Doctors question the sedative dose used in Oklahoma’s execution

While medical experts say it’s unclear why an Oklahoma inmate began cramping and vomiting after giving the first of three drugs used to execute him, everyone agrees that the dose was massive compared to what’s standard for surgeries — one doctor called it “crazy.”

The state prison service is now likely to face a new lawsuit, which could focus on the state’s description of John Marion Grant’s execution for the 1998 murder of a prison cafeteria worker as “according to protocol.”

Grant, 60, convulsed and vomited after administration of the sedative midazolam. This drug was followed by two others: vecuronium bromide, a paralytic, and potassium chloride, which stops the heart.

Lethal injection Thursday ended a voluntary six-year moratorium on executions in Oklahoma due to concerns about execution methods, including prior use of midazolam.

Oklahoma protocols call for 500 milligrams of sedative to be given. Arkansas and Ohio are among the other states that use the midazolam dose in executions.

“It’s just a crazy dose and there’s probably no data on what that can cause,” said Jonathan Groner, a professor of surgery at The Ohio State University School of Medicine and an expert on lethal injections.

He added that the sedation does not increase as the dose increases.

“There is a reason these drugs are given by anesthesiologists and not by prison guards,” he said.

Grant was strapped to a stretcher inside the execution room when the drugs were administered. Several minutes later, two of the execution team wiped vomit from his face and neck. He was declared unconscious about 15 minutes after receiving the first medication, and pronounced dead about six minutes after that, at 4:21 p.m.

In a statement issued immediately after the execution, state prison spokesman Justin Wolf said the attack “was carried out in accordance with the protocols of the Oklahoma Department of Corrections and without complications.”

On Friday, Director of Prisons Scott Crowe said it was “without complications” because there was no interruption in the agency’s process of executing someone. He said Grant’s vomiting “wasn’t fun to watch, but I don’t think it was inhumane.”

Crowe said the doctor watching the execution said that Grant was unconscious when vomiting and that “regurgitation is not completely uncommon or occurs with someone who is under anesthesia.”

Dr. Karen Seibert, anesthesiologist and professor at UCLA, argued that this type of nausea is not usually associated with the class of drugs that includes midazolam. The lack of oxygen can cause convulsions, she said, along with Grant’s high levels of anxiety and distress.

“Midazolam does not usually cause it on its own,” Seibert said.

Even before Grant’s execution, more than two dozen Oklahoma death row inmates were part of a Federal lawsuit challenges state lethal injection protocols, Arguing that the three-drug method risks causing unconstitutional pain and suffering. A trial is scheduled for early next year.

Robert Denham, executive director of the Death Penalty Information Center, a death penalty clearinghouse that opposes the death penalty, said the state would almost certainly face new lawsuits over enforcement protocols. Denham said the Department of Corrections’ statement that the execution was not botched could provide evidence that the protocols were unconstitutional.

“Either they lied to the public and cannot be trusted, or they told the truth and the protocol cannot be trusted,” Denham said.

Grant was the first person to be executed in Oklahoma since then A series of defective lethal injections in 2014 and 2015. He was serving a 130-year sentence for multiple armed robberies when witnesses said he dragged prison cafeteria worker Guy Carter into a mop cabinet and stabbed her 16 times with a homemade leg.

Countries have switched to midazolam over the past decade after supplies of more powerful barbiturates like this one Sodium thiopental Or companies made them unavailable after pressure from death penalty opponents. Even opponents of the death penalty agreed that such a drug would not cause pain.

Midazolam has been linked to another Disturbing executions, with reports of inmates snoring and panting after eating it, or coughing loudly, or their stomachs swollen and deflated.

In April 2014, Oklahoma prisoner Clayton Lockett Struggle on a stretcher Before he died 43 minutes after his fatal injection during the state’s first use of midazolam – and after the state prison chief ordered the executioners to stop.

Oklahoma halted executions in 2015 after another lethal injection. While the moratorium was in effect, Oklahoma moved ahead with plans to use Nitrogen gas to execute prisoners, but in the end scrapped that idea and announced last year that it Plan to resume executions Using the same three-drug lethal injection protocol that was used during the flawed executions.

In 2015, a divided US Supreme Court said Oklahoma was using midazolam He did not violate the prohibition of the Eighth Amendment to the Constitution A cruel and unusual punishment. The court also said that “some risk of pain is inherent in any method of execution”.

But Denham notes that the court said the prisoners who challenged its use did not prove it was unconstitutional, not that the drug itself was constitutional.

Oklahoma has six more executions scheduled through March, and prison officials say they have confirmed a source to provide all needed medication.

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