Christa Pike: What is agonal breathing, and pentobarbital drug as Tennessee death row inmate survives execution

Christa Pike, Tennessee's only woman on death row, remained alive after executioners administered two injections of lethal-injection drugs Wednesday night, according to her lawyers, in an extraordinary development during the state's attempt to carry out her execution.

Christa Pike survives execution after 2 lethal injections. (X/@DavidB92801)Pike's attorneys said in a federal court filing that she had not lost consciousness and still had a heartbeat after the injections. Witnesses also reported that Pike was snoring and appeared to complain of pain during the procedure, according to NBC News.

Tennessee's current lethal-injection protocol uses the single drug pentobarbital. The Tennessee Department of Correction says the state revised its protocol in 2024 to use pentobarbital alone.

Agonal breathing refers to abnormal, irregular gasping or labored breathing that can occur when the body is severely deprived of oxygen or during the dying process. It can sometimes sound like gasping, snoring or choking.

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Importantly, agonal breathing does not necessarily mean that a person is conscious or experiencing pain. It is an involuntary physiological response that can occur when the brain and body are shutting down.

In Pike's case, NBC News reported that witnesses heard her snoring after the lethal-injection drugs had been administered. Her lawyers said she remained conscious and had a heartbeat. Whether the breathing observed during the attempted execution was medically classified as agonal breathing has not been established in the reporting available so far.

Pentobarbital is a barbiturate that depresses activity in the central nervous system. At sufficiently high doses, it can cause profound unconsciousness followed by suppression of breathing and, ultimately, cardiac arrest.

Tennessee says its revised execution protocol uses pentobarbital as a single drug, replacing the state's earlier three-drug protocol. The Tennessee Department of Correction announced the revised protocol in December 2024.

The state says the revised procedure was developed after a comprehensive review and in consultation with the Tennessee Attorney General's Office.

Pike's lawyers had challenged Tennessee's use of pentobarbital before her scheduled execution, arguing that the drug could cause serious complications under certain circumstances.

A federal court filing containing expert evidence in Pike's case raised concerns about pulmonary edema, a condition in which fluid accumulates in the lungs. The filing cited an expert opinion that pulmonary edema could cause severe pain if it occurred while a person remained conscious.

The state's position has been different. The Death Penalty Information Center reported that Tennessee argued pentobarbital would induce unconsciousness before serious pain could be registered and that Pike's veins were accessible.

Pike's execution process began after the U.S. Supreme Court cleared the way for Tennessee to proceed following a series of last-minute legal challenges.

According to NBC News, witnesses said two syringes of lethal-injection chemicals were administered. Pike was reportedly still breathing and had a heartbeat afterward. An ambulance was also seen arriving at the prison and later leaving.

Her lawyers subsequently filed an emergency motion seeking to halt the execution and provide lifesaving measures.

Asmi is a Senior Content Producer primarily covering stories related to NRIs, immigration, visas, citizenship and global mobility. She closely follows developments that affect Indians living, working and studying abroad, with a particular focus on translating complex policies and international developments into clear, accessible stories for readers. As part of the US Desk, Asmi also reports on a wide range of political, economic and social developments in the United States, exploring their relevance to Indian and global audiences. Her work spans breaking news, features, trends and explanatory stories, with an emphasis on accuracy, timely reporting and audience-focused storytelling. Asmi likes finding the human angle behind major developments and bringing context to stories that can often feel complicated or distant. She is especially interested in stories around immigration, life abroad, careers, education and the experiences of the Indian diaspora, while also exploring a wide range of topics that spark curiosity and conversation. Outside the newsroom, Asmi is an avid reader and loves travelling, discovering new places, experiencing different cultures and collecting stories along the way.Read More