- Associated Press - Wednesday, September 2, 2015

HELENA, Mont. (AP) - Two medical experts offered conflicting views Wednesday on whether a drug used to execute Montana prisoners by lethal injection meets the standard set by lawmakers.

Dr. Mark Heath, a Columbia University Medical Center anesthesiologist, testified on behalf of two death row inmates. Dr. Lee Evans, dean of Auburn University’s pharmacy school, spoke on behalf of state attorneys defending Montana’s execution methods in a trial expected to last until Thursday.

Death row inmates Ronald Allen Smith and William Gollehon are challenging those methods, saying that if the barbiturate pentobarbital does not take effect quickly enough, a condemned inmate could remain conscious while he suffocates to death.

Pentobarbital is one of two drugs that would be used in a Montana execution now that the barbiturate previously used, sodium pentothal, is no longer available in the U.S. The state’s last execution was carried out in 2006, and pentobarbital has not been used in its lethal injection mixture.

In a lethal injection, pentobarbital would be administered first to render the inmate unconscious, followed by pancuronium bromide. Together, the two drugs are meant to stop the inmate from breathing and cause death by asphyxia.



State law requires the use of an “ultra-fast-acting” barbiturate to make the inmate lose consciousness. Lawmakers did not define what they meant by “ultra-fast-acting” when they passed the law in the 1980s, but District Judge Jeffrey Sherlock interpreted it to mean the amount of time for the drug to take effect after entering the system.

Pentobarbital is used by doctors in clinical practice primarily to reduce the threat of seizures in epilepsy patients or to induce a barbiturate coma to shut down the electrical activity in the brain, Heath told Sherlock.

It is not used to induce anesthesia, and it takes longer for the drug to take full effect compared to sodium pentothal, which is also known as sodium thiopental, Heath told Sherlock.

“With thiopental, it’s lights out,” Heath said. “Whereas with pentobarbital, the prisoner continues to talk and increasingly slurs their words.”

Heath said the medical community classifies only three drugs as “ultra-fast-acting” because of their molecular structures. Thiopental is one of those three, but pentobarbital isn’t,” he said.

Assistant Attorney General Pam Collins attempted to paint Heath as an anti-death penalty advocate. She pointed out that he had not witnessed any executions where pentobarbital was used and he could not name any specific cases in which the condemned prisoner continued to speak, breathe and move after the drug was administered.

Collins also suggested that the Legislature’s use of the term “ultra-fast-acting” was meant to be descriptive, not as the medical classification that Heath described.

Evans testified that barbiturates are classified by the duration of effect, not by the amount of time it takes to become effective, as Heath said. Pentobarbital and thiopental are both considered “short-acting” barbiturates, Evans said.

Pentobarbital will reach its maximum effect within a minute after being injected, he said.

“It’s absorbed very rapidly in the brain,” Evans said.

The amount of pentobarbital the state’s execution method calls for is enough to cause anesthesia and death, and its lethal injection protocols call for a test to determine whether the inmate is still conscious after he is dosed, he said.

The trial is expected to last through part of Thursday, and state attorneys plan to present their own witness to counter Heath’s testimony.

The state’s lethal injection protocols were changed in 2013 in response to the lawsuit by Smith and Gollehon.

Sherlock previously ruled that the changes satisfied all of the issues raised by the defendants in their constitutional challenge of how the state carries out its executions except for the question of pentobarbital.

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This version corrects that pentobarbital has not been used in an execution in Montana.

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