Botched Executions in the U.S.: Methods, States, and Court Response

A botched execution in the US is one in which unanticipated problems or delays cause unnecessary suffering for the prisoner or reveal gross incompetence by those carrying it out. Researchers estimate that about 3 percent of all American executions since 1890 have gone wrong, but that average hides a much worse record for lethal injection: more than 7 percent through 2009, and roughly 37 percent of attempts in 2022 alone.¹² Failures have continued through 2026, and no U.S. court has yet struck down a state’s chosen method as cruel and unusual.

How a Botched Execution Is Defined

The most widely cited definition comes from Austin Sarat, a professor at Amherst College and author of Gruesome Spectacles: Botched Executions and America’s Death Penalty (2014). Sarat calls a botched execution one “involving unanticipated problems or delays that caused, at least arguably, unnecessary agony for the prisoner or that reflect gross incompetence of the executioner.” Working with a team of undergraduate researchers, he analyzed newspaper accounts of 8,776 executions between 1890 and 2010 and identified 276 that met the definition.³

The Death Penalty Information Center (DPIC) tracks post-1976 incidents using a narrower standard, counting only failures that occur after the prisoner is already inside the execution chamber. Its list, compiled by Professor Michael L. Radelet, includes 63 well-documented examples, 50 of them by lethal injection.⁴²

Sarat’s methodology has critics. A review in the William & Mary Law Review called his definition “arbitrarily expansive,” arguing that many of the incidents he counts — a difficult IV insertion, a delay before death is pronounced — don’t necessarily involve a painful death. The review contends that of the 75 lethal injections Sarat classifies as botched, 64 show no evidence of a painful death beyond the discomfort of the needle.⁵ Defenders and critics of capital punishment do agree on one point: the number of visibly problematic executions has grown since 2020.

Why Lethal Injection Fails More Often Than Any Other Method

Since the first lethal injection on December 7, 1982, more than 1,377 prisoners have been put to death by that method. Through 2009, Sarat found more than 7 percent of them botched — far higher than any other method. In 2022, seven of 19 execution attempts, about 37 percent, were classified as botched.² Several forces drive the failure rate.

Drug shortages and compounding pharmacies. In 2011, Hospira, the sole U.S. manufacturer of sodium thiopental, stopped producing it to distance the company from executions. Other pharmaceutical companies followed with similar restrictions. States turned to compounding pharmacies, which custom-mix drugs but are loosely regulated and whose products are not FDA-approved or independently tested.⁶ If a compounded sedative fails to induce deep anesthesia, the prisoner may remain conscious while a paralytic agent hides all outward signs of distress.

Secrecy laws. Many states classify the identities of drug suppliers as confidential, sometimes designating the compounding pharmacy as an “execution team member” to invoke shield laws.⁷ Courts, defendants, and the public are left with no way to verify drug quality.

Untrained personnel. Major medical associations consider physician participation in executions unethical, so injections are typically administered by prison staff who lack clinical backgrounds. Establishing intravenous access is the single most common point of failure, particularly in older prisoners or those with compromised veins.²

Evidence That Lethal Injection Causes Suffocation

A 2007 study in PLOS Medicine analyzed execution logs and postmortem data from North Carolina and California and concluded that the standard three-drug protocol — anesthetic, paralytic, potassium chloride — does not reliably work as intended. Pancuronium bromide, the paralytic, masks signs of distress; if the anesthetic fails, the prisoner may die of suffocation while appearing outwardly calm.⁸

An NPR investigation reviewed 216 autopsy reports of prisoners executed by lethal injection between 1990 and 2019 and found evidence of pulmonary edema — lungs filled with fluid — in 84 percent of cases. Pulmonologists consulted for the report said the condition produces sensations of drowning, suffocation, and panic. In 2018, federal magistrate judge Michael Merz in Ohio compared the sensation to waterboarding and ruled it constituted “severe pain and needless suffering.” The Sixth Circuit overturned that ruling, reasoning that because hanging is constitutionally permitted, suffocation during lethal injection is not “constitutionally inappropriate.”⁹

Oklahoma: The Pattern in One State

On April 29, 2014, Oklahoma tried to execute Clayton Lockett using a new three-drug protocol that substituted midazolam for the standard sedative. Lockett was declared unconscious ten minutes in, but witnesses then watched him nod, mumble, and writhe. The IV had failed — a vein collapsed, and the drugs were absorbing into surrounding tissue rather than the bloodstream. The execution was called off, and Lockett died of a heart attack roughly 43 minutes after the process began.¹⁰ An investigation later found that a 1.25-inch needle had been used instead of the 2- to 2.25-inch needle required for the femoral vein, and that the Attorney General’s office had pressured officials to move quickly.¹¹

In January 2015, Oklahoma executed Charles Warner under the same protocol. His final words, as reported, were “My body is on fire.” Months later, when officials were preparing for Richard Glossip’s execution, they discovered that the drug used to stop Warner’s heart had been potassium acetate, not the potassium chloride required by protocol. It was the first known instance of a U.S. execution using the wrong lethal drug, and execution logs had falsely recorded that the correct drug was administered.¹²¹³ The Oklahoma Court of Criminal Appeals imposed a moratorium in October 2015.¹⁴

Executions resumed in October 2021 with John Grant. Witnesses from the Associated Press and other outlets reported that Grant experienced repeated full-body convulsions and vomited for nearly 15 minutes after receiving midazolam. Medical staff entered the chamber multiple times to clear vomit from his face while he was still breathing. The state’s official statement said the execution was carried out “without complication.” Confronted with witness testimony, the corrections director called the convulsions “dry heaves” and the vomiting “regurgitation,” and said the department had no plans to change its protocol.¹⁵ An independent bipartisan commission later issued a 300-page report recommending more than 40 changes. According to commission member Judge Andy Lester, none of the recommendations have been implemented.¹⁶

Alabama: Repeated IV Failures and the Nitrogen Gas Experiment

In February 2018, Alabama prison staff spent two and a half hours trying to establish an IV line in Doyle Hamm, puncturing his legs, ankles, and groin, and hitting his femoral artery, before giving up.¹⁷ Hamm filed a civil rights suit and reached a confidential settlement in which the state agreed never to seek another execution date for him; he died of cancer on death row in November 2021.¹⁸

In a single five-month stretch in 2022, Alabama botched three more. The July execution of Joe James lasted three and a half hours; a private autopsy found multiple puncture wounds and jagged lacerations. In September, officials spent nearly two hours trying to access Alan Miller’s veins while he was strapped in an upright position, then called it off. In November, they attempted to execute Kenneth Smith but stopped after repeatedly stabbing his collarbone and arms.¹⁷ Governor Kay Ivey suspended executions and ordered an internal review that produced promises to add medical personnel, acquire new equipment, and increase rehearsals, but identified no specific protocol changes.¹⁹

Alabama then turned to nitrogen gas. On January 25, 2024, the state executed Kenneth Smith by that method, the first jurisdiction to do so. Officials had predicted unconsciousness within seconds; witnesses instead reported Smith writhed and thrashed violently for several minutes, with about 32 minutes elapsing between when the curtain opened and the pronouncement of death. Justice Sonia Sotomayor, dissenting from the Supreme Court’s denial of a stay, wrote that Alabama had selected Smith as a “guinea pig” to test an untried method after already failing to kill him once.²⁰

Alan Miller was executed by nitrogen in September 2024. On October 23, 2025, Alabama executed Anthony Boyd by the same method in a process that lasted nearly 40 minutes; eyewitness journalist Lee Hedgepeth counted more than 225 agonized breaths after Boyd began violently thrashing against his restraints.²¹ Justice Sotomayor again dissented, joined by Justices Kagan and Jackson, writing that there was “mounting and unbroken evidence” the method inflicts “unnecessary suffering.”²²

Recent Failures in Other States, 2025–2026

South Carolina Firing Squad

On April 11, 2025, South Carolina executed Mikal Mahdi by firing squad. An autopsy commissioned by his attorneys found only two entry wounds rather than three, and the wounds pierced his liver rather than striking the heart directly. Forensic pathologist Dr. Jonathan Arden concluded Mahdi experienced “excruciating conscious pain and suffering for about 30 to 60 seconds.” Witnesses said he cried out and continued to breathe for roughly 80 seconds after his initial vocalization.²³ The finding matters legally because the South Carolina Supreme Court had upheld firing squad executions on the explicit assumption that pain would last only 10 to 15 seconds, “unless there is a massive botch of the execution in which each member of the firing squad simply misses the inmate’s heart.”²⁴ The state’s corrections department submitted an affidavit asserting all three rifles fired and that two bullets entered through the same wound path. The allegations were raised in a federal lawsuit filed on behalf of death row inmate Stephen Stanko, challenging all three of the state’s authorized methods.²⁵

Indiana Pentobarbital

On May 20, 2025, Indiana executed Benjamin Ritchie using pentobarbital. Defense attorney Steve Schutte and two other witnesses reported that Ritchie lifted his head and shoulders “violently” from the gurney shortly after the injection. Dr. Jonathan Groner, emeritus professor of surgery at Ohio State University, said the movement suggested the drug had not been effectively administered, possibly due to drug quality problems or IV placement.²⁶ Indiana’s Department of Correction denied the execution was botched. Independent verification was difficult: a federal judge had days earlier denied a request by five news outlets for access to witness executions, and the state does not require autopsies for executed prisoners. Indiana had paid $900,000 for its pentobarbital supply but refused to disclose the drug’s quantity, storage, or expiration dates.²⁷

Tennessee’s Failed Attempt on Tony Carruthers

On May 21, 2026, Tennessee tried to execute Tony Carruthers at Riverbend Maximum Security Institution. The team established a primary IV line but could not find a suitable vein for the backup line required under state protocol. Over more than an hour, personnel punctured Carruthers more than a dozen times in his left arm, hand, and foot, then tried and failed to insert a central line. His attorney, Maria DeLiberato, who witnessed the process, described him “wincing and groaning” throughout.²⁸

A federal lawsuit filed by the Federal Public Defender’s Office identified the physician who attempted the central line as Dr. Mark Walton Fowler, a family medicine doctor from Union City, Tennessee. In a deposition, Dr. Fowler confirmed he had not placed a central IV line since approximately 2013 and holds no hospital privileges.²⁹²⁸³⁰

The Carruthers incident was Tennessee’s second major failure in four years. In April 2022, the state halted Oscar Smith’s execution after discovering the drugs had not been tested for contaminants. An independent investigation later revealed “widespread mismanagement” of drug testing across all seven lethal injections Tennessee had carried out since 2018. Two top corrections officials — head lawyer Debra Inglis and Inspector General Kelly Young — were fired.³¹

Older Methods, Same Pattern

The problems with state killing long predate lethal injection. The electric chair debuted on August 6, 1890, when New York executed William Kemmler. Backers, including Thomas Edison, called it “quick, effective, painless, and humane.” The first jolt failed to kill Kemmler, witnesses demanded more power, and the chamber filled with the smell of burning flesh; newspapers called it a “historic bungle.” The Supreme Court upheld the method the same year in In re Kemmler.³²

Later electrocutions produced similar scenes. Alabama’s John Evans in 1983 required three jolts over 14 minutes, with sparks and flames erupting from his leg and temple. Florida’s Jesse Tafero in 1990 and Pedro Medina in 1997 both had flames shoot from the headpiece. Allen Lee Davis, executed in Florida in 1999, bled so profusely that blood soaked his shirt and oozed through the strap buckles, prompting Florida Supreme Court Justice Leander Shaw to publicly call the execution “barbaric.” Gas chamber executions fared no better. Mississippi removed witnesses from Jimmy Lee Gray’s 1983 execution after eight minutes of gasping (it later emerged the executioner was intoxicated), and Arizona’s Donald Eugene Harding took more than ten minutes to die in 1992, with witnesses reporting violent spasms lasting over six minutes.⁴

Every one of these methods was introduced with promises of humanity and reliability. Lethal injection replaced the electric chair on the same promises a century later, and nitrogen gas is now being marketed as the successor to lethal injection.

Why Courts Have Not Stopped Botched Executions

The Supreme Court has never struck down a state’s chosen method of execution as cruel and unusual punishment under the Eighth Amendment. Three modern decisions define the framework.

In Baze v. Rees (2008), a plurality rejected a challenge to Kentucky’s three-drug lethal injection protocol, holding that the Eighth Amendment does not require an execution to be pain-free. In Glossip v. Gross (2015), the Court formally adopted that reasoning and added a critical requirement: a prisoner challenging a method must identify a “feasible and readily implemented alternative” that would “significantly reduce a substantial risk of severe pain.” In Bucklew v. Precythe (2019), the Court extended that requirement to “as-applied” challenges, where a prisoner argues that a unique medical condition makes the standard protocol especially dangerous for them personally. Writing for the 5–4 majority, Justice Neil Gorsuch stated that the Eighth Amendment “does not guarantee a prisoner a painless death.”³³³⁴

Justice Stephen Breyer, in dissent, argued the alternative-method requirement creates an “insurmountable hurdle” for prisoners and undermines the Eighth Amendment’s purpose. Legal scholars have noted that constitutional doctrine has played only a modest role in the recent decline of executions; the larger forces are pharmaceutical companies refusing to sell drugs for executions, doctors refusing to participate, and institutional investors pressuring corrections contractors.⁵

The Cycle of Pause and Resume

States that botch executions typically pause them, conduct internal reviews, and resume with limited changes. Alabama suspended executions for three months after its three failed injections in 2022, then resumed with nitrogen gas.¹⁹ Oklahoma paused after Lockett and Warner, then resumed in 2021 with the troubled Grant execution.¹⁶ Tennessee halted executions in 2022, adopted a new single-drug pentobarbital protocol, and then had the Carruthers attempt fail in 2026 for different reasons.³⁰

In her 2025 book Secrets of the Killing State: The Untold Story of Lethal Injection, University of Richmond law professor Corinna Barrett Lain argues the method was never based on sound medical science. She traces the origins of the three-drug protocol to an individual who later admitted he “didn’t do any research” and “just thought what might work.” Lain characterizes the system’s continued operation as dependent on “decades of state secrecy,” including lowering blinds during executions, cutting audio after final statements, and eliminating autopsies.³⁵

1
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2
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16
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Death Penalty Information Center. Lawyers Raise Concern as Autopsy Finds South Carolina Firing Squad Execution May Have Been Botched
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Death Penalty Information Center. Violent Movements During Indiana Execution Raise Unanswered Questions
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32
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