THE IV USED to administer a lethal injection to a US death row inmate during a recent botched execution was badly placed and not properly monitored, an inquiry has found.
Clayton Lockett, a convicted murderer and rapist, was put to death in Oklahoma on 29 April using an untested three-drug protocol in a process that took 43 minutes — well over the expected time of a little over 10 minutes.
Authorities said Lockett, who was seen writhing in pain, bucking off the gurney and mumbling unintelligibly, ultimately died of a massive heart attack.
The incident drew widespread condemnation and led the state to temporarily halt executions and order an investigation.
According to a 32-page report made public by the Oklahoma Department of Public Safety, “the physician and paramedic attempted IV placement access in multiple locations and were unsuccessful” before doing so in the right groin area and administering the anesthetic Midazolam followed by the two other drugs.
The physician noticed the IV failure some 20 minutes later when the inmate “began to move and make sounds on the execution table.”
While trying in vain to insert the IV into the femoral artery and elsewhere,” the physician made the observation that the drugs appeared to be absorbing into Lockett’s tissue.”
His heart stopped shortly after the execution was interrupted and he was pronounced dead at 7:06 pm, 43 minutes after the first injection at 6:23 pm, the report said.
“This investigation concluded the viability of the IV access point was the single greatest factor that contributed to the difficulty in administering the execution drugs,” the investigators said.However, “the IV failure complicated the ability to determine the effectiveness of the drugs,” they added.
The investigators listed a series of recommendations, including the creation of a “formal and continuing training program for execution personnel.”
Lawyers for death row inmates regularly criticise what they see as the lack of qualifications of those administering lethal injections in the 32 US states that allow capital punishment.
The report calls for executions not to be scheduled within seven calendar days of each other, highlighting that it was “apparent the stress level” at the facility in question was elevated because two executions were scheduled for 29 April — a first since 2000.
In the end, the second one was called off due to what happened with Lockett.
The report also recommends that an IV catheter insertion point or points “should remain visible during all phases of the execution and continuously observed by a person with proper medical training in assessing the ongoing viability of an IV.”
More questions than answers
In a statement, Lockett’s lawyer said “the state’s internal investigation raises more questions than it answers.”
“Once the execution was clearly going wrong, it should have been stopped, but it wasn’t,” Dale Baich said.
“Whoever allowed the execution to continue needs to be held accountable,” he added, noting that a pending federal lawsuit now presented the “best chance” to determine what happened.
Deborah Denno, a professor at Fordham University School of Law, said the the challenges with IV access, hindered visibility and inadequately trained personnel were all foreseeable problems in Lockett’s case due to previously botched executions.
“The need for more ‘thorough research and review’ of these procedures has been urged repeatedly over the decades, yet regularly ignored by departments of corrections,” she said in an email.
“Our country’s confidence in states’ abilities to conduct executions properly has reached the lowest point.”
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