, told Truthout, "Every state that carries out executions requires the participation of medical personnel of some type. Some states specifically require a physician to perform some tasks; others list different categories -- doctors, nurses, phlebotomist, EMT, paramedics, military corpsman -- that corrections officials can choose from."

There are many tasks that blur the lines between the practice of medicine and the practice of capital punishment.

Prior to executions, a condemned person typically receives a medical exam to assess their veins and a psychiatric evaluation to assess whether or not they are competent to be executed. The execution drugs are mixed by a pharmacist. And medical professionals set IVs, administer drugs, check consciousness and declare death.

Thus, many organizations that accredit medical professionals have told their members not to participate in lethal injection executions. In addition to the American Medical Association, the National Association of Emergency Medical Technicians, American Nurses Association, American Board of Anesthesiology and American Pharmacists Association have all asserted that participating in lethal injections contradicts medical ethics.

Because they lack any national representative organization, phlebotomists (medical technicians who draw blood) have not taken a similar stance. This is significant because state protocols in Florida, Texas and Ohio allow for phlebotomists to be members of the execution team.

Moreno said that it's likely that states added phlebotomists to the list of those who can participate after the US Supreme Court's 2008 Baze v. Rees decision, which upheld the constitutionality of lethal injection. Chief Justice John Roberts' opinion notes that Kentucky's execution team includes a "certified phlebotomist" with years of experience. In other words, a phlebotomist who is trained and has taken an accredited course in phlebotomy.

But not all phlebotomists are certified, nor do they all have significant experience. In Oklahoma, according to the Tulsa World, phlebotomists are not trained to insert IVs, and yet one was involved in the attempted execution of Clayton Lockett. There was also a phlebotomist on the team that attempted to insert an IV in order to execute Romell Broom.

Florida's execution protocol permits phlebotomists on its execution teams for "achieving and monitoring peripheral venous access" -- which could mean inserting an IV. The state says these phlebotomists must be certified by the American Society for Clinical Pathology, National Certification Agency for Medical Laboratory Personnel, American Society of Phlebotomy Technicians or American Medical Technologists.

But it's not clear how phlebotomists actually participate. Alberto C. Moscoso, press secretary for the Florida Department of Corrections, told Truthout that "we can't elaborate on team member duties as, due to the security concerns and sensitivity of assignments surrounding death row, the details of staff responsibilities during the execution process are restricted from release."

When contacted by Truthout, an employee at the American Society of Phlebotomy Technicians indicated that the society was not aware that it was on Florida's list. Nor does the organization have a specific policy on participating in lethal injection executions. IV insertion, the employee said, is a separate certification and phlebotomists do not typically conduct IV insertions.

A spokesperson for American Medical Technologists told Truthout via email, "The detailed exam blueprint for AMT's Registered Phlebotomy Technician exam does not include any tasks that would appear to encompass inserting an intravenous catheter for purposes of administering fluids, as opposed to drawing blood."

Dennis Ernst, director of the Center for Phlebotomy Education, a nationally recognized expert on the profession, said that this is complicated territory. "There's nothing in any state that restricts phlebotomist from starting an IV. But as far as I know, no state allows them [to] start meds. And no legitimate organization would certify for putting in meds."

In one scenario, Ernst said he could imagine a phlebotomist inserting an IV, and someone else could start the medication.

Ernst said that the extent of phlebotomist participation in lethal injection executions is news to him. "Phlebotomy is not very regulated," he said, adding that he has been working most of his life to point this out. "Phlebotomists need to have regulation or oversight. Only four states require certification: California, Louisiana, Nevada and Washington. Phlebotomists have no scope of practice, and there is no professional organization representing them. Phlebotomy is one of health care's darkest corners; its best-kept secret."

This assertion was underscored when Truthout asked American Medical Technologists if phlebotomists are governed by the principle of "do no harm." A spokesperson said via email, "There is nothing in AMT's Standards of Practice that equates to a 'do no harm' mandate, although the Standards do require that 'The AMT professional shall place the health and welfare of the patient above all else.' We do not, however, read that as prohibiting a member from participating in a state-sponsored execution. For instance, we do not see the inmate about to be executed as a 'patient' per se."

Now some states are proposing old methods, like the firing squad or the electric chair, as backups to lethal injection. And other states are exploring new means to execute people -- for example, Oklahoma is considering using nitrogen gas. In other words, states are inventing new ways of killing that may exclude medical professionals.

But in some ways, they have already moved in that direction.

"Hippocratic Paradox"

Dr. Jonathan Groner said that he was always a death penalty agnostic, until a series of encounters turned him into an abolitionist. The first came when, at the end of his residency, he testified in the capital trial of Jerry Lee Allard. Allard had killed his wife and child and very nearly his other child, but Groner, as a young trauma surgeon, was able to help save that child's life.

Testifying at the trial made Groner uneasy. He said Allard was sentenced to death and sent to prison, but "he got cancer and died. Never got the ultimate punishment, but he did, in a way."

Later Groner read about the 1997 triple execution of Earl Van Denton, Paul Ruiz and Kirt Wainwright in Arkansas (the state held another triple execution three years earlier). Groner said that as a Jewish kid who had studied the Holocaust while growing up, the story about Arkansas resonated.

"The way they described IV insertion -- they had medicalized the process just like the Nazis," he said. Groner was incensed by this diffusion of responsibility.

"When I read [Robert Jay] Lifton's The Nazi Doctors, I learned that they used direct cardiac injections of phenol to kill prisoners in the T-4 euthanasia program," he said. "Some states are now using central venous catheters for executions, so they are getting pretty close to the same thing."

Groner was clear that he's not comparing the death penalty to the Holocaust; he's pointing to doctors who crossed boundaries. For over a decade now, Groner has been persistent in his public critique of the medicalization of the death penalty and the troubling links to this history.

"There are certain times throughout history where medicalization has been used to justify things that are inhumane," he said. "Waterboarding -- they had a doctor present. First electrocution -- there were several doctors present. But doctors have an esteemed position in society and because of that we can do things that others can't. There are times when I perform major surgery -- literally cut an infant open -- to deal with a life-threatening issue such as a bowel obstruction. Why does a family who has never met me before allow me to do that to their child? Because people trust us. In exchange for that, we can never use our powers to cause harm."

Source: truth-out.org, Jack Shuler, May 17, 2016. Jack Shuler is author of three books, including The Thirteenth Turn: A History of the Noose (PublicAffairs, 2014). His writing has appeared in Truthout, Salon, The Atlantic and Los Angeles Times, among others.

Autopsy reveals Oklahoma used wrong drug for execution of Charles Warner in January

Charles Warner
Charles Warner
An autopsy shows that Oklahoma used the wrong drug when it executed an inmate in January.

The Oklahoman reported Thursday that corrections officials used potassium acetate -- not potassium chloride, as required under the state's protocol -- to execute Charles Frederick Warner.

Last week, Gov. Mary Fallin issued a last-minute stay of execution for inmate Richard Glossip after officials discovered that potassium acetate had been delivered.

The autopsy says the items used in Warner's execution included 12 empty vials labeled "single dose Potassium Acetate Injection."

Potassium chloride, which stops the heart, is the final drug in the state's protocol.

After receiving the first drug in the series, midazolam, Warner said, "My body is on fire," but showed no other signs of distress and was pronounced dead after 18 minutes.

Source: kjrh.com, October 8, 2015

Oklahoma Used The Wrong Drug To Execute Charles Warner

Corrections officials in Oklahoma used the wrong drug to execute Charles Warner back in January. 

The revelation was included in Warner's autopsy report, which was just made public by the Oklahoma Office of the Chief Medical Examiner. According to the report, officials used potassium acetate - not potassium chloride, as state protocol calls for - to stop Warner's heart. 

Warner, 47, had been scheduled to die on the same night as Clayton D. Lockett. If you remember, Lockett's 2014 execution was also botched. A report issued after his death, found that a phlebotomist misplaced the IV line intended to deliver the lethal cocktail of drugs directly into Lockett's bloodstream. Instead, the cocktail was delivered to the surrounding tissue and Lockett eventually died of a heart attack. 

According to The Oklahoman, which first reported on Warner's autopsy report, explains: 

"The drug vials and syringes used in Warner's execution were submitted to the Office of Chief Medical Examiner after his death. 2 of the syringes were labeled with white tape '120 mEq Potassium Chloride,' his autopsy report shows. 

"However, the 12 empty vials used to fill the syringes are labeled '20mL single dose Potassium Acetate Injection, USP 40 mEq\2mEq\mL,' the autopsy report shows." 

Back in September, Gov. Mary Fallin stopped the execution of Richard Glossip, saying that the state had received potassium acetate rather than potassium chloride. 

Following that stay, Robert Patton, Oklahoma's prisons director, told reporters that the state's drug provider told them that the 2 drugs were interchangeable. Medical professionals say they are 2 different drugs. 

In a statement, Fallin said she had not been made aware that the 2 drugs may have been switched during the Warner execution until she was told the wrong drugs were procured for the the Glossip execution. 

"The attorney general's office is conducting an inquiry into the Warner execution and I am fully supportive of this inquiry," she said. "It is imperative that the attorney general obtain the information he needs to make sure justice is served competently and fairly." 

Fallin said that until the state has "complete confidence in the system" she will delay any scheduled executions. 

Oklahoma death chamber
Oklahoma's death chamber
Glossip's attorney, Dale Baich, said in a statement that Oklahoma cannot be trusted to get this procedure right. 

"The State's disclosure that it used potassium acetate instead of potassium chloride during the execution of Charles Warner yet again raises serious questions about the ability of the Oklahoma Department of Corrections to carry out executions," Baich said. "The execution logs for Charles Warner say that he was administered potassium chloride, but now the State says potassium acetate was used. We will explore this in detail through the discovery process in the federal litigation." 

According to the AP, Oklahoma's execution protocol does allow for some wiggle room in the kind of drugs used in executions. 

"The protocols include dosage guidelines for single-drug lethal injections of pentobarbital or sodium pentothal, along with dosages for a 3-drug protocol of midazolam, vecuronium bromide and potassium chloride," the AP reported. "The protocols also allow for rocuronium or pancuronium bromide to be substituted for the 2nd drug. The protocols do not list an alternate for potassium chloride, which is the 3rd drug used." 

Of course, this case again points to the issues surrounding how and where states are getting their execution drugs. Oklahoma and other states have struggled to adjust to new combinations of execution drugs after manufacturers, under pressure from critics of capital punishment, ceased providing states with drugs they had long used. 

States have turned to so-called compounding pharmacies for new drug combination that the states and the pharmacies may know little about. 

Source: NPR.org, October 8, 20125

The Botched Execution of Clayton Lockett

A diagram from an autopsy performed on Lockett. Pathologists found nothing to explain why the doctor and the paramedic had had so much trouble placing an IV. (Oklahoma Department of Public Safety / AP)
A diagram from an autopsy performed on Lockett. Pathologists
found nothing to explain why the doctor and the paramedic had
had so much trouble placing an IV.
(Oklahoma Department of Public Safety / AP)
The botched execution of Clayton Lockett—and how capital punishment became so surreal

On the morning of his execution, Clayton Lockett hid under the covers.

Before a team of correctional officers came to get him at 5:06 a.m., he fashioned a noose out of his sheets. He pulled the blade out of a safety razor and made half-inch-long cuts on his arms. He swallowed a handful of pills that he’d been hoarding. And on April 29, 2014, when the team of officers knocked on the door of his cell in the Oklahoma State Penitentiary in McAlester, Oklahoma, Clayton Lockett—a 38-year-old convicted murderer—pulled a blanket over his head and refused to get up.

The officers left and asked for permission to tase him. While they were gone, Lockett tried to jam the door. They came back, forced their way in, tased him, and dragged him out.

Eleven hours later, at about 5:20 p.m., after a medical examination, X‑rays, eight hours in a holding cell, and a shower, Lockett was brought by a five-member strap-down team into the death chamber. It was a small, clinical-looking room with white walls and a polished floor that reflected the lights overhead. A gurney stood in the center of the room; above it hung a microphone for Lockett’s final words.

One of the walls in the chamber had a pair of baseball-size holes through which IV lines could pass into the chemical room, a small space where three executioners would administer the drugs that would kill him. The executioners had been driven to the prison earlier in the day, and had put on hoods as they approached. They would remain out of sight until after Lockett was dead.

In the execution chamber, Lockett was belted to the gurney. To his left, beige blinds covered the windows to the viewing area. Soon, shadows would be visible as the seats on the other side filled up. There was so much media interest in his execution that the prison had had to draw names to decide which reporters could attend.

A clock on the wall read 5:26. The execution was scheduled to begin at 6 p.m. Lockett could expect to be dead within about 45 minutes.

At 5:27 p.m., a paramedic approached the gurney. Like the three executioners, she would remain anonymous. Before the blinds opened, she would retreat into the chemical room while a doctor and the prison’s warden stayed with Lockett in the death chamber. But first she had a job to do: prepare the drugs and medical equipment, and get an IV into Lockett. (Those who participated in the execution either did not respond to requests for interviews or could not be reached. Court records provide a detailed account of what happened.)

The paramedic later told investigators that she’d felt incredible pressure since she’d walked into the room an hour earlier. She’d never participated in an execution that used midazolam. She’d never participated in two executions in one night—not many people in the world had. And she knew the media were watching.

Oklahoma's death chamber. (AP)
Oklahoma's death chamber. (AP)
To make matters worse, the equipment was all wrong: the saline was packed in bags instead of syringes, the drugs were in syringes that looked smaller than she was used to, and the tubing for the IV was the wrong kind. But she tried to focus on doing her job and getting everything set up on time. She would be paid $600 for the two executions.

The paramedic stuck a needle into a vein in Lockett’s left arm. A few drops of blood moved up the catheter—“flashback.” A good sign. It meant the needle was in the vein. But she’d forgotten tape to hold the IV in place. She asked someone to bring it to her, but the IV slipped out before she could secure it. Lockett’s arm started to bleed, so she put pressure on it and tried again. This time, she didn’t get flashback. Then she tried a brachial vein, near Lockett’s biceps. No luck there.

By now, she’d tried to place an IV three times. She’d been taught that if you can’t find a vein after the third attempt, you ask someone else to step in. So she asked the doctor to help.

The doctor, Johnny Zellmer, was a last-minute substitute. (Zellmer, whose name was revealed in a lawsuit following the execution and in multiple press reports, has not denied his involvement. He did not respond to requests for comment.) He was a local family-medicine and emergency-room physician who’d participated in just one previous execution. Zellmer had arguably violated his profession’s oath to “never do harm” the moment he stepped into the death chamber. Indeed, the American Medical Association’s code of ethics states that physicians should not participate in executions, even in a supervisory capacity. But Zellmer thought his job would be limited to checking the offender for consciousness and pronouncing the time of death. He wasn’t expecting to actually do anything to Lockett.

The paramedic’s request for help put him in the position of no longer just observing the execution but actively facilitating it. She was clearly struggling, though. He scanned Lockett’s body and didn’t see any good veins. Then Lockett turned his head, and the paramedic saw a vein in his neck pop up. She pointed it out to Zellmer. “Get me a needle for the jugular,” he said.

This was an odd choice. IVs in the neck are painful, and also hard to place. On the arms and legs, you can use a tourniquet to bring the veins up. You cannot do that on the neck, because a tourniquet on the neck is effectively a noose, and while this was an execution, it was not a hanging.

As Zellmer tried to get the needle into the jugular, the paramedic stuck Lockett three more times on his right arm, failing each time.

Zellmer got the needle into Lockett’s neck and saw flashback, but then saw blood spread under the skin—he thought the needle might have gone all the way through the vein. Zellmer decided to try a subclavian line, in a vein running beneath Lockett’s collarbone. The paramedic brought him a central-venous catheterization kit, and Zellmer numbed Lockett’s chest with lidocaine. The paramedic tried two different veins on Lockett’s right foot; both attempts failed.

Clayton Lockett
Clayton Lockett
Zellmer kept trying to get the needle into Lockett’s subclavian vein. He finally saw a little flashback, then lost the vein and couldn’t get the needle back in. After repeatedly sticking Lockett’s chest, he decided to try the femoral vein, in Lockett’s groin. The paramedic went to get a longer needle.

As the warden, Anita Trammell, watched the doctor and the paramedic work on Lockett, she felt a sliver of pride for the inmate. He’d now been stuck with needles more than a dozen times. She knew he was in pain, but she thought he was taking it like a man. Trammell tried to make conversation to help calm him. She knew he had been a drug user. “What was your drug of choice?” she asked him.


“I thought that was a white man’s drug,” she said, and he laughed.

The paramedic came back and said she had no needles longer than an inch and a quarter. That presented a problem. The femoral vein lies deeper in the body than other veins, so they would ideally use a needle at least twice that length. There were longer needles inside a second central-venous catheterization kit, like the one they’d just used on Lockett’s chest, but neither Zellmer nor the paramedic thought of it. Zellmer asked for an IO-infusion needle. IO stands for “intraosseous”—into the bone. It is, in effect, a power drill, used to bore a hole through bone and into the marrow, and therefore doesn’t require finding a vein.

The prison had no IO needle. Zellmer had only the absurdly short one-and-a-quarter-inch needle. “Well,” he told the paramedic, “we’ll just have to make it work.”

Lockett’s prison scrubs and underwear were cut away. Zellmer stuck the needle into Lockett’s femoral vein and saw flashback on the first try. Finally, after almost an hour, they had an IV.

Right away, the paramedic noticed a potential warning sign. Saline should have been flowing easily through the IV, but it flowed only when she propped up the line. Instead of starting over, though, she taped the IV in place. Two IVs are typically used to administer the drugs, but with the execution running way behind schedule, the doctor and the paramedic decided they would proceed with just one.

Warden Trammell asked Lockett whether he needed anything. “I was gonna see if I could get my mouth wiped off,” he said. She got a Kleenex and wiped it for him.

Finally, a sheet was draped over Lockett, covering him up to his chest. The execution could begin.

Source: The Atlantic, Jeffrey E. Stern, June 2015 Issue

Ohio executes Dennis McGuire using a new, never-before-tried lethal injection combination

Dennis McGuire
Dennis McGuire
A man convicted of murder in the US state of Ohio has been executed using a new, never-before-tried lethal injection combination.

Dennis McGuire, 53, was killed on Thursday with a two-drug cocktail, after the maker of the previous execution drug refused to allow its use in capital punishment.

His lawyers argued the new method would cause him to experience extreme terror.

McGuire was sentenced to death for the 1989 rape and murder of Joy Stewart. Stewart was pregnant.

In recent years, US states have had increasing difficulty obtaining drugs for use in lethal injections, as their manufacturers have grown unwilling to provide them for that use.

Ohio officials elected to use intravenous doses of the sedative midazolam and painkiller hydromorphone for McGuire's execution.

Lawyers for McGuire had said the drugs placed him at risk of air hunger, a phenomenon which causes terror as the patient struggles to catch his breath.

During the more than 15-minute procedure, McGuire gasped several times and his mouth repeatedly opened and closed, according to an Associated Press news agency reporter who witnessed the execution.

'I'm going to heaven, I'll see you there when you come,' he said in the small, windowless room in the Lucasville correctional facility. He was pronounced dead at 10:53 a.m., after one of the longest executions since Ohio resumed capital punishment in 1999.

McGuire thanked his 22-year-old victim's family for a letter he received from them, referring to 'kind words' that meant a lot. Joy Stewart's sister Carol Avery wrote in the note that she had forgiven him but also insisted 'it is time - past time - for him to pay for what he did to my sister.'

The 53-year-old opened and shut his hands as if waving to his adult son, daughter and daughter-in-law sitting a few feet away and a full minute later he stood up and told them, 'I love you, I love you.'

On Wednesday, he arrived calmly at the death house and spent the night writing letters, phoning his mother and sister and visiting with his son and daughter.

An Ohio federal judge had rejected a last-minute appeal to delay the execution after McGuire's legal team argued a jury never heard details of his reportedly troubled childhood.

McGuire's lawyers alleged he was abused, leading to impaired brain function that made him prone to impulsive actions.

Ohio Governor John Kasich also rejected McGuire's efforts to become an organ donor, a legal manoeuvre that previously allowed another death row inmate an eight-month reprieve.

Source: BBC News, Daily Mail, January 16, 2014

Dennis McGuire’s execution takes almost 25 minutes

LUCASVILLE, Ohio — A condemned man appeared to gasp several times and took an unusually long time to die — more than 20 minutes — in an execution carried out Thursday with a combination of drugs never before tried in the U.S.

Dennis McGuire’s attorney Allen Bohnert called the convicted killer’s death “a failed, agonizing experiment” and added: “The people of the state of Ohio should be appalled at what was done here today in their names.”

McGuire’s lawyers had attempted last week to block his execution, arguing that the untried method could lead to a medical phenomenon known as “air hunger” and cause him to suffer “agony and terror” while struggling to catch his breath.

McGuire, 53, made loud snorting noises during one of the longest executions since Ohio resumed capital punishment in 1999. Nearly 25 minutes passed between the time the lethal drugs began flowing and McGuire was pronounced dead at 10:53 a.m.

Executions under the old method were typically much shorter and did not cause the kind of sounds McGuire made.

Prison officials gave intravenous doses of two drugs, the sedative midazolam and the painkiller hydromorphone, to put McGuire to death for the 1989 rape and fatal stabbing of a pregnant newlywed, Joy Stewart.

The method was adopted after supplies of a previously used drug dried up because the manufacturer declared it off limits for capital punishment.

The execution is certain to launch a new round of federal lawsuits over Ohio’s injection procedure. The state has five more executions scheduled this year, with the next one to come on Feb. 19.

What was particularly unusual Thursday was the five minutes or so that McGuire lay motionless on the gurney after the drugs began flowing, followed by a sudden snort and then more than 10 minutes of irregular breathing and gasping. Normally, movement comes at the beginning and is followed by inactivity.

In pressing for the execution to go ahead, Assistant Ohio Attorney General Thomas Madden had argued that while the U.S. Constitution bans cruel and unusual punishment, “you’re not entitled to a pain-free execution.”

U.S. District Judge Gregory Frost sided with the state. But at the request of McGuire’s lawyers, he ordered officials to photograph and preserve the drug vials, packaging and syringes.

A few minutes before McGuire was put to death, Ohio prison director Gary Mohr said he believed the state’s planning would produce “a humane, dignified execution” consistent with the law.

➤ Click here to read the full article

Source: The Washington Post, January 16, 2014

Arizona botches Joseph Wood's execution

Joseph Wood
Joseph Wood
A convicted killer gasped on the gurney for more than an hour as the state of Arizona attempted to execute him on Wednesday, before being declared dead almost two hours after the process began.

Attorneys for Joseph Wood attempted to halt the execution in an emergency court motion, saying he had been "gasping and snoring for more than an hour". The state attorney general announced that Wood had died before the court could rule on the motion

The developments echoed the botched execution of Clayton Lockett, who writhed and groaned on a gurney for nearly 45 minutes before eventually dying of a heart attack.

"We respectfully request that this court stop the execution and require that the Department of Corrections use the lifesaving provisions required in its protocol," the laywers said.

"He is still alive. This execution has violated Mr Wood’s eighth amendment right to be executed in the absence of cruel and unusual punishment," the court filing said.

The hours leading up to the execution were marked by a frenzied legal battle over the secrecy imposed by state officials on the source of the drugs. It was put on hold several times – first by a federal appeals court, then by the state supreme court of Arizona – only to have the stays lifted and the procedure go ahead.

Even the US supreme court was asked to intervene, but on Tuesday night declined to do so without giving an explanation for its decision.

Source: The Guardian, July 23, 2014

Arizona inmate takes two hours to die in botched execution using experimental two-drug cocktail

The state of Arizona today took one hour and 57 minutes to kill a prisoner in a botched execution, which was carried out using the same combination of drugs as those used in the botched execution of an Ohio prisoner earlier this year.

Joseph Wood, 55, was eventually pronounced dead at 3.49pm local time after he had been seen ‘gasping and snorting’ over an hour into his execution, according to an emergency stay filed mid-execution by his lawyers as they saw what was happening.

Wood was executed using the drugs Midazolam and Hydromorphone, a combination that has been used only once before in an execution that also went badly wrong in Ohio in January. Dennis McGuire was seen struggling and gasping for breath during an execution that took over 25 minutes.

The botched execution of Wood follows that of Clayton Lockett in Oklahoma in April. Both states insisted on conducting the executions behind a veil of secrecy, refusing to name the manufacturers of the drugs or provide critical details which could have helped assure their quality.

Like Lockett, Wood had received a stay just moments prior to the execution so that the court could consider the issue of the experimental drugs. However that stay was then lifted and Wood’s execution began at 1.52pm local time.

There are just a handful of manufacturers of both Midazolam and Hydromorphone which do not yet have comprehensive distribution controls in place to ensure their medicines are used to improve and save the lives of patients, and are not sold to prisons to end the lives of prisoners in potentially torturous executions. International human rights NGO Reprieve has worked extensively with pharmaceutical companies, the majority of which have taken steps to protect their medicines from abuse in executions like this one.

Maya Foa, Director of Reprieve’s Death Penalty Team, said: “The State of Arizona had every reason to believe that this procedure would not go smoothly; the experimental execution ‘cocktail’ had only been used once before, and that execution too was terribly botched. Despite the evidence, the state pushed ahead, jettisoning due process and cloaking the procedure in secrecy. The result was an exercise in torture. No one in the medical profession or industry wants anything to do with executions. Manufacturers and medics have long protested the abuse of medicines (which are designed to save lives) in executions designed to end them. How many more botched executions must we witness before states finally take heed?”

Source: Reprieve, July 23, 2014

Lawyers demand outside probe of two-hour Arizona execution

(Reuters) - Lawyers for a convicted double-murderer whose lethal injection in Arizona dragged on for two hours, while witnesses watched him gasping for breath and attorneys scrambled to halt the process, have called for an outside review of the "horrifically botched execution."

The ordeal in putting Joseph Wood to death on Wednesday at a prison facility southeast of Phoenix marked the third instance this year of a lethal injection gone awry, after mishaps in Ohio and Oklahoma that renewed the U.S. debate over capital punishment.

"He gasped and struggled to breathe for about an hour and 40 minutes," said Dale Baich, one of Wood's lawyers, who watched the execution and tried in vain to stop it. He called for an independent inquiry.

An Arizona Republic journalist who witnessed the event said he counted Wood gasping for air about 660 times before the 55-year-old inmate fell silent.

During that time, defense attorneys took the extraordinary step of filing emergency court petitions seeking to cut short the procedure and resuscitate their client, arguing Wood was being subjected to unconstitutionally cruel and unusual punishment.

But U.S. Supreme Court Justice Anthony Kennedy denied the appeal, and Wood was pronounced dead at 3:49 p.m. local time, one hour and 57 minutes after the execution had officially begun.

State Corrections Director Charles Ryan disputed suggestions that Wood had suffered, saying in a statement that once sedated - five minutes into the procedure - the inmate "did not grimace or make any further movement."

Ryan characterized Wood's breathing as "sonorous respiration, or snoring," and said execution team members with whom he conferred during the process assured him "unequivocally that the inmate was comatose and never in pain or distress."

He added that the time it takes to complete an execution varies for each individual.

Click here to read the full article

Source: Reuters, David Schwartz, July 24, 2014

Reporter describes gruesome scene of Ariz. execution

Arizona Death Chamber
Arizona Death Chamber
FLORENCE, Ariz. — The first glimpse was from above, framed by two closed-circuit TVs.

Joseph Rudolph Wood was strapped to a gurney in an orange jumpsuit as prison medical staff prepared to set intravenous lines in his arms.

It was 1:30 in the afternoon at Housing Unit 9, the small, one-story, free-standing stucco building where executions are carried out at the Arizona Prison Complex-Florence. The viewing room is 15 feet by 12 feet, painted in calming tones of blue, with three rows of risers that climb from the big window that looks into the lethal-injection chamber in front to the bay windows of the gas chamber behind.

Federal law requires that witnesses to executions see every phase, including the setting of IV lines. But in Arizona, it's done on camera.

Wood's eyes flitted back and forth, and his eyebrows arched as men in scrubs, their faces out of camera range, fussed with blood-pressure cuffs and trays of IV needles. The lines went in easily. They don't usually; Arizona is one of three states that will surgically cut a catheter into a condemned man's groin after failing to find veins in the arms or hands, a process used in nine of the past 14 executions.

Then, the curtains opened.

According to Arizona Republic reporter Michael Kiefer, Wood was unconscious by 1:57 p.m.. At about 2:05, he started gasping.

Then at 2:05, Wood's mouth opened. Three minutes later it opened again, and his chest moved as if he had burped. Then two minutes again, and again, the mouth open wider and wider. Then it didn't stop.

He gulped like a fish on land. The movement was like a piston: The mouth opened, the chest rose, the stomach convulsed. And when the doctor came in to check on his consciousness and turned on the microphone to announce that Wood was still sedated, we could hear the sound he was making: a snoring, sucking, similar to when a swimming-pool filter starts taking in air, a louder noise than I can imitate, though I have tried.

It was death by apnea. And it went on for an hour and a half. I made a pencil stroke on a pad of paper, each time his mouth opened, and ticked off more than 640, which was not all of them, because the doctor came in at least four times and blocked my view.

I turned to my friend Troy Hayden, the anchor and reporter from Fox 10 News, who was sitting next to me. Troy and I witnessed another execution together in 2007, and he had seen one before that, so he also knows what it looks like.

"I don't think he's going to die," I said.

Click here to read the full article

Source: USA Today, Michael Kiefer, The Arizona Republic, July 24, 2014

Witness to a 2-hour Arizona execution: Joseph Wood's final 117 minutes

Inside the chamber, I counted 660 gulps. The priest's watch counted 117 minutes. The death penalty was not supposed to go like this.

You want to be prepared to watch a man who has been prepared to die. Wednesday afternoon was scheduled to be the state of Arizona's first time using this particular combination of lethal-injection drugs. But this was also my first time witnessing a state execution, so I made sure the state prison staff here had a notepad ready, and I asked my colleagues what it was supposed to be like.

It's all very clinical, I was told. The end of death row usually lasts about 10 minutes.

This was not what I saw inside the execution chamber when Joseph Wood died. That took 117 minutes, and it was clear that nothing was as it was supposed to be.

After going through prison security, and waiting for hours because of a last-minute appeal to the Arizona supreme court, prison staff escorted us – just a handful of witnesses – across the vast yard and into the small place where a killer was about to be killed. The family of Debra and Eugene Dietz, whom Wood brutally shot and killed at a Tucson autobody shop in 1989, followed. We were all seated under televisions, with images of Wood strapped to the gurney above.

The curtains opened. The medical staff checked the man's veins. He said his last words – "God forgive you all" – and the lethal drugs began to flow, at 1.52pm. James Wood appeared to fall asleep, albeit strapped down to a table, and he looked straight ahead at the wall. The first 10 minutes went according to plan.

Then, a hard gulp. I looked over to my left: the priest praying the rosary. To my right: the family watching on. Then dead ahead: the side of Wood's stomach appeared to move, even after the Arizona state prison's medical staff had announced he was sedated.

I saw a man who was supposed to be dead, coughing – or choking, possibly even gasping for air.

Click here to read the full article

Source: The Guardian, Mauricio Marin, July 24, 2014

Some Lethal Injection Problems in US Executions

Since Texas became the 1st state to use lethal injection as its execution method on Dec. 7, 1982, some problems have been reported during the process nationwide. Those include delays in finding suitable veins and needles becoming clogged or disengaged. Some past examples:

- December 13, 1988. Texas inmate Raymond Landry was pronounced dead 40 minutes after being strapped to the execution gurney and 24 minutes after the drugs started flowing into his arms. 2 minutes after the drugs were administered, the needle came out of Landry's vein, spraying the chemicals toward witnesses. The curtain separating witnesses from Landry was pulled, then reopened 14 minutes later after the execution team reinserted the needle.

- May 10, 1994. Serial killer John Wayne Gacy's execution in Illinois was interrupted as the lethal chemicals unexpectedly solidified, clogging the intravenous tube that led into his arm. Prison officials drew blinds to cover the witness window and the clogged tube was replaced. 10 minutes later, the blinds were opened and the punishment resumed. The problem was blamed on prison officials' inexperience.

- July 18, 1996. Indiana inmate Tommie J. Smith's lethal injection took 69 minutes when prison technicians were unable to locate suitable veins. A physician was summoned to give Smith a local anesthetic. The doctor also tried unsuccessfully to insert the lethal needle in Smith's neck. A vein in his foot finally was successful 49 minutes after the process began. He was pronounced dead 20 minutes later.

- April 23, 1998. Texas inmate Joseph Cannon made his final statement and the injection process began. When there was no immediate reaction, he had a quizzical look on his face, then blurted out: "It's come undone." A vein in Cannon's arm had collapsed and the needle popped out. A curtain was pulled to block the view of the witnesses. Fifteen minutes later, it was reopened and the execution was completed.

- May 2, 2006. In Ohio, Joseph L. Clark's lethal injection was stalled for 22 minutes before prison technicians located a suitable vein. Shortly after the execution began, the vein collapsed and Clark's arm began to swell. He raised his head and said: "It don't work. It don't work." Curtains were closed while the technicians worked for 30 minutes to find another vein. Clark wasn't pronounced dead until nearly 90 minutes after the process started.

- Dec. 13, 2006. When Florida inmate Angel Diaz continued to move, was squinting and grimacing after receiving the injection, a second dose of chemicals was administered. An autopsy later found his liver undamaged but that the needle had gone through Diaz's vein and out the other side, meaning the chemicals went into soft tissue and not the vein.

- Sept. 15, 2009. In Ohio, inmate Romell Broom avoided execution after prison technicians were unable to find a suitable vein after trying for two hours. Broom even had helped to find a good vein. Then-Gov. Ted Strickland ordered the halt. Broom remains on Ohio's death row.

- Jan. 16, 2014: Dennis McGuire repeatedly gasped during the record 26 minutes it took him to die in Ohio's execution chamber. The Department of Rehabilitation and Correction said its review determined McGuire was asleep and unconscious a few minutes after the drugs were administered and "he did not experience pain, distress or air hunger after the drugs were administered or when the bodily movements and sounds occurred."

- April 29, 2014: Clayton Lockett's execution in Oklahoma was halted by the state's prison director after Lockett writhed and groaned on the gurney. He died 43 minutes after the drugs began to flow. Oklahoma was using a new sedative, midazolam, as part of its 3-drug lethal injection procedure. The doctor who oversaw the execution said at the time that he died of a heart attack, but a state autopsy later determined that the drugs killed him.

- July 23, 2014: Joseph Rudolph Wood gasped and snorted for more than 90 minutes after his execution began in Arizona, prompting lawyers to file an emergency appeal with the U.S. Supreme Court demanding that it be stopped. Wood was pronounced dead 1 hour and 57 minutes after the execution started.

- Dec. 9, 2015. In Georgia, inmate Brian Keith Terrell winced, reportedly in pain, because it took the nurse assigned to the execution an hour to get the IVs inserted into both of the Terrell's arms. Ultimately, she had use Terrell's right hand.

- Feb. 3, 2016. In Georgia, it took more than an hour for Brandon Jones to be strapped down and have IV lines that would deliver the lethal drug placed on his body. A doctor was called in to help the 2-person team place the IV lines. One line was put in Jones' right arm and another in the groin area. A media witness reported his eyes closed within a minute of the warden leaving the execution chamber, but they popped open 6 minutes later.

Source: Associated Press, December 10, 2016

Different execution methods used in each US State

According to a 2002 study in the Journal of Forensic Science, the average length of time from the 1st injection to death is 8 minutes, 40 seconds.

Doctors in the US cannot participate in the executions because it violates their ethical vows.

This is often problematic because the injections are left to inexperienced prison staff.

If a vein is missed or if the needle becomes clogged, inmates experience extreme pain such as burning.

But death row inmates in the US face execution by 4 other methods other than lethal injection.

All 31 states carrying out capital punishment as well as the US military and the US Government use the 3-drug method as their primary method.

Mississippi's death chamber
Since 1976 when the death penalty was reinstated in America 1,266 inmates have been put to death by lethal injections.

But anyone convicted in Alabama, Arkansas, Florida, Kentucky, Oklahoma, South Carolina, Tennessee and Virginia, can opt to die through the electric chair.

In the last 40 years, 158 men have died through electrocution.

Anyone convicted in Arizona, California, Missouri, Wyoming and Oklahoma can choose the gas chamber.

Last year politicians in Oklahoma voted 9 - 0 to introduce the "nitrogen hypoxia" bill after concerns were raised over the recent series of botched executions using injections.

Lawmakers claim it is a painless way in which to kill those condemned to death.

11 have opted for such a method.

Oklahoma and Utah have also legislated to use a firing squad in the event the drugs required for lethal injection are unavailable, or the method along with electrocution are later found to be unconstitutional.

Hanging is still on the books Delaware, New Hampshire, Washington although all prefer lethal injection.

3 men have gone to the gallows since 1976.

➤ For up-to-date figures and information about capital punishment in the US, see the Death Penalty Information Center (DPIC)

Source: mirror.co.uk, December 10, 2016

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