Tennessee tried to execute Christa Gail Pike via lethal injection on September 30. The convicted killer was unsuccessfully given two doses of pentobarbital. (According to the NLM database, pentobarbital is a barbiturate that primarily acts on the central nervous system. It is approved by the FDA for managing seizures, status epilepticus, and short-term treatment of insomnia. In higher doses, it is an anticonvulsant for emergent seizure control and for inducing medically induced comas.)  Currently, Pike is unconscious and on a ventilator. She has burned and blistered arms, suggesting the drug leaked into tissue instead of her veins. A brain injury is likely but has not been confirmed.

Nearly all execution methods kill by depriving the brain of oxygen. Pentobarbital suppresses breathing. Nitrogen removes oxygen directly. Beyond pharmaceutical means, electrocution can burn the brainstem, and hanging and firing squads cut off blood flow. However, a method may not fully work, as a person can survive a stretch of low oxygen, resulting in hypoxic brain injury.oxygen

Earlier survivors of pharmaceutical execution, including Romell Broom and Kenneth Smith, lived because staff never got an IV line working. Pike is the first person known to survive after the drugs were given.

In a broader sense, recreational drug overdose often involves medications used in the medical field, but at a much smaller dose. Typically, emergency services often come quickly. Reportedly, it took more than an hour for Pike to receive emergency treatment. According to prison protocol, inmates who survive or experience acute medical distress during the process are legally required to be transferred to an off-site medical facility for life-saving care.

Her recovery depends on how long her brain was deprived of oxygen, which is unknown. The law generally allows a second attempt. But if she can no longer understand why she is being executed, Supreme Court rulings forbid it. Gov. Bill Lee has paused executions in Tennessee pending an independent review.