Q&A: A look at Oklahoma's drug mix-up, what's next

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Posted: Oct 02, 2015 2:54 AM
Q&A: A look at Oklahoma's drug mix-up, what's next

McALESTER, Okla. (AP) — An Oklahoma execution was called off at the last minute this week because the state received an incorrect drug from its supplier.

Oklahoma's protocols called for potassium chloride to be used as part of a three-drug combination in the scheduled lethal injection of inmate Richard Glossip, but the state received potassium acetate instead. The attorney general on Thursday asked for an indefinite hold on all scheduled executions to allow time for a review.

Here are some questions and answers about the state's execution process and what's next:

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Q: ARE POTASSIUM CHLORIDE AND POTASSIUM ACETATE ALIKE?

A: According to the National Institutes of Health, potassium acetate and potassium chloride can each be used in medical settings to treat low levels of potassium, restoring appropriate heart rhythms, blood pressure and kidney function. NIH does not describe the drugs' use in death penalty cases. Executioners use potassium chloride to stop an inmate's heart.

Dr. Alice Chen, an internal medicine specialist and executive director of Doctors for America, says the two drugs are not interchangeable.

"As with any other drug, people react to them in different ways," Chen said.

But Robert Patton, Oklahoma's prisons director, told reporters Thursday that the state's drug supplier believed one drug could be swapped with the other. He refused to say who supplied the drug; state law keeps the information a secret.

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Q: HAS POTASSIUM ACETATE BEEN USED IN A U.S. EXECUTION?

A: No, according to Jen Moreno, a staff attorney with the Death Penalty Clinic at the at the University of California's Berkeley Law School.

"It's never been used, and actually doctors and pharmacologists we're talking to aren't super familiar with it," Moreno said. "It's not a very common drug it seems."

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Q: WHAT'S ALLOWED UNDER OKLAHOMA'S EXECUTION PROTOCOLS?

A: Oklahoma has some leeway in the drugs it uses in lethal injections. The protocols include dosage guidelines for single-drug lethal injections of pentobarbital or sodium pentothal, along with dosages for a three-drug protocol of midazolam, vecuronium bromide and potassium chloride. The protocols also allow for rocuronium or pancuronium bromide to be substituted for the second drug. The protocols do not list an alternate for potassium chloride, which is the third drug used.

Much attention has been paid to midazolam, a sedative that Oklahoma first used in the April 2014 execution of Clayton Lockett. That execution — which lasted more than 40 minutes — led to a lawsuit that ended up before the U.S. Supreme Court, which ruled in June that the use of midazolam is constitutional.

The protocol says the state must notify the inmate within 10 days of the execution which drugs will be used. In an Aug. 11 letter to Glossip's attorneys, the state said it planned to use midazolam, rocuronium bromide and potassium chloride in Glossip's execution and that the drugs "have been obtained." While Patton on Thursday said the vendor believed potassium chloride and potassium acetate could be used interchangeably, he did not explain why the change was made.

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Q: WHEN DID THE STATE FIND OUT IT HAD THE WRONG DRUG?

A: Patton said a sealed box from the drug supplier was opened about 1 p.m. CDT Wednesday, two hours before Glossip's scheduled execution. He said the prison system immediately reached out to the supplier and was told potassium acetate was a suitable substitute.

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Q: WHAT HAPPENS NOW?

A: Attorney General Scott Pruitt on Thursday asked the Oklahoma Court of Criminal Appeals to halt next Wednesday's execution of Benjamin Cole, plus the executions of John Marion Grant and Glossip over the next month. Glossip's execution was rescheduled for Nov. 6.

Pruitt said his office needs time to determine what went wrong Wednesday and whether the state's execution guidelines should be reviewed again.

"Until my office knows more about these circumstances and gains confidence that DOC can carry out executions in accordance with the execution protocol, I am asking the Oklahoma Court of Criminal Appeals to issue an indefinite stay of all scheduled executions," Pruitt said in a statement.

His request came hours after Gov. Mary Fallin said she was confident the state could resolve its problems in time for an execution set for next week.

The court did not immediately rule on Pruitt's motion.