Execution Error in US Lethal Injection: The Christa Pike Case and a Troubling Record

The botched execution of Christa Pike has reignited debate over the death penalty in the United States, where experts say the lethal-injection method is routinely disrupted by errors and a lack of professionalism.

Pike, sentenced to death for her role in the murder of a classmate when she was 18, was taken to be executed on September 30 but the procedure was halted after two doses of pentobarbital failed to kill her. Witnesses said Pike was still breathing, snoring and able to lift part of her body off the gurney despite having been injected. Her lawyers said that by October 6, Pike had regained consciousness in hospital but faced a long recovery.

Tennessee Governor Bill Lee announced a halt to all executions in the state and pledged a comprehensive review involving a third party. It is the second time this year that authorities in Tennessee have had to stop an execution after a lethal injection failed.

The Tennessee Department of Correction declined to comment when asked why this execution failed and whether it planned to try to execute Pike again.

Though the case has drawn national attention, experts say botched executions — mainly by lethal injection — are a troubling and fairly common reality in the US capital punishment system.

Robin Maher, executive director of the Death Penalty Information Center (DPIC), a nonprofit research group in Washington, D.C., said: “This is an opportunity for everyone to stop and look very carefully at everything that went wrong in this execution, and to make the right decision about how to proceed, if we are going to proceed with this method.”

A medical problem

Among execution methods used in the US, lethal injection is the most common but also among the least reliable.

States including Tennessee, Idaho, Alabama, Arizona, Texas and Oklahoma have each recorded at least one botched lethal injection since 2022. A survey of executions in the US from 1890 to 2010 found that the error rate for lethal injection was more than twice that of all other methods combined.

Researchers attribute this poor record to a range of factors, including the difficulty of carrying out a medical procedure in a prison setting without adequately qualified personnel. Major medical organizations bar their members from taking part in executions, citing a violation of the principle of “do no harm”, forcing prisons to rely on staff or officials with questionable credentials to carry out the process.

“Lethal injection has all the delicacy of a medical procedure: it is error-prone and demands high precision. But it is distorted to fit the execution setting,” said Corinna Barrett Lain, a professor at the University of Richmond School of Law and author of a book on lethal injection. She said she had witnessed botched executions lasting hours, with prisoners punctured by needles more than a dozen times. “It is a very bad combination of a delicate procedure that is not carried out in a delicate way.”

Drug companies also restrict the use of their products in executions, forcing some states to buy drugs through so-called compounding pharmacies. These facilities often prepare a drug that is not commercially manufactured, and their products are not as tightly tested as mass-produced medicines. Some states have sought to extend the shelf life of their stockpiles even though the drugs may have expired or degraded.

The risk is heightened further by the people being injected. Death-row inmates often wait years, even decades, before being put to death. Because many are elderly, they are prone to health problems that complicate the procedure. Botched executions frequently involve failure to find a vein or to place an IV line.

Although state authorities have not explained why Pike’s execution failed, her lawyers had argued that Pike has small veins and a blood condition that makes injection prone to problems. After the injection, her lawyers described Pike’s arm as swollen and burning. Maher said those symptoms suggested the drug may not have entered the bloodstream properly. “Everyone is speculating that the drug was administered but did not reach the vein in sufficient quantity to kill her. It is possible her vein ruptured, or the needle went through the vessel wall,” she said.

The dominant method

When injected drugs are not delivered properly, an execution can drag on and sometimes cause unnecessary pain to the prisoner. After the first dose of pentobarbital, Pike was said to have remarked that her arm felt “like it was going to explode”.

In May, Tennessee also called off the execution of Tony Carruthers after staff struggled for more than 90 minutes to establish a backup IV line. In February 2024, Idaho halted the execution of Thomas Creech, a man in his 70s, after the execution team failed in eight attempts to place an IV in his arms, legs and feet.

Despite such incidents, lethal injection has become the primary execution method in 28 of the 29 states that still allow the death penalty, according to the National Conference of State Legislatures. The first lethal injection execution took place in Texas in 1982.

According to the Death Penalty Information Center, 39 people were executed by lethal injection in 2025, compared with five by lethal gas and three by firing squad. The most recent execution by electric chair took place in 2020, and older methods such as hanging have not been used since the 1990s.

Michael Radelet, a sociology professor at the University of Colorado who tracks botched executions, said lethal injection replaced older forms of execution seen as backward and brutal. Those methods also produced grisly scenes that left witnesses traumatized. Prisoners subjected to the electric chair sometimes caught fire or nauseated witnesses with the smell of burning flesh. “Lethal injection is relatively new, but it is part of a long trend stretching back hundreds of years to find a more ‘humane’ method of execution,” Radelet told Al Jazeera.

He added, however, that the promise of a smoother, more medical procedure has been belied by the method’s poor record. He also pointed to autopsy findings showing that even when the process appears sterile, prisoners still experience pain.

Critics say such information calls into question the widespread use of lethal injection and whether the method should be abandoned altogether. “Lethal injection, from the outset, was meant to produce an execution that looks humane, not one that is humane. There is a very big difference,” law professor Lain said.