How Carey Dean Moore’s execution, Nebraska’s first lethal injection, will be carried out
LINCOLN — Nebraska’s official death penalty procedure says this week’s execution of Carey Dean Moore will be accomplished by the injection of substances in a quantity sufficient to cause death without the unnecessary and wanton infliction of pain.
If a federal appellate court doesn’t halt Moore’s execution between now and 10 a.m. Tuesday, the prison staff members responsible for what sounds like a straightforward task will be under a high degree of scrutiny.
Nebraska has carried out 37 state-sanctioned executions, but Moore’s will be the first by lethal injection. Bill Clinton occupied the White House the last time the Nebraska Department of Correctional Services executed an inmate, using the electric chair.
Moore, 60, has served for 38 years on death row for the 1979 killings of Omaha cabdrivers Reuel Van Ness and Maynard Helgeland. He has recently told friends and family that he is ready to die and does not want his execution halted.
Another factor at play Tuesday: The state will give Moore a four-drug combination never used before in an execution. Death penalty critics have said that raises the likelihood of a botched execution, meaning it could take longer than normal or Moore could experience excess pain.
“Nobody is hoping things go wrong,” said Robert Dunham, director of the Death Penalty Information Center in Washington, D.C. “Everybody is hoping, if it happens, it happens smoothly.”
Corrections Director Scott Frakes declined a request to be interviewed for this story.
But a former high-ranking member of the department said no one wants the execution to go smoothly more than staff members who will serve on the execution team.
“My concern is that it’s been so long,” said Brian Gage, who spent 34 years with corrections and served as warden of Tecumseh State Prison. “The majority of them will be new to an execution.”
Based upon the state’s protocol document, the execution team conducts training sessions at least once a month throughout the year. But when an execution date has been set, the frequency of training increases to at least once per week.
Execution team members volunteer for the duty, and most have their identities shielded under state law.
With the execution just two days away, Moore will have been transported from death row at the Tecumseh prison to a holding cell at the Nebraska State Penitentiary in Lincoln, Gage said. The penitentiary houses the execution chamber.
He will be under what’s called death watch, which means he will be closely monitored so he doesn’t commit suicide.
At least 48 hours before the execution, the IV team leader will examine Moore to find appropriate veins to insert the IV needle. The IV team leader must have completed training as an emergency medical technician and in needle insertion.
As the hour of his execution approaches, Moore will be given expanded visiting time with his minister, family and friends. He also will be afforded the chance to eat a “final meal,” which Gage said is not an elaborate dinner ordered from outside the facility. Rather, he can make a choice of whatever happens to be on the cafeteria’s full menu at the time.
When the time arrives, Gage said members of the escort team will accompany Moore to the execution chamber. When the state last carried out an execution, the inmate walked from the holding cell down a set of stairs to the execution chamber.
Moore will then be placed on the padded table, where his arms, legs and torso will be secured in place by restraints. The escort team will then leave the room.
The IV team leader will set primary and backup IV lines in two of Moore’s veins. The team leader will test the lines using saline fluid and will attach a heart monitor to the inmate.
When the corrections director gives the order, the IV team leader will begin the lethal injection. The sequence of drugs and doses to be injected:
2 milligrams of diazepam (a sedative) per kilogram of body weight followed by additional doses until the inmate is unconscious. A 50 cc saline flush will follow the diazepam.25 micrograms of fentanyl (a powerful opioid painkiller) per kilogram of body weight, followed by a 50 cc saline flush.1.6 milligrams of cisatracurium (a paralyzing drug intended to stop the inmate’s breathing) per kilogram of body weight followed by a 50 cc saline flush.240 milliequivalents of potassium chloride (a drug that causes heart attack in high doses) followed by a final saline flush.
After the diazepam is given, the IV team leader must conduct a consciousness check of Moore. Common methods include pinching an eyelid or cheek and calling his name. The inmate must be unconscious before the remaining three drugs are injected.
Lethal injections without obvious complications typically take about 10 minutes to result in death, Dunham said. But some botched executions have taken significantly longer.
If the staff member who sets the IV misses a vein and the drugs flow into the inmate’s muscles, death can be prolonged and extremely painful, he said. Or if the inmate regains consciousness, he can experience an intense, burning pain from the potassium chloride, the drug that stops the heart.
A coroner or medical professional will check to determine whether Moore is dead after the four drugs are injected. If the coroner determines he is still alive, the IV team leader must carry out the injection sequence a second time.
In a lawsuit heard Friday in federal court, a lawyer for a Germany-based drug company said state documents suggest the paralyzing drug has not been stored at the proper temperature by corrections staff. The lawyer said if the drug has degraded as a result, it may not work as prison officials hope.
Eric Berger is a professor at the University of Nebraska College of Law who has studied lethal injection for over a decade. In an opinion piece published by The World-Herald, Berger wrote that if the inmate is not properly anesthetized by the first two drugs, Moore could experience a sensation that’s been described as “being burned alive from the inside” when the final drug, potassium chloride, enters his bloodstream.
“Nobody disputes that the injection of potassium chloride alone would violate the Eighth Amendment’s prohibition on cruel and unusual punishment,” Berger said.
Frakes, the prisons director, said in a court affidavit filed this week that he relied on “opinions of qualified pharmacological and medical anesthesiology experts” to come up with the drugs and dosages. In addition, he said the drugs underwent lab testing to confirm their composition.