Tennessee Execution Doctor Admits IV Error Caused Failed Lethal Injection

Tennessee's capital punishment process relies on precise medical procedures, but a recent execution attempt revealed critical flaws in how those procedures were carried out. Dr. Mark Fowler, the physician who oversaw Christa Pike's failed execution, has identified a misplaced intravenous line as the primary cause of the botched procedure.

Fowler told New York Magazine in an interview published Friday that the IV needle was not properly inserted into Pike's veins. Instead of entering the bloodstream, the device delivered pentobarbital into the subcutaneous tissue of her arms. He stated that the medication was "delivering medicine to the subcutaneous tissue," which prevented the drug from taking effect as intended.

The execution attempt took place on Sept. 30. Pike, 50, survived the procedure after receiving two doses of the lethal drug. She was hospitalized for several days and eventually regained consciousness. Fowler noted that the process lasted about 45 minutes, a duration that initially made him question whether Pike's body was simply reacting slowly to the medication.

As time passed, Fowler grew concerned that Pike might survive with irreversible brain damage. He diagnosed her as comatose before a deputy commissioner ordered the execution to stop. Fowler then administered oxygen, and Pike was transported by ambulance to Vanderbilt University Medical Center.

Pike's legal team previously filed documents stating that the inmate complained of severe pain during the procedure. She told witnesses in the chamber, "My arm feels like it’s about to burst open." Fowler acknowledged that the execution team should have halted the process and reassessed the situation when she voiced those concerns. He said, "They should have stopped and reassessed, and they didn’t."

This is not the first time Fowler's role in a lethal injection has drawn attention. He also participated in the 2025 execution of Byron Black and a failed attempt in May involving Tony Carruthers. In the Carruthers case, Fowler attempted to place an IV near the clavicle after standard access failed. He stopped the procedure because the inmate was in too much pain and Fowler lacked adequate anesthetic.

Fowler argued that Tennessee's current protocol requires changes to prevent similar errors. He recommended that the medical staff who place the IV lines remain in position to monitor the sites while the drugs are being administered. He stated, "The people who place the IV lines should thereafter be observant about what’s happening with them as the medicine goes in."

Governor Bill Lee paused the state's remaining executions for the year and ordered an independent review of the incident. Lee indicated last week that Pike remains in custody and that her death sentence is likely to stand unless courts rule otherwise. Pike was sentenced to death in 1995 for the murder of Colleen Slemmer. Her attorneys have asked the governor to commute her sentence to life without parole.