LETHAL INJECTION: New Execution Practices Raising Medical Concerns

Medical experts are con­cerned that untried lethal injec­tion pro­ce­dures in some states could cause pro­longed, painful deaths. Ohio will try a pro­ce­dure nev­er used before in an exe­cu­tion on November 14 when it plans to inject a com­bi­na­tion of the seda­tive mida­zo­lam and the painkiller hydro­mor­phone. According to Dr. Jonathan Groner, a pro­fes­sor of clin­i­cal surgery at Ohio State University College of Medicine, a hydro­mor­phone over­dose can cause painful side effects, includ­ing an extreme burn­ing sen­sa­tion, seizures, hal­lu­ci­na­tion, pan­ic attacks, vom­it­ing, and mus­cle pain. He said, ​“You’re basi­cal­ly rely­ing on the tox­ic side effects to kill peo­ple while guess­ing at what lev­els that occurs.” Groner added, if the hydro­mor­phone IV is set poor­ly, ​“it would be absorbed under the skin, sub­cu­ta­neous­ly, very slow­ly, and that death could be extreme­ly prolonged…It may be painful, and it may take for­ev­er.” Doctors also raised con­cerns about Missouri​’s planned use of pen­to­bar­bi­tal from a com­pound­ing phar­ma­cy. Compounding phar­ma­cies are not reg­u­lat­ed by the Food and Drug Administration, and drugs from one such phar­ma­cy caused a dead­ly out­break of fun­gal menin­gi­tis in 2012. David Waisel, an asso­ciate pro­fes­sor of anes­the­si­ol­o­gy at Harvard Medical School, said that con­t­a­m­i­nat­ed pen­to­bar­bi­tal could cause a sen­sa­tion sim­i­lar to rub­bing an open wound with sand­pa­per. Florida was the first state to use mida­zo­lam, although it employed dif­fer­ent sec­ondary drugs than Ohio. In an October 15 exe­cu­tion, the inmate appeared to remain con­scious longer than usu­al and made move­ments after losing consciousness.

Florida’s next exe­cu­tion will be on November 12. South Dakota and Texas have already used pen­to­bar­bi­tal from com­pound­ing phar­ma­cies in recent executions.

(M. Redden, ​“New Lethal Injections Could Cause Extreme Pain, Make Deaths ​‘Drag on’ for Hours,” Mother Jones, November 7, 2013). See Lethal Injection and Compounding Pharmacies.