After the state of Tennessee failed in its attempt to execute Tony Carruthers last month, defense attorneys were in a mad dash to preserve evidence.
Tennessee Department of Correction staff and medical contractors had tried to establish an IV into Carruthers’ arms — and, when that failed, a doctor tried twice to cut into his chest and then once into his shoulder before the execution was called off.
Carruthers’ legal team asked the Davidson County Chancery Court for a few things: They wanted an independent doctor to examine Carruthers. Ideally, they said, he would undergo the exam within 48 hours of the failed execution — so by the end of the day on May 22. And they wanted the court to order TDOC to keep all the equipment used that day.
Today, the judge officially denied the medical examination, while ordering TDOC to preserve the equipment. That includes things like syringes, catheters and restraints, as well as documentation detailing who handled the medications, any video or photo evidence of the process, written communications about the incident and training materials referenced during the execution. Attorneys for the state could appeal that order.
The state’s legal team effectively convinced the court that Carruthers was already undergoing medical treatment. Riverbend Maximum Security Institution Warden Kenneth Nelsen said under oath that the department examined Carruthers and documented his condition with photos.
In addition to advocating for Carruthers, attorneys on his legal team are also involved in a lawsuit arguing Tennessee’s lethal injection protocol fails to protect people from cruel and unusual punishment. That protocol — a governing document written and enforced by TDOC with no outside oversight — was finalized in 2025. That was after an independent investigation found the agency was violating its own rules and, among other things, failing to test its lethal drugs for contaminants. Gov. Bill Lee halted executions for years until the new protocol was implemented; attorneys argue its protections are even weaker than before.
While Carruthers isn’t a plaintiff in that lawsuit, nine other death row inmates are, and the proceedings following his failed execution have been folded into that lawsuit. Carruthers’ attorneys say his experience is relevant to the overall challenge to the protocol. The argument has been that the written policy itself is flawed, and that the Tennessee Department of Correction has a long track record of reckless behavior around executions — flouting rules and bringing in people with insufficient training.
“What Mr. Carruthers experienced last Thursday may be the starkest example yet of TDOC’s errors and ineptitude, but it was not an isolated incident,” one of his attorneys, Kit Thomas, said in a press conference last week.
Another of his attorneys, the American Civil Liberties Union’s Maria DeLiberato, said there are a few reasons to pursue an independent medical exam. She said he shouldn’t be receiving care from the same doctor who tried to kill him a few days before. She also said that without an independent witness, medical staff could try to hide mistakes.
An expert witness made a similar argument to the court.
Attorneys for Carruthers filed a declaration — basically, relevant written testimony — from Dr. Mark J.S. Heath. He has been working as a medical witness in lethal injection legislation for decades, and submitted testimony about Tennessee’s lethal injection protocol in 2007. At the time, he raised red flags about the risk of misplaced IV lines.
In the declaration, Heath said he’s personally conducted exams like these for five prisoners who survived execution attempts, which had involved failed IV and, at times, central line placement attempts. They spanned from 2009 to 2024, and took place in Ohio, Alabama and Idaho.
He said the interview portion of these independent exams can catch issues that might otherwise be missed. Heath pointed to Alabama’s failed attempt to execute a man named Doyle Hamm in 2018. Hamm had cancer and Hepatitis C, according to the Death Penalty Information Center. Experts had warned that establishing an IV would prove difficult.
They ended up trying to put a catheter into his femoral artery — a large blood vessel that provides most of the lower body with oxygen. Usually, doctors do this by placing an incision in the crease between the thigh and groin.
“It became apparent that the physician who attempted femoral central venous access inadvertently punctured or lacerated Mr. Hamm’s urethra or bladder with a large bore needle,” Heath wrote.
DeLiberato was in the room during Carruthers’ botched execution, and offered a graphic depiction of the proceedings. She said he was visibly in agony.
And although that portion of the attempt has gathered a lot of attention, the earlier portion where the IV team failed to establish access in Carruthers’ arms has also raised legal scrutiny. Thomas said that the lawsuit, which was filed last year, rang the alarm that this kind of thing could happen.
“The complaint specifically warned that the 2025 protocol failed to ensure the execution participants were sufficiently trained, qualified, and prepared to establish IV access safely and reliably,” she said.
The relevant portion of the protocol reads: IV Team: consists of at least two members who are either physicians, physician assistants, nurses, emergency medical technicians (“EMTs”), paramedics, military corpsman with relevant medical training, or other certified or licensed personnel including those trained in the United States Military. All team members are currently certified, licensed and/or qualified within the United States to place IV lines. IV Team members are selected by the Commissioner.
Attorneys challenging the protocol have argued there is no process in place to ensure licenses are up to date, and that the team members are in good standing professionally. And even if there were, they argue, there is no outside oversight of TDOC, meaning there is no way to be sure the department is following its own rules, and it has a documented history of failing to do so.
Establishing an IV can be difficult in any circumstance. But it’s typically even harder in older adults. Their skin and veins tend to be a bit looser and harder to work with. Because capital sentences take a long time, death row inmates tend to be seniors before getting to the death chamber. Tennessee executed three people last year. Oscar Franklin Smith, the first man to die under the 2025 lethal injection protocol, was 75. Byron Black was 69. Harold Wayne Nichols was 64. Carruthers is younger, at 58.
On Air - 90.3 WPLN-FM