The four states which have used midazolam in lethal injection executions are Arizona, Florida, Ohio and Oklahoma. Three executions that used midazolam triggered formal state investigations into why they did not go as planned (Brief for Petitioner at p. 31). In all of these botched executions, the prisoners initially appeared to lose consciousness, but then started moving and demonstrating signs of struggle and suffering, including:
Mr. Happ was executed on October 15, 2013, which was the first time midazolam was used in lethal injection. Media witnesses reported, “It appeared [William] Happ remained conscious longer and made more body movements after losing consciousness than other people executed recently by lethal injection.” All 11 men executed with midazolam in Florida received paralytic drugs, so it is impossible to say what these men experienced once they were prevented from moving and speaking.
Mr. McGuire was executed on January 16, 2014. Media eyewitness reports of Mr. McGuire’s execution, which took more than 20 minutes, observed, “McGuire started struggling and gasping loudly for air, making snorting and choking sounds which lasted for at least 10 minutes, with his chest heaving and his fist clinched. Deep, rattling sounds emanated from his mouth.” McGuire was executed using a new, untested two-drug combination: midazolam and hydromorphone, a morphine derivative.
Mr. Lockett’s torturous execution on April 29, 2014, took over forty minutes during which he writhed, gasped, and attempted to speak, according to media witnesses. A state-commissioned report later concluded that a catheter failure caused the lethal drugs, at some point, to infiltrate Mr. Lockett’s tissue instead of directly entering his bloodstream. As a result, the second drug failed to effectively paralyze Mr. Lockett, allowing witnesses to see his return to consciousness and suffering.
Lasting almost two hours on July 23, 2014, Mr. Wood’s execution was the longest in recent history. Mr. Wood received 750 mg of midazolam, demonstrating that even extremely high doses of midazolam are not effective. Oklahoma has raised its midazolam dose from 100 to 500 mg, claiming that a larger dose of midazolam will ensure that the drug will work as intended, but, as Mr. Wood’s execution demonstrates, midazolam has a “ceiling effect” and does not exert more effect above a certain dose.