Oklahoma Execution: Doctors Question Sedative Dose

Doctors are questioning the dose of sedative used in the botched execution of Clayton Lockett. The doctor who participated in the execution has stepped down, while other doctors have called for an investigation into how much midazolam was administered to Lockett before he died 43 minutes after being given a lethal injection.

Some doctors are saying that an investigation is necessary to determine whether the execution of Lockett could have been prevented. This comes after one of three drugs used in his lethal injection cocktail failed, leading him to convulse and gasp for air before he died 43 minutes later.

Dr. Jonathan Groner, a surgeon who has written several books about the death penalty, said that midazolam does not completely sedate patients before executions.

It’s my understanding if they give enough of it to fully sedate someone, they will die without any problems, Groner said. The problem is you can’t give them so much that they stop breathing.

Dr. Joel Zivot, an anesthesiologist who is an associate professor at Emory University in Atlanta, said that another doctor who participated in the execution has told him that Lockett’s vein collapsed. He said that it seems likely that had more of the drug been administered through another vein, things would have gone differently.

It appears they did not give enough of the drug to cause death, and that’s why we’re having this discussion. I think it could be easily rectified by simply having enough of the drug available so if the IV access is difficult they can try another site, Zivot said.

Doctors also noted other problems related to Lockett’s execution:

Jackson canceled a news conference shortly after the execution started Tuesday night, saying a vein had popped. He did not indicate whether that was one of Lockett’s veins or an alternate site.

A paramedic said in an affidavit that IV problems contributed to lengthy delays in the delivery of the three drugs used in Lockett’s execution. The paramedic said there were not enough needle pokes to deliver the drugs, and there were secondary puncture sites on Lockett’s arms.

In talking to my colleagues across the country, an additional 10 minutes is a long time for that drug to be given, Zivot said of midazolam. Midazolam is not approved by the Food and Drug Administration for use as a sedative during executions.

Dr. David Lubarsky, a psychiatrist at the University of Miami Miller School of Medicine and an expert on lethal injection, told The Associated Press that midazolam is not approved for use in such executions and is typically used to start and maintain anesthesia. He said if it was given in high doses for that purpose, it would render the person being executed unconscious.

Zivot said that several states have approved midazolam for use in executions and that one of his colleagues had been involved in such an execution but was not allowed to speak about it afterward.