Autopsies Show Excess Fluid in Lungs of All Four Prisoners Put to Death in Oklahoma Execution Spree

Autopsies of the four men exe­cut­ed by Oklahoma between October 2021 and February 2022 show that all four pris­on­ers had excess flu­id in their lungs, giv­ing addi­tion­al cre­dence to death-row pris­on­ers’ claims that Oklahoma’s lethal-injec­tion process will sub­ject them to an uncon­sti­tu­tion­al­ly torturous death.

The autop­sy report for Gilbert Postelle, obtained by Oklahoma Watch through a pub­lic records request and pub­lished May 25, 2022, found that Postelle expe­ri­enced pul­monary ede­ma with ​“frothy parenchy­mal flu­id” dur­ing his February 17, 2022 exe­cu­tion. Pulmonary ede­ma is an abnor­mal build-up of flu­id in the lungs. The report, pre­pared by Medical Examiner Ross Miller, M.D., indi­cat­ed that Postelle’s lungs had a com­bined weight of 1,220 grams, mak­ing them between a quar­ter to a third larg­er than the aver­age adult lung size of between 900 and 1,000 grams. 

Medical experts for the pris­on­ers tes­ti­fied dur­ing a six-day fed­er­al trial in February and March 2022 on the con­sti­tu­tion­al­i­ty of Oklahoma’s exe­cu­tion pro­to­col that froth­ing could only occur if ​“the pris­on­er is alive and breath­ing” when the ede­ma occurred. The autop­sy results from the exe­cu­tions of John Grant and Bigler Stouffer, they said, indi­cat­ed that the men expe­ri­enced severe pain from pul­monary ede­ma that occurred while they were being put to death. John Grant’s lungs weighed 1,390 grams, and Stouffer’s lungs weighed 1,510 grams. John Grant also suf­fered intra­mus­cu­lar bleed­ing of his tongue, which is com­mon­ly found in fire fatal­i­ties, drown­ing vic­tims, and vic­tims of asphyxiation.

Autopsy results for Donald Grant, who was exe­cut­ed on January 27, 2022, and Postelle were not avail­able at the time of the tri­al. Donald Grant’s autop­sy also indi­cat­ed that his ​“lung tis­sue dis­plays ede­ma and con­ges­tion.” According to the autop­sy, Donald Grant’s lungs weighed 880 grams.

The find­ings from the autop­sies sug­gest that the men may have expe­ri­enced severe pain from the flu­id build­ing up in their lungs short­ly after the lethal injec­tion exe­cu­tions began. The news of Postelle’s autop­sy comes while the par­ties await a deci­sion from U.S. District Court Judge Stephen Friot on the con­sti­tu­tion­al­i­ty of the state’s execution protocol. 

An NPR analy­sis of autop­sies of more than 200 pris­on­ers exe­cut­ed by lethal injec­tion found that pul­monary ede­ma was not­ed in 84% of the autop­sies and was even more ubiq­ui­tous in mul­ti-drug exe­cu­tions involv­ing the seda­tive drug mida­zo­lam. Oklahoma’s three-drug exe­cu­tion pro­to­col uses a com­bi­na­tion of mida­zo­lam, the par­a­lyt­ic drug vecuro­ni­um bro­mide, and the drug potas­si­um chlo­ride to stop the prisoner’s heart.

Dr. Mark Edgar, a pathol­o­gist and autop­sy direc­tor at the Mayo Clinic in Florida, who reviewed more than 30 autop­sies of pris­on­ers exe­cut­ed by death penal­ty pro­to­cols that employed mida­zo­lam, tes­ti­fied that 27 of those pris­on­ers had expe­ri­enced ​“severe pul­monary ede­ma,” which would pro­duce sen­sa­tions of ​“doom, pan­ic, drown­ing, and asphyx­i­a­tion.” Oklahoma State University phar­ma­col­o­gy pro­fes­sor Dr. Craig Stevens tes­ti­fied that mida­zo­lam has a ​“ceil­ing effect” above which it los­es any addi­tion­al seda­tive effect. The drug, he tes­ti­fied, lacks the phar­ma­co­log­i­cal prop­er­ties nec­es­sary to ade­quate­ly ren­der pris­on­ers uncon­scious and insen­sate before they are par­a­lyzed by the sec­ond drug and sub­ject­ed to what he called the ​“burn­ing fire” sen­sa­tion of the potas­si­um chlo­ride. Dr. Gail Van Norman, pro­fes­sor of anes­the­si­ol­o­gy and pain med­i­cine at the University of Washington Medical School, tes­ti­fied to a ​“vir­tu­al med­ical cer­tain­ty” that the four pris­on­ers exe­cut­ed under Oklahoma’s cur­rent pro­to­col ​“expe­ri­enced extreme pain and suffering.”

Prosecutors argued that the evi­dence of pul­monary ede­ma did not prove that the exe­cu­tions were tor­tur­ous. Dr. Joseph F. Antognini, an anes­the­si­ol­o­gist and pro­fes­sor at the University of California at Davis who has tes­ti­fied for pros­e­cu­tors in numer­ous lethal-injec­tion cas­es, dis­put­ed that the flu­id build-up occurred while the pris­on­ers were con­scious and argued that the dosage of mida­zo­lam admin­is­tered to the pris­on­ers ​“would ren­der some­body inca­pable of expe­ri­enc­ing or feel­ing pain from a noxious stimulus.” 

“Even if inmates were con­scious of the pul­monary ede­ma lat­er found in their autop­sies,” state pros­e­cu­tors argued in their post-tri­al brief­ing, ​“the evi­dence is still insuf­fi­cient to show they were sure or very like­ly in severe pain.”