Tennessee corrections chief resigns as governor orders third-party review
Tennessee’s attempt to execute Christa Pike last week left the 50-year-old on a ventilator in a hospital, marking what legal experts describe as the first time a U.S. prisoner has survived two doses of a state’s lethal-injection drugs. Her attorneys said her arms were swollen and blistered, with one turned purple, after executioners gave her at least seven needles trying to find a vein. She remains critically ill, intubated and unconscious.
The procedure began more than nine hours late because of last-minute legal fights. Once inside the death house, witnesses said, Pike sang with her spiritual adviser as the caustic barbiturate began flowing into the IV lines, then told the team her arm felt like it was about to burst open. “Does this happen like that?” she asked, according to ProPublica.
Pike’s was Tennessee’s third execution in 14 months to go awry. In May, executioners trying to execute Tony Carruthers jabbed his hands and feet more than a dozen times before the state called off the attempt, according to Maria DeLiberato, senior counsel at the American Civil Liberties Union’s Capital Punishment Project, who witnessed it. Last year, the state executed 69-year-old Byron Black, who had dementia and congestive heart failure and used a wheelchair with an implanted defibrillator. Witnesses said Black lifted his head as the drugs flowed and said, “It’s hurting so bad.”
Hours after Pike’s execution was halted, the Tennessee Department of Correction said in a statement that it had “followed every step” of the state’s established protocol, which “has been consistently effective.” The head of the agency resigned on Saturday. Gov. Bill Lee said in a statement that he had ordered “a comprehensive, third-party review to determine exactly what occurred” and that an execution previously set for December would no longer take place this year.
Pike’s lawyers filed a motion Friday asking a court to preserve evidence related to the state’s failed attempt. They said the filing “details the serious complications that occurred during the execution attempt, many of which Christa and her attorneys had warned the State and the courts about months earlier.” Pike was sentenced to death for the 1995 murder of 19-year-old Colleen Slemmer, a fellow Job Corps student in Knoxville. She was 18 at the time and, like many people on death row, had a history of mental illness and childhood sexual abuse.
In August, her legal team warned that her small veins and a blood disorder could complicate the IV placement required to administer the lethal dose. The Tennessee Supreme Court rejected the request for a stay, calling the arguments “speculative.”
Tennessee’s protocol relies on pentobarbital, a barbiturate that has drawn federal scrutiny. The Justice Department under President Joe Biden said there was too much uncertainty about whether the drug would cause “unnecessary pain and suffering” and stopped using it in federal executions. President Donald Trump’s Justice Department reversed that decision this year and readopted its use.
Despite supply difficulties and repeated lawsuits from death row prisoners arguing that using pentobarbital is cruel and unusual, several states still use it, including Georgia, Missouri, South Carolina and Texas. In Texas, a ProPublica reporter who previously worked for the Houston Chronicle witnessed five executions in the late 2010s: four of the condemned prisoners said the drug burned, two said they could taste it, and one said he could “hear it going through the vein.” All of them stopped moving within minutes and were declared dead in under an hour.
Pike’s lawyers said in Friday’s filings that it was “abundantly clear” that Tennessee prison officials either didn’t know the IV lines were out of place or didn’t realize her veins had been so badly damaged that the highly alkaline liquid began leaking into the surrounding tissue of her arm. Joel Zivot, a professor of anesthesiology in Atlanta and one of Pike’s medical experts, told ProPublica that the result was that not enough of the drug reached her bloodstream at once to kill her. “It just got into her arms, and most of it stopped there,” he said.
The pattern reflects how long condemned prisoners spend awaiting their sentences. People put to death in 1988 had spent an average of less than seven years on death row, according to federal data. By 2023, the most recent year with figures, that average had risen to more than 23 years. An analysis by the nonprofit human rights group Reprieve found that the odds of a botched lethal injection increased 6 percent on average with each additional year of age.
The most notable failed executions of the past decade have involved aging and ill prisoners. In 2017, Ohio halted the execution of Alva Campbell after the execution team couldn’t find a usable vein; his attorneys had warned in legal filings beforehand that his medical problems — including lung cancer, COPD, prostate cancer and pneumonia — could make for an exceptionally painful execution. The 69-year-old died on his own in prison three months later. The following year, Alabama failed to kill 61-year-old Doyle Hamm, a terminally ill cancer patient; executioners spent more than two hours trying to find a vein, possibly puncturing his bladder before giving up, and he died three years later from cancer complications. And in 2024, Idaho called off the execution of 73-year-old Thomas Creech after trying to find a vein for nearly an hour. He’s still alive and on death row.
Death penalty experts compared what happened last week in Tennessee to a 2006 Florida execution, where the first dose of drugs failed to kill 55-year-old Ángel Díaz. He struggled for about half an hour, and executioners eventually dosed him a second time. It turned out the needles had gone through his veins and the drugs had seeped into the surrounding tissue, leaving footlong burns on his arms. An investigation found the state hadn’t provided adequate training or followed its own protocols, and the lead executioner later testified he had “no medical training and no qualifications.” Following a short moratorium, the state revised its procedures and resumed executions in 2008.
After Oklahoma executed Clayton Lockett in 2014 in a drawn-out and bloody procedure, a paramedic involved later testified that it took a long time because “Black people have smaller veins than white people.”
Defense attorneys say similar problems could surface next week in Florida, where Gov. Ron DeSantis signed a warrant for the execution of 74-year-old William Lee Thompson for a 1976 murder in Miami-Dade County. Since August, Thompson — who has dementia and does not always remember he is facing execution — has suffered from sepsis, pneumonia, blood clots in his lungs, a severe sacral wound and an array of other debilitating conditions. Bri Lacy, the lead attorney on Thompson’s case, told ProPublica her client is also malnourished and dehydrated, which could make it even harder for executioners to access his “hard, fragile veins.” She said Thompson had been in an outside hospital until the night before DeSantis signed the warrant, after which prison officials put him in death watch, the section for people with scheduled executions. Last week, DeSantis issued an executive order temporarily staying the execution and requiring that Thompson be evaluated by a panel of three psychiatrists to determine whether he is competent to be executed. The results are still outstanding.
Concerns about execution team competence have surfaced in multiple states. Both the American Medical Association and the American Nurses Association have strongly opposed their members taking part in death penalty procedures, according to ProPublica. During Carruthers’s attempted execution in May, a physician who identified himself as Dr. Mark Fowler tried to place a central line — an invasive procedure involving the neck, chest or groin — after failing to access a vein. DeLiberato told ProPublica that Fowler had previously admitted in a deposition that he did not have hospital privileges and had not placed a central line in about 12 years. “His hands were shaking, and it appeared to me he didn’t know what he was doing,” she said. By the time Fowler gave up trying to put one in Carruthers, DeLiberato could hear her client moaning and see blood oozing out of his puncture wounds. After more than an hour, the governor called off the execution and gave Carruthers a one-year reprieve.
“Placing a central line is like riding a bicycle. You don’t forget,” Fowler said in a text message to ProPublica. “My hands were not shaking and the process requires deliberation. I stopped because it was uncomfortable for Carruthers.” He added that his lack of hospital privileges was “irrelevant.”
It’s not clear whether Fowler took part in Pike’s attempted execution last week. Though he previously told local media that he would, neither the state nor the defense team confirmed his participation. He declined to comment on the matter to ProPublica.
For years, the physician overseeing executions in Missouri was a surgeon who had been disciplined by the state board and sued about 20 times for malpractice, he estimated in a deposition, according to the St. Louis Post-Dispatch. At least five of those cases ended in settlements, and one ended in a court judgment that he appealed and lost, the paper reported. In court testimony in the mid-2000s, he admitted that he sometimes confused names of different drugs and said he’d decided on his own to halve the amount of anesthetic given to condemned prisoners. A court eventually banned him from taking part in executions in Missouri — though federal officials later put him on the execution team at the federal death chamber in Indiana. He did not respond to phone calls and an email seeking a comment.
The week after the failed Carruthers execution, several dozen Tennessee doctors and nurses wrote to the governor urging a moratorium on the death penalty, saying that medical providers who take part in executions “are those willing to set aside their professional ethics” and that bungled executions “are the predictable result of working with such unscrupulous actors.”
Robert Dunham, director of the Death Penalty Policy Project, said such problems are systemic. “The types of failures that went into this botch happen all the time,” he told ProPublica. “There is nothing in the execution process that states are incapable of getting wrong.”
Secrecy about execution procedures has made it difficult to hold teams accountable. States generally shield the names of execution team members, and many withhold drug purchase dates, supplier information, and sterility testing results. In Florida, Maya Foa of Reprieve said, officials “tape [prisoners’] fingers so you can’t see if they’re wiggling or still conscious.”
Tennessee’s record gives little reason for confidence. In 2022, citing a “technical oversight,” the governor called off the execution of Oscar Smith, then paused future executions and ordered an investigation that ultimately found the state hadn’t been testing its death drugs for bacterial toxins as required by its own rules. After a three-year hiatus, the state resumed executions last year.
It’s not clear how old the drugs were that Tennessee used in Pike’s execution, though records obtained by ProPublica suggest the state purchased some earlier this year. An email from the corrections department to the state comptroller, turned over in response to a public records request regarding payments for lethal injection drugs, showed that the prison agency spent $650,000 this year on execution-related expenses. Legal experts said it’s still not clear where the drug supplies came from, when they were made or even whether they were manufactured by a pharmaceutical company or mixed in a compounding pharmacy.
In Tennessee, six condemned men are now suing for information about the state’s pentobarbital supplies — its age, origin and expiration dates. Kit Thomas, a deputy chief in the Middle District of Tennessee’s federal public defender office, said state officials have resisted providing even basic details about whether the drug was manufactured by a pharmaceutical company or mixed in a compounding pharmacy. “Without public accountability or transparency,” Thomas said, “we should expect to see more people strapped to gurneys and tortured for hours at a time.”
Jamaal Howard, 46, is scheduled for execution in Texas on Wednesday in connection with the May 2000 shooting of a convenience store clerk in Hardin County. On Saturday, his legal team asked Gov. Greg Abbott for a 30-day reprieve — not because their client is innocent, but because they want more information about the drugs Texas plans to use. In the past, the state has routinely turned over testing results and other records, but in recent months, that has changed — and after the botched execution in Tennessee, Howard’s attorneys say they want more proof the drugs are still good. “We expect [the Texas Department of Criminal Justice] will assure you that its drugs are sound,” attorneys Don Bailey and Jeff Newberry wrote. “Tennessee gave the same assurance.” Abbott’s office didn’t immediately respond to requests for comment. Amanda Hernandez, a Texas prison spokesperson, said the state has successfully put to death more than 600 people since 1976 and “stands ready to carry out the execution scheduled for Oct. 7.”