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Protesters hold a banner during a demonstration at the governor's mansion in Oklahoma City on April 29, 2014, over the planned execution of two inmates. An execution that used a new drug combination left an Oklahoma inmate writhing and clenching his teeth on the gurney later Tuesday, leading prison officials to halt the proceedings before the inmate's eventual death from a heart attack.KT KING/The Associated Press

The botched execution of a murderer in Oklahoma Tuesday is again highlighting the ongoing controversy stemming from a number of American states who are straining to continue with the death penalty despite a scarcity of drugs.

The decision by pharmaceutical firms to stop selling barbiturates for use in lethal injections has created a chaotic situation where U.S. correctional authorities are pushing ahead by adopting new drug protocols, hoarding existing stockpiles or finding non-industrial suppliers.

Death-row inmates are challenging the states to disclose the source of their drugs to argue that they are not reliable. Each execution is now under intense scrutiny because of the untried procedures.

In the past five years in the United States, there have been more changes in lethal-injection protocols than there have been in the past three decades, according to an analysis of over 300 recent cases by Fordham University law professor Deborah Denno.

"They're doing everything they can to perpetuate this process. At the same time they have their backs against the wall because the drugs they have been using in the past are no longer available," Prof. Denno told The Globe and Mail earlier this year.

A RARE DOUBLE EXECUTION

In the latest controversial development, Oklahoma had scheduled a double execution Tuesday because of delays caused by the drug shortage.

Clayton Lockett was the first inmate to enter the death chamber. He was injected with a new three-drug combination: first the the sedative midazolam, then the paralytic drug vecuronium bromide and potassium chloride, which stops the heart.

According to reporters at the scene, three minutes after Mr. Lockett received the drugs by IV and had been declared unconscious, he began to move again, blinking and twitching.

The blinds of the chamber were then lowered and the microphone turned off.

The Oklahoma Department of Corrections said it appeared a vein had collapsed and they decided to halt the execution, but Mr. Lockett died of a heart attack.

The execution of the second inmate, Charles Frederick Warner, was postponed for two weeks.

In a press release, Oklahoma Governor Mary Fallin said she ordered "a full review of Oklahoma's execution procedures to determine what happened and why."

THE THREE-DRUG PROTOCOL

The American protocol for lethal injections is typically a three-drug process: an anesthetic renders the prisoner unconscious, then a muscle relaxant paralyzes the inmate and finally a dose of potassium chloride stops the heart.

Since 2011, the European Union has banned exports of products that could be used for capital punishment such as gallows and guillotines, but also sodium thiopental and other similar barbiturate anesthetics.

The sole American maker of the barbiturate sodium thiopental, Hospira, ended production in January, 2011, because its plant was in Italy and it did not want to be held liable. Six month later, H. Lundbeck A/S, a Danish pharmaceutical firm that produced another lethal-injection sedative, pentobarbital sodium, at a plant in Illinois, stopped selling to prisons in U.S. states carrying out the death penalty.

While not lethal, the first injection of anesthetic is a key component because it renders the inmate unconscious, bolstering claims that the execution process is compassionate. Without sedation, the prisoner would remain lucid but unable to move while getting injected with potassium chloride, which causes excruciating pain.

WARNING SIGNS

Oklahoma had already raised concerns last January when it executed Michael Lee Wilson, who had been convicted of killing a convenience store co-worker, Richard Yost, beating him with a baseball bat before attempting to rob the safe.

The state used pentobarbital as the first of the three drugs it injected into Mr. Wilson. "I feel my whole body burning," he uttered before dying.

The human-rights group Reprieve, which campaigns against capital punishment, argues that his words are proof that the pentobarbital was not working, either because it came from an expired stockpile or from an unreliable compounding pharmacy.

A week later, Dennis McGuire, a convicted rapist and murderer, was executed at the Southern Ohio Correctional Facility.

Because Ohio had run out of its supply of pentobarbital, Mr. McGuire was the first inmate to be injected with a new combination of drugs, midazolam and the opiate pain-killer hydromorphone.

He gasped loudly for air and convulsed for up to 10 minutes, witnesses to the execution reported.

A review by the Ohio Department of Rehabilitation and Correction released this week said he did not experience pain but the state nevertheless announced that it would increase its dosage of drugs for the next execution.

WHO IS TO BE EXECUTED?

The two men Oklahoma wanted to execute this week were Mr. Warner, who was convicted of killing his girlfriend's infant daughter in 1997, and Mr. Lockett, who was on death row for shooting a woman and burying her alive.

Nineteen-year-old Stephanie Neiman was murdered in 1999 after she and a female friend walked in on a home invasion being perpetrated by Mr. Lockett and two accomplices who were looking for drugs.

The female friend was raped several times. The victims were then taken to a country road and, when Ms. Neiman refused to promise that she wouldn't report on them to police, Mr. Lockett fired at her with a shotgun, then buried her alive in a shallow grave.

"We are thankful this day has finally arrived and justice will finally be served," Ms. Neiman's family said in a statement released after Mr. Lockett's execution.

Under U.S. jurisprudence, death row inmates don't have the right to a totally pain-free execution, but they have a constitutional protection from the risk of cruel and unusual punishment.

Capital-punishment opponents say that injecting untested drug cocktails on inmates or purchasing sedatives from poorly regulated source is inhuman and tantamount to using people as medical guinea pigs.

Capital punishment

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