Their voices were electronically disguised and backgrounds kept secret.
But in hearings before the state lethal injection commission over the past month, members of Florida's execution team revealed enough about their qualifications to raise questions.
The state's primary executioner said he lacked medical qualifications and was last trained when the state started lethal injection seven years ago. An execution doctor said he was medically qualified and had 84 executions under his belt, but failed to recognize problems with IVs in the botched execution of Angel Diaz.
The commission's recommendations, being issued today in a report to Gov. Charlie Crist, would improve execution procedures to prevent inmates from suffering and forestall legal challenges. But a legal expert said the qualifications of the individuals conducting executions, while at this point largely unexamined, could end up being a bigger issue for the state.
"To me, the more worrisome factor is who's doing this," said Deborah Denno, a Fordham University law professor who has written about lethal injection.
Florida and a dozen other states have suspended executions, she said, mainly because of problems with lethal injection. Legal challenges in Missouri and California led to revelations about the execution team's lack of qualifications, she said.
Diaz's Dec. 13 execution took about 20 minutes longer than the typical execution, a problem later linked to dislodged IVs that caused the lethal drugs to slowly seep into his flesh. The problem prompted then-Gov. Jeb Bush to halt all executions and create the commission to investigate.
But the commission's investigation was hindered by its inability to hear about the qualifications and backgrounds of execution team members. It was also hamstrung by the ethical constraints of doctors both on the commission and testifying before the panel, who said those constraints prevented them from offering advice on improving the procedure.
The Florida Department of Corrections has interpreted a state law protecting the identity of the executioner as also covering the medical professionals who assist in executions. Department Secretary James McDonough said revealing their identities would threaten their safety and harm their standing in the community.
"Perhaps ... your family doesn't know about it, your church doesn't know about it, your neighbors don't know about it," he said.
But the identities of doctors involved in executions is an open secret, as they are identified in public records. Their identities are regularly discussed on a lethal-injection blog operated by members of a prisoner support group.
State law requires doctors to pronounce death in executions and those doctors are identified in autopsy records.
Diaz's autopsy report identified Elio Maden, a doctor at Florida State Prison who also works at an after-hours clinic in Starke, as the doctor who pronounced death in the inmate's execution.
Autopsy and court records also identify another prison doctor, Victor Selyutin, who has been involved in previous executions. But prison officials won't reveal whether either of these doctors was the one who testified before the commission.
In the execution doctor's testimony, he made several claims conflicting with medical expert opinion and witness accounts of the execution.
The execution doctor insisted IV lines were secure throughout Diaz's execution. He claimed the IVs were both dislodged when Diaz's body was moved after the execution and the chemicals left in the lines then migrated into the inmate's arms.
Alachua County Medical Examiner Dr. William Hamilton said he found chemical-filled pockets about a foot long — essentially large blisters — on both Diaz's arms during the autopsy. Hamilton said the evidence suggested the IVs were dislodged before or during the procedure, causing the chemicals to be distributed outside the veins.
"None of the materials injected went to the right place," he said.
Hamilton and other medical experts declined to speculate whether the problem caused Diaz pain. But evidence of chemicals being injected into Diaz's flesh suggests that was the case, said Dr. Jonathan Groner, an associate professor of surgery at Ohio State University who has written about physical involvement in executions.
"I just have to believe that it is extremely painful to do that," he said.
Execution witnesses, including members of the news media, saw Diaz moving for 26 minutes of the execution. University of Massachusetts anesthesiologist Dr. Mark Dershwitz testified an inmate should fall asleep and die within a few minutes if procedures are followed and the IV properly inserted.
"There's essentially no chance the person would wake up for hours," he said.
A member of the execution's medical team had explained the prolonged length of the execution by saying Diaz had liver disease that caused difficulty metabolizing the drugs, according to Tim Westveer, a Florida Department of Law Enforcement agent who observed the execution.
But Dr. Nikolaus Gravenstein, anesthesiology department chairman in the University of Florida College of Medicine, said liver disease would cause no such effect. And Hamilton said he didn't find evidence of liver disease in Diaz, saying the inmate instead had a heart condition that would have caused lethal drugs to kill him faster.
There was also questions about why the execution team switched to a backup IV line, administering a paralytic before the sedative had taken effect. Columbia University anesthesiologist Dr. Mark Heath said if not for the fact the backup line was also dislodged, Diaz might have felt the effects of the final two drugs.
"They did exactly the wrong thing," he said.
But according to the execution doctor himself, questioning the execution as if it was a medical procedure isn't valid. The doctor testified that only the insertion of IV lines was done as if it were a medical procedure, and the rest of the procedure is focused on killing the inmate.
"An execution has absolutely nothing even remotely connected to medicine ... From that point onward, the condemned inmate will not leave the death chamber alive," he said.
Nathan Crabbe can be reached at 352-338-3176 or crabben@gvillesun.com.
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