Opinion ID: 204393
Heading Depth: 3
Heading Rank: 2

Heading: constitutionality of the protocol

Text: We next turn to Dickens's argument that questions of fact remain as to the Protocol's constitutionality, even under the substantial risk standard. We begin by noting what Dickens is not arguing: by and large, Dickens is not arguing that the Protocol's safeguards are inadequate. Although Dickens urges that Arizona should be required to adopt some additional safeguards, the heart of his argument is that questions of fact remain as to whether Arizona will follow the Protocol and ensure that its existing safeguards are implemented properly. Dickens claims that evidence obtained during discovery suggests that Arizona is incapable ofor not interested inhiring competent individuals to serve on the execution teams and adhering to the Protocol's procedures during an execution. If Arizona does not follow the Protocol, Dickens contends, there is a substantial risk that he will be inadequately anesthetized when the pancuronium bromide and potassium chloride are administered. Baze does not foreclose Dickens's argument. Baze creates a safe harbor for lethal injection protocols that are substantially similar to Kentucky's protocol; the plurality states that such protocols do not create a substantial risk of serious harm. Id. at 61, 128 S.Ct. 1520. Arizona's Protocol falls within this safe harborit incorporates even more safeguards against maladministration than Kentucky's protocol, including requirements that the Medical Team monitor the inmate with a microphone and camera and physically confirm unconsciousness. See Baze, 553 U.S. at 55, 128 S.Ct. 1520 (describing the safeguards in the Kentucky protocol). Dickens, however, asks us to look beyond the Protocol's facial constitutionality to consider whether there is a substantial risk that it will be implemented in an unconstitutional manner. In Baze, the plurality specifically stated that there was no evidence of improper implementation of Kentucky's protocol. Id. at 46, 128 S.Ct. 1520. Dickens asserts that there is such evidence here, and we must evaluate the Protocol in light of Dickens's evidence. This is an important inquiry. If a court could never look beyond the facial constitutionality of an execution protocol when presented with evidence of improper administration, states could simply adopt constitutionally sufficient protocols similar to Kentucky's and then flout them without fear of repercussion. Nonetheless, to succeed on his argument, Dickens faces an uphill battle. Most of the evidence Dickens cites comes from events occurring before Arizona adopted the Protocol and its safeguards. For the evidence to affect our analysis, Dickens must raise issues of fact as to whether there is a substantial risk that he will be improperly anesthetized despite the Protocol's safeguards, including those added through amendment. See, Baze, 553 U.S. at 56, 128 S.Ct. 1520 (In light of [the protocol's] safeguards, we cannot say that the risks identified by petitioner are so substantial or imminent as to amount to an Eighth Amendment violation.). In addition, the evidence must show more than a single accident or mistake or failure to follow the Protocol. Although we do not discount in any way a singular violation or mistake, Baze held that an isolated mishap alone . . . while regrettable, does not. . . give rise to a substantial risk of serious harm. Id. at 50, 128 S.Ct. 1520 (internal quotations and citations omitted). Overcoming these evidentiary hurdles is not an impossible task, but it is a difficult one. See id. at 53, 128 S.Ct. 1520 (plaintiffs must meet the heavy burden of showing that Kentucky's procedure is cruelly inhumane) (internal quotations and citation omitted). Indeed, since Baze, every circuit court that has considered a challenge to a lethal injection protocol has upheld the challenged protocol, despite evidence of past problems carrying out executions. See Raby, 600 F.3d at 558-61 (evidence of problems with inserting IVs and monitoring); Nooner, 594 F.3d at 601, 608 (evidence that inmates may have been conscious during second injection); Jackson, 594 F.3d at 212-13, 229 (evidence that wrong amounts of chemicals were administered and that personnel did not check equipment and attend training); Cooey, 589 F.3d at 217-18, 224, 233-34 (evidence of problems inserting IV); Clemons, 585 F.3d at 1125, 1128 (past employment of incompetent medical team personnel); Harbison, 571 F.3d at 537, 539 (evidence of hiring personnel with drug and mental health problems, and insufficient training); Emmett, 532 F.3d at 303, 306-08 (evidence of inadequate doses of sodium thiopental and problems with IV lines).
Dickens argues that past missteps in hiring and training raise an issue of fact as to whether Arizona will hire competent team members in the future. The evidence Dickens points to is Arizona's hiring of two unqualified MTMsDr. Alan Doerhoff and an individual known as MTM # 3and its failure to interview and screen a current member of the SOT and an MTM known as MTM # 1. Arizona hired Doerhoff to serve on the Medical Team for the Comer execution in May 2007. Doerhoff is a physician and licensed surgeon who lives in Missouri; he has assisted with executions in several states and for the federal government. At the time Arizona hired Doerhoff, he had testified in a case challenging Missouri's execution protocol that he is dyslexic, has problems with numbers, knowingly improvised the doses of lethal injection drugs, adhered to no set protocol, and kept no records of procedures. Following Doerhoff's testimony, Missouri publicly announced that it would no longer use him in executions. Arizona hired MTM #3 in February 2008. During discovery, Dickens learned that MTM #3 did not attend medical school, had his nursing license suspended, and did not have any other medical licenses. When he was hired for the Medical Team, MTM # 3 owned an appliance business. He has been treated for post-traumatic stress disorder from service in Iraq, and has been arrested multiple times. As one of the amendments to the November 1, 2007 protocol, Arizona agreed never to use Doerhoff or MTM # 3 in future executions. We do not question the challenges to Doerhoff and MTM # 3, nor do we reject the claim that a Medical Team made up of individuals like them could undermine the Protocol. At the time that Doerhoff and MTM # 3 were hired, however, there were neither formal experience and training requirements nor routine background and license checks on MTMs. These requirements are all amendments to the November 1, 2007 protocol that were adopted through the Joint Report. It is undisputed that neither Doerhoff nor MTM #3 would have been hired under the current Protocol. But the fact that Arizona hired unqualified MTMs before the Protocol was in place does not create an issue of fact as to whether Arizona will do the same when operating under the Protocol. [4] See Raby, 600 F.3d at 560 (evidence of past failure to follow protocol did not rise to the level of constitutional significance because the Execution Procedure mandates . . . that sufficient safeguards are in place to reduce the risk of pain below the level of constitutional significance); Jackson, 594 F.3d at 226 (evidence of failure to follow former procedures does not suggest the existence of conditions that are sure or very likely to cause serious illness and needless suffering) (internal citation and quotation omitted); Clemons, 585 F.3d at 1128 (The mere allegation Missouri employed [Doerhoff] in the past simply does not support the prisoners' allegations Missouri will employ `incompetent' and `unqualified' personnel in the future.). During discovery, Dickens also learned that Arizona failed to interview and screen MTM # 1 and a current member of the SOT. When MTM # 1 was hired in 2007, there were no interview or screening requirements for MTMs. Arizona was required to interview and screen the SOT member, and it failed to do so. One, isolated failure to follow a procedure does not create an objectively intolerable risk of harm, particularly where there is no evidence that the SOT member is unqualified for his job or that any problems have arisen from his participation on SOT. See Baze, 553 U.S. at 50, 128 S.Ct. 1520 ([A]n isolated mishap alone . . . while regrettable, does not suggest . . . a substantial risk of serious harm.) (internal quotation and citation omitted); Raby, 600 F.3d at 560 (possibility that warden had not screened execution team members did not raise issue of fact where no evidence that the team members lacked required qualifications). [5]
Dickens also contends that there were problems with administering the chemicals during Comer's execution. The records from Comer's execution indicate that the chemicals were administered more quickly than planned. The checklist setting forth each step of the execution states that the administration of the sodium thiopental should take approximately two minutes and forty-five seconds. The execution records, however, reflect that it took less than two minutes to administer. In addition, the SOT members administering the chemicals did not flush the line with heparin/saline between two of the injections. MTM # 1 caught the error before the second injection and instructed the SOT members to flush the line. Although we agree with Dickens that it is critical for Arizona to follow the procedures set forth in the Protocol when conducting an execution, the evidence from Comer's executionundertaken before the Protocol was in placeis insufficient to cast doubt on Arizona's ability or willingness to do so. Even construing the evidence in the light most favorable to Dickens, there is no indication that Arizona failed to follow the procedures in place at the time of the execution. Absent any evidence that Arizona failed to adhere to execution procedures in the past, it would be pure speculation to conclude that Arizona might fail to follow the Protocol in the future or even that a material issue of fact has been raised with respect to the effect of past compliance. See Emmett, 532 F.3d at 304 ([S]peculation and building of inferences [of improper administration]. . . is wholly insufficient to create a genuine issue of material fact that Virginia has a history of failing to properly administer full doses of thiopental. . . .). Since Comer's execution, Arizona also has adopted additional safeguards to reduce the risk of improper anesthetization. Team members must undergo extensive training, the MTMs must physically confirm unconsciousness and SOT must wait three minutes before the pancuronium bromide is injected. Even if the evidence suggested that Arizona's past execution procedures created a substantial risk of harm, that evidence, alone, would not establish an issue of fact as to whether such a risk exists under the Protocol. See Nooner, 594 F.3d at 602 ([E]ven if [Arkansas] engaged in a `series of abortive' execution attempts under previous protocols, the record does not establish a genuine issue of material fact about whether the Inmates will remain conscious . . . under the current protocol.). Finally, without dismissing the significance of any problems that might have occurred during Comer's execution, we are bound by Baze to hold that an isolated mishap . . . while regrettable, does not suggest . . . a `substantial risk of serious harm.' Baze, 553 U.S. at 50, 128 S.Ct. 1520 (quoting Louisiana ex rel. Francis v. Resweber, 329 U.S. 459, 67 S.Ct. 374, 91 L.Ed. 422 (1947) (upholding a second attempt to electrocute a prisoner after the first attempt failed)).
Dickens's remaining complaints regarding the adequacy of the Protocol's safeguards are unpersuasive. Dickens argues that Arizona should be required to add three safeguards to the Protocol: a requirement that an MTM have experience monitoring anesthetic depth (the depth of an inmate's unconsciousness following administration of the sodium thiopental); a requirement that all MTMs be screened for medical and psychological problems; and a requirement that at least one MTM have experience placing a percutaneous central line, in case it is necessary to resort to this back-up procedure during an execution. Baze counsels that an inmate cannot succeed on an Eighth Amendment claim simply by showing one more step the State could take as a failsafe for other, independently adequate measures. Baze, 553 U.S. at 60-61, 128 S.Ct. 1520. Where an execution protocol contains sufficient safeguards, the risk of not adopting an additional safeguard is too remote and attenuated to give rise to a substantial risk of serious harm. Id. at 58-59, 128 S.Ct. 1520. The Protocol contains more safeguards than the Kentucky protocol and there is no evidence that Arizona will fail to follow it in future executions. Accordingly, the risk that Dickens will be improperly anesthetized if Arizona fails to adopt the additional safeguards is too remote and attenuated to raise questions of fact as to the Protocol's constitutionality. Id.; see also Harbison, 571 F.3d at 537-38 (failure to require physical consciousness check and evidence of hiring personnel with drug problems and PTSD did not render protocol unconstitutional where there were sufficient safeguards to ensure proper anesthetization); Nooner, 594 F.3d at 604 (requirement that alternative central line be placed by licensed physician was sufficient to address risk that unqualified personnel will place line); Jackson, 594 F.3d at 227 ([B]y speculating about what [the] officials might do in what the record intimates to be the very unlikely hypothetical scenario in which the backup IV line cannot be established, the Plaintiffs have failed to show the degree of imminence Baze requires.). Dickens also challenges the Protocol's failure to provide formal procedures for amendment. If Arizona amends the Protocol to modify the current safeguards, Dickensor another affected death row inmatemay be able to challenge the constitutionality of the amended protocol. The notion that Arizona might adopt and use a new, unconstitutional protocol can only be dismissed as rank speculation.