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Dr Teresa A. Zimmers, research assistant professor of surgery at the Miller School of Medicine and lead author of the report.

Dr. Mark Dershwitz, a professor of anesthesiology at the U. Mass Medical Center told HRW there is a better way

Last October, the American Society of Anesthesiologists issued an advisory warning that the risk of experiencing awareness during surgery increases when the patient has a history of substance abuse and when the anesthesia is administered intravenously, an action noted in the Human Rights Watch report.

Thiopental is an ultra-short acting barbiturate and is most commonly used in the induction phase of general anesthesia. Following intravenous injection the drug rapidly reaches the brain and causes unconsciousness within 30–45 seconds. At one minute, the drug attains a peak concentration of about 60% of the total dose in the brain. Thereafter, the drug distributes to the rest of the body and in about 5–10 minutes the concentration is low enough in the brain such that consciousness returns.

On December 13, 2006, Angel Nieves Diaz was not executed successfully in Florida using a standard lethal injection dose. Diaz was 55 years old, and had been sentenced to death for murder. Diaz did not succumb to the lethal dose even after 35 minutes, he required a second dose of drugs to complete the execution. At first a prison spokesperson denied Diaz had suffered pain and claimed the second dose was needed because Diaz had some sort of liver disease.^[22] After performing an autopsy, the Medical Examiner, Dr. William Hamilton, stated that Diaz’s liver appeared normal, but that the needle had been pierced through Diaz’s vein into his flesh. The deadly chemicals had subsequently been injected into soft tissue, rather than into the vein.^[23] Two days after the execution, Governor Jeb Bush suspended all executions in the state and appointed a commission “to consider the humanity and constitutionality of lethal injections.”^[24]

Anesthetic - Sodium thiopental, which has the trademark name Pentothal,

The three chemicals used for lethal injections are sodium thiopental, which renders a person unconscious; followed by Pavulon, which paralyzes the muscles, including those that control breathing; followed by potassium chloride, which causes cardiac arrest. Lawyers have argued that the second drug could be eliminated and that a less painful drug could be substituted for the third.