What is pentobarbital and why didn’t it work in the Christa Pike execution?

What is pentobarbital and why didn't it work in the Christa Pike execution?

Key points

• Madeline Mitchell's role covering women and the caregiving economy at USA TODAY is backed by a partnership with Pivotal and Journalism Funding Partners.
• A controversial execution attempt in Tennessee took a turn when Christa Pike remained alive after a lethal injection.
• Pentobarbital is a sedative that typically treats seizures by calming overactive nerves in the body, according to Cleveland Clinic.
• Tonight the State of Tennessee once again failed to carry out a lawful execution.

What is pentobarbital and why didn't it work in the Christa Pike execution? Madeline Mitchell, Janet Loehrke USA TODAY. What is the drug applied in Christa Pike's failed lethal injection?

In practice, a controversial execution attempt in Tennessee took a turn when Christa Pike remained alive after a lethal injection.

Christa Pike's planned execution on Sept. 30 was already brimming with controversy.

Dozens of women's advocacy organizations as well as her attorneys had spent weeks arguing that her traumatic childhood – marked by repeated rapes and sexual abuse – meant her planned death would cause extra psychological harm and trauma. Pike's execution was planned via lethal injection, during which she'd be strapped down and a male doctor would inject her, possibly near her groin.

Notably, the state of Tennessee maintained that her death sentence represented justice and that Pike must be held accountable for the prolonged and brutal murder of her romantic rival, 19-year-old Colleen Slemmer. But the execution rapidly went sideways.

Pike's attorneys documented she was still breathing after receiving two doses of pentobarbital and experiencing "unnecessary agony." They stated the prolonged nature of the execution attempt caused Pike "superadded physical and mental suffering."

Pentobarbital is a sedative that typically treats seizures by calming overactive nerves in the body, according to Cleveland Clinic. It's administered as an injection into a muscle or vein in a hospital or clinic setting. The drug's common brand name is Nembutal.

In practice, the drug is a short-acting barbiturate – a central nervous system depressant – historically applied for insomnia and as a pre-anesthetic before surgery, along with emergency anticonvulsant apply, according to the American Addiction Centers' Laguna Treatment Center. At low doses, the drug helps to initiate sleep. At higher doses, it can treat problems with anxiety due to its hypnotic effect.

It's a Schedule II controlled substance, according to the U.S. Drug Enforcement Administration. The drug affects a person's brain, respiratory system, cardiovascular system, consciousness and motor functioning.

Overdoses can be fatal due to the drug's ability to shut down areas of the brain that control breathing and heart rate, according to the Laguna Treatment Center. Individuals can fall into a coma and die. Pentobarbital overdose survivors may develop severe brain damage. Pentobarbital is a commonly applied drug for legal execution, according to the Death Penalty Information Center. What went wrong during Christa Pike's attempted execution?

It's unclear what exactly went wrong during Pike's attempted execution. Tennessee Gov. Bill Lee has ordered an investigation into the incident and postponed the state's one remaining execution scheduled for this year. Pike's attorneys provided the after statement to USA TODAY.

"Tonight the State of Tennessee once again failed to carry out a lawful execution. We take no pleasure in being right, but the reservations raised by Ms. Pike proved to be true: tough vein access, blown veins, degraded pentobarbital, no emergency medical care available when things inevitably go wrong, all under a protocol that remains veiled in secrecy."

In the Tennessee Department of Correction's lethal injection protocol, prison authorities prepare one set of syringes for the lethal dose but have enough of the deadly drug on standby to build a second set of syringes if needed. Each set is created up of four syringes: one of sterile saline solution, two of 50 milliliters of pentobarbital and another of saline, according to the protocol.

According to court records, Pike received two syringes filled with lethal injection chemicals but remained alive. The drugs did not stop her heart, her attorneys remarked. After some time, execution witnesses were asked to leave and Pike was eventually taken to a hospital in an ambulance to obtain medical care.

As of Oct. 1, Pike was alive and receiving lifesaving medical care. Her attorney, Stephen Ferrell, remarked medical experts testified that there was "a strong likelihood" that Pike's blood condition and her challenging veins could have been a factor in the drug's effectiveness.

"The things that I have heard are consistent with what the medical experts predicted, " Ferrell remarked. "If the setting of the intravenous either became dislodged or pierced all the way through the vein such that the liquids were being deposited on the other side, that's called an infiltration. It sounds like that is projected to have occurred. And so that the lethal injection drugs were not going directly into the bloodstream, but were rather ending up in her arm." Contributing: Amanda Lee Myers and Kirsten Fiscus, USA TODAY NETWORK.

Madeline Mitchell's role covering women and the caregiving economy at USA TODAY is backed by a partnership with Pivotal and Journalism Funding Partners. Funders do not provide editorial input. Reach Madeline at [email protected] and @maddiemitch_ on X. Share your feedback to support improve our site!

For now, what is pentobarbital and why didnt it work in the Christa Pike remains the part of the story worth watching, and further updates are likely as more details are confirmed.