Still Breathing After Two Doses of Pentobarbital: The Pike Case Shatters America's 'Humane' Myth of Lethal Injection

According to Al Jazeera, on September 30, Tennessee's lethal injection execution of Christa Pike was forcibly halted after two doses of pentobarbital failed to kill her. Multiple witnesses said that, strapped to the execution bed, Pike continued to breathe, snore, and repeatedly raise her body. Pike's lawyers said on October 6 that she had regained consciousness in the hospital, but that her recovery would still take time.

Pike was sentenced to death for her involvement in the murder of a classmate, a case that occurred when she was 18 years old. Governor Bill Lee immediately announced a suspension of all executions in Tennessee and pledged a "comprehensive third-party review" of the incident. This marks the second time this year that the state has halted an execution due to a failed injection — in May, staff were unable to establish a backup intravenous line for Tony Carruthers within more than 90 minutes, and the execution was likewise called off.

The Tennessee Department of Correction, in response to Al Jazeera's inquiries, refused to explain the cause of Pike's failed execution, nor did it clarify whether it would attempt to carry out her death sentence again.

Pike's lawyers had previously warned that their client's veins were small and that she suffered from a blood disease, making lethal injection likely to be complicated. After the execution, the lawyers described swelling and burns appearing on both her arms. Robin Maher, executive director of the Death Penalty Information Center, a nonprofit research organization headquartered in Washington, D.C., noted that these symptoms suggest the drugs did not enter the bloodstream in sufficient quantities — the veins may have been pierced, and the needle may have penetrated the vessel wall. "Everyone assumes the drugs were injected, but not in a sufficient dose to enter the bloodstream and kill her," she told Al Jazeera.

This is not an isolated case. Data cited by Al Jazeera shows that since 2022, states including Tennessee, Idaho, Alabama, Arizona, Texas, and Oklahoma have all recorded at least one failed lethal injection. A study covering U.S. execution cases between 1890 and 2010 showed that the failure rate of lethal injection is more than double that of all other execution methods.

Structural flaws in the system make such failures almost foreseeable. Major medical organizations prohibit their members from participating in executions, on the grounds that this violates their professional ethics of "doing no harm." This means prisons can only rely on staff or outside personnel with questionable qualifications to carry out this precise procedure in the execution chamber. Corinna Barrett Lain, a professor at the University of Richmond School of Law and author of a monograph on lethal injection, told Al Jazeera bluntly: "Lethal injection has every characteristic of a medical procedure — it's prone to error, it requires precision — but it has been distorted to fit the execution scenario." She added that she has witnessed failed executions last for hours, with the condemned being jabbed with needles more than a dozen times. "It is a precise procedure, but carried out in an extremely imprecise manner."

Drug supply likewise poses hidden dangers. Pharmaceutical companies restrict their products from being used in executions, and some states can only obtain pentobarbital and other drugs through "compounding pharmacies." The products these pharmacies formulate typically do not undergo the same rigorous review as large-scale commercial pharmaceuticals; some states extend the use of stockpiled drugs, which may be expired or have deteriorated.

The physical condition of the condemned further amplifies the risk. Death row inmates often spend years or even decades waiting, growing old and frail, with health problems further complicating the execution procedure. According to Al Jazeera's reporting, the case of Thomas Creech in Idaho in February 2024 is another typical example: the execution team attempted to insert IV lines eight times in the prisoner's arms, legs, and feet, all of which failed, and Creech, who was over seventy years old, was ultimately not executed.

After the first injection, Pike reportedly said she "felt like her arm was going to explode," and the promise of a "precise" injection procedure collapsed completely at that moment. Despite the frequent failures, injection remains the dominant method of execution in the United States. According to statistics from the National Conference of State Legislatures, of the 29 states that still retain the death penalty, 28 use injection as their primary method of execution. Death Penalty Information Center data shows that in 2025, a total of 39 people were executed by injection, 5 by lethal gas, and 3 by firing squad; no electrocutions have been carried out since 2020, and hanging has been abandoned since the 1990s.

Michael Radelet, a sociology professor at the University of Colorado, has long tracked failed execution cases. He told Al Jazeera that lethal injection continues the centuries-long American search for a "more humane" method of execution — electrocution once disturbed witnesses because the condemned caught fire and the air filled with the smell of burning flesh. But the "calm and clinical" procedure promised by injection has been proven a lie by its poor record. Radelet pointed out that autopsies show that, even under relatively "clean" procedures, prisoners still endure pain.

Lain's judgment is more blunt: "Lethal injection was, from the very beginning, about an execution that looks humane, not a humane execution. There is a world of difference between the two."

Whether the suspension and third-party review promised by the governor will bring systemic change to the injection procedure remains unclear. Those responsible for explaining why Pike's case failed and deciding whether to carry out her death sentence again will be the same system that experienced another injection failure just five months ago.