What happened in the failed execution of Christa Pike - and what next?

Warning: This article contains details that readers may find distressing

US convicted murderer Christa Pike is in a critical condition in hospital after Tennessee authorities failed to execute her by lethal injection, her lawyer says.

The case of Pike, whose attempted execution on Wednesday had already been the subject of a high-profile legal battle, raised a number of questions, including what went wrong? And what happens next?

A third-party review has been ordered by state Governor Bill Lee, who has halted executions in Tennessee for the rest of the year.

Pike was scheduled to be put to death in Tennessee on Wednesday evening local time. The injections were allowed by the Supreme Court at the 11th hour.

She was given two injections of the drug pentobarbital, but her legal team said these failed to stop her heartbeat. As of Thursday night, she was unconscious, intubated and on a ventilator.

Pike's lawyers filed an emergency motion on Friday to preserve "any and all evidence" related to her botched execution.

During the execution attempt, prison officials tried to start intravenous (IV) lines by using at least seven needles on Pike, according to her lawyers.

While receiving the two doses, "she could be heard crying, whimpering, and breathing loudly", her lawyers said.

"At no point did any member of the execution team realise that the IV lines were not correctly placed or that the veins had blown and that the pentobarbital was, in whole or in part, entering Ms Pike's body," her lawyers said in the filing.

Her lawyers had warned something like this might occur.

In January, Pike's legal team filed a lawsuit, external challenging the state's lethal injection protocol. In it, they said Pike suffered from a blood-clotting condition known as thrombocytosis and said she had "small veins that make insertion of a needle more difficult".

After the botched execution, Pike's attorney Stephen Ferrell said setting an IV line was more difficult than a simple blood draw, adding: "We knew this was coming."

Pike's other attorney, Randy Spivey, said he noticed during the execution that "her right arm was turning purple" and that there was "burning around the sites of the injection" afterwards.

Pike's lawyers also raised the issue of degraded pentobarbital, suggesting that it may have lost its potency.

The Tennessee Department of Correction has defended the method it used, saying "the protocol does not allow for additional procedures beyond what was carried out".

The state protocol does not clearly specify what should happen if an inmate remains alive after a second dose, according to the AP news agency.

Authorities are yet to say whether they will try again to execute Pike. They have not explained why the dosage given to Pike proved to be non-fatal.

Opponents of the death penalty said it was difficult to know what went wrong, because part of Pike's execution happened behind a curtain.

Maya Foa, the head of international legal organisation Reprieve, said: "Lethal injection relies on secrecy at every stage, to hide the violence of the state taking a human life."

Pike survived two doses of the lethal drug pentobarbital. Dr Joel Zivot, an anaesthesiologist advising Pike's defence team, said this was enough that, had it entered her bloodstream in normal circulation, "she would have surely died".

Zivot said the only possible explanation for her survival "is that the pentobarbital blood level was never high enough to cause death" and that blisters on her arm after the botched execution indicated a ruptured vein.

So, instead of entering Pike's bloodstream, he said, the pentobarbital was more likely to have spread across the tissue under her skin.

Pike's medical condition of thrombocytosis may have also played a role, forming blood clots at the injection site that would potentially block pentobarbital from entering her veins.

Regarding the possibility the pentobarbital was degraded, Zivot explained that if this was the case, it could be due to factors including poor manufacturing or improper storage.

The Tennessee correction department said Pike had been taken to an off-site medical facility. Hospital staff were working to save her life and clear the drug used, pentobarbital, from her system, her lawyers said in a court filing on Friday.

Dr Joel Zivot said: "It's very possible that as a consequence of the delay of the beginning of resuscitation she [Pike] will have a brain injury."

Pike's lawyers are now asking for her sentence to be commuted, but it is not clear what might happens next.

Historically, the US Supreme Court has not halted second attempts at executions, said John Mills, a lawyer who works with inmates sentenced to death.

In 2024, it allowed Alabama to proceed with a second execution of Kenneth Eugene Smith, using an experimental oxygen deprivation method, after their attempt to kill him by lethal injection failed two years earlier.

Pentobarbital is a potent sedative that slows down the body, including the nervous system. Doctors sometimes use it as a treatment for certain conditions, but in high doses it can also be used as a lethal injection to cause death.

Its use in lethal injections came under renewed scrutiny last year after a US federal government review during the Biden administration raised concerns about the drug's potential for "unnecessary pain and suffering".

The Biden government banned its use in federal executions, but that did not bind individual states such as Tennessee, which can choose their own methods.

In recent years, states have found some drugs needed for lethal injections harder to come by, because pharmaceutical companies have opposed the use of their products for such purposes.

The Tennessee correction department has not specifically addressed an allegation from Pike's legal team that the pentobarbital it used was "degraded".

But the department said in a statement the lethal injection chemical had "consistently been effective".

The attempted execution of Pike was not the first in Tennessee in 2026 that did not go to plan.

The execution of Tony Carruthers, who was convicted of kidnapping and murdering three people in 1994, was postponed in May after staff were unable to find a vein for a lethal injection. He was granted a year's reprieve by the governor.

In 2022, more than a third of executions across the US were botched or highly problematic, according to the Death Penalty Information Center.

Pike, now 50, was sentenced to death in 1996 for the murder a year earlier of 19-year-old Colleen Slemmer, which was perpetrated along with her then-boyfriend, Tadaryl Shipp.

Pike killed Slemmer at a camp for troubled teens, after accusing Slemmer of insulting her and attempting to steal Shipp from her.

Two other residents at the camp later testified that Pike had bragged about the murder and showed them a piece of Slemmer's skull.

Shipp was given a life sentence with the possibility of parole and he remains in prison. He was spared the death penalty for his part in the attack because he was not yet legally an adult at the time.

Correction 1 October: This article originally referred to the inmate executed by the state of Louisiana in 1947 as Willie Smith. We have amended the article to make clear that his name was Willie Francis.