Applications of the Death Penalty: Lethal Injection

In the USA, where lethal injection is now the most common form of judicial execution, both the American Medical Association and the House of Delegates' Council for Ethical and Judicial Affairs have taken the view that physicians cannot take part in deliberately killing someone.

Death by needle is universally carried out by untrained prison staff; and that has led to the sort of attendant horrors that advocates are keen to keep out of the headlines.

This method of exacting the death penalty is used in Guatemala, the People's Republic of China, Taiwan, Thailand, the United States of America and Viet Nam. It was briefly the chief mode of execution in the Philippines too, until that nation abolished the death penalty.

There is little information about how death by needle occurs in China.

The assumption is that the same drugs are used as in the USA, but no-one outside the Communist officials who perform the executions actually knows.

From the scant data emerging there is one stark difference. The prisoner does not know that he, or she, is about to be killed.

They are taken from their cell, escorted by guards, and led outside. A police van is waiting, as if the condemned is to be transferred to another institution. It is only as they climb inside that the awful truth confronts them. This is the mobile execution chamber and inside it they die.

No witnesses, no press, no warning given to family and friends. It can take days before a statement is given; and the corpse just disappears.

It is assumed that a similar state of affairs might take place in Taiwan too, but that has yet to be put to the test. Though lethal injection is now on the statute books there, it has yet to be used. Executioners continue to favor a single gunshot to the head.

In Thailand, death row prisoners never know the day of their execution. They will be called to one side and informed just hours before it actually takes place. Those last frantic moments will be spent drawing up their will, trying to contact relatives and making their peace with the end of their lives.

In this country, as with Guatemala, the Philippines and the USA, a death chamber is set aside. It contains three or more rooms, each overlooking a central one with a gurney. Straps cover this bed, ready to hold the prisoner down as the drugs cause their muscles to spasm.

Once the individual is led onto it and restrained, large plastic catheter syringes are inserted into two veins. Typically these will be in each of the arms, pinioned out in a crucifixion pose. (Some Christians have objected on the grounds that this mode of execution apes the position in which Christ received the death penalty. It is considered heretical by them to kill criminals in this same pose, even if the actual mode of death is not the same.)

Linked to the catheters are long tubes snaking through a hole in the wall to an adjoining room. In Guatemala, this is affixed to a machine. A single executioner presses a button to start the machine humming. The drugs are then administered electronically into the plastic tubes.

In the USA, Philippines and Thailand, three prison officers stand with their thumbs on the plungers. At a signal, they press down. One tube is blocked. It's a back up only. Another empties harmlessly into a bucket beneath the gurney. The third issues its drugs into the victim's arm. In this way, no-one knows who killed that person. Each warden can tell themselves that it wasn't them.

Should the killing tube fail, then the blocked tube is released into the other arm. Death may be delayed by up to twenty minutes, but it happens anyway.

Viet Nam set up its death chambers in 2011, but the country has not yet used them.

Every drug used in lethal injections is also used in every major hospital every day. The difference is the quantity.

This has caused a public relations nightmare for the manufacturers, as well as several court cases involving the United States Food and Drug Administration (FDA).

The former have to explain to potential customers why their drug is perfectly safe in a hospital, but a killer in a death chamber. The latter have the responsibility of certifying any drug used in the USA as 'safe and effective'. There is an obvious conflict in lethal injections here.

In March 1985, the United States Supreme Court finally ruled that the FDA need not certify the drugs used in lethal injections. Justice William H. Rehnquist stated that it was 'implausible' to approve them as 'safe and effective' in the context. Therefore the FDA was legally excused from doing so.

The drugs of choice in the USA, Guatemala, the Philippines and Thailand are:

• Sodium thiopental. This is a fast-acting barbiturate, which seeks to induce a coma. At the very least, it should sedate the victim. The idea is that witnesses need only see a person falling asleep, then lying immobile as the rest of the concoction is painlessly administered. 

It is sold medicinally under the brand name Pentothal, but is better known as the 'truth serum' of psychology and movie plots. It was developed for use in childbirth, as it acts upon the central nervous system and reduces anxiety.

Yes, you did read that correctly. A drug used for the safe delivery of infants in hospitals is exactly the same as that given in a lethal injection. Are you spotting that aforementioned public relations nightmare yet?

• Pancuronium bromide. This has its root in the plant curare, which First Natives in America used to smear over their arrow-heads. As it plunged into their prey, the chemicals would swiftly deploy as a depolarized muscle relaxant. In short, the creatures would slump paralyzed to the ground, as all of their muscles stopped working. It works in exactly the same way on the human being strapped on the gurney.

This drug is sold medicinally under the brand name Pavulon. Surgeons everywhere use it alongside a general anesthetic.

Public relations nightmare number two. You or a loved one is about to undergo essential, life-saving surgery. Then you discover that the drug that will be used to relax your muscles as they cut into you is also used in lethal injections. Do you feel safe?

• Potassium chloride. There are so many and varied applications of this compound. You've probably already eaten some today, as it's used in many food preparations and is part of the feedstock given to animals slaughtered for their meat.

In lethal injections, it's used to flood the system with so much potassium that the heart can't cope. It quivers, then eventually just gives up and stops beating. It's used in precisely the same way by surgeons about to conduct cardio-surgery, but they will have stabilized the body first with a bypass machine.

Potassium chloride is sold under several brand names, including K-Dur, Klor-Con, Micro-K, Slow-K and Kaon Cl. It's extensively used in the treatment of Hypokalemia and also as a dietary supplement.

And public relations nightmare number three. You are suffering from a chronic potassium deficiency in your body, which no amount of scoffing bananas is going to fix. Your doctor prescribes the actual killing drug from death by needle. Are you thrilled about this?

Pharmaceutical companies the world over have not been made happy by the introduction of the lethal injection, as a method of administering the death penalty. As as result of their use in this deadly cocktail, some of these drugs are no longer legally available within the USA.

In 1980, a consortium of Death Row prisoners launched a lawsuit against the FDA. The inmates, who were all awaiting execution in Oklahoma or Texas, in the USA, sought to force manufacturers to attach labels to their drugs.

The labels, which would be visible to all of those ladies in childbirth, individuals going into surgery or people suffering from potassium deficiency, should highlight each drug's use in lethal injections. The manufacturers were naturally not keen to do this.

Better still, argued lawyers on behalf of the prisoners, the labels should state that the drugs 'are not approved for use as a means of execution, are not considered safe and effective as a means of execution and should not be used as a means of execution.' (F Drimmler, Until You Are Dead, p 77)

It was this lawsuit, which was decided against the prisoners, which ruled that the FDA need not certify the named drugs.

However, this was too much for the manufacturer of Pentothal. The Italian owned company Hospira immediately put out a statement that it did not condone the use of its drug in executions. It refused to supply any customer who declared that this was the intended use. For the next two decades, all lethal injection cocktails were created by subterfuge.

Pentothal was widely available for legal use as a barbiturate and this is how it was purchased, usually through third parties, by executioners. Hospira was not impressed but slow to act. After all, there was little it could do without halting all sales.

Then it did just that.

Originally Hospira simply closed its US factories and moved to Italy.

Hundreds of employees in Lake Forest, North Carolina lost their jobs, in what was openly a bid to stop the drug being diverted into executions.

The company believed that American laws on drug importation would stop Pentothal being used in lethal injections. This didn't transpire to be the case.

On January 4th 2011, as the first shipment came in from Italy, the FDA were forced to release a statement,

FDA releases this shipment, which is being imported by or on behalf of state correctional authorities.  In keeping with established practice, FDA does not review or approve products for the purpose of lethal injection.  FDA has not  reviewed the products in this shipment to determine their identity, safety, effectiveness, purity, or any other characteristics.
Statement from the FDA Regarding Oversight of Lethal Injection Drugs and Release of Foreign Shipments to States

In short, these drugs were now being manufactured under Italian, not US, law; and their use in executions meant that the FDA weren't even looking inside the packages. The department was legally obliged not to. 

For ordinary Americans, this was a worrying development. For those on Death Row, it meant that they could technically be injected with anything. All of the ordinary checks and balances, on any medical procedure or administration of pharmaceuticals, had now been completely stripped away.

The American Medical Association had stopped doctors being present. The American Nursing Association had forbidden their trained nurses from inserting those deadly syringes. Now even the contents of the tubes were unexamined foreign imports. They only had the reputation of Hospira, a company openly and actively opposed to the death penalty, as assurance that all was well.

If Hospira had inserted something else, to highlight the deficiency of the system, then no-one would know until the drug was in the victim's system.

Hospira did not do that. Instead, despairing of ever stopping its main brand drug being used in this way, it simply stopped manufacturing it. On January 25th 2011, the pharmaceutical company announced that not even the Italian factory would continue making Pentothal. The insistence of prison authorities, in the USA, Thailand and Guatemala, to include it in executions was the reason given.

The Los Angeles Times: Maker of anesthetic used in executions is discontinuing drug
When Hospira attempted to move production to a factory in Liscate, Italy, near Milan, Italian authorities demanded assurances that the drug wouldn't end up in the hands of executioners. Hospira spokesman Dan Rosenberg said company officers couldn't make that guarantee and decided instead to "exit the sodium thiopental market."

Globe and Mail: Demise of a death drug puts patients at risk
Canadian pharmacists and doctors are worried that surgeries will be cancelled and patients put at risk because a common anesthetic will no longer be available in Canada due to concerns about its use in lethal injections in the United States.

USANews: Will Loss of Lethal Injection Drug Harm Surgical Patients?
The American Society of Anesthesiologists (ASA) issued a statement saying that its members are "extremely troubled" that they will no longer have access to Pentothal, which has been used in preoperative sedation since the 1940s.

With legal suppliers refusing to do business and a world wide shortage of Pentothal, prison officials saw no option but to illegally import the drug.

As early as 2010, some US wardens had been looking to Britain to supply the drug. When the story hit, it caused outrage there amongst the populations and its politicians alike. Archimedes Pharma UK argued that it had not sold the drug directly to the USA, but their defense fell on deaf ears.

Pentothal supplied by them had been used in executions in Arizona and California and that's all that anyone cared about. The government's Business Secretary Vince Cable immediately set about writing legislation, which would criminalize any export of drugs used in lethal injections to the USA.

Then, just three months later, came an even more incredible story. Dream Pharma were operating from the back of a driving school in London. Their drug supply came from a long chain, along which quality control was impossible.

By now, the black market price on Pentothal was up to five times more than its previous tag. CEO Mehdi Alavi was able to command a sum of £4,528.25 for vials containing all three of the lethal injection drugs. They were used to execute Jeffrey Landrigan in Arizona, in October 2010. More batches had made their way to Arkansas and six more death chambers around the country. Each had cost more than 35 times their original market value.

As Britain is part of the European Union, all such exports have been illegal since 2005. Council Regulation 1236/2005 (PDF) makes it a crime to 'trade in certain goods which could be used for capital punishment, torture, or other cruel, inhuman or degrading treatment.'  Vince Cable's law-making merely tightened those restrictions for Britain.

The Americans were forced to look further afield, which is how the Indian company Naari got into trouble.

Naari believed that it was shipping Pentothal to sub-Saharan Africa. It was supposed to be used in life-saving surgery. The Indians had no idea that their cargo had been diverted into Nebraska, USA, until lawyers acting on behalf of Death Row prisoner Michael Ryan filed their lawsuit.

In November 2011, Naari's CEO Prithi Kochhar wrote to the Nebraska Department of Correctional Services demanding the return of the drugs. He explained that a third party had become involved in Zambia and that the shipment was illegally in the USA. The response was curt, 'Please refrain from sending any further communications regarding this matter to Nebraska supreme court given that such ex parte communications are generally improper.'

However, the recent furor over illegally imported and improperly processed drugs has finally made some headway in the United States. By March 26th 2012, the anti-Death Penalty pressure group Reprieve was able to make a welcome report:

The US Drug Enforcement Agency (DEA) seized the supplies of drugs imported from the UK from California, Georgia and Tennessee, they ordered the seizure and destruction of drugs imported from India to Nebraska and South Dakota, and sent letters of admonition to a number of other states requesting that they hand over their illegally imported drugs.
The Stop the Lethal Injection Project (SLIP) in Further Detail

The USA, along with Guatemala, Thailand and Viet Nam, may yet be forced to stop executing with lethal injections simply because no-one will supply them the drugs to do so.

Naturally all of the countries involved could just manufacture their own, but which pharmaceutical company would want to do that?  The publicity and lawsuits would ruin their reputation in seconds and they would forever be associated with death. That's not a happy public relations situation for companies dealing in live-saving medicines.

Done correctly, with doctors administering quality controlled drugs, in properly measured quantities, then there is an argument that lethal injection could be a humane way to die.

Obviously that statement does not take into consideration the mental torture of someone knowing precisely when and where they will die. Nor does it factor in the psychological strain of being led into a death chamber and strapped to a gurney.

And it most certainly does not reflect the reality. 

The only doctors present are those brought in afterwards to pronounce that the individual is dead. Sometimes that doesn't occur until the autopsy. The Justice of the Peace has to determine when death has taken place.

Dr Ward Casscells (Massachusetts General Hospital) talked of the difficulty for untrained prison guards in finding a vein. "It's not like a tetanus shot at the doctor's." He explained. "You're inserting a plastic catheter of fairly large dimension inside a vein. If it doesn't go into the vein, it can be excruciating. And in about one in four cases, where there is no decent vein in the hands or arm, it can take hours and be a real blood bath." 

He also pointed out that, in those circumstances, personnel would have to cut into the arm and surgically find a vein. (F Drimmer, Until You Are Dead, pp 78-79)

As has been already demonstrated, the drugs used are not properly sourced and therefore fall well short of the checks and balances placed on all other medication. If the drugs are too diluted or not administered in high enough quantities, then they fail in their function.

The victim is rendered wide awake when their body is paralyzed and able to feel the agony of their diaphragm failing, suffocating them from inside. They suffer the sensation of their heart tremors and the ultimate cardiac arrest.

Moreover, this does not take the anticipated five minutes to play out. It can last for over half an hour.

On December 13th 2006, Ángel Nieves Díaz was strapped to the gurney in Florida State Prison, Raiford, USA.

His execution did not take the expected five minutes. It took 34 minutes and he was patently conscious for the first 25.

What occurred during that time was to result in a self-imposed two-year death penalty moratorium for the state of Florida. Officials decided that they really needed to get their lethal injection procedures sorted out first.

The problem was determined by the subsequent autopsy. As with all death by needle executions, no trained medical staff can insert the large catheter syringe. The warden who did so misjudged the pressure and sent it straight through Ángel's vein and into the soft tissue of his arm beneath.

It takes longer for tissue to absorb the drugs. The Pentothol failed immediately, unable to shut down his brain and induce a coma in time. Ángel was wide awake when first the Pavulon paralyzed his muscles, then the potassium chloride surged into his limb.

Witnesses watched him struggle, but his jaw was clenched. He couldn't tell them what was wrong. His fist opened and closed rapidly. He kept trying to move against his straps. The Pavulon was only partially working. Tiny sounds issued from his burning throat. They may have been his attempts to scream.

After five minutes, the Pentothol would have worn off anyway, taking with it his last hope of unconsciousness.

It would have felt like napalm had been poured down his chest. Chemical burns scored the underside of his veins, all around the soft tissue into which the drugs were battling to overtake his body.

He blinked rapidly, licking his lips and blowing out air from his mouth. His expression became fixed in a permanent grimace. Fifteen minutes after the drugs entered his system, Ángel was still able to turn his head to stare beseechingly at the witnesses through the death chamber window. He was trying to mouth words, but they wouldn't come. His throat was too constricted. He was slowly suffocating to death.

"It really sounds like he was tortured to death," said Jonathan Groner, associate professor of surgery at the Ohio State Medical School, who has written articles on lethal injection. "My impression is that it would cause an extreme amount of pain."
The Ledger: Doctors: Botched Execution Likely Slow, Painful

Twenty-four minutes after the execution had begun, officials had to face facts. Ángel was in agony, but he was not dying. The order was given for the contents of the stand-by tube to be administered too.

Only they didn't know that the catheter was feeding into the wrong place. Into that riot of horrific pain that was his right arm came a second set of the same drugs.

It took a further ten minutes for Ángel Díaz to die. He had thankfully passed out for the final nine.

James David Autry was only the second American to be killed using death by needle; and he wasn't impressed.

It didn't seem a very manly way to die and he was every bit a macho man. His nickname on Death Row was the Cowboy and he swaggered.

His last meal was a hamburger.

His whole attitude was testosterone fueled. He would rather, he said, be executed by a headman's ax, or failing that, hanging.

At 12.01am, on the morning of his execution, James was taken to the gurney and strapped down. The catheters were inserted into his arms and saline solution started to drip through one of them.

Then the warden burst in to say that there had been one more stay of execution, while a last minute appeal was heard. For another seven minutes, they all waited as Justice Byron White of the Supreme Court in Washington decided whether it was worth further consideration. It was. The catheters were removed and James was taken off the gurney at 12.08am.

But he was not the same man who had been placed onto it shortly before. The whole experience had broken him. James suffered nightmares and he was visibly traumatized during the day. He was examined by psychiatrists and two justices agreed that his near miss had caused 'profound psychological torment.'

Unfortunately for the victim, none of the other Supreme Court judges concurred. His appeal was over-ruled and James Autry was led to the gurney again on March 14th 1984. He asked that the whole execution be televised, because 'it ain't real - all that real - to the public unless they see it on television.'  His request was turned down.

In some ways, James was lucky. His subsequent execution went without a hitch. However it's worth bearing in mind how completely he was broken in just seven minutes, when you consider the timescales involved in some of the others.

Stephen Peter Morin. (March 13th 1985, Texas, USA.) As a long-time drug user, Stephen had a lot of scar tissue over his veins. This made it very difficult to find one suitable for inserting the large catheter. For 45 minutes, wardens stabbed and probed at his legs and arms, until they were finally able to get the needle securely in. The rest of the execution went without a hitch.

Randy Woolls. (August 20th 1986, Texas, USA.) Precisely the same situation happened with Randy. All of the prominent veins in his arms had long since collapsed, but he just wanted to get it over with. He had two tattoos, one in the shape of the Grim Reaper and another as a buzzard holding a syringe. He used them to direct wardens to a place where a vein could be found. Randy would know, he'd stuck enough needles into it himself.

Elliot Rod Johnson. (June 24th 1987, Texas, USA.) In some distress, Elliot maintained to the very end that he was innocent. He told reporters that he was being 'rail-roaded' into admitting that he killed a jeweler, but he hadn't done it. As a drug user, Elliot also had collapsed veins all over his body. Wardens labored for over an hour trying to find somewhere to insert the catheter. Shocked Elliot provided no help at all, but they eventually succeeded and executed him.

Ricky Ray Rector.(January 24th 1992, Arkansas, USA.) After committing his murders, Ricky shot himself in the head. It was a failed suicide, which resulted in a lobotomy. He had no way of understanding his trial, let alone his death sentence. For his last meal, he was given a pecan pie, which he couldn't finish. Ricky told wardens that he'd save it until later. But Bill Clinton was determined that the man should die. The politician had a presidential campaign riding on him taking a hard line here.

Once in the death chamber, another problem emerged. Anti-psychotic drugs had been injected into Ricky for some time, collapsing all of his veins. He was also a big man, with a lot of fatty tissue obscuring where those veins might be.  It led to a desperate situation, where five officers surrounded his gurney for over 50 minutes, all trying to find somewhere to insert the catheter. Witnesses behind the drawn curtain could hear Ricky's anguished cries, as they searched.

Billy Wayne White. (April 23rd 1992, Texas, USA.)  Long-time heroin use had scarred and collapsed Billy's veins. He suffered 47 minutes of wardens probing all over his body looking for somewhere to insert the catheter, until he couldn't stand it any longer. He offered his own assistance in locating a spot. Billy's arms were untied, so that he could sit up and use his hands to indicate precisely where he could be killed. The execution duly followed.

Richard Townes, Jr. (January 23rd 1996, Virginia, USA.) It took 22 minutes of probing before wardens found a way to insert that deadly catheter. They finally just pushed it through the top of his right foot.

Tommie J. Smith. (July 18th 1996, Indiana, USA.) Tommie's execution was highly unusual in that a physician finally got involved, but only after one hour and nine minutes of wardens fervently hunting for a vein. In this case, it was that the victim had very small veins, which didn't show up all that well.

The doctor gave him a local anesthetic before twice attempting to insert the catheter into Tommie's neck. That failed, so an angio-catheter was brought in. This was finally managed to be placed into his foot and the syringe fitted inside it.

Michael Eugene Elkins. (June 13th 1997, South Carolina, USA.)  Michael suffered from liver and spleen disease, which meant that his body was swollen when he was strapped to the gurney. It took nearly an hour before wardens managed to get a catheter into his neck. Michael had tried to be helpful. Witnesses overheard him asking if it would be of assistance if he moved his head this way or that.

Genaro Ruiz Camacho, Jr. (August 26th 1998, Texas, USA.) Genaro had made it to Mexico and freedom, before being lured back to the USA in a sting operation. There he was sentenced to death. Genaro had perhaps the longest wait of all, while strapped to the gurney. It took wardens over two hours to locate a suitable vein beneath all of the heroin induced scar tissue.

Roderick Abeyta. (October 5th 1998, Nevada, USA.) In comparison, Roderick got away quite lightly. It took a mere 22 minutes to find a vein on him.

Christina Marie Riggs. (May 3rd 2000, Arkansas, USA.) Christina was a large lady, which made it difficult to spot suitable veins. They were hidden under fatty tissue. However, she was also a registered nurse, which made her the most medically qualified person present. After waiting through 18 minutes of probing, she suggested that they insert the catheter into her wrists. The execution could then commence.

Claude Jones. (December 7th 2000, Texas, USA.) Heroin use had scarred Claude's veins, so it took thirty minutes to find somewhere to insert the catheter. The head warden was starting to panic, in case there had to be a 'cut-down' (surgery by untrained officers to locate a buried vein), but then a member of staff pushed the catheter into a vein under Claude's left calf.

Jose High. (November 6th, 2001, Georgia, USA.) After searching for a vein for twenty minutes, wardens simply gave up. They requested the presence of a physician. This was problematic, as any medical personnel could lose their license for helping. Nevertheless a nurse stepped in. She tried for another half an hour, finally getting one of the catheters inserted into a vein in Jose's arm. But there are two required.

Eventually a doctor was persuaded to intervene. He 'inserted a 7 French gauge, triple lumen, 20cm long, central venous catheter into High's right subclavian vein'. Over two hours after being led into the death chamber, Jose was executed.

Christopher Newton. (May 24th 2007, Ohio, USA.) Christopher almost certainly had severe mental illness, but he had never been able to afford to have that diagnosed. The Ohio supreme court refused permission for his defense counsel to claim funds for the diagnosis. If he had been certified, then the death penalty could not have been administered.

But it was and it took a long time to occur. For well over two hours, wardens struggled to find a vein in the heavily built man. Halfway through their probing, Christopher requested and was granted permission to go to the bathroom. He relieved himself and he was returned to the gurney. Wardens stuck needles into him ten times, before finding places to secure them.

Curtis Osborne. (June 4th 2008, Georgia, USA.) Curtis was offered life imprisonment in return for a plea bargain. Unfortunately he never got to hear about that, because his court-appointed defense attorney decided, "The little nigger deserves the death penalty." 

Curtis was strapped to the gurney while a last minute appeal was going through the US Supreme Court. He waited for 55 minutes, until the news came back that it had failed. Then came a further 35 minute wait, while wardens found a vein. They couldn't have done it very well, as it took another 14 minutes for the lethal injection to kill him.

Romell Broom. (Georgia, USA.) Romell is still alive, but only after a two hour struggle to kill him failed in 2009. Wardens really could not find a vein. After the first hour, Romell tried to help them, but he couldn't locate one either.

Romell became distraught, covering his face with both hands and sobbing. With wardens and witnesses becoming equally distressed, Ohio's Governor Ted Strickland called a one week reprieve. A physician would just have to be persuaded to come help them find a vein.

Three years later, Romell is still on Death Row. He cannot now be executed until he is finished with his latest lawsuit. His lawyers are challenging the constitutionality of Ohio's lethal injections. He is their main witness.

Death by needle is supposed to be a quiet affair. The victim slips into sleep, then dies with barely a murmur.  Unless they don't.

Bennie Demps's execution was a literal bloodbath. No suitable vein could be found, so wardens began cutting him to find one. Three large bore marks were etched into his groin and legs, and he was 'bleeding profusely' from them. There were lesser scratches elsewhere.

When the curtain was finally raised to display him, a white sheet had been draped over him to cover up the injuries. Bennie screamed at witnesses, "They butchered me back there. This is not an execution, it is murder."  Sutures were now in place to stem the flow of blood.

But they had got the catheters into his arms now and Bennie died on June 7th 2000, in Texas, USA.

Raymond Landry Sr. was a muscular man. One warden described him as having arms like cartoon character Popeye. Finding a vein was not a problem. Keeping it in was very much one.

Two minutes after the catheter was inserted and the drugs started flowing, it started leaking. For one moment, the deadly cocktail was dribbling down Raymond's arm, but then the pressure became too much.

The whole syringe came loose and the tube shot up into the air. The liquid drugs showered over everyone present and drenched the window, behind which witnesses watched in horror.

Wardens rushed to stop the flow and a curtain was drawn back to shield onlookers from the scene on the gurney now.  However, they could still hear everything.

For over 14 minutes there was movement with doors opening and closing. They overheard Raymond groaning loudly, then silence. When the curtain was drawn back, he was already dead, staring motionless up at the ceiling.

This same scenario occurred again at the execution of Joseph Cannon, in Texas, USA, on April 23rd, 1989. His vein collapsed as the drugs rushed through the tube and the catheter just popped out.

An incredulous Joseph must have thought that he was saved. He looked at it and gasped at witnesses, "It's come undone!" Then his head fell back onto the gurney and he closed his eyes in relief.

Prison wardens merely closed the curtains, so that witnesses could no longer see. But they heard Joseph start to cry. He was visibly weeping, when the curtains parted again fifteen minutes later. The execution started again and this time it killed him.

Incidentally, Joseph had been on Death Row for twenty-one years for a murder committed when he was just seventeen years old. He was also schizophrenic. Both his mental state and the fact that he was a juvenile at the time of receiving his death penalty rendered his case extremely controversial.

In 1989, Texan prison officials and execution witnesses were just not prepared for what was about to happen to Stephen McCoy. Unknown to all present, including the victim, he was allergic to Pentothol.

As soon as the drugs hit Stephen's system, it was obvious that his reaction was not textbook. His chest starting heaving and he gasped for breath. Next he began choking, before a fully fledged seizure threatened to tear the straps from his limbs. His back arched and he was obviously asphyxiating.

The scene was so violent that one of the male witnesses fainted outright, collapsing onto the lady beside him. Everyone watching had turned pale and Stephen's lawyer honestly believed that a chain reaction of fainting would begin. But then Stephen died in front of their eyes.

It had not been lethal injection per se that had killed him, but his allergic reaction to it. The Texas Attorney General Jim Mattox opined that the dosage in the tubes may have been too strong.

On March 10th, 1992, something very similar occurred in Oklahoma during the execution of Robyn Lee Parks.  Spasms began in his abdomen and assaulted his neck and jaw too. He started choking, gasping out for breath.

It took eleven minutes for Robyn to die, in an execution which a witness called 'scary and ugly'.

Shortly afterwards, it happened yet again in Texas. Justin Lee May displayed all of the now classic signs of allergic reaction. He started coughing raucously, as his body went into spasm. His mouth wide in a gasping scream, Justin's back arched so violently that all of the straps were strained to the limit of their endurance.

Then his body froze and he slumped back onto the gurney. Horrified witnesses still heard groans, but Justin was now paralyzed. His eyes and mouth remained fixed open until the very end.

On May 3rd 1995, in Missouri, USA, Emmitt Foster's death by lethal injection did not go well. The drugs had been in his system for seven minutes. He should have been comatosed by now, but he was wide awake and gasping for air. He should have also been paralyzed, but his body was wracked by convulsions. He should have been dead, but he patently was not.

The curtains were drawn to save the witnesses from any more distress, but they could still hear Emmitt's desperate struggles on the gurney.

The Washington County Coroner William "Mal" Gum was waiting in another room ready to receive the corpse. As the nearest medical man, he was requested to go into the death chamber and give his expert opinion on what could possibly be done to end Emmitt's suffering.

William agreed to go in and he spotted the problem immediately. The straps on the gurney were so tight that they were cutting off the big man's circulation. The drugs were all trapped behind them, so couldn't reach either Emmitt's brain nor heart. This had now been on-going for thirty minutes.

The wardens loosened the straps and Emmitt quickly died shortly afterwards.

Convulsions were very much in evidence for the execution of Scott Carpenter, in Oklahoma, USA, on May 8th 1997. At first, there were just groans, then his stomach and chest began 'pulsing'. His complexion turned yellowish grey, before the first convulsion began. It was very violent; and it was the first of eighteen such seizures.

It took eleven minutes for Scott to die. He did so in agony, with his face now turned a vicious purple and his jaw clenched. Finally the convulsions became less frenzied. There were eight mild spasms, until he died with a final gasp.