Christa Pike is the first person ever to survive two lethal injections — here’s how

Christa Pike has survived the lethal injection (Picture: Knoxville News Sentinel-USA TODAY NETWORK) Christa Pike’s failed death row execution in Tennessee has sparked an internet firestorm after she survived not one, but two, lethal injections. She was due to be the first woman put to death in that state in 206 years, after she tortured and killed a fellow student, Colleen Slemmer, in 1995. The 50-year-old was taken to hospital after she was heard snoring behind the closed curtain, despite the attempted execution. Her survival has been dubbed ‘singular and unparalleled’ by Robin M Maher, executive director of the Death Penalty Information Center. Nine men have also survived their execution dates in the past 80 years, the most recent being Tony Carruthers, who was sentenced to death for a 1994 triple murder. His execution failed on May 21, 2026, after there were no suitable veins left to secure a ‘back up line’ which is a lethal injection protocol. But, none of those who survived actually had a lethal dose administered, until Christa. We spoke to a doctor to try and find out why. What is a lethal injection? GP Dr Nikki Ramskill tells Metro that there actually isn’t one universal lethal injection combination, because different states use different protocols. ‘Traditionally, some executions have involved three drugs: first a sedative or anaesthetic to make the person unconscious, then a neuromuscular-blocking drug which paralyses the muscles, including those needed for breathing, and finally a potassium-based drug which disrupts the electrical activity of the heart and causes cardiac arrest and ultimately death,’ she explains. To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video However, in Christa’s case, this reportedly wasn’t what was used. Ask Metro Use AI to go deeper into the stories you care about – powered by Metro and trusted publications. ‘Tennessee currently uses a single-drug protocol involving pentobarbital, a powerful barbiturate,’ Dr Ramskill adds. Christa’s lawyers said she’s been administered two doses of this drug, which ‘suppresses activity in the central nervous system’, according to the doctor. ‘At therapeutic doses, barbiturates cause sedation, but in a sufficiently large overdose that suppression ultimately causes death,’ she adds. ‘The person can progress from deep unconsciousness into coma, with severe suppression of the brain centres controlling breathing. ‘Blood pressure can fall and cardiovascular function can become compromised. Ultimately, respiratory arrest, circulatory collapse and death can occur.’ Dr Ramskill, The Female Health Doctor, points out that responses to barbiturates are ‘not completely predictable’. ‘The toxic dose can vary considerably between individuals,’ she explains. How could someone survive a lethal injection? When it comes to how Christa survived two doses of pentobarbital, Dr Ramskill says it’s a ‘fascinating and medically important question’. ‘I don’t think anybody can responsibly give a definitive explanation for Christa Pike’s survival,’ she says. ‘If a dose expected to be fatal has genuinely been administered intravenously and somebody survives, you would need to investigate the entire process, not simply assume that their body was somehow unusually resistant to the drug.’ Questions or possibilities raised would include whether the full intended dose actually entered her circulation, and whether the IV access was done correctly. Christa Pike at the time she was sentenced to death in 1996 (Picture: WBIR-TV via AP) ‘If an IV line is not functioning correctly, for example, some medication can enter the tissues surrounding the vein rather than reaching the circulation as intended,’ Dr Ramskill says. Speculatively, there could’ve been an issue with the concentration and potency of the drug, it’s preparation and storage, as well as the speed it was administered, according to the GP. There’s also a possibility that how the drug was metabolised could’ve played a part, but she adds that ‘it would be premature to say that Christa survived because her body metabolised the drug unusually quickly’. ‘That would require proper medical and toxicological evidence,’ Dr Ramskill says. Could any medical conditions affect the drug? In short, not really. ‘There isn’t a recognised medical condition that would make somebody reliably “immune” to a massive pentobarbital overdose,’ she admits. That being said, if someone has had barbiturates administered in the past, Dr Ramskill suggests there could be some level of tolerance to the drug, while your body composition and liver function could also influence how the body responds. ‘But, those factors shouldn’t be used to explain this particular case without evidence,’ she adds. ‘Surviving an execution dose would be extraordinarily unusual.’ What now? Tennessee Governor Bill Lee has ordered an investigation into what happened in Christa’s case. Christa Pike was set to be the first woman executed in Tennessee in more than 200 years(Picture: Tennessee Department of Corrections) ‘Carrying out a lawfully imposed sentence is among the State’s most serious responsibilities, and the people of Tennessee expect it to be done in a manner that is not only legal and constitutional, but is effective,’ Lee said. ‘I have ordered a comprehensive, third-party review to determine exactly what occurred.’ A statement by the Tennessee Department of Correction claimed it ‘followed every step of the state’s lawful, established execution protocol approved by the Attorney General’s Office’. Christa is currently being treated in hospital but Dr Ramskill says surviving the initial administration of the drug ‘doesn’t mean somebody is out of danger’. ‘A person with profound barbiturate poisoning would still need urgent hospital assessment and monitoring because respiratory depression, low blood pressure, coma and other complications can be life-threatening,’ she says. Deals of the Day Kurt Geiger's new Notting Hill collection is a love letter to London's chaotic weather I’ve found the Hoover gadget that could make cleaning your floors so much easier I tried L'Oréal Paris's new PDRN serum and my skin looked glossier after one use This new Cricut gadget turns your favourite photos into stickers in minutes From kitchen hatches to burgundy walls – the biggest home trends for 2027 ‘Until toxicology, the precise administration records and the findings of the investigation are available, I think the medically accurate answer to why she survived is that we just don’t know enough yet.’ Do you have a story you’d like to share? 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