The same doctor was involved in two Tennessee execution attempts that did not reach their intended outcome this year, intensifying scrutiny of the state's lethal injection system after Christa Pike remained alive following Wednesday night's procedure.
Dr Mark Fowler was involved in the May attempt to execute Tony Carruthers and was identified in court proceedings as having a medical role in Pike's procedure on Wednesday, 30 September. The circumstances were different: Carruthers never received the execution drug after problems establishing the additional intravenous access required by Tennessee's protocol, while Pike received pentobarbital but survived.
Tennessee Governor Bill Lee has now ordered a comprehensive third-party review and halted the state's remaining execution scheduled for 2026.
Same Doctor Was Involved Months Earlier
Fowler's involvement had attracted scrutiny before Pike's scheduled execution.
In May, medical personnel successfully established a primary IV for Carruthers but were unable to establish the required backup line. Fowler subsequently attempted to establish central venous access, but that effort was also unsuccessful.
Lee eventually halted the execution before later granting Carruthers a one-year reprieve.
Fowler acknowledged in an October 2025 deposition that he had not performed a central-line procedure in more than a decade after leaving emergency-room work.
None of those circumstances establishes that Fowler was responsible for the outcome of either procedure.
Pike Remained Alive After Pentobarbital
Pike's execution had already been delayed by last-minute legal challenges.
The Sixth Circuit temporarily stayed the execution. Tennessee sought emergency intervention from the US Supreme Court, which subsequently lifted the stay and allowed the procedure to proceed that evening.
BREAKING: Christa Pike’s lawyers asked a federal court to stop her execution. They say she was given two shots of pentobarbital but is still alive.
— Sarah Fields (@SarahisCensored) October 1, 2026
They wrote that she is not unconscious, still has a heartbeat, and is snoring.
The motion was filed in U.S. District Court in… pic.twitter.com/aiozHO6SQC
According to an emergency filing from Pike's lawyers, the procedure began at around 8pm Central Time. Pike received two syringes containing pentobarbital and remained alive afterwards. Her attorneys provided additional details about the procedure, while witnesses described hearing what sounded like snoring as curtains covering the viewing area were repeatedly closed.
Those observations do not establish why the procedure failed to produce its intended outcome.
The Tennessee Department of Correction said it followed every step of the state's lawful established protocol. It added that the protocol did not permit additional procedures beyond those already performed.
Pike was subsequently transported to an outside medical facility.
Tennessee's Protocol Faces New Scrutiny
Concerns about Pike's procedure had been raised before Wednesday. Her lawyers had argued that a condition affecting her veins could complicate intravenous access and challenged the involvement of medical personnel following the Carruthers attempt.
More than 40 Tennessee doctors and nurses had also previously urged Lee to pause executions and reconsider the protocol, raising concerns about medical participation and professional ethics. Those concerns do not establish what caused the outcome of Pike's procedure or assign responsibility to Fowler or any other individual involved.
Lee's independent review will now examine what happened before Tennessee proceeds with further executions.
The two cases involved substantially different problems. Carruthers' procedure stopped before the execution drug could be administered after staff were unable to establish the required additional IV access. Pike received pentobarbital but remained alive.
Within five months, however, two execution attempts involving the same physician did not reach their intended outcome. Exactly why Pike survived, what role the state's procedures played, and whether Tennessee's lethal injection protocol requires changes remain questions for the independent review.
