Why Christa Pike’s Execution Failed After Two Pentobarbital Doses

Tennessee's failed attempt to execute death row inmate Christa Pike has left legal scholars, medical experts and state officials searching for answers after she reportedly survived two doses of pentobarbital and was transported to a hospital.

The case has already prompted Tennessee Governor Bill Lee to halt the state's remaining scheduled executions for the year and order a third-party review. Experts interviewed by Newsweek said three possible explanations stand out: the drugs may never have properly entered Pike's bloodstream, the pentobarbital may have been ineffective, or Pike may have had an unusual physiological response to the drug.

State officials have not publicly disclosed Pike's condition. The Tennessean reported Thursday that medical staff were working to save Pike's life, although Vanderbilt University Medical Center declined to comment when contacted by Newsweek and referred questions to the Tennessee Department of Correction. The department told Newsweek: "We are unable to provide information regarding Pike's condition at this time. She remains at an off-site medical facility."

One of the leading theories focuses on the intravenous lines used to administer the drugs.

Corinna Barrett Lain, author of Secrets of the Killing State: The Untold Story of Lethal Injection and the George E. Allen Chair in Law at the University of Richmond School of Law, said Pike's case appears unlike any previous modern lethal injection execution.

"We've never had someone who has survived their own execution when the drugs are going into them," Lain said. "We've had several people... that have survived an execution because they couldn't get access to the veins. But this is the first time where they had access and yet she lives."

Lain said one possibility is that the IV lines failed during the process, causing the drugs to enter surrounding tissue instead of Pike's bloodstream.

Attorney Stephen Ferrell told reporters Thursday that Pike's legal team warned for months that her medical history and blood condition could make IV access difficult, raising the risk of a prolonged execution attempt.

According to witness accounts, Pike complained during the execution attempt that her arm felt as though it was "about to burst open." Lain said that description could be consistent with an IV infiltration, in which medication leaks into tissue after a catheter comes out of a vein.

Joel Zivot, a professor at Emory University School of Medicine who was retained by Pike's legal team as a medical expert but spoke to Newsweek in a personal capacity, offered a similar theory.

Zivot said one possible explanation is that the IV lines failed during the procedure, causing the pentobarbital to leak outside the veins rather than fully entering Pike's circulation. He said that could explain why Pike appeared affected by the drug but survived the execution attempt.

Zivot said a properly administered dose of pentobarbital should have been fatal.

"One round properly done should kill her," he said.

A second possibility centers on the drug itself.

Both Lain and Zivot said degraded or ineffective pentobarbital cannot be ruled out.

"The other possibility is that the pentobarbital itself was degraded," Zivot said, noting that details about how execution drugs are procured and prepared are often kept secret.

Lain pointed to Tennessee's previous problems with execution-drug storage and handling. She noted that the state previously paused executions and conducted an independent review of its lethal injection procedures after discovering protocol problems. According to Lain, that review found issues involving the storage of compounded execution drugs, which require strict temperature controls.

"It could've been weak drugs," Lain said. "It could have been drugs that were fine but that were stored improperly.”

Unit in a Huntsville, Texas, prison where lethal injections are carried out on inmates. | Jerry Cabluck/Sygma via Getty Images

Pentobarbital is a barbiturate sedative used by several states in single-drug lethal injection protocols. At sufficiently high doses, it is intended to render a person unconscious, stop breathing and ultimately cause death.

But obtaining pentobarbital for executions has become increasingly difficult in recent years.

According to information compiled by death penalty researchers, major pharmaceutical manufacturers have repeatedly objected to having their products used for executions. One manufacturer stated in 2015 that it "strongly object[s]" to the use of its drugs in capital punishment, while other companies have imposed contractual restrictions designed to prevent execution-related use.

Lain said states have increasingly turned to compounding pharmacies and alternative supply chains to obtain execution drugs after large pharmaceutical companies moved to block such sales. She argued that those arrangements can raise quality-control concerns because compounded injectable drugs have different manufacturing and oversight standards from mass-produced pharmaceuticals.

Lain said degraded drugs could not be ruled out, while stressing that it remains impossible to know exactly what happened in Pike's case without additional evidence.

However, both Lain and Zivot stressed that there is currently no public evidence showing the drugs used in Pike's execution were defective.

Lain also cautioned against assuming there is only one possible cause.

Bodies can respond differently to medications, she said, and it is theoretically possible that Pike experienced an unusual physiological response to the drug. Even so, she emphasized that the apparent survival of an inmate after lethal drugs were administered is unlike any previous execution case she is aware of.

Pike was convicted of the 1995 killing of Colleen Slemmer. Now 50, Pike was 18 years old at the time of the crime.

Pike met Slemmer while taking part in the Job Corps government program in Knoxville, which provides low-income young adults with educational and vocational training.

Prosecutors said Pike became jealous of Slemmer, whom she accused of attempting to steal her boyfriend Tadaryl Shipp.

On January 12, 1995, Pike, Shipp and another student lured Slemmer to a secluded area near the University of Tennessee's campus, where Pike and Shipp tortured, beat and killed her. Shipp also carved a pentagram into her chest.

Pike kept a piece of Slemmer’s skull, which she later showed to classmates, according to witness testimony at trial.

She was convicted of first-degree murder and conspiracy and sentenced to death in 1996, when she was 20.

Tennessee Governor Bill Lee denied a clemency request on Monday.

Photographs of Colleen Slemmer, who was murdered in 1995, are displayed outside Riverbend Maximum Security Institution before the planned execution of... | AP Photo/George Walker IV

State officials have not yet publicly explained why the execution failed.

The Tennessee Department of Correction has said it followed the state's approved execution protocol and reported that Pike was transported to an off-site medical facility after the procedure.

Tennessee's execution protocol allows officials to administer a second set of drug syringes if an inmate is not dead after the first set. However, the protocol does not specify what should occur if the inmate remains alive after the second set, raising additional questions investigators will likely examine.

The failed execution also comes months after a separate execution attempt involving inmate Tony Carruthers was called off when officials were unable to establish IV access. That incident prompted renewed scrutiny of Tennessee's lethal injection procedures.

Speaking at a Thursday news conference, Pike attorney Randy Spivey said Pike was in critical condition and receiving life-saving care at a hospital, though her legal team had not been given additional details about her condition.

Neither Lain nor Zivot said there was enough publicly available information to determine exactly what happened. Both said definitive answers will likely depend on information that has not yet been released, including medical records, details about the IV lines used during the procedure and information about the pentobarbital itself.

"It is hard to know," Zivot said. "She could survive intact, survive with a series of injuries including brain injury, or die in the hospital. All of that is possible."

Newsweek’s reporters and editors used Martyn, our AI assistant, to produce this story. Learn more about Martyn here.

Contact Newsweek editors on this story: Steve Mollman and Gray R. Thomas

Become a member for a fresh perspective—ad-free reading, access to our editors, and insight beyond the conventional wisdom.