Tennessee's handling of the death penalty is again questioned after failed execution

Christa Pike’s failed execution followed other death penalty miscues in Tennessee, which performs just a fraction of the nation’s executions but is now halting them for a second time since 2022, reigniting questions over the state’s handling of capital punishment.

Pike, 50, remained on a ventilator and unconscious at a Nashville-area hospital on Friday, according to her attorneys, who say she was poked with needles at least seven times in the state's death chamber and then hospitalized with burned and blistered arms after being given two doses of lethal drugs .

The unsuccessful attempt was the second failed execution in four months in Tennessee. Since 2022, the state has carried out just four of the more than 140 executions that have taken place nationwide, according to the Death Penalty Information Center.

Republican Gov. Bill Lee paused executions in the state following the unsuccessful attempt to put Pike to death and ordered an independent investigation into what went wrong, as both critics and supporters of the death penalty called for changes.

“Number one, I think we need to get better people that are doing these executions because I don’t know that they’re trained well enough to be doing this on difficult patients,” said Republican state Sen. Joey Hensley, a family physician, adding that he suspects the IV line was not properly inserted.

Days after the attempt to execute Pike, who received two lethal doses of pentobarbital , she had blisters on her arms from the bleach-like, caustic substance that was injected into her body, her attorneys wrote in an emergency court filing on Friday.

Pike’s attorneys said they believed problems with the IV lines caused the pentobarbital to flow into her body instead of her bloodstream.

“Apparently at no point did any member of the execution team realize that the IV lines were not correctly placed or that the veins had blown and that the pentobarbital was, in whole or in part, entering Ms. Pike’s body,” they wrote.

They wrote that instead of “remedying this failure” prison officials prepared and administered a backup set of pentobarbital syringes.

Pike's case is not the first time Tennessee's execution practices have drawn criticism.

Earlier this year, Tennessee stopped the execution of Tony Carruthers after medical workers placed an IV into his right arm but couldn’t get a secondary IV line, proceeding to attempt to place one into his other arm, his left hand and his left foot, then finally failing to establish a central line.

Lee ordered officials to wait at least a year before trying to execute Carruthers again.

Four years before that, the governor ordered an independent review into capital punishment after abruptly stopping the April 2022 execution of Oscar Smith in the 11th hour when officials became aware of a mishandling of the drugs. Lee paused all executions over a week later after acknowledging the state had failed to ensure its lethal injection drugs were properly tested.

The report he ordered, released in late December 2022, found that the state hadn’t complied with its own lethal injection process since it was revised in 2018.

In that time period, Tennessee put seven inmates to death — two by injection and five in the electric chair. The report said that in none of those, nor in the execution Lee halted, did the pharmacy conduct the required test for endotoxins, and in one of the lethal injections, the drug midazolam was not tested for potency.

At the time, the state's lethal injections were performed through a three-drug series of midazolam, vecuronium bromide and potassium chloride. The state later switched to using just pentobarbital.

The report, conducted by former U.S. Attorney Ed Stanton, also found that the state’s unidentified executioner had no formal healthcare training and learned the role mainly through on-the-job experience.

After the release of the report, the Tennessee Department of Correction fired its longtime top attorney and another employee.

One of Pike’s attorneys, Steve Ferrell, was skeptical of the progress made since those revelations, saying the investigation resulted in “a less detailed protocol and more secrecy."

It's not uncommon for executioners to have minimal medical training, according to Corinna Lain, a law professor at the University of Richmond and author of a book on lethal injections.

Lain said lethal injection has become more popular because it is considered less gruesome and hides the violence of state killing. But she said that, even when states follow protocol, the method still poses risks. A number of attorneys have echoed those concerns in lawsuits, arguing that the method is unconstitutional.

Lain said she has only found about 10 medically licensed doctors in the entire country who work with states on executions. Doctors she interviewed told her that they believed executions to be contrary to their oath to take care of people.

In many ways, executions are shrouded in secrecy . The identity of execution team members, the details about where and how lethal drugs are procured, and in some states even what happens in the death chamber is hidden from public view.

“Tennessee has botched executions so badly that two people this year have survived their own executions,” Lain said. “That’s quite something."

Still, experts like Jordan Steiker, the co-director of the Capital Punishment Center at the University of Texas, say that the method is likely to continue to be an option for states with the death penalty.

That is in large part, Steiker said, because of a deferential judicial approach to the execution process, which has consistently empowered states to carry out executions.

“I think it gives states confidence that even if they take shortcuts, it’s unlikely that the courts will intervene in their ability to carry out executions,” Steiker said.