Tennessee execution team used baby-sized needle in failed lethal injection

Tennessee execution officials used a 24-gauge needle, a size typically reserved for infants, during the failed lethal injection of Christa Pike on 30 September. The procedure lasted nearly an hour before the team administered a full dose of pentobarbital that failed to end her life. Pike’s attorneys filed a detailed account of the event in court on 24 October, describing a chaotic process that left the inmate on a ventilator for several days.

The timeline submitted by attorney Randy Spivey states that four unidentified members of the intravenous team struggled to secure a line in Pike’s arms. They used approximately 10 needles during the attempt. At multiple points, team members expressed concern that Pike’s veins had blown. The protocol required 50cc of pentobarbital to be injected into each arm, totaling 5 grams of the drug. Pike survived the full dose.

Jonathan Groner, an emeritus professor of clinical surgery at Ohio State University, reviewed the events and called the performance astounding in its incompetence. He noted that the timeline showed no clear leader and no visible plan. Groner said a standard pentobarbital label instructs staff to stop the infusion immediately if a patient complains of pain. Pike grimaced repeatedly and told the team her arm was really burning.

At 7:05 pm, roughly 30 minutes into the procedure, a team member requested a 24-gauge needle. Joel Zivot, an anesthesiologist and surgeon in Atlanta who provided expert testimony, identified that catheter size as one used for babies or small children. Zivot stated it was physically impossible to push a 50cc syringe through such a small line without damaging the vein. At 7:07 pm, a team member confirmed the suspicion, saying, I think it is blown.

The team attempted to locate a vein using ultrasound, a technique Groner said requires extensive specialist training. He observed that the team did not know how to use the equipment. By 7:23 pm, they pushed saline through the line with difficulty. Groner described this as a flashing red light. One minute later, at 7:24 pm, the team declared the IV set and began the injection. Groner argued that no clinician would administer a caustic drug through a line that did not flush easily.

Pike’s legal team had warned the state multiple times before the execution that she had exceptionally small and compromised veins. Zivot identified several major failures in the process, including a poorly written protocol and a lack of supervision. He also noted the team used technology they may not have had permission to employ. Pike was sentenced to death in 1995 for the murder of her classmate, Colleen Slemmer.

After the injection, Pike spent 10 days in a hospital, including several days on a ventilator. Her lawyers initially believed she was brain-dead. She has since returned to her prison cell and can now talk and walk. Tennessee has paused all executions while a review of the process takes place.

Both Groner and Zivot said the incident exposes deep flaws in lethal injection, the primary method of execution in the United States. Groner called the process a medical charade. Zivot emphasized that medicine prioritizes safety and training, none of which were evident in the chamber during Pike’s execution.