Tennessee’s governor on Monday ordered a halt to all executions through the end of the year and opened an investigation into why the state had failed to properly test lethal injection drugs that were set to be used on a prisoner last month.
The execution of that prisoner, Oscar F. Smith, was halted about an hour before he was scheduled to be killed because the drugs were not tested for endotoxins, contaminants that could cause unforeseeable side effects if injected. The moratorium will temporarily delay the execution of Mr. Smith and four other men who had been scheduled to die this year.
The failure to test for the toxins, which experts said could cause respiratory failure or other distressing symptoms before death, was the latest in a string of errors and challenges for states seeking to carry out the death penalty while lethal drugs are harder to procure. A judge in Oklahoma is currently weighing whether a drug used during executions in several states, including Oklahoma and Tennessee, is constitutional, and South Carolina is preparing to carry out its first execution by firing squad after saying it could no longer acquire lethal injection drugs.
Gov. Bill Lee of Tennessee, a Republican, said on Monday that Ed Stanton, a former federal prosecutor in Tennessee, would lead an investigation into why the drugs used for lethal injection were not tested for the endotoxins.
Mr. Smith’s lawyers, who had called for a moratorium and investigation, welcomed the governor’s move.
“The use of compounded drugs in the context of lethal injection is fraught with risk,” Kelley Henry, the top death penalty lawyer in the Federal Public Defender’s Office in Nashville, said in a statement. “The failure to test for endotoxins is a violation of the protocol. Governor Lee did the right thing by stopping executions because of this breach.”
Wendy Galbraith, a professor of pharmaceutical sciences at the University of Oklahoma Health Sciences Center, said she was alarmed that a pharmacist had apparently not tested the drugs for endotoxins, given that it is a standard part of compounding drugs and takes only about 20 minutes to complete.
“It’s so simple,” Dr. Galbraith said, noting that the U.S. Pharmacopeia, or U.S.P., issues standards for pharmacists, including for testing for endotoxins, and that “every pharmacist follows the U.S.P.”
Harry Kochat, an expert in pharmaceutical science at the University of Tennessee Health Science Center, says endotoxins are left behind when bacteria are killed and can quickly cause hypotension, respiratory failure and other catastrophic effects, depending on the dose.
“The moment the endotoxins get in, the first symptom that is often reported is a fever, and that can cause secondary infections and affect your organs,” said Dr. Kochat, who runs the university’s center for studying sterile drug delivery.
In 1990, a jury convicted Mr. Smith of three counts of murder and sentenced him to death for killing his estranged wife and two of her children the year before. Mr. Smith, who is 72 and the oldest prisoner on the state’s death row, has maintained his innocence.
On April 21, when Mr. Smith was scheduled to be executed, he was taking communion with his spiritual adviser, the Rev. Matthew Lewis, when a warden informed him that he had been granted a last-minute reprieve, Mr. Lewis said at a recent news conference.
For more than a week, Governor Lee did not disclose what had gone wrong with the lethal injection drugs, and Mr. Smith’s lawyers said as recently as Friday that they did not know why he had been granted a reprieve.
“It is possible to both be grateful for life and also stuck in a horrible place of not knowing,” Amy Harwell, one of his lawyers, said then, describing Mr. Smith’s state. “Mr. Smith is currently living in a limbo to which the courts did not condemn him.”
Tennessee uses three drugs in executions: one intended to make a prisoner unconscious, another to induce paralysis and a third to stop the heart. When the state cannot obtain the drugs from manufacturers and instead must compound them, a licensed pharmacist must follow standard safety procedures in compounding the drugs and must test them for potency, sterility and for endotoxins, according to the state’s lethal injection manual.
Several drug experts said there was an irony in halting executions over failure to test for something that may cause illness or death.
“With lethal injection, everything’s ironic,” said Dr. Jonathan Groner, a professor of surgery at the Ohio State University College of Medicine who has studied and written in opposition to the death penalty. “You’re worried about something that might kill someone in a drug that’s meant to kill someone.”