The last time Florida carried out an execution, witnesses said the condemned man — Eric Branch — screamed and thrashed as lethal chemicals coursed through his veins.
Whether Branch's final acts that February night were theater or a response to severe pain has fueled new death row appeals in the 10 months since.
When the brown curtain rises once again inside the state's death chamber Thursday night, whatever follows will surely be scrutinized in what is a long-running debate over the state's lethal injection methods.
Barring an unlikely last-minute stay, Jose Antonio Jimenez will be strapped to a gurney at 6 p.m. and injected with a lethal combination of chemicals. Jimenez, 55, was condemned for the 1992 stabbing of 63-year-old Phyllis Minas, a court clerk slain after she caught Jimenez burglarizing her North Miami apartment.
Like other recent death penalty cases, Jimenez's final appeals have attacked the state's current lethal injection protocol.
Florida is the only state that uses etomidate as the lead drug in its executions. Critics say the drug is capable of causing severe pain — that it doesn't last long enough to ensure the prisoner won't feel the excruciating effects of the other two drugs in Florida’s execution cocktail.
The state’s old combination of execution drugs included a drug known as midazolam.
In recent years midazolam has become difficult to acquire for use in executions; pharmaceutical companies refuse to sell such products to prison agencies in states that have the death penalty.
In January 2017, Florida adopted what has been referred to as the etomidate protocol. In a letter to Gov. Rick Scott that month, Department of Corrections Secretary Julie Jones wrote that the procedure "is compatible with the evolving standards of decency that mark the progress of a maturing society, the concepts of the dignity of man, and advances in science, research, pharmcology and technology."
"The process will not involve unnecessary lingering or the unnecessary or wanton infliction of pain and suffering," Jones wrote.
Classified as a hypnotic, etomidate is administered in a massive dose designed to render the condemned inmate unconscious. After that comes rocuronium bromide, a paralytic meant to stop all movement and, ultimately, cause the subject to stop breathing. The final drug, potassium acetate, disrupts electrical activity in the heart, bringing on cardiac arrest.
"In general, the use of etomidate is a terrible idea," said Dr. David Lubarsky, an anesthesiologist and the vice chancellor of human health sciences at the University of California-Davis.
Lubarsky is one of several doctors who have weighed in on the effects of etomidate as part of the ongoing legal challenges to Florida's execution procedures.
"The pain from etomidate is significant, real pain," Lubarsky wrote, "and the prisoner will feel it at the injection site and will continue to feel it as the entire 200 mg of etomidate is pushed into his veins or until he loses consciousness."
The doctor also wrote that etomidate is "ultra short-acting," that there is a substantial risk that it could wear off as the second and third drugs are administered. Any pain caused by those drugs would likely be masked by the second drug, rocuronium bromide, which renders the prisoner immobile.
The prisoner would experience a sensation “akin to being buried alive," Lubarsky wrote.
Four Florida prisoners have been executed using etomidate. Subsequent court filings have noted signs of movement during some of the executions.
But lawyers for the state said that there is no evidence that any of the four felt any significant pain. That includes Eric Branch.
"There were no irregularities in Branch's execution," Assistant Attorney General Lisa-Marie Lerner wrote in a court filing as part of the Jimenez case. "If there had been, the state would have conducted an inquiry into the execution."
Lethal injections have gone wrong before. In 2007, it took 34 minutes for Angel Nieves Diaz to be pronounced dead. Observers reported that he was still moving 24 minutes after the execution started and that he had to be given a second dose of the deadly chemicals.
Then-Gov. Jeb Bush ordered a temporary halt to executions and convened a panel to study the procedures. It was later revealed that the execution team had improperly placed the intravenous line in Diaz's arm, causing the deadly chemicals to saturate his flesh.
If Jimenez's execution takes place as planned, it will be the 28th carried out under Scott. He will leave office having presided over more executions than any governor in Florida history.
His successor, Republican Ron DeSantis, takes office Jan. 8.
Contact Dan Sullivan at firstname.lastname@example.org or (813) 226-3386. Follow @TimesDan.