Thursday, 24 July 2008

Doctor banned from executions in Mo. now in Ariz.


Doctor banned from executions in Mo. now in Ariz.

A Missouri surgeon who was banned by a federal judge from taking part in
capital executions by lethal injection in his home state apparently
participated in Arizona's most recent execution.

Dr. Alan Doerhoff is believed to have taken part in the May 22, 2007,
execution of Robert Comer, 11 months after Doerhoff's Missouri
lethal-injection procedure was ruled unconstitutional and eight months
after the physician was prohibited from further executions in Missouri
because of questions about his standards and competence.

Doerhoff's signature appears below the flat line of an electrocardiogram
tape that recorded Comer's last heartbeats, suggesting that Doerhoff at
least monitored the murderer's condition in his final moments.

The doctor's techniques appear to have influenced new Arizona procedures
for execution by lethal injection, specifically a practice of
administering the killing chemicals through a catheter in the groin
instead of through an arm. It's a method that some critics say is too
complex and contributes to higher risks of error that could lead to undue

According to a prominent medical expert on lethal injection, that practice
occurs only in the Missouri and federal protocols, which Doerhoff is
believed to have influenced or devised. He is known to have participated
in executions for those jurisdictions.

Association denied

The Arizona Department of Corrections at first denied having any
association with Doerhoff, a Jefferson City, Mo., resident. When told that
The Republic had his signature from Comer's electrocardiogram, Corrections
officials cited state statutes that protect the identity of Arizona

Doerhoff did not return calls. Nor did Corrections Director Dora Schriro,
who before coming to Arizona oversaw Missouri's prisons from 1993 to 2001,
during the same period Doerhoff was advising that state on lethal

The doctor is not forbidden from participating in Arizona executions, but
the controversy surrounding his past may be another hindrance as the state
seeks to resume executing death-row prisoners.

Competency questioned

Lethal injection is under a legal microscope nationwide. In April, the
U.S. Supreme Court ruled that lethal injection is not cruel-and-unusual
punishment in itself but that defense attorneys can argue that the various
state methods of doing so are at least flawed. Defense attorneys have
repeatedly questioned the competence of executioners.

Prisoners are usually killed by a dose of potassium chloride, a chemical
that causes excruciating pain. At question in state protocols in Arizona
and nationwide is whether the condemned prisoners are sufficiently
anesthetized so that death is as painless as possible and whether a third
chemical administered to paralyze the prisoner masks any reaction to pain.

In its April ruling, the high court upheld the lethal-injection protocol
for Kentucky, but since then, a federal judge in Tennessee and a state
judge in Ohio have ruled that the risk of an agonizing or painful death
was too great because of the three-chemical procedure. They ordered a
single-drug approach using an overdose of anesthesia or barbiturate, which
might take slightly longer but is assuredly pain-free.

The Arizona protocol is already under legal analysis.

Jeffrey Landrigan, 48, the next Arizona prisoner awaiting execution, will
be granted evidentiary hearings in Maricopa County Superior Court to
determine if the Arizona procedure passes constitutional muster. A
separate suit filed by the Office of the State Capital Post Conviction
Defender is trying to obtain detailed information about the training of

Based on motions filed by the Arizona Attorney General's Office, the state
is vigorously fighting the release of that information on the premise that
it will reveal identities of people involved in executions.

Extensive experience

According to the St. Louis Post Dispatch, which first learned of
Doerhoff's name in 2006, Doerhoff assisted in more than 54 executions in
Missouri. Court records say that he also developed procedures, inserted
catheters and monitored prisoner consciousness in federal executions in

In 2006, according to court records, a doctor testified under the
pseudonym "John Doe 1" and admitted under oath that he was dyslexic, that
he "improvised" the dosages of the drugs (partly because of how
conveniently or inconveniently they were packaged), had no set protocol
and kept no records of procedures.

His testimony led the federal judge to rule that "Missouri's
lethal-injection procedure subjects condemned inmates to an unnecessary
risk that they will be subject to unconstitutional pain and suffering when
the lethal-injection drugs are administered."

The judge ordered the state to develop an acceptable written state
protocol and in September 2006 enjoined John Doe 1 from participating "in
any manner, at any level," in Missouri's lethal-injection process.

The Post-Dispatch unmasked John Doe 1 as Alan Doerhoff. The newspaper also
learned that Doerhoff had been sued for malpractice 20 times and had paid
several settlements.

The paper reported that, in 2003, he was officially reprimanded by the
Missouri Board of Healing Arts for not disclosing malpractice suits to a
hospital where he practiced and was subsequently barred from some

Identity admitted

Doerhoff later admitted to an Associated Press reporter that he was John
Doe 1, stating that he was proud of his service to Missouri and displeased
at being portrayed as an "ogre who is dyslexic."

The doctor had become a focal point in death-penalty appeals and an
example of what can go wrong with the system. Attorneys appealing the
death sentence of a Virginia killer learned that Doerhoff had devised the
federal lethal-injection protocol and had participated in executions at a
federal prison in Indiana, where high-profile prisoners such as Timothy
McVeigh have been executed. The attorneys wrote in their briefs that the
U.S. Justice Department relied "upon the services of the only person in
this country who has been barred from participation in executions."

The doctor in question was referred to in court documents as "Protected
Person No. 2," but in November 2007, the Los Angeles Times revealed that
it was Doerhoff.

Arizona's protocol

Arizona's lethal-injection protocol came under scrutiny in the case of
Landrigan, who killed a man in Phoenix in 1989 and whose scheduled Nov. 1,
2007, execution was stayed while the Supreme Court pondered the Kentucky

The Arizona protocol prescribes injecting 3 drugs in close succession:
sodium thiopental to induce unconsciousness, followed by pancuronium
bromide to paralyze the condemned person and potassium chloride to stop
the heart. The dosages are spelled out in the protocol, and there are
stated contingency plans if higher doses are deemed necessary.

Though the American Medical Association states that it is an ethical
violation for a physician to participate in lethal injections, the Arizona
protocol lists physicians as possible participants in the procedure. To
cover their work, state law says that people participating in executions
on behalf of the government cannot have their licenses revoked or
suspended by state regulatory boards.

Under the supervision of a "medical team leader" appointed by the director
of the Department of Corrections, the drugs are administered by six people
into two separate ports. One dose of each chemical goes into the person to
be executed, the other into a waste bucket so that none of the people
injecting the drugs will know if he or she made a fatal injection.

Flaws in procedure

Filed with Landrigan's petition for hearings on the lethal-injection
protocol was an affidavit by a Columbia University anesthesiologist named
Mark Heath, who pointed out presumed flaws in the Arizona procedure.

Heath noted that Arizona's proposed use of a catheter placed in the
femoral vein instead of an arm was used only in the Missouri and federal
protocols. And he pointed out that the use of a waste bucket so that the
people injecting the drugs would not know if they were injecting into the
prisoner or into a dead-end tube was used only in federal executions.
Those protocols were purportedly developed or influenced by Doerhoff.

Both of those details, Heath contended, made the process overly complex
and prone to error. The Landrigan motions also ask that Arizona convert to
a one-drug protocol as ordered in Tennessee and Ohio.

Nolberto Machiche, a Department of Corrections spokesman, said Doerhoff
did not write the Arizona protocol. In a formal response, Machiche wrote:
"The department has consulted with a number of correctional systems and
conferred with a number of individuals in the medical field. The
department assembled a team of physicians who were recommended by others.
They worked collaboratively with each other, none of them assumed a lead
role and none of them was responsible for administering any lethal

Machiche further wrote that the department could not disclose names under
state law.

Catheter method used

Comer, the only prisoner to be executed during Schriro's tenure, was put
to death using a catheter in the femoral artery. The current protocol with
the six executioners and the waste bucket was devised after his execution.

Comer's execution appeared peaceful to eyewitnesses, including a Republic
reporter. The 6-minute-long EKG tape monitoring his last minutes shows his
heartbeat holding steady at the point where someone has written in the
moment that the first drug was injected, the point at which Comer lapsed
into unconsciousness, and when the second and third drugs were
administered. Then, about 30 seconds after the last fatal injection, the
heartbeat wavers, the pointed regular peaks and nadirs of the EKG round
out, and then, over the next 40-some seconds level off to a flat line. The
moment of death is noted.

Then the signature: AR Doerhoff MD.

(source: Arizona Republic)

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