Christa Pike survived after Tennessee administered two doses of pentobarbital during her scheduled execution on Wednesday, Sept. 30, raising questions about what went wrong during the lethal injection and prompting an investigation.

Pike, 50, was transported to a hospital after prison officials stopped the procedure at Riverbend Maximum Security Institution in Nashville. Witnesses reported hearing her breathing and snoring well after the injections. Her lawyers said they had not initially been told about her medical condition.

What Does Pentobarbital Do?

Pentobarbital is a barbiturate that depresses the central nervous system by enhancing the effects of the neurotransmitter GABA. In medical use, intravenous administration acts rapidly and can produce profound central nervous system depression. At high exposure, barbiturates can suppress breathing and ultimately lead to death.

Tennessee switched to a single-drug pentobarbital protocol after completing a review of its lethal-injection procedures in December 2024. The state says the drug has consistently been effective under its protocol.

Previous lethal-injection failures in the U.S. have included difficulties establishing or maintaining intravenous access, although there is currently no public finding that an IV problem caused Pike's failure. In 2024, Idaho abandoned an execution after its team could not establish a working IV line for pentobarbital.

Pike's execution was already delayed by a last-minute court battle on Sept. 30. The Sixth Circuit initially issued a stay shortly before the scheduled procedure while it considered whether Pike's claims involving her childhood sexual abuse and sentencing history could proceed. The U.S. Supreme Court later vacated that stay, clearing the way for Tennessee to proceed. Justice Sonia Sotomayor, joined by Justices Elena Kagan and Ketanji Brown Jackson, dissented.

According to witnesses cited by Al Jazeera and other outlets, the execution began at about 7:46 p.m. CDT. The curtain was briefly reopened three minutes later, when witnesses could hear Pike. The curtain closed again at 8:06 p.m., and witnesses continued hearing sounds from the chamber until roughly 8:53 p.m., when they were instructed to leave. Pike was later taken to a hospital for medical treatment.

The Tennessee Department of Correction said it had followed every step of the state's approved protocol and that the protocol does not authorize additional procedures beyond those carried out Wednesday night.

Pike remained alive after two doses of pentobarbital, but the reason the execution failed remains unclear.

Tennessee's protocol calls for a second set of syringes if the prisoner is not deceased after the first set. It does not specify another procedure if the prisoner remains alive after the second set.

Tennessee Gov. Bill Lee has ordered a third-party review to determine what happened. He said the state's execution process must be "legal and constitutional" as well as "effective."

As of Oct. 1, Pike is receiving treatment at a hospital after the failed execution. No new execution date has been announced. Lee has also suspended Tennessee's remaining scheduled execution for the rest of 2026 while the independent review takes place.

Until the review determines what went wrong, there is not enough evidence to conclude that pentobarbital itself failed.

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