Autopsy Shows John Grant Suffered Pulmonary Edema and Intramuscular Hemorrhage and Aspirated Vomit During Oklahoma Execution

Autopsy results for an Oklahoma death-row pris­on­er whose exe­cu­tion state offi­cials claimed ​“was car­ried out … with­out com­pli­ca­tion” have con­firmed eye­wit­ness reports that John Grant like­ly suf­fered a tor­tur­ous death. The autop­sy, con­duct­ed by Tulsa Medical Examiner Jeremy Shelton, M.D., the morn­ing after Grant was exe­cut­ed on October 28, 2021, revealed that Grant suf­fered pul­monary ede­ma and intra­mus­cu­lar hem­or­rhag­ing, and aspi­rat­ed on his vom­it as a result of the lethal injection. 

The autop­sy find­ings indi­cate that Grant’s lungs were ​“heavy” with flu­id, sug­gest­ing that he expe­ri­enced ​“flash pul­monary ede­ma,” a swift build-up of flu­id that cre­ates a feel­ing of suf­fo­ca­tion or drown­ing that experts have likened to water­board­ing. 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 drug mida­zo­lam. Oklahoma’s three-drug exe­cu­tion pro­to­col uses a com­bi­na­tion of mida­zo­lam and the par­a­lyt­ic drug vecuro­ni­um bro­mide, fol­lowed by the drug potas­si­um chlo­ride to stop the prisoner’s heart.

The aver­age weight of a human lung is between 400 and 450 grams. Because of the flu­id build-up, Grant’s lungs weighed a com­bined 1390 grams at the time of the autop­sy. Dr. Shelton also not­ed that Grant had suf­fered intra­mus­cu­lar bleed­ing of his tongue, which is com­mon­ly found in fire fatal­i­ties, drown­ing vic­tims, and vic­tims of asphyxiation.

Grant was the first per­son exe­cut­ed in Oklahoma after a six-year hia­tus fol­low­ing a string of botched exe­cu­tions in 2014 and 2015. His exe­cu­tion was sched­uled despite the pen­den­cy of a fed­er­al tri­al, sched­uled to begin in late February 2022, on the con­sti­tu­tion­al­i­ty of the state’s exe­cu­tion process. The U.S. Court of Appeals for the Tenth Circuit stayed Grant’s exe­cu­tion and that of Julius Jones on October 27, 2021, cit­ing the inequity of exe­cut­ing them by a method suf­fi­cient­ly prob­lem­at­ic to war­rant a tri­al. Allowing the exe­cu­tions to go for­ward, the appeals court wrote, cre­at­ed an unac­cept­able risk that the men would be ​“unable to present what may be a viable Eighth Amendment claim to the fed­er­al courts before they are exe­cut­ed using the method they have challenged.” 

Without opin­ion, and over the dis­sents of Justices Stephen Breyer, Sonia Sotomayor, and Elena Kagan, the Supreme Court vacat­ed the stay, per­mit­ting the exe­cu­tion to move for­ward. Media wit­ness­es report­ed that Grant suf­fered repeat­ed con­vul­sions and vom­it­ed dur­ing a near­ly 15-minute peri­od after the mida­zo­lam was admin­is­tered. Media wit­ness Sean Murphy of the Associated Press report­ed in the post-exe­cu­tion news con­fer­ence that Grant began con­vuls­ing almost imme­di­ate­ly after the mida­zo­lam was inject­ed into his body. After being admin­is­tered “[t]he first drug — the mida­zo­lam — he exhaled deeply, he began con­vuls­ing about two dozen times — full-body con­vul­sions,” Murphy said. ​“Then he began to vom­it, which cov­ered his face, then began to run down his neck and the side of his face.”

Medical experts have been crit­i­cal of the use of mida­zo­lam in lethal injec­tion pro­ce­dures. Emory University pathol­o­gist Dr. Mark Edgar told Oklahoma City’s Fox 25 that the pris­on­ers ​“would be aware of sen­sa­tions of drown­ing, asphyx­ia, and ter­ror if you have severe pul­monary ede­ma like most of these inmates did.” Ohio State University Medical School pro­fes­sor Dr. Jonathan Groner not­ed that Oklahoma admin­is­tered a dosage of mida­zo­lam well beyond any clin­i­cal­ly accept­able lev­el. ​“It’s just an insane dose and there’s prob­a­bly no data on what that could cause,” he said.

Oklahoma had not attempt­ed to car­ry out an exe­cu­tion since September 30, 2015, when then-Governor Mary Fallin at the last minute called off Richard Glossip’s exe­cu­tion after being informed that Oklahoma Department of Corrections (ODOC) had received the wrong drug, potas­si­um acetate, instead of the potas­si­um chlo­ride required as the third drug in the state’s lethal-injection protocol.

It was lat­er revealed that the state had known for months that it had obtained and used the same unau­tho­rized drug to exe­cute Charles Warner in January 2015. Media wit­ness­es report­ed that Warner had said dur­ing his exe­cu­tion, ​“It feels like acid,” and ​“My body is on fire.”

Oklahoma also botched the exe­cu­tion of Clayton Lockett in April 2014, fail­ing for 51 min­utes to set an intra­venous exe­cu­tion line and then mis­plac­ing the line in Lockett’s groin, inject­ing the drugs into the sur­round­ing sub­cu­ta­neous tis­sue. With Lockett writhing on the gur­ney in a pool of blood, the exe­cu­tion was called off but 43 min­utes after the drugs were first admin­is­tered, he died.

After botch­ing the exe­cu­tion of Grant, ODOC offi­cials dis­put­ed media accounts of Grant’s suf­fer­ing. A prison spokesman said ​“Inmate Grant’s exe­cu­tion was car­ried out in accor­dance with Oklahoma Department of Corrections’ pro­to­cols and with­out com­pli­ca­tion.” The next day, ODOC Director Scott Crow called the eye­wit­ness accounts of the exe­cu­tion ​“embell­ished,” describ­ing the con­vul­sions report­ed by mul­ti­ple wit­ness­es as ​“dry heaves” and Grant’s vom­it­ing as ​“regur­gi­ta­tion.”

Oklahoma City Fox tele­vi­sion anchor Dan Snyder’s minute-by-minute account of the exe­cu­tion report­ed that Grant con­vulsed ​“so much so that his entire upper back repeat­ed­ly lift­ed off the gur­ney.” Snyder report­ed that, “[a]s the con­vul­sions con­tin­ued, Grant then began to vom­it. Multiple times over the course of the next few min­utes med­ical staff entered the death cham­ber to wipe away and remove vom­it from the still-breathing Grant.” 

Following ODOC’s san­i­tized descrip­tion of the exe­cu­tion, Snyder tweet­ed, ​“As a wit­ness to the exe­cu­tion who was in the room, I’ll say this: repeat­ed con­vul­sions and exten­sive vom­it­ing for near­ly 15 min­utes would not seem to be ​‘with­out complication.’”