OKLAHOMA CITY — Oklahoma’s execution protocol leaves offenders sensate but paralyzed and unable to convey that they’re feeling extreme pain, one expert testified Monday during the first day of a federal trial challenging the constitutionally of the state’s three drug cocktail method.

Dr. Craig Stevens, a professor of pharmacology and faculty member at the Oklahoma State University Center for Health Sciences, testified that the second drug in Oklahoma’s three-drug lethal injection cocktail — vecuronium bromide — is designed to paralyze offenders. It leaves them unable to move, speak or breathe, and no one would know if someone is in pain. Stevens testified as an expert witness called by the plaintiffs challenging the state’s protocols in the nearly 8-year-old lawsuit.

He said studies reported that people under the influence of the drug without a general anesthetic reported feelings of being buried alive and shortness of breath. Those under the influence of the third drug — potassium chloride — without anesthesia reported experiencing “intense burning pain” and feeling like fire was in their veins, Stevens said.

In all, 28 death row inmates and their attorneys are attempting to prove that the execution protocol and the use of midazolam — the first drug administered as part of Oklahoma’s three-drug lethal injection cocktail — create a risk of serious pain and suffering and that there are alternatives that could curtail those risks. The inmates argue the state’s protocols violate their Eighth Amendment guarantee against cruel and unusual punishment.

Stevens told U.S. District Judge Stephen Friot that midazolam doesn’t work as a general anesthetic, even at the extremely high dosage the state administers it for executions. He argued that it instead causes sedation, and does not depress the activity of the brain enough so that an offender wouldn’t feel the administration of the second or third drugs. He also said that overdoses of midazolam are rarely fatal.

Stevens suggested the state use other drugs to render unconsciousness or eliminate the paralytic so that intense pain wouldn’t be hidden by a neuromuscular blocker.

The Attorney General’s Office, meanwhile, argued that midazolam is federally approved for induction of general anesthesia, and said the scientific studies that Stevens was relying on to formulate his opinion were conducted on animals or doses of the drug administered at a much lower dose than Oklahoma uses to execute inmates.

Oklahoma won’t present its witnesses until later in the week, but indicated in federal court filings ahead of the trial that it plans to argue that for the inmates to prevail, they must prove that the state’s lethal injection procedure creates a certain or very likely “demonstrated risk of severe pain.” The inmates also must prove there’s an alternative.

Oklahoma attorneys also argued in federal court filings that a risk of pain is inherent in any execution method, and that the U.S. Constitution doesn’t require the avoidance of all pain. Nor does it force a state to be the first to experiment with an execution method.

The state, meanwhile, has its own slate of doctors who will testify about the efficacy of midazolam. It also plans to call Department of Corrections officials to testify that it has since corrected and updated execution training and protocols, according to court filings. Those prison officials also plan to testify that they’ve had difficulties obtaining alternative execution drug options such as pentobarbital and sodium thiopental, and no reputable lab is willing to create pentobarbital for the Oklahoma DOC. Fentanyl, too, is unavailable, they argue in federal court filings.

The state’s problems with executions date back to 2014 when it bungled the execution of Clayton Lockett, who took 43 minutes to die. Witnesses reported that Lockett writhed and appeared to be conscious at points during the execution, leading critics to question whether midazolam was powerful enough to render a person unconscious. A state investigation later found that an IV used to administer the lethal drugs to Lockett had come loose, but wasn’t immediately noticed, during the execution.

The state then used a non-approved drug in the January 2015 execution of Charles Warner.

Following the two execution mishaps, the U.S. Supreme Court in 2015 upheld Oklahoma’s execution procedure that relied on midazolam to render unconsciousness. At the time, Oklahoma was one of five states that used midazolam. The Attorney General at the time though agreed to halt all executions pending the outcome of the federal trial.

Under the leadership of a new attorney general, Oklahoma ended a nearly seven-year execution moratorium in October 2021 when DOC officials used its new lethal injection protocols to put John Grant to death. Media witnesses reported Grant convulsed and vomited. An autopsy later confirmed that Grant vomited, aspirated and inhaled stomach contents into his airways.

The state has since executed three more who were on death row. Those executions reportedly occurred without similar problems.

Janelle Stecklein covers the Oklahoma Statehouse for CNHI’s newspapers and websites. Reach her at jstecklein@cnhinews.com.