Acetate Gate: What’s An Executioner to Do?

Written by Jim Kelly

The state may accuse the meddling death penalty abolitionists, but it hasn’t take any potshots at the large pharmaceutical companies.

aNewDomain — Oklahoma inmate Charles Warner, 47, said his “body was on fire” after executioners used the wrong drug cocktail to execute him, according to an autopsy report released yesterday by the Oklahoma Office of the Chief Medical Examiner.

Oklahoma falls again under the searing glare of the national spotlight over lack of transparency and for shrouding executioner-providers following the international spectacle of messed-up executions — now focusing on the maladministration of the three-drug series in Warner’s execution of the controversial sedative, Midazolam, the delivery of a paralytic, and the remaining drug supposed to be potassium chloride to stop the heart.

Instead of the required potassium chloride, however, as required by the state’s protocol to induce cardiac arrest, the autopsy report prepared a day after Warner’s execution reveals that the wrong drug was used to kill Warner.

It was potassium acetate — the same drug at the center of Richard Glossip’s eleventh-hour stay last week by Oklahoma Governor Mary Fallin.

richard glossip execution stay acetate

The confusion appears to have occurred because the syringes were marked as potassium chloride but the vials were listed as “single dose Potassium Acetate Injection” which absorbs at a slower rate than the chloride form in the potassium pharmacological family. Nevertheless, the state is obliged to investigate the reasons the chemical provider — who remains anonymous — supplied the state with potassium acetate instead of the potassium chloride mandated by state law.

In any event, Warner was scheduled for execution on the same evening as Clayton D. Lockett.

After Lockett’s death, a report found that a phlebotomist failed to properly insert an IV line to inject the lethal cocktail of drugs into Lockett’s veins. Instead, the misdirected cocktail breached into other tissue and Lockett eventually died of cardiac arrest following 40 minutes of what appeared to be writhing pain.

The state’s mismanaged lethal injection administration has  drawn considerable heat due to the state’s pattern and practice of violating their protocols. Earlier this year, Akorn Pharmaceuticals wrote in correspondence to Oklahoma Attorney General Scott Pruitt that its pharmaceuticals “may have been used by some correctional facilities in the United States” and that Akorn “strongly objects to the use of its products in capital punishment” and requests their products return without further elaboration about their efforts to stop executioners from using their products.

richard glossip

Another Close Call

In his highly-publicized scheduled time, Glossip, 52, was set to be executed on September 30 by lethal injection for his purported role in the 1997 murder of an Oklahoma City motel owner.

Glossip’s case has received international attention and the Pope’s request for a commuted sentence.

Two hours prior to Glossip’s execution, officials first realized that potassium acetate had been delivered rather than potassium chloride.  The Oklahoma Court of Criminal Appeals (“OCCA”) on October 2 postponed the three pending executions indefinitely at the request of the Attorney General following the stay by the governor.

Since the stay, Robert Patton, Oklahoma‘s director of the Department of Corrections, claimed that the pharmacy advised that the drugs were the same and interchangeable.

Medical advisers distinguish potassium chloride as higher in pH which allows easier absorption of the drug into the blood stream and, in turn, is therefore far more potent than potassium acetate.

Fallin claims she was unaware that the two drugs had been mixed up in the Warner execution and only discovered for the first time the switch in the lead up to the Glossip execution.

“The attorney general’s office is conducting an inquiry into the Warner execution and I am fully supportive of this inquiry,” Fallin stated. “It is imperative that the attorney general obtain the information he needs to make sure justice is served competently and fairly.”

Fallin announced that she will delay any execution until she has “complete confidence in the system.”

Dale Baich, Glossip’s attorney, cast serious doubt that Oklahoma is capable of correcting its repeated breaches of procedure and protocol.

“The State’s disclosure that it used potassium acetate instead of potassium chloride during the execution of Charles Warner yet again raises serious questions about the ability of the Oklahoma Department of Corrections to carry out executions,” Baich commented. “The execution logs for Charles Warner say that he was administered potassium chloride, but now the State says potassium acetate was used. We will explore this in detail through the discovery process in the federal litigation.”

Notably, slight variance is permissible in the state’s execution protocol involving the use of drugs in executions:

“The protocols include dosage guidelines for single-drug lethal injections of pentobarbital or sodium pentothal, along with dosages for a 3-drug protocol of midazolam, vecuronium bromide and potassium chloride,” the AP reported. “The protocols also allow for rocuronium or pancuronium bromide to be substituted for the 2nd drug. The protocols do not list an alternate for potassium chloride, which is the third drug used.”

“Death Wish” States Trying to Score Drugs

The remaining issues of how and where the states will obtain the necessary drugs to carry out executions has required adjusting with new experimental combinations of pharmaceuticals from manufacturers who have become increasingly wary of death penalty opponents and providing drugs in use for a long time.

As a result, compounding pharmacies have become sought after for states scrambling and hard pressed to secure drugs otherwise and know little about these compounding operations which receive light FDA oversight and regulation. Recognizing that drugs for executions may be unavailable, Oklahoma passed a law earlier this month that will allow it to carry out executions with nitrogen gas.

Meanwhile, the state may accuse the meddling death penalty abolitionists, but it hasn’t take any potshots at the large pharmaceutical companies.

Earlier this year, Politico Magazine reported that the European Union (EU), which is America’s fourth largest trading partner, has taken the biggest swipe at the state governments’ craven appetite for human destruction:

“The EU disapproves of capital punishment in all circumstances and works toward its universal abolition, has banned European companies from exporting drugs if they are to be used in executions. Reflecting just how strongly the EU feels about capital punishment, the ban is contained in a law regulating trade in all goods that ‘could be used for capital punishment, torture or other cruel, inhuman or degrading treatment or punishment.’”

Given the EU’s seriousness of purpose, the international organization went further to say, “And the list of banned exports includes ‘gallows or guillotines;’ electric chairs ‘for the purpose of execution of human beings;’ and  ‘air-tight vaults, made of, e.g., steel and glass, designed for the execution of human beings by the administration of a lethal chemical substance.'”

Bottom line, capital punishment in economic quarters is viewed as bad for business, public policy and international good will — but the state continues to make it its business for political capital at the expense of human capital and incurring mounting costs in protracted litigation.

As Camus wrote: “We know enough to say that some crimes require severe punishment. We do not know enough to say when anyone should die.”

For aNewDomain, I’m James Kelly.