Execution team used 10 needles, child-sized catheter before Pike survived dose, filing shows

Four unidentified members of Tennessee's execution team spent nearly an hour jabbing at Christa Pike's arms and using about 10 needles before they could establish an intravenous line, according to a chronology filed by her lawyer in proceedings on Thursday, 22 October. The account covers the 30 September attempt, during which Pike survived a dose of pentobarbital that is normally lethal.

Jonathan Groner, an emeritus professor of clinical surgery at Ohio State University who studies execution methods, said the record shows the sequence went badly from the start. "I'm shocked and disturbed by what happened inside the death chamber," he said. "The level of incompetence is astounding, and difficult to comprehend." He said the timeline showed nobody in charge and no plan in sight.

Pike's lawyer Randy Spivey wrote that the team repeatedly poked her arms without securing a line, and that at several points staff worried her veins might have "blown." The account records Pike grimacing several times and saying her arm was "really burning." Groner noted that the label on a pentobarbital vial instructs providers to stop the infusion at once if a patient reports pain.

At 7.05pm, roughly half an hour into the procedure, a team member asked for a 24-gauge needle and "moved that needle around a lot," the filing states. Joel Zivot, a professor of anesthesiology and surgery in Atlanta who testified before the execution, said that size catheter is used for infants and small children. Tennessee's protocol called for 50cc of pentobarbital in each arm, 5g total, and Zivot said there was "no way" to push a 50cc syringe through a catheter that small without blowing the vein. At 7.07pm, a team member said, "I think it is blown."

The team also tried to find a vein using ultrasound. Groner said the technique requires many hours of specialist training and as many as 20 actual procedures to perform smoothly, and that the team clearly did not know how to use it. At 7.23pm saline moved through the line "with difficulty," which Groner called a flashing red light. A minute later, at 7.24pm, the team concluded the IV was in place and the procedure could begin. "No clinician would give a caustic drug through an IV where it didn't flush easily," he said.

Pike's lawyers, relying in part on Zivot's expert opinion, had warned the state several times before the attempt that her veins were exceptionally small and compromised. Zivot listed the failings he observed: a poorly written protocol, no one in charge, technology the team may not have had permission to use, and catheters far too small for the purpose.

Pike was 18 when she was sentenced to death for the 1995 murder of her classmate Colleen Slemmer. After the failed execution she spent several days on a ventilator, and her lawyers assumed she was brain-dead. She returned to her prison cell after 10 days in hospital and can now talk and walk, though her long-term prospects are unknown. Tennessee has halted all executions pending a review.

Groner called the episode a "medical charade." "The ultimate penalty in our country, whether one agrees with it or not, is death. It is not torture, then death," he said. Zivot said the team should have stopped. "Medicine is obsessed with safety, accountability and training," he said. "You didn't see any of those things in Pike's execution chamber."