"One is absolutely sickened, not by the crimes that the wicked have committed, but by the punishments that the good have inflicted." -- Oscar Wilde

Monday, April 10, 2017

As judge considers Arkansas' executions plan, doctor shares concerns about state's drugs

Midazolam
A doctor who specializes in anesthesiology expressed concerns in federal court Monday over the three-drug mixture with which Arkansas plans to execute seven men next week.

The testimony kicked off a three-day hearing scheduled by U.S. District Court Judge Kristine G. Baker after she was asked to halt the executions of seven inmates set to die over 11 days beginning April 17.

The men’s lawyers requested an injunction on the grounds that the compressed schedule violates their Eighth Amendment rights to be free from cruel and unusual punishment, the Arkansas Democrat-Gazette previously reported.

Dr. Joel B. Zivit, an associate professor at Emory University who specializes in anesthesiology and critical care medicine, appeared via video as an expert for the plaintiffs. Zivit, who said he witnessed an execution in Georgia, spent much of the morning answering questions posed by federal public defender Julie Vandiver about Arkansas’ lethal injection protocol.

Zivit first told the courtroom he has no comment or knowledge on how to improve lethal injections. 

The physician said he has concerns about the drugs Arkansas plans to use, how those drugs are handled and mixed, how they will then be administered to the inmates and if those drugs will cause an excessively painful death.

Under the state Department of Corrections protocol, three drugs — midazolam, vecuronium bromide and potassium chloride — will be given intravenously.

Zivit said the first drug, midazolam, is generally used as a calming agent and to create amnesia in a patient, but it in no way blocks pain.

The second drug, vecuronium bromide, is often used to paralyze muscle movement while patients undergo surgery, he said. Hospitals use an apparatus to ensure the patient can breathe. Without it, the person will suffocate, Zivit said. “It’s like being held underwater."

Vandiver asked the doctor if he would ever give a patient midazolam followed by a dose of vecuronium bromide during a procedure. He responded that he would, but only in a rare circumstance, and “if a patient survived, I would apologize later."

The third drug, potassium chloride, can affect the way a heart muscle contracts, Zivit said. Potassium, when it’s injected, is “quite painful” because the element destroys the vein while it passes along its length, he said.

Zivit added that he has concerns about how the drugs will be given to each inmate, based on his study of autopsy reports of other people who have been put to death through similar methods. He said he has been administering anesthesia for 25 years and it’s “not a simple thing to do.”

There is no such thing as training to put an IV in someone who will be executed, Zivit said. Doctors and medical professionals are trained to deal with patients who are “volunteers” to the treatment they are undergoing, he said, which is not the case in executions.

Zivit said when he studied an autopsy of Oklahoma inmate Clayton Lockett, the man had puncture wounds on his “arms, legs, neck, chest” where professionals had tried, and failed, to insert an IV.

The state objected several times during Zivit’s testimony to the doctor speaking about anything other than the general use and effects of the three drugs. Baker recognized the state’s objections but allowed the doctor's testimony to continue.

Source: Arkansas Online, Emma Pettit, April 10, 2017

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