The execution team went through at least seven needles trying to find a vein suitable for delivering doses of a lethal drug to Tennessee inmate Christa Pike, her lawyers said on Thursday. <\/p>\n
Ms. Pike, who survived the botched execution on Wednesday night, was left with blistering and burning around the intravenous insertion sites that the execution team ultimately used to deliver the drug, the lawyers added.<\/p>\n
Those details reinforced the sense among outside medical experts that Ms. Pike had survived the procedure because the drug, pentobarbital, probably poured into tissue surrounding the insertion sites instead of entering her bloodstream.<\/p>\n
That could have prevented the drug from reaching the levels needed in her circulatory system to stop her breathing.<\/p>\n
The drug may nonetheless have lowered her oxygen levels or weakened her circulation enough to cause permanent brain damage. Any leak of the drug into her tissue could also have caused chemical burns.<\/p>\n
Ms. Pike\u2019s lawyers said she was in critical condition and receiving lifesaving medical care. <\/p>\n
Stephen Ferrell, one of her lawyers, said that while details of the execution attempt were consistent with there having been problems with the intravenous delivery, a number of other factors could have been involved.<\/p>\n
The Tennessee Department of Correction said in a statement on Wednesday night that it \u201chad followed every step of the state\u2019s lawful, established execution protocol approved by the attorney general\u2019s office.\u201d Officials did not answer questions on Thursday about what went wrong with the administration of the drug.<\/p>\n
Medical experts said there were signs that the two intravenous catheters, rather than directing the drug into Ms. Pike\u2019s bloodstream, had allowed it to leak into the tissue surrounding the insertion point.<\/p>\n
That could have been because of how or where the catheters were inserted, the fragility of Ms. Pike\u2019s veins, or for another reason. Her lawyers said that doctors had always had difficulty finding veins during her blood draws and that Ms. Pike has a blood disorder that exacerbates that problem.<\/p>\n
During the execution attempt, they added, Ms. Pike even tried to help the staff place the two IV lines.<\/p>\n
\u201cShe over and over again said, \u2018Please, try up on my shoulder higher, please try here, please try here,\u2019\u201d Randy Spivey, another of her lawyers, said. He added that Ms. Pike thanked them once staff members thought they had established the two lines.<\/p>\n
Instances in which intravenous drugs leak into tissue under the skin are known as \u201cIV infiltration,\u201d and have been cited in past botched executions, including ones that caused extensive chemical burns. <\/p>\n
Experts said that experienced doctors in a medical setting would typically be able to recognize signs of an IV infiltration as it occurred.<\/p>\n
Members of the news media who served as witnesses to the execution attempt said that Ms. Pike at one point described a burning spot in her arm that felt as if it were going to burst and asked if that was normal.<\/p>\n
\u201cThe pain in her arm should have been a bright red flag that the IV was infiltrating,\u201d said Dr. Mark Heath, an assistant professor of anesthesiology at Columbia University Irving Medical Center.<\/p>\n
A vial of pentobarbital.Credit…Department of Justice, via Associated Press<\/p>\n
Dr. Joel Zivot, a professor of anesthesiology at the Emory University School of Medicine who said that he had previously been retained by Ms. Pike\u2019s lawyers as a medical expert, said that such an event would have caused the type of reaction that witnesses described.<\/p>\n
The result, he said, could have been a highly alkaline solution leaking into Ms. Pike\u2019s arm. \u201cEssentially, they\u2019ve injected bleach into the tissue of her arm,\u201d Dr. Zivot said.<\/p>\n
He added that he was speaking on his own behalf and not for Ms. Pike\u2019s legal team, and that he had no direct knowledge of what happened during the execution attempt.<\/p>\n
Having examined Ms. Pike\u2019s medical records before the execution attempt, Dr. Zivot said that she was also susceptible to an IV infiltration. Ms. Pike\u2019s lawyers had previously argued that the procedure could be agonizing for her in part because she has small veins.<\/p>\n
\u201cHer venous system was small, and there could be some fragility there,\u201d Dr. Zivot said. \u201cYou push a lot of a caustic substance into a small vein like that, under pressure, it\u2019s going to blow.\u201d<\/p>\n
He said chemical properties of the lethal drug, pentobarbital, mean that it can burn tissue and skin during executions.<\/p>\n
Pentobarbital is a barbiturate that can treat seizures; it works by depressing activity in the nervous system. It is a mainstay drug for euthanizing animals. The drug has also been used in states with legal medical aid in dying.<\/p>\n
Its main effect is to shut down electrical activity in the brain, including neurons in the brainstem that control breathing. The body enters a coma-like state, followed by respiratory failure and cardiac arrest.<\/p>\n
The federal government adopted single-drug pentobarbital<\/a> for lethal injections during the first Trump administration.<\/p>\n Under President Biden, the protocol was rescinded after a review by the Justice Department<\/a> in January 2025 concluded that there remained \u201csignificant uncertainty\u201d about whether using the drug for lethal injections \u201ccauses unnecessary pain and suffering.\u201d<\/p>\n