As the federal government began to carry out the second round of executions it has scheduled for 2020, autopsy results from the first round of executions in July suggest to a “virtual medical certainty” that federal death-row prisoners will experience “excruciating pain” while they are being put to death by lethal injection with pentobarbital.

An autopsy of Wesley Purkey (pictured), authorized by Purkey’s next-of-kin and conducted by Western Michigan University forensic pathologist Joyce L. deJong, found that Purkey suffered “[s]evere bilateral acute pulmonary edema” during his execution on July 17. Reviewing the autopsy results, Dr. Gail Van Norman — an expert for the death-row prisoners who are challenging the federal execution protocol — said Purkey had experienced “flash pulmonary edema,” a condition that can occur only when a person is still alive. Purkey’s autopsy results were consistent with those of other prisoners executed with pentobarbital, Van Norman said. The results, she said, affirmed the opinion she had provided before the execution that “premortem flash pulmonary edema is a virtual medical certainty in any execution carried out” under the federal government’s pentobarbital lethal-injection protocol.

Van Normal said the prisoners would experience a sensation “identical to that reported by victims of near drowning or suffocation” like that produced during “enhanced interrogations” such as waterboarding. “These are among the most excruciating feelings known to man,” she said. “Prisoners executed by lethal injection in accordance with the Federal Protocol remain sensate and able to experience the extreme pain and suffering related to the occurrence of flash pulmonary edema,” Van Norman said.

Dr. DeJong’s autopsy reported evidence of “[f]rothy pulmonary edema” in Purkey’s trachea and mainstem bronchi, meaning that fluid had built up in both of his lungs and spilled into his airways during the execution. Dr. Van Norman said the autopsy results showed that Purkey’s lungs increased in weight to “between 2.73 and 4.3 times that of normal lungs” as a result of the fluid build-up.

Federal prosecutors said that the three federal executions in July “were implemented without any pentobarbital-related complications” and were “humane.”

The government executed Lezmond Mitchell August 26 and has scheduled the execution of Keith Nelson for August 28.