Alabama inmate coughs, heaves, during execution by injection

ATMORE, Ala. (AP) — An Alabama inmate coughed repeatedly and his upper body heaved for at least 13 minutes during an execution using a drug that has previously been used in problematic lethal injections in at least three other states.

Ronald Bert Smith Jr., 45, also appeared to move slightly during two tests mean to determine consciousness before he was finally pronounced dead at 11:05 p.m. Thursday – about 30 minutes after the procedure began at the state prison in southwest Alabama.

Alabama uses the sedative midazolam as the first drug in a three-drug lethal injection combination.

Oklahoma's use of midazolam as the first in a three-drug protocol was challenged after the April 2014 execution of Clayton Lockett, who writhed on a gurney, moaned and clenched his teeth for several minutes before prison officials tried to halt the process. Lockett died after 43 minutes. A state investigation into Lockett's execution revealed a failed line caused the drugs to be administered locally instead of into Lockett's blood.

Ohio and Arizona have used midazolam as the first in a two-drug protocol. Ohio inmate Dennis McGuire repeatedly gasped and snorted over 26 minutes during his January 2014 execution. The state abandoned that method afterward and has yet to resume executions. Arizona halted executions after the July 2014 lethal injection of convicted killer Joseph Rudolph Wood, who took nearly two hours to die.

Smith and other Alabama inmates argued in a court case that the drug was an unreliable sedative and could cause them to feel pain, citing its use in problematic executions. The U.S. Supreme Court ruled in a challenge by Oklahoma death row inmates that they had failed to prove that the use of midazolam was unconstitutional.