Doctors question sedative dose used in Oklahoma execution
While medical experts say it’s unclear why an Oklahoma inmate began convulsing and vomiting after the first of three drugs used to execute him was administered, all agree the dosage was massive compared with what’s standard in surgeries — with one doctor calling it “insane.”
The state’s prisons agency is now likely to face new litigation, which may focus on the state’s description of the execution of John Marion Grant for the 1998 slaying of a prison cafeteria worker as “in accordance with” protocols.
Grant, 60, convulsed and vomited after the sedative midazolam was administered. That drug was followed by two more: vecuronium bromide, a paralytic, and potassium chloride, which stops the heart.
Thursday’s lethal injection ended a six-year moratorium on executions in Oklahoma that was brought on by concerns over its execution methods, including prior use of midazolam.
Oklahoma’s protocols call for administering 500 milligrams of the sedative. Arkansas and Ohio are among other states that use that dose of midazolam in executions.
“It’s just an insane dose and there’s probably no data on what that could cause,” said Jonathan Groner, an Ohio State University medical school surgery professor and lethal injection expert.
He added that sedation does not increase as the dosage goes up.
“There’s a reason these drugs are given by anesthesiologists and not prison guards,” he said.
Grant was strapped to a gurney inside the execution chamber when the drugs were administered. After several minutes, two members of the execution team wiped the vomit from his face and neck. He was declared unconscious about 15 minutes after receiving the first drug and declared dead about six minutes after that, at 4:21 p.m.
In a statement released immediately after the execution, state prisons spokesman Justin Wolf said it “was carried out in accordance with Oklahoma Department of Corrections’ protocols and without complication.”
On Friday, prisons director Scott Crow said it was “without complication” because there was no interruption of the agency’s process for putting someone to death. He said Grant’s vomiting “was not pleasant to watch, but I do not believe it was inhumane.”
Crow said the doctor monitoring the execution said Grant was unconscious when he was vomiting and that “regurgitation is not a completely uncommon instance or occurrence with someone who is undergoing sedation.”
Dr. Karen Sibert, an anesthesiologist and professor at UCLA, disputed that, saying that type of nausea is not normally associated with the class of drugs that includes midazolam. A lack of oxygen could have brought on the convulsions, along with Grant’s high levels of anxiety and distress, she said.
“Midazolam does not usually cause it by itself,” Sibert said.