How did Christa Pike survive two lethal injections – and what happens now?

Convicted murderer Christa Pike has woken up and begun speaking from her hospital bed almost a week after authorities in the US state of Tennessee botched her execution, her lawyers said.
Pike, 50, was sent to hospital after surviving two attempts to execute her via lethal injection for the 1995 murder of a 19-year-old she met at a summer camp for troubled teens.
An independent review of what went wrong in the Nashville execution chamber on 30 September has been ordered by Tennessee Governor Bill Lee.
He has also halted executions in the state for the rest of the year.
Warning: This article contains details that readers may find distressing
How did Pike survive?
The Tennessee Department of Correction is yet to say why the execution did not go as planned, though it has defended the method it used.
Dr Joel Zivot, an anaesthesiologist advising Pike’s defence team, says it was not the case that Pike had some “special immunity” but suggested it was simply that not enough of the drug pentobarbital reached her bloodstream to kill her.
Pike was injected with a second dose of the drug, according to the prison authorities’ protocol, after the first did not kill her.
In interviews with the BBC, Zivot has suggested the pentobarbital was more likely to have spread across the tissue under Pike’s skin than to have entered her bloodstream.
“Most of the pentobarbital, instead of circulating in her body, ended up in her arms, and that’s how she lived,” Zivot said.
Pike’s medical condition of thrombocytosis, a blood-clotting condition, was highlighted in advance by Pike’s legal team as an additional issue that could scupper the process. Before the attempted execution, they had filed a legal case challenging the injection protocol.
If clots of blood formed at the injection site as a result of thrombocytosis, they would potentially have blocked the chemical from entering her veins, the lawyers warned.
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As the attempted execution took place, prison officials used at least seven needles on Pike during their efforts to establish intravenous (IV) lines, Pike’s lawyers said afterwards. The woman could simultaneously be heard “crying, whimpering, and breathing loudly”.
May Martinez, the mother of Colleen Slemmer who was murdered by Pike and her then-boyfriend, told NBC the failed execution had been “a mess”.
Family handoutThe Tennessee Department of Correction has defended the method it used, saying “the protocol does not allow for additional procedures beyond what was carried out”.
The state protocol does not clearly specify what should happen if an inmate remains alive after a second dose, according to the AP news agency.
After it became clear that Pike was not going to die from the two doses, she was taken to hospital for life-saving treatment. States have a legal obligation not to deny medical treatment to prisoners.
What is pentobarbital?
Pentobarbital is a potent sedative that slows down the body, including the nervous system. Doctors sometimes use it as a treatment for certain conditions, but in high doses it can also be used as a lethal injection to cause death.
Its use in lethal injections came under renewed scrutiny last year after a US federal government review during the Biden administration raised concerns about the drug’s potential for “unnecessary pain and suffering”.
The Biden government banned its use in federal executions, but that did not bind individual states such as Tennessee, which can choose their own methods.
In recent years, states have found some drugs needed for lethal injections harder to come by, because pharmaceutical companies have opposed the use of their products for such purposes.
The Tennessee correction department has not specifically addressed an allegation from Pike’s legal team that the pentobarbital it used was “degraded”.
But the department said the lethal injection chemical had “consistently been effective”.

















