Many states have backup execution plans, but failures still happen

Long before Christa Pike was brought into Tennessee’s execution chamber, prison leaders reviewed and approved a backup plan detailing exactly what to do if the first attempt at lethal injection failed. But the backup plan also failed, and Thursday — 24 hours later — Pike was still alive but in critical condition at a Tennessee hospital, though her prognosis remained uncertain. It’s not yet clear what went wrong.

Twenty-seven states have capital punishment, and they vary widely in how they administer the death penalty and just how much of that lethal process they keep hidden from public view, according to the nonprofit Death Penalty Information Center, a clearinghouse for information on U.S. Some states have extensive backup plans. Others don’t Tennessee falls somewhere in the middle of the pack when it comes to contingency plans, with two redundancies built into its execution process.

First, inmates are supposed to have two intravenous lines placed. Thus, if the first IV site fails, the execution team can switch to the second one. A physician on the execution team can even insert a central line — which typically involves making an incision in a major blood vessel in the groin, neck or armpit in order to thread a catheter into the body to a spot near the heart — if needed.

Intravenous lines can fail for several reasons, like a needle and catheter not being properly placed in a vein or wiggling out of place — or a vein rupturing and letting blood and IV fluid leak into tissue surrounding the IV site. Tennessee also allows for a second 100 mg dose of pentobarbital to be administered if the condemned person is still alive five minutes after the first dose was given. Tennessee prison officials gave Pike a second dose, but it’s not clear if they used the primary IV site or the backup site to do so.

Little backup in Alabama, a lot in Idaho Alabama has a three-drug lethal injection protocol. It allows for a backup dose of the first drug, the sedative midazolam, to be given if the inmate isn’t unconscious from the first dose. But the protocol doesn’t include additional instructions for what to do if the condemned person is still alive after the first dose of the next two drugs, rocuronium bromide and potassium chloride.

Idaho, meanwhile, has contingency plans for nearly every step of the execution process, with backup IV sites, allowances for administeri… It's not yet clear what went wrong.Twenty-seven states have capital punishment, and they vary widely in how they administer the death penalty and just how much of that lethal process they keep hidden from public view, according to the nonprofit Death Penalty Information Center, a clearinghouse for information on U.S. executions.Some states have extensive backup plans.