Medical experts shocked by Tennessee team’s ‘malpractice’ in botched execution of Christa Pike | Christine Pike

Medical experts have expressed shock at the apparent incompetence shown by the Tennessee execution team in the failed lethal injection of Christa Pike, the prisoner who survived a normally lethal dose of pentobarbital, which they say would be considered medical malpractice in any other context.

New details emerged Thursday about how Tennessee’s intravenous (IV) team struggled for nearly an hour to set up a line in Pike’s arms through which she would receive the lethal dose of sedative. A detailed account was made public during the court proceedings by Pike’s attorney, Randy Spivey, who was present inside the death chamber during his botched execution on September 30.

The technical procedures attempted by the four unidentified members of the IV team while trying to find a vein, as described by Spivey, caused concern among medical experts. They said the standards applied appeared to fall significantly short of anything that would be considered acceptable in a medical environment.

“I am shocked and disturbed by what happened in the death chamber,” said Jonathan Groner, professor emeritus of clinical surgery at Ohio State University and an expert on execution methods. “The level of incompetence is staggering and difficult to understand. »

Groner, who wrote an upcoming book, The Hippocratic Paradox, which explores the ethical contradictions involved in lethal injections, said Spivey’s detailed timeline painted a picture in which no one was in charge and no plan was in sight.

“What they did to Christa Pike would have been malpractice in a clinical situation. No one would inject her with a drug like pentobarbital, known to cause burns, if they weren’t sure the IV was actually in place.”

Groner pointed out that the label on a vial of pentobarbital states that the infusion should stop immediately if the patient complains of pain. Spivey’s account repeatedly reports that Pike “winced” and said his arm was “really burning.”

Pike was sentenced to death for the 1995 murder of a classmate, Colleen Slemmer, when she was 18. After her failed execution, she spent several days on a ventilator and her lawyers assumed she was brain dead.

After 10 days in the hospital, she was returned to her prison cell. She can now talk and walk, but her long-term outlook is unknown.

The gruesome nature of Pike’s experiences in the death chamber, which some likened to torture, prompted nationwide interest in the death penalty. Tennessee has canceled all executions, pending a review.

In Spivey’s detailed account, Team IV used about 10 needles repeatedly poking Pike’s arms, failing to secure a line. At several points, team members feared that his veins had “exploded.”

Joel Zivot, an Atlanta, Ga.-based professor of anesthesiology and surgery who testified as an expert in court hearings preceding Pike’s botched execution, said the new timeline highlights several serious areas of concern. “Here we have a poorly written protocol, no managers, technology they may not have had permission to use, and catheters that are way too small for their intended purpose. We could go on and on…”

Pike’s lawyers, based in part on Zivot’s expertise, warned the state several times before the failed execution attempt that the prisoner had exceptionally small and compromised veins.

Spivey’s timeline reports that at 7:05 p.m. on the evening of the botched execution, about a half hour into the procedure, a member of the IV team asked for a 24-gauge needle “and moved that needle a lot. Christa continued to grimace.”

Zivot said a 24-gauge catheter is very small. “It’s the kind of catheter you put in a baby or small child.”

He added that there was “no way to insert a 50 cc syringe into that little catheter without it bursting the vein.” According to the Tennessee protocol, 50 cc of pentobarbital was to be injected into each of Pike’s arms, a massive total dose of 5 g of the sedative.

At 7:07 p.m., another IV team member said, “I think it’s toast.” »

The Spivey timeline also reveals that Team IV attempted to find a vein using ultrasound technology. Groner said that, from his own personal experience, using an ultrasound requires many hours of specialized training and up to 20 actual procedures before an individual can perform the technique smoothly.

“Inserting an IV under ultrasound guidance is a practice-based skill that requires a lot of training. The Tennessee team clearly didn’t know how to use it,” he said.

At 7:23 p.m., the IV team pushed the saline solution through the line they had established “with difficulty,” according to Spivey. It should have been a flashing red light, Groner said.

“No clinician would administer a caustic drug intravenously where it does not drain easily. This would be malpractice.”

Despite this red flag, the IV team concluded that the IV was set and the procedure could begin one minute later, at 7:24 p.m.

Medical experts said the timeline highlights fundamental problems with lethal injections, the overwhelmingly dominant form of execution in the United States in the modern era. Groner said this underscored that lethal injections were a “medical sham. Pike did not deserve this. The ultimate punishment in our country, whether one agrees with it or not, is death. It is not torture and then death.”

Zivot said his takeaway was that the execution team continued when it should have stopped. “It was clear that it wasn’t feasible, and yet they continued to do it anyway. »

He added: “Lethal injection is the theft of a medical procedure, and they stole the wrong part. Medicine is obsessed with safety, accountability and training. You saw none of that in Pike’s execution chamber.”