One of at least seven needles inserted into the arm of a death row inmate during a botched execution attempt appeared "bent" when removed, according to her lawyers.
Warning: This story contains details that may be distressing for some readers.
Christa Pike, 50, remains in hospital on a ventilator and unconscious according to the latest court filing, after surviving two doses of the lethal injection drug pentobarbital.
Pike was sentenced to death in 1996 after the murder of another teenager, Colleen Slemmer, when she was 18 years old.
Witnesses to the execution reported Pike was still making noise and "very much alive" when the execution chamber was abruptly closed, and they were ordered to leave the Nashville prison on Wednesday night, local time.
Pike's lawyer, Randy Spivey, said her arm appeared to "turn purple" after the second dose of the sedative pentobarbital was injected.
"It is our understanding that there is some blistering and burning around the site of injection right now on her," he said.
"It took an hour to establish the [intravenous] IV lines … despite the fact Ms Pike was not just cooperative by trying to help instruct [the team].
"And she thanked them when … they thought they had established the line."
For Pike, a survivor of lifelong sexual abuse, how the execution unfolded was "her biggest fear", he added.
"That she would be pinned down, prodded, poked, cut for a prolonged period of time, during which she could be reliving her past trauma," he said.
"For a traumatised person to be put through this … no-one should have to do this."
A minute-by-minute timeline of Christa Pike's execution
At 6:41pm, local time, witnesses were led into an antechamber at Riverbend Maximum Security Institution in Nashville.
They were left waiting there for almost an hour, according to WKRN journalist Tori Gastner.
Ms Gastner, who has witnessed five Tennessee executions to date, rifled through her notes as she recounted the disorder in the execution chamber.
"We could hear a little crying and whimpering at times," she said.
The curtain opened at 7:26pm for Pike to say her last words, joined by her spiritual advisor.
She had been strapped down to the execution gurney and an IV line had been inserted into her right arm.
"She mentioned she was looking forward to being free," Ms Gastner said.
"They were singing … saying, 'I'll go in peace'.
It was unclear when Pike received the first dose of the drug, but witnesses said she told staff her arm was "really throbbing".
At 7:37pm, Pike took "four separate significant breaths" deep enough to see her body rising off the gurney.
At 7:39pm, she lifted her head and looked at the IV.
She continued making movements and sounds for several more minutes.
At 7:46pm, the curtains between the witness room and the execution chamber were closed again, presumably to administer the second dose of pentobarbital.
At 7:49pm, they opened again, and Pike was still moving, making sounds and at times rising from the gurney.
The curtain was "abruptly" closed for a second time at 8:05pm.
Witnesses sat listening to loud breathing and "snoring" for almost 50 minutes before the microphone to the chamber was cut off.
They were then ordered to leave the area by the prison warden.
Tennessee's practice injections and a history of botched executions
A redacted copy of state protocol, published by the Death Penalty Information Center, says prison officials should have been practising for this moment at least twice a week since last month.
That same protocol calls for four syringes, two containing saline solution and two containing pentobarbital, to be administered as part of "Primary Set A".
The saline solution keeps the IV lines open before the pentobarbital is administered.
A back-up "Set B" dose was only to be prepared if the inmate was not deceased after Set A was administered.
Pike's lawyers have said they witnessed at least seven syringes being inserted at different times throughout the process.
The protocol does not say what happens if neither dosage is successful.
Pike's was the second botched execution in Tennessee this year, after officials failed to establish an IV line during the execution attempt of inmate Tony Carruthers.
Tennessee updated its execution protocol in 2025, having hired Commissioner Frank Strada in 2023 to oversee the upgrade.
While many states use a three-drug lethal injection method, at least 10 states, including Tennessee, use a single pentobarbital method.
Mr Strada had previously overseen executions in another of those states, Arizona.
In 2022, Arizona saw three "visibly problematic" executions drawn out because of difficulties inserting IV catheters.
Each of the three was defined as "botched" by the Death Penalty Information Center.
According to Kit Thomas, an assistant federal defender in Tennessee, those failed attempts were "eerily similar" to the botched execution of Carruthers.
In a 169-page "briefing packet", Ms Thomas alleged new Tennessee protocol had relaxed standards and "recycled" language from previous Arizona protocol.
On Thursday, Tennessee Governor Bill Lee faced questions about Mr Strada, but pushed back, saying staff followed procedure "so far as we know".
Tennessee Department of Correction officials said in a statement their staff followed protocol, which they noted had been "consistently" effective.
Four executions have been carried out since new protocol was put in place and the practice was resumed last year.
Two so far have been botched, and executions have again been paused for the rest of 2026.
A second execution attempt not impossible for Tennessee
Tennessee could still have the option to try and execute Pike a second time, according to legal experts.
The governor has called for a comprehensive third-party review of the execution to understand what went wrong.
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Pike's legal team called on the state to commute her sentence following the incident.
Surviving the injection was "very rare", Maya Foa, chief executive of international human rights group Reprieve, told the ABC.
"If her brain was starved of oxygen during this process, which it may have been, she could have suffered brain damage," she said.
"The pentobarbital can cause kidney damage. It's a massive overdose.
"Whether that means she is fit, as they say in the US, to stand execution or not will be something that all her lawyers will be watching very, very closely for."
Pike has not been granted a one-year reprieve, as in the case of Carruthers, who will again face execution once that time period has expired.
"And that an independent review may well not lead to a fundamental change in their approach to capital punishment.
"But we have to hope that this time it will be different."
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Pike's lawyers had raised concerns about a blood condition and "small veins" which would have made lethal injection more risky.
"Last night was not just inefficient; it was cruel, and it was torturous," Mr Spivey said.
"It was also predictable."
Pike's condition remained unclear.
