Expert says IV mistakes were made in execution
February 06. 2007 6:01AMTAMPA — Medical staff involved in a botched execution in December failed to adequately check an IV line for problems, according to an expert testifying Monday before a state commission on Florida's lethal injection procedures.
But testimony from members of the medical staff was delayed until another day, thanks to technical problems in disguising their voices.
The 11-member commission heard from Dr. Denise Clark, an Orlando specialist in vein therapy. Clark said medical staff monitoring Angel Diaz's Dec. 13 execution should have recognized that trouble injecting the chemicals signaled problems with the IV line.
"When an IV line is in the proper location, it should be effortless," she said.
Diaz's execution took 34 minutes, about 20 minutes longer than the typical execution. The Alachua County Medical Examiner later reported that a misplaced IV line caused Diaz to suffer nearly foot-long chemical burns on his arms.
Then-Gov. Jeb Bush subsequently halted all executions and created the commission to investigate.
The hearing, the commission's second, was supposed to feature the testimony of medical staff involved in the execution. The Florida Department of Corrections has closely guarded the identities of the medical staff. While public records show the names of doctors involved in executions, the department has said that confirming their involvement could compromise their safety.
Department officials had pushed for the medical staff to testify by phone as a way to protect their identities. Technical problems in disguising their voices pushed the testimony to Friday.
But the panel's lone witness added to evidence that key mistakes were made in the execution.
State Sen. Victor Crist, R-Tampa, said he was initially persuaded by corrections officials who testified last week that there were no noticeable problems in the procedure. But he said Monday's meeting left him believing otherwise.
"Maybe something did go wrong," he said.
A task force commissioned by Department of Corrections Secretary James McDonough had reported earlier that medical staff said it took two to three times longer than usual to push drugs through an IV line in Diaz's left arm.
The staff switched to a line in his right arm to finish injecting the drugs, but then decided to simultaneously use the first line for a second round of drugs, according to the report.
Clark testified that medical staff should have recognized that problems injecting the drugs meant the first IV line was likely dislodged. "If it's in the proper place, it shouldn't require a lot of force," she said.
In a medical procedure, she said, the vein would typically be checked to determine if the line needed adjustment. If it was determined the line had gone through the vein or there were other problems, the line would be inserted into a different vein.
Commission member Dr. David Varlotta, a Tampa anesthesiologist, said he couldn't explain the medical staff's decision to return to the problematic line. "It's not likely it would fix itself," he said.
In addition to the execution's medical staff, several more medical experts are scheduled to testify before the commission in meetings Friday and Monday.
Among those experts is Dr. Nikolaus Gravenstein, anesthesiology department chairman in the University of Florida College of Medicine. The commission also plans to hear from Dr. William Hamilton, the Alachua County medical examiner, who oversaw Diaz's autopsy.
Varlotta said he'll be submitting to the commission the American Society of Anesthesiologists' ethical policy restricting doctors from participating in executions.
Like the American Medical Association and other medical groups, the society asks members to refrain from even monitoring executions.
A member of the group's board, Varlotta said he wants to ensure doctors also aren't involved in helping the state develop new execution procedures. "It think it was a mistake to get physicians involved in the first place," he said.