Oops

Started by cittykat
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These kind of cases are always wild to me. Wasn’t it obvious which leg was infected/gangrenous and needed to come off?? I’m not saying I’m above mistakes, I just don’t understand how this even happens.
 
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These kind of cases are always wild to me. Wasn’t it obvious which leg was infected/gangrenous and needed to come off?? I’m not saying I’m above mistakes, I just don’t understand how this even happens.
A year before I arrived at my first place, they had a wrong site surgery for an amputation. At first, I had the same reaction. Apparently, both feet were horrible, but the right was slightly worse and deemed unsalvageable (the left only likely unsalvageable). She ended up getting both lopped off, which was going to be the outcome anyway, followed by the usual death by a thousand cuts of vascular surgery's endless revisions and moving farther and farther up the legs.
 
Reminds me of a joke. What is the mascot for vascular surgery?


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A year before I arrived at my first place, they had a wrong site surgery for an amputation. At first, I had the same reaction. Apparently, both feet were horrible, but the right was slightly worse and deemed unsalvageable (the left only likely unsalvageable). She ended up getting both lopped off, which was going to be the outcome anyway, followed by the usual death by a thousand cuts of vascular surgery's endless revisions and moving farther and farther up the legs.
Or the poly trauma with all their limbs bandaged and multiple ORs planned with an old site marking still on the splint.
 
Wonder if she had blocks and if she had the correct leg blocked.


I heard that this case got dismissed yesterday by a judge. Apparently, she still also had to get the other leg amputated. The judge correctly noted that she didn't have a leg to stand on.

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Not my case but the wrong knee was operated on at a prior hospital where I worked. Luckily she needed both knees done so no harm was done and no compensation was warranted
 
A year before I arrived at my first place, they had a wrong site surgery for an amputation. At first, I had the same reaction. Apparently, both feet were horrible, but the right was slightly worse and deemed unsalvageable (the left only likely unsalvageable). She ended up getting both lopped off, which was going to be the outcome anyway, followed by the usual death by a thousand cuts of vascular surgery's endless revisions and moving farther and farther up the legs.
Yep used to be a running joke in residency. We had so many patients that we would initially preop for the toe amp and then foot, bka, aka, hip disarticulation. Then finally we would code them on the floor.

Every time we got a new toe amp it would be “uh oh here we go again!”
 
I heard that this case got dismissed yesterday by a judge. Apparently, she still also had to get the other leg amputated. The judge correctly noted that she didn't have a leg to stand on.

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Do you have a reference? The indication for the amputation was reportedly squamous cell carcinoma of the right leg.





“On Sept. 19, 2025, Ms. Jacks agreed to have her lower right leg amputated after her doctor recommended the procedure as part of a treatment plan for a diagnosis of squamous cell carcinoma, a type of skin cancer, Mr. Layne said.”
 
Do you have a reference? The indication for the amputation was reportedly squamous cell carcinoma of the right leg.





“On Sept. 19, 2025, Ms. Jacks agreed to have her lower right leg amputated after her doctor recommended the procedure as part of a treatment plan for a diagnosis of squamous cell carcinoma, a type of skin cancer, Mr. Layne said.”
Here is a useful reference:

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Another oops. IV infiltration?

Seems like some states are technically incapable of carrying out lethal injection so why not shoot her in the head like Kristy Noem’s GWP or behead her?


This will revive the concerns about redheads and anesthesia.
 
Another oops. IV infiltration?

Seems like some states are technically incapable of carrying out lethal injection so why not shoot her in the head like Kristy Noem’s GWP or behead her?


Yea I saw this today my first thought was IV infiltration.

Also it’s my understanding they use solo pentobarbital? Anyone have any experience with this?

I could imagine trying to use just propofol would not be 100% effective. Seen people breathe through some pretty ridiculous doses.
 
Yea I saw this today my first thought was IV infiltration.

Also it’s my understanding they use solo pentobarbital? Anyone have any experience with this?

I could imagine trying to use just propofol would not be 100% effective. Seen people breathe through some pretty ridiculous doses.
Don’t over complicate. Prop…sux…no tube.
Surprised that they can’t find a retired doc e.g., expert at venous access-cardiac anesthesia, crit care etc. who doesn’t have a license who is pro-capital punishment who would be happy to volunteer. I could see some of the contributors to SDN anes volunteering.
 
Yea I saw this today my first thought was IV infiltration.

Also it’s my understanding they use solo pentobarbital? Anyone have any experience with this?

I could imagine trying to use just propofol would not be 100% effective. Seen people breathe through some pretty ridiculous doses.
200mg rocuronium, 1000mcg fent, 10mg versed.

Heck, just sprinkle some of the street fentanyl on their last meal.

I dont understand how high school kid can accidentally OD on some pills off snapchat...but they cant manage to perform a lethal injection
 
Don’t over complicate. Prop…sux…no tube.
Surprised that they can’t find a retired doc e.g., expert at venous access-cardiac anesthesia, crit care etc. who doesn’t have a license who is pro-capital punishment who would be happy to volunteer. I could see some of the contributors to SDN anes volunteering.
The ASA "Strongly Discourages" it.
 
200mg rocuronium, 1000mcg fent, 10mg versed.

Heck, just sprinkle some of the street fentanyl on their last meal.

I dont understand how high school kid can accidentally OD on some pills off snapchat...but they cant manage to perform a lethal injection
Some protocols call for 500 mg of Versed… These meds are relatively cheap, albeit relatively expensive compared to a bullet. Just give 500 mg of Versed, 5 mg of fentanyl, and 50 mg vecuronium.
 
Some protocols call for 500 mg of Versed… These meds are relatively cheap, albeit relatively expensive compared to a bullet. Just give 500 mg of Versed, 5 mg of fentanyl, and 50 mg vecuronium.
Interesting. Do they make a concentrated version of versed?

Yea, its pretty easy.

Maybe they should do IO catheters?
 
Don’t over complicate. Prop…sux…no tube.
Surprised that they can’t find a retired doc e.g., expert at venous access-cardiac anesthesia, crit care etc. who doesn’t have a license who is pro-capital punishment who would be happy to volunteer. I could see some of the contributors to SDN anes volunteering.

Why suxx? Use pancurinium
 
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Cluster****. If we’re going to have execution, we need competent executioners.


 
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Cluster****. If we’re going to have execution, we need competent executioners.


It is interesting, for lack of a better word, that she is undergoing life-sustaining critical care interventions when she is sentenced to death.
 
Being in a profession where our #1 goal is to NOT kill people, it is mind blowing that it is this hard to successfully do lethal injection. Grab a ton of any opioid medication, and make the patient take it - IV, PO, sublingual, nasal, rectal, IM...$hit do a spinal/epidural and just give a ton of opioid. How is it this hard? I really don't understand. Even simpler - go to the nearest major city, find your local drug dealer and buy 10X their recommend dose and give it to the person.

edit: In residency, we would get patients that did 'skin popping' where the opioid was injected subcutaneously. Add that to the list of options.
 
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I wonder how much of the IV access issues we keep seeing in these botched executions are due to uncooperative patients actively trying to sabotage the effort.

Add in un- or barely-skilled people starting the IVs. It's a wonder they ever work.

Probably both. I can’t blame the prisoner for that really.
 
It is interesting, for lack of a better word, that she is undergoing life-sustaining critical care interventions when she is sentenced to death.


Our tax dollars at work. Can’t let them die by “botched” execution. We have standards. #winning
 




They claim they followed their protocol but they clearly did not.

“So far as we know, the Department of Correction followed exactly the protocol that was outlined and vetted and approved by the attorney general’s office,” Mr. Lee said on Thursday.

“Special Operations Team Leader” and “physician”🤡 did not fulfill their roles. Steps 6 and 7 did not happen. No where in the protocol is a central line kit mentioned. It would be interesting to know the date of the physician’s last central line insertion. They had a plan B on paper but never attempted it. Even though Plan A has failed in this state and others in the past. They should practice real IVs in their practice sessions because it is clearly a trouble spot for them.


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The catheters were connected to tubing that ran outside the chamber, to an out-of-view location where a “special operations team” would administer two syringes of the drug pentobarbital. At 7:34, Ms. Pike began experiencing obvious pain, witnesses said.

“The vein in my arm feels like it’s about to bust,” Ms. Pike said, though she was smiling and laughing. Moments later, Mr. Puckett said, “I saw a tear roll down her right eye, and then she said, ‘One spot is really throbbing.’”



“Mr. Spivey, the lawyer, was similarly in the dark. He did not know what was happening to his client, because after the IVs were inserted he was required to move to the witness room. Cellphones were not allowed, and he had no way to notify his colleagues on the outside of the situation.

“It took approximately seven minutes and passage through six locked doors to finally get me to a phone,” he said.

After the call, Ms. Pike’s legal team on the outside tried to get her medical attention. The governor’s office did not respond, they said. The emergency number they had been given for the State Supreme Court went straight to voice mail. Finally, they filed two separate emergency motions and were able to have a hearing, where they learned from the state attorney general’s office that an ambulance had been called.“
 
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The problem with lethal injection is that the people who have technical expertise to carry it out want nothing to do with it so it becomes amateur hour every time. Perhaps we should outsource to China, the world leader in lethal injection.

 
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I wonder how much of the IV access issues we keep seeing in these botched executions are due to uncooperative patients actively trying to sabotage the effort.

Add in un- or barely-skilled people starting the IVs. It's a wonder they ever work.
I also wonder (but dont even want to find out) what type of equipment they use. not to give any ideas, but how hard is it to train someone to put a u/s probe on a neck and put at minimum a 22 in the IJ and just tape it down. but i wonder how many manufacturers just wont sell them the equipment, much like how Propofol manufacturers refuse to sell it.
 
I also wonder (but dont even want to find out) what type of equipment they use. not to give any ideas, but how hard is it to train someone to put a u/s probe on a neck and put at minimum a 22 in the IJ and just tape it down. but i wonder how many manufacturers just wont sell them the equipment, much like how Propofol manufacturers refuse to sell it.


It’s a personnel/expertise/competence issue. Not an equipment issue.

 
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I also wonder (but dont even want to find out) what type of equipment they use. not to give any ideas, but how hard is it to train someone to put a u/s probe on a neck and put at minimum a 22 in the IJ and just tape it down. but i wonder how many manufacturers just wont sell them the equipment, much like how Propofol manufacturers refuse to sell it.
No one's getting an IJ into an awake patient who doesn't want it.
 
Another oops. IV infiltration?

Seems like some states are technically incapable of carrying out lethal injection so why not shoot her in the head like Kristy Noem’s GWP or behead her?



Lethal injection seems too intellectually difficult for your average corrections officer/agent/ government official.

Unless you can get a physician involved states shouldn't even bother with lethal injection. Too many variables at play for low IQ individuals.

Gas chamber
Hanging
Electric chair
Firing squad

All effective and easier to carry out.

Heck, the guillotine is simple and effective.