'Fire in the vein' 

Inmate’s lawsuit questions lethal injection, and the process behind the curtain.


Though victims’ rights advocates have long complained that execution by lethal injection is too placid a death for convicted killers, a federal civil rights lawsuit filed by an Arkansas inmate argues the procedure can conceal an agonizing demise. Detailing a number of problematic Arkansas executions of years past, the lawsuit maintains that untrained medical staff and the type of chemicals used to kill condemned inmates raise the likelihood of an excruciatingly painful death.

Filed May 1 by Arkansas Death Row inmate Terrick Terrell Nooner, the lawsuit lists several Arkansas Department of Correction officials as plaintiffs, as well as “Does 1-50, Unknown Executioners” — the anonymous support personnel who assist in and carry out the execution process.

Julie Brain, the federal public defender who is representing Nooner, refused to comment for this article, citing the policy of her office. The lawsuit is still pending, despite some twists and turns in other federal courts.

In addition to questioning the use of untrained medical personnel to administer the lethal injection process (doctors and nurses are barred from participating in executions by the Hippocratic oath), another issue addressed in Nooner’s lawsuit is the three drugs used to anesthetize, paralyze and finally stop the heart of the condemned. According to ADC protocol outlined in the lawsuit, the first drug administered is two grams of Thiopental, a fast-acting barbiturate that is supposed to render the subject unconscious and anesthetized from pain. The IV lines are flushed with saline, and then 100 milligrams of pancuronium bromide are injected. A paralytic, pancuronium bromide stops all voluntary muscular function in the body, but does nothing to control either pain or conscious thought (as such, it has featured prominently in many botched-anesthesia horror stories in which patients were operated on while fully conscious and yet unable to move). Yet another saline flush is followed by 150 milliequivalents of potassium chloride, which stops the heart, but which the lawsuit points out feels like “a fire traveling through the vein” if the subject is not properly anesthetized (as such, the American Veterinary Medical Association prohibits the use of potassium chloride in euthanizing animals unless the subject has reached a “surgical plane” of anesthesia prior to the injection).

Nooner’s objection to methods of lethal injection and the three-drug “cocktail” used to execute the condemned isn’t new. Death penalty opponents have long questioned whether inmates might feel pain during the lethal injection process if the initial anesthetizing dose was botched — especially when administered by untrained personnel.

The issue gained considerable steam in April 2005 when an article appeared in the prestigious British medical journal The Lancet. In the article, a team of researchers from the University of Miami examined the toxicology reports on 49 executed inmates from four states. They found that 43 of the subjects had concentrations of Thiopental in the blood that didn’t meet the requirements for surgical anesthesia. Furthermore, in 21 of the inmates, researchers concluded that the amount of Thiopental in the blood was insufficient to render the subject unaware of his or her surroundings — a state which the subsequent dose of pancuronium bromide would have masked.

“We certainly cannot conclude that these inmates were unconscious and insensate,” wrote Dr. Leonardis Koniaris, the leader of the study. “However, with no monitoring and with little use of the paralytic agent, any suffering of the inmate would be undetectable.”

While the ADC insists that the initial dose of Thiopental is more than enough to kill the condemned prisoner outright — about 10 times what a patient might receive during surgical procedure — the Nooner lawsuit lists a number of the state’s 26 lethal injections in which the inmate showed signs of consciousness up to several minutes after the first drug was administered.

As detailed in the lawsuit, these include:

Ronald Gene Simmons, who was executed on June 25, 1990. Though the first chemical was given to Simmons at 9:02 p.m., at 9:05 p.m., witnesses said he called out “Oh! Oh!” and began to cough, continuing for the next two minutes. Simmons didn’t become still until 9:07 p.m., well after the process was under way. ADC employees adjusted the IV twice, and Simmons’ face and arm turned blue and then purple. He was not pronounced dead until 9:19 p.m.

Rickey Ray Rector, put to death on Jan. 24, 1992. Two minutes after the execution began, according to one witness, Rector was conscious enough to say, “I’m getting dizzy.” Three minutes later, his lips began moving rapidly, as if he was drawing shallow breaths. He was pronounced dead 19 minutes after the execution began, and that only after ADC personnel punctured Rector’s hands and arms 10 times before finally resorting to a “cut down” — a deep incision in the arm — to locate a suitable vein.

Christina Riggs, put to death on May 2, 2000. Her execution was also delayed while ADC personnel tried to locate a vein in her arm before finally inserting the needles into her wrists. The execution proceeded, but a full minute after the Thiopental began to flow, witnesses said that Riggs was speaking, saying, “I love you, my babies.”

On May 22 of this year, the U.S. Supreme Court refused to consider a case similar to Nooner’s lawsuit. Tennessee death row inmate Abu-Ali Abdur’Rahman had also challenged execution by lethal injection on the grounds that the drugs used might violate the Eighth Amendment’s prohibition against cruel and unusual punishment.

That case seemed to bode ill for Nooner’s suit. However, on June 12, the Supreme Court ruled that a lawsuit filed on similar grounds by Florida inmate Clarence Edward Hill could go forward. Citing the Miami University study, Hill’s suit challenged the three drugs used in executions, saying they could cause pain if they were used. The Supreme Court decision in the Hill case opens the door for a flood of other inmate challenges to the methods and drugs used in the lethal injection process.

Meanwhile, the ACLU may challenge another facet of Arkansas execution protocol: the opening and closing of curtains separating the execution chamber and the witness gallery in order to conceal the pre- and post-execution process and the identities of those participating in it. According to current ADC procedure, the curtains remain closed while the condemned inmate is led into the chamber and strapped down to the execution table. After IV lines are in place and support personnel have cleared the room, the curtains are opened. The prison warden reads the death warrant, last statements are made, and — in a control room adjacent to the death chamber — two executioners depress a series of syringes containing the deadly chemicals. After the prisoner is pronounced dead by the coroner, the curtains are closed again while the body is removed.

“We’re taking a serious look at the public’s right to view the entire execution process from beginning to end,” said ACLU executive director Rita Sklar. “We’re talking about the right of the public to know exactly what happens during this process. That’s our perspective.”

Sklar said that with an execution date coming up, if the ACLU decides to file something on the issue, they would likely do it as soon as possible.



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