What Happened to Tony Carruthers Is Horrifying

Used needles clinked into the plastic medical-waste bin in the death chamber at Riverbend Maximum Security Institution in Nashville. Tony Carruthers was strapped to a gurney for his scheduled execution on May 21, but as his attorney Maria DeLiberato watched the medical team repeatedly try and fail to access her client’s veins, she knew something was going terribly wrong. The medics whispered and gestured to one another. One asked for bigger needles, then smaller ones. Another grunted softly while shoving needles into Carruthers’s arm. DeLiberato, who had entered the chamber when the process began at 10:22 a.m., noticed the wall clock said it was 10:54. Carruthers’s breathing was labored and much of the color had drained from his dark skin.

“How long do you let this go on?” she asked the prison warden. “Until they tell me they can’t,” he said.

DeLiberato left the chamber to call Carruthers’s other attorneys and tell them what was happening. When she returned minutes later, the execution was still dragging on. The worst was yet to come.

Carruthers, 57, who has always maintained his innocence, was convicted in 1996 for his role in the February 1994 kidnapping and murder of three people: Marcellos Anderson, a drug dealer and friend of Carruthers’s; Anderson’s mother, Delois; and Anderson’s friend, 17-year-old Frederick Tucker. All three were abducted from Delois’s home in Memphis and were discovered a week later, shot and buried together in a local graveyard; they had been bound with cloth, socks, and pantyhose. Prosecutors relied on the allegations of paid informants to charge Carruthers and two brothers, James and Jonathan Montgomery, with murder, alleging that they sought to rob Marcellos and assert dominance in the neighborhood. The prosecutors, seeking the death penalty, would also allege that the victims had been buried alive. Police recovered no forensic evidence linking Carruthers to the crimes.

Instead, prosecutors relied on the testimony of Alfredo Shaw, a convicted felon, to secure an indictment. Shaw claimed that in 1993, Carruthers and two other men had pressured him on two occasions to help carry out a murder-for-hire plot. But Shaw, a regular police informant, publicly recanted his claims before Carruthers’s trial began in 1996, saying that prosecutors had paid him to use police files to conjure up a credible tale for the grand jury.

Carruthers, whose appellate lawyers say has a schizoaffective disorder that leads to extreme paranoia, ended up representing himself at trial, having alienated no fewer than eight public-defense attorneys with his paranoid delusions. After Carruthers’s last attorney withdrew from the case, the presiding judge denied Carruthers additional representation. “This is the situation that you’ve created,” the judge said. “And you’re going to have to do the best you can.”

Prosecutors had lost a key witness: Shaw. And they failed to produce any DNA, fingerprint, or eyewitness evidence linking Carruthers to the crimes, according to the appellate lawyers. But Carruthers, who had no legal training, sabotaged his defense with a predictably appalling performance in court. He asked witnesses the same questions over and over, failed to object to misstatements of fact, and often spoke so softly that the jury could not hear him. More damning still, Carruthers did not call to the stand a medical examiner who had evidence that challenged the prosecution’s claim that the victims had been buried alive. Carruthers’s defense was so mangled that jurors wrote notes to the judge questioning his capacity to represent himself. “Judge Dailey,” one note read, “Mr. Carruthers has been scratching or pulling around his groin when facing the jury. We find this very offensive and distracting.”

[Elizabeth Bruenig: Donald Trump dreams of more executions]

The jury found him guilty, and sentenced him and James Montgomery to death. (Jonathan Montgomery killed himself while in jail.) Montgomery successfully appealed his verdict on the grounds that Carruthers’s courtroom behavior had deprived his co-defendant of his right to a fair trial. Montgomery then took a plea deal that massively reduced his sentence; he was released from prison in 2015. Carruthers has meanwhile languished on death row. His appellate lawyers, including DeLiberato, have pushed for the courts to consider DNA evidence recovered from the crime scene that could exonerate him.

Lethal injection has been the preferred method of execution in the United States for decades. With its veneer of medical professionalism, the procedure has long been billed as a more humane and consistent alternative to hanging, gassing, or electrocution. Conceived in 1976 by a couple of physicians in Oklahoma, lethal injection began as a three-drug protocol: a sedative, a paralytic, and a drug that stopped the heart. But even as the practice has evolved and streamlined in some places into two- and one-drug protocols, the drugs themselves have become harder for corrections departments to come by. A growing number of pharmaceutical companies and international distributors have expressly banned the use of their products for capital punishment, owing to ethical concerns.

Lethal-injection protocols vary by state, but they generally require execution squads to place two intravenous lines in a prisoner’s body, a primary line for introducing the drugs, and a secondary one if the primary line fails, whether because the first needle punctures through the vein and leaches chemicals into the surrounding tissue or because the IV line becomes blocked. Despite this precaution, execution teams frequently fail.

In 2022, Alabama botched three executions in a row. First came Joe Nathan James, whom the state apparently tried to fit with IV catheters inserted in each of his arms and hands, and a foot, resulting in broad smears of violet bruising and odd cuts in his arms. The state was evasive about what had happened, but an independent autopsy found that he had likely suffered a long and torturous death. Alabama then attempted to execute Alan Miller, piercing his veins for more than an hour without success, until the execution was finally called off. (The state then used nitrogen hypoxia to successfully asphyxiate him in 2024.) Undeterred, the state then attempted to execute Kenneth Smith, which involved medical staff once again fecklessly missing the veins in his arms only to stab him in the chest with a large surgical needle. Smith’s execution concluded in failure, too, and Alabama Governor Kay Ivey instituted a brief moratorium on executions to allow for an internal investigation into the state’s protocol, the results of which were never revealed to the public.

Tennessee has similarly struggled with lethal injection. In 2018, the state adopted the use of a three-drug lethal-injection cocktail including midazolam, a benzodiazepine intended to render prisoners unconscious before execution. But autopsies of prisoners killed with cocktails that included midazolam have revealed the presence of pulmonary edema, the sudden flooding of the lungs with fluid, which some argue is akin to waterboarding as opposed to mere sedation. Midazolam’s effectiveness as a sedative is also unclear. In 2014, the state of Oklahoma injected a drug cocktail including midazolam into a prisoner named Clayton Lockett, who woke up and began thrashing and crying out, then died of a heart attack after a 45-minute ordeal. Five Tennessee prisoners subsequently elected to die via electrocution instead.

In 2022, Tennessee Governor Bill Lee announced a moratorium on executions an hour before the scheduled killing of a prisoner named Oscar Smith. Lee’s office explained that in response to an inquiry from Smith’s attorney, prison authorities had learned that the drugs to be used in Smith’s execution had not been tested in accordance with the state’s protocol, specifically for the presence of endotoxins, a byproduct of bacterial contamination, which can trigger severe physiological distress. An independent investigation found that the state had consistently failed to test its drugs for potency and the presence of endotoxins, and had relied on an unnamed executioner with no medical training. Lee made staffing changes at the Department of Corrections, which then adopted a single-drug protocol using pentobarbital, the same method used by the federal government. Tennessee resumed lethal injections last year, first executing Oscar Smith in May, then Byron Black in August, and Harold Nichols in December. Tony Carruthers was up next.

As time passed in the death chamber with Carruthers, DeLiberato’s panic began to rise. A man then entered the room, introduced himself as Dr. Mark Walton Fowler, and began directing the execution staff to seek suitable veins in Carruthers’s feet.

The execution staff went on to puncture his feet without tapping a vein, and Carruthers was clearly in pain. Fowler then asked aloud if anyone in the room knew how to access the jugular. Jugular access? DeLiberato wondered. He’s going to bleed out on the table. But Fowler, who did not return requests for comment, apparently thought better of it. Instead, he said, they were going to set a central line, a more invasive procedure to access a vein in the neck, chest, or groin.

[Elizabeth Bruenig: Tortured to death in Alabama]

Joel Zivot, an anesthesiologist and intensive-care specialist at Emory University School of Medicine, told me that setting a central line is a delicate, dangerous process that can be safely carried out only in a sterile hospital setting. Zivot explained that locating the deep internal veins for a central line requires an ultrasound. A mistake could easily lead to air embolisms, collapsed lungs, or fatal bleeding.

DeLiberato objected to the procedure, arguing that Fowler was not qualified to perform it. She had learned that he had admitted in a 2025 deposition that he had not set a central line since 2013 and that he lacked hospital-admittance privileges, meaning he had not been approved by a hospital board to carry out complex procedures. Medical organizations typically prohibit members from participating in state-sanctioned executions because it contradicts the medical duty to “do no harm.” As a result, the physicians who tend to be involved may have inadequate training for the job.

“I am qualified,” Fowler insisted.

DeLiberato watched him inject Carruthers with lidocaine, a local anesthetic commonly used during dental procedures. Fowler then began poking Carruthers’s chest with a scalpel, asking if he could feel it.

Yes, Carruthers said. “It hurts. It hurts.” DeLiberato then watched Fowler push the blade of the scalpel all the way in. Carruthers groaned and grunted so loudly that journalists on the other side of the wall could hear him. Fowler had failed to reach the vein he was looking for, so he pulled the scalpel out and stabbed Carruthers again in another place. Blood was streaming down Carruthers’s chest, which Fowler mopped up as he worked.

Finally Fowler admitted defeat. “I can’t,” he said, according to DeLiberato. “I can’t set a central line.”

But the execution staff was not ready to give up on killing Carruthers. Instead, they tried again to find a vein in Carruthers’s arm, this time near his armpit. DeLiberato saw blood backfilling the tube, and she wasn’t sure whether they had actually established sufficient venous access. For several moments, she wondered whether the execution would actually go ahead, with Carruthers now pale, clammy, bleeding, and in pain. (In an NBC interview earlier this month, Fowler said that “every attempt was made to minimize the defendant’s discomfort in the case at hand.”)

Then the phone in the execution chamber rang, and the prison’s warden answered, listened, and then hung up. More than an hour after the grueling process had started, the warden announced that the execution had been called off. Having learned about the medical staff’s ineptitude from Department of Corrections officials, Governor Lee granted Carruthers a year’s reprieve.

When one of Carruthers’s attorneys reached out to notify his family in Memphis that the execution had been canceled, Carruthers’s sister Tonya at first believed that her brother had been spared by divine intervention. She told me she felt otherwise after hearing from a brother who had visited the typically upbeat Carruthers and found a hollow, shaken man, he had limped and struggled to use his arm and hand in a way that suggested that he might have suffered a stroke on the gurney.

Stories like this, which undermine claims about the humanity of state-sanctioned killing, have compromised public support for the death penalty. Juries around the country are mostly handing down fewer death sentences year over year. But as the practice loses public support and alienates trained medical professionals, the executions that do move forward are likely to be more brutal still, the preserve of vengeful politicians and feckless medics. America’s controversial practice of punishing mercilessness with mercilessness may one day come to an end, but there’s little question that the end will be bloody.