Something went wrong dur­ing the exe­cu­tion of Ricky Gray (pic­tured), who was put to death in Virginia on January 18, 2017, accord­ing to an inde­pen­dent expert who reviewed the offi­cial autop­sy report of Gray’s death. Dr. Mark Edgar, asso­ciate direc­tor of bone and soft tis­sue pathol­o­gy at the Emory University School of Medicine, reviewed the offi­cial autop­sy report, which Gray’s fam­i­ly obtained from the Virginia med­ical exam­in­er’s office. Dr. Edgar says Gray suf­fered an acute pul­monary ede­ma dur­ing the exe­cu­tion, with liq­uid in his upper air­ways and blood enter­ing his lungs while he was still breath­ing. ​“The anatom­ic changes described in Ricky Gray’s lungs are more often seen in the after­math of a sarin gas attack than in a rou­tine hos­pi­tal autop­sy,” Edgar said. ​“This is of con­cern espe­cial­ly giv­en the fact that mida­zo­lam is not an anes­thet­ic, but a seda­tive often used for med­ical pro­ce­dures requir­ing con­scious seda­tion and the issue that the com­pound­ed drugs used in this case may have lacked poten­cy or been impure.” Virginia’s lethal-injec­tion pro­to­col con­sists of three drugs: mida­zo­lam, a seda­tive intend­ed to ren­der the pris­on­er uncon­scious, fol­lowed by a par­a­lyt­ic intend­ed to stop the pris­on­er’s breath­ing, fol­lowed by potas­si­um chlo­ride, which stops the pris­on­er’s heart. The use of mida­zo­lam in exe­cu­tions is con­tro­ver­sial because it is not an anes­thet­ic, it is used in med­ical set­tings only for low­er lev­els of seda­tion rather than to pro­duce full uncon­scious­ness, and its use has been linked to numer­ous prob­lem­at­ic exe­cu­tions. In Virginia, both the mida­zo­lam and the potas­si­um chlo­ride are pro­duced by com­pound­ing phar­ma­cies whose iden­ti­ties are secret under state law. ​“This way of dying is intol­er­a­ble. You can’t con­trol your breath­ing — it is ter­ri­ble,” Edgar said. ​“When it is this severe, you can expe­ri­ence pan­ic and ter­ror and, if the indi­vid­ual was in any way aware of what was hap­pen­ing to them, it would be unbear­able.” After Edgar’s report was released on July 6, lawyers for William Morva — whose exe­cu­tion was sched­uled in Virginia that night — asked Governor Terry McAuliffe for a tem­po­rary reprieve. ​“We believed a reprieve was appro­pri­ate to allow time for fur­ther inves­ti­ga­tion to ensure that the Commonwealth car­ries out future exe­cu­tions — includ­ing Mr. Morva’s — in a man­ner that avoids unnec­es­sary pain and suf­fer­ing,” explained Rob Lee, one of Morva’s attor­neys. McAuliffe denied the reprieve, and wit­ness­es report­ed that Morva made a loud noise after the mida­zo­lam was admin­is­tered and had sev­er­al sharp con­trac­tions of his abdomen. The same three-drug pro­to­col used in Virginia has been pro­posed for use in Ohio, but is being chal­lenged in court by death-row prisoners. 

(F. Green, ​“Pathologist says Ricky Gray’s autop­sy sug­gests prob­lems with Virginia’s exe­cu­tion pro­ce­dure,” Richmond Times-Dispatch, July 7, 2017.) See Lethal Injection.

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