How Lethal Injection Works
For thousands of years, many governments have punished people convicted of certain crimes by putting them to death, using various means to accomplish this. The death penalty is considered by many to be the ultimate form of punishment for those who have committed society's most heinous crimes, including rape and murder. As times have changed, so have the methods of execution.
The idea of someone being put to death is not a pleasant one. About 54 of the world's countries and 35 American states have a death penalty [source: Amnesty International]. The vast majority of executions in 2009 took place in China, Iran, Iraq and Saudi Arabia [source: Amnesty International].
The form by which prisoners are executed is changing. In America and a growing number of other countries, lethal injection has become the most commonly used form of capital punishment, replacing other forms such as hanging and the electric chair. In this article, we'll examine how lethal injection is carried out and what a prisoner experiences in the days prior to execution.
Killer's skin rips and he 'chokes for air' in 'worst botched execution ever'
Just after 6pm on December 13, 2006, Angel Nieves Diaz grimaced in pain and jutted his head as a lethal cocktail of drugs was pumped into the convicted killer's body.
Witnesses looked on in horror as he struggled to speak and coughed before his body shuddered while strapped to a gurney in the ensuing ten minutes.
By then he should have been dead, but the execution was botched from the beginning - needles were mistakenly inserted into soft tissue in his arm instead of veins, resulting in horrific chemical burns.
He remained conscious and at one point asked: "What's going on?"
Diaz, 55, appeared to stop moving but his body suddenly "jolted" in the 24th minute and he opened his eyes widely, sparking panic in the death chamber in Florida's state prison.
By the time he was finally pronounced dead, two full doses were administered and the execution lasted 34 minutes instead of the usual ten to 15.
It was clear the convicted murderer suffered as chemical burns turned the skin on his arms black and caused the outer layer to tear away, exposing pink and white flesh.
Abnormal swelling in his neck suggested he may have struggled for air during one of the worst botched executions of all time.
The gruesome death sparked immediate outrage, forcing then-governor Jeb Bush, the brother of then-president George W Bush, to temporarily suspend executions so Florida's lethal injection protocol could be reviewed.
Born in Puerto Rico, career criminal Diaz was 28 when he and two friends held up a strip club - the Velvet Swing Lounge - in Miami on December 29, 1979.
Bar manager Joseph Nagy was shot dead during the robbery while most of the terrified customers and staff were locked in a toilet.
The murder went unsolved until 1983, when Diaz's then-girlfriend told the police that he was involved.
Diaz was arrested and in 1986 was put on trial, where he represented himself even though he barely spoke English and there were claims he wasn't competent.
He pleaded not guilty and in his defence he claimed that a co-defendant, Angel Toro, was responsible for the murder.
But he was found guilty and sentenced to death in an 8-4 vote by a jury.
The prosecution's case relied on evidence from Ralph Gajus, an inmate who claimed Diaz had confessed in jail to shooting Mr Nagy.
Diaz's legal team later produced a sworn declaration from Gajus, who admitted that he had lied because he was angry with Diaz after being left out of a previous escape attempt and the police had promised to help him with the charges he was facing at the time.
Despite Diaz's claims that he was convicted based on bogus testimony and faulty evidence, his last-ditch appeals - including one challenging the chemicals used - were denied.
The governor refused to grant clemency as the convicted killer's date in the execution chamber approached.
For his part, Toro accepted a deal with prosecutors and was sentenced to life in prison.
Almost 27 years after the strip club murder, Diaz was put to death at the state prison in rural upstate Florida.
He refused to order a last meal and was served a meal off the menu of the day - shredded turkey, shredded cheese, rice, pinto beans and tortilla shells, along with apple crisp for dessert and iced tea to drink.
In his final statement, he said in Spanish: "The state of Florida is killing an innocent person. The state of Florida is committing a crime, because I am innocent.
"The death penalty is not only a form of vengeance, but also a cowardly act by humans.
"I'm sorry for what is happening to me and my family who have been put through this."
Diaz was restrained on a gurney and the curtain opened at 6pm local time on December 13, 2006, as witnesses - including journalists, a chaplain and prison staff - watched.
After the final statement, three drugs were pumped into Diaz - one intended to dull his pain, a second to paralyse his body and a third to stop his heart.
At 6.02pm he was seen grimacing and appearing to say something.
Four minutes later he continued to move and blink his eyes and his chin jutted as if he was in pain. The movements continued for a few more minutes.
At one point, he was heard muttering: "What's going on?"
At 6.12pm - around the time Diaz should have died - his head shifted to the right, he began coughing and his body appeared to shudder.
Three minutes later his mouth opened and he breathed heavily.
It was clear something had gone wrong. A member of the execution team got on the phone at 6.18pm as Diaz continued to breathe deeply and move.
Diaz began to slowly stop moving but at 6.26 there were distressing scenes as his body suddenly jolted and his eyes opened widely.
An execution team member got back on the phone and a doctor, whose face was masked, entered at 6.34pm to check Diaz's vital signs.
There are 29 US states where the death penalty is still legal and lethal injection is the primary method for each one.
Some states have authorised one or more alternative methods in circumstances where others are deemed unconstitutional or are unavailable or impractical.
Some states allow the death row prisoner to choose an alternative if they don't want to be injected with a lethal cocktail of drugs.
Nine states still allow electrocution - Alabama, Arkansas, Florida, Kentucky, Mississippi, Oklahoma, South Carolina, Tennessee and Virginia.
The gas chamber is an alternative in seven states - Alabama, Arizona, California, Mississippi, Missouri, Oklahoma and Wyoming.
Hanging is still an option in Delaware, New Hampshire and Washington.
Three states - Mississippi, Oklahoma and Utah - still permit execution by firing squad, with the last such case happening in Utah in 2010. This method has been used three times since 1976.
A minute later, the doctor returned to check for a pulse, and then nodded to the execution team.
Two minutes later, at 6.36pm, Diaz was pronounced dead and the curtain closed. His family described it as "torture".
When lethal injections go as planned the inmate is usually unconscious and motionless within five minutes and dead within ten to 15.
A day later, it emerged that a second dose was needed to kill Diaz because the needles were wrongly injected through his veins and into the soft tissue in his arms.
In the fallout, James McDonough, then the secretary of Florida's prison system, said the executioners did not notice any swelling in Diaz's arms and he was told that the inmate had become unconscious and was heard snoring .
Witnesses said otherwise.
The gruesome scene
Witnesses were left traumatised after watching Diaz die in an execution that lasted more than twice as long as it should have.
His chaplain, Rev Dale Recinella, told how he watched in horror as Diaz writhed in pain after the convicted killer asked him to be there for him.
The chaplain, who has witnessed almost 20 executions, previously told Mirror Online: "I have never witnessed an execution by electric chair, thank the Lord.
"But I have witnessed a botched lethal injection and what I found out is there is not much difference between burning a human being to death alive from the outside in with electricity than burning a human being to death from the inside out with chemicals.
"I testified in a court case to try and ban executions in Florida because of what Angel suffered during the last 34 minutes of his life."
Mr Recinella said he sees a counsellor to help him digest the horrors he has witnessed at the state prison.
Former journalist Ron Word wrote in his report afterwards that it seemed like Diaz would never die.
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At one point, the convicted killer even looked towards the official 25 witnesses.
Mr Word previously told Mirror Online: "It took more than a half-hour for Diaz to die, a process that usually takes 10 minutes.
"He appeared to be conscious for much of the procedure.
"Corrections official blamed the long process on liver disease, but the autopsy showed the IV line delivering the deadly chemicals had been pushed through his veins into his arms.
"The medical examiner noted chemical burns and said there was no evidence of liver disease."
It wasn't the first time Mr Word had witnessed a botched execution.
He once saw flames shoot out of the head of a convicted killer who died in an electric chair called "Old Sparky".
As a journalist, he witnessed more than 60 executions, including the electric chair death of serial killer Ted Bundy.
It has been more than 50 years since the last prisoners were put to death in the UK.
Peter Allen, 21, and Gwynne Evans, 24, were hanged at separate prisons - Walton and Strangeways - on August 13, 1964 for robbing and murdering laundry worker John West.
Their deaths came a year and three months before the death penalty for murder in Great Britain was suspended for five years - and and replaced with a mandatory life sentence - under the Murder (Abolition of Death Penalty) Act 1965. The act became permanent four years later.
The death penalty for murder in Northern Ireland was abolished in 1973.
The so-called "Bloody Code" remained for crimes including espionage and treason until it was fully abolished in 1998.
Britain is now barred from restoring the death penalty as long as it is a member of the European Convention on Human Rights.
Capital punishment had been used for centuries in the countries that became the UK. Death sentences were doled out for crimes including murder, rape, theft, adultery, arson and witchcraft.
Ancient methods were grotesque and especially cruel - ranging from beheadings and live burials to people being burned at the stake or thrown to wild animals.
As times changed, so did attitudes, with capital punishment undergoing many reforms to eliminate certain methods and crimes, and eventually raise the minimum age to 18.
Public executions ended in the UK in 1968.
After the execution, Governor Bush initially claimed that all protocols were followed. He blamed a "preexisting medical condition" for the execution taking much longer than usual.
But a day later, amid increasing pressure, he called for a review under Mr McDonough's watch and the explanation soon changed.
Corrections spokeswoman Gretl Plessinger had told reporters that Diaz was given a second dose because he suffered from liver disease, which slowed his metabolism, the New York Times reported the day after the execution.
She said: “It was not unanticipated that the metabolism of drugs delivered would take additional time."
Diaz's family told reporters that they weren't aware of the condition.
Ms Plessinger also claimed it wasn't believed that Diaz was in any pain.
The statement from the governor said: "A preexisting medical condition of the inmate was the reason tonight's procedure took longer than recent procedures carried out this year."
But a coroner, who was ordered to carry out an expedited post-mortem, revealed that the needle with the lethal chemicals had punctured Diaz's veins and gone into his soft tissue.
Death penalty opponents argued that the inmate had suffered during a botched execution, fuelling their calls for the "cruel and unusual" practice to be abolished across the US.
Mark Elliott, a spokesman for Floridians for Alternatives to the Death Penalty, told the New York Times back then: “This is further proof of the broken death penalty system in Florida. Florida has no business in executions.”
Amid mounting shock and outrage, one of Diaz's lawyers asked Florida's Supreme Court to declare the state's lethal injection procedure unconstitutional.
Two days after saying all protocols were followed, Governor Bush suspended all upcoming executions so Florida's lethal injection protocol could be reviewed, asking a commission to probe the "humanity, constitutional imperative and common sense" of procedures.
In 2014, eight years after Diaz's death, horrific photos emerged showing the chemical burns on his arms.
The executions resume
After Diaz's death, Florida's execution chamber was silent for more than 18 months until convicted murderer and paedophile Mark Schwab, 39, was put to death by lethal injection on July 2, 2008.
Under a new governor, Charlie Crist, Florida resumed executions after updating its procedures - requiring more staff training and better monitoring of proceedings in the death chamber - and following a US Supreme Court ruling.
It kept the three-drug method.
Schwab, convicted of kidnapping, raping and killing an 11-year-old boy, Junny Rios-Martinez, in 1991, was the first prisoner to die under the state's updated procedures and the first in Florida after the Supreme Court ruled that the three-drug cocktail was not cruel and unusual punishment under the Constitution.
Florida has executed 35 prisoners since Diaz, all by lethal injection.
Lethal injection remains the primary method in the 29 states where the death penalty is still legal.
On November 7, the state is scheduled to executed its 100th prisoner since capital punishment resumed in 1976.
James Dailey, now 73, was convicted of stabbing and drowning 14-year-old Shelly Boggio in 1985.
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