Tennessee Execution Protocol: 5 Grams of Pentobarbital Fail to Kill Inmate

Five grams of pentobarbital, a dose intended to end Christa Pike's life, failed to do so because execution staff struggled for nearly an hour to insert an IV line. Pike survived the attempt on September 30, 2026, and has since returned to her prison cell after ten days in a hospital. New legal filings released on Thursday detail the procedural failures that led to her survival.

Randy Spivey, Pike's attorney, submitted a chronology of events observed inside the death chamber. He stated that four members of the IV team used approximately 10 needles to locate a vein in Pike's arms. The team expressed concern that her veins had blown during the process. Pike grimaced and reported that her arm was really burning, a symptom that standard protocols say should stop the infusion immediately.

Jonathan Groner, an emeritus professor of clinical surgery at Ohio State University, called the display of incompetence astounding. He noted that the team appeared to lack a clear plan or a designated leader. Groner added that the use of ultrasound to locate veins requires extensive specialist training, which the team did not appear to possess.

Joel Zivot, a professor of anesthesiology and surgery in Atlanta, provided expert testimony before the execution. He identified a critical error at 7:05 pm when a team member requested a 24-gauge needle. Zivot explained that this size of catheter is typically used for infants or small children. Under Tennessee protocol, 50 cc of pentobarbital must be pushed through the line. Zivot stated there was no way to force that volume through such a small tube without rupturing the vein.

At 7:07 pm, a team member stated they believed the vein was blown. Despite this, the team continued the procedure. At 7:23 pm, saline was pushed through the line with difficulty. One minute later, the team declared the IV ready and began the lethal injection. Groner argued that no clinician would administer a caustic drug through an IV that did not flush easily.

Pike was sentenced to death for the 1995 murder of Colleen Slemmer. She spent several days on a ventilator following the failed injection, with her legal team assuming she was brain-dead. She can now talk and walk, though her long-term prognosis remains uncertain. Tennessee has suspended all executions pending a review of its protocol.

Zivot listed several serious failings, including a poorly written protocol and the use of technology the team may not have been authorized to employ. Both experts said the incident exposes fundamental flaws in lethal injection as a method of execution. Zivot noted that medicine prioritizes safety and accountability, elements he said were absent from the execution chamber.