Some pharmaceutical companies refuse to sell their products to states that have the death penalty, creating a struggle among many corrections agencies to obtain the drugs they use in executions.
But Florida seems to be having no trouble, judging from purchase invoices and drug supply logs obtained by the Tampa Bay Times.
As recently as July and August, the state Department of Corrections obtained new vials of etomidate and potassium acetate, two of the drugs in Florida's three-drug execution protocol.
"One of the things these records show us is that Florida is still able to obtain the drugs it needs," said Megan McCracken, at attorney at the Death Penalty Clinic at the University of California-Berkeley. "At a time when states are saying they can't get the drugs, it's clear that they (Florida) can."
Just how Florida manages to keep its supply flowing is an elusive question.
The records obtained by the Times are heavily redacted, hiding the identity of the supplier. This is permitted under a state law shielding anything that could identify people involved in executions.
On Thursday, Florida put to death Jose Antonio Jimenez - the fifth prisoner executed with the unique combination of drugs that begins with the sedative etomidate.
Jimenez, 55, was condemned for the 1992 stabbing of 63-year-old Phyllis Minas, a court clerk slain after she caught Jimenez burglarizing her North Miami apartment.
Corrections officials reported that his death occurred "without incident," but as the drugs were administered, Jimenez appeared to take numerous rapid, deep breaths and occasionally moved his head. The execution is sure to undergo scrutiny in what is a long-running debate over the state's lethal injection methods.Before Jimenez, there was Eric Branch, who screamed and thrashed on the death gurney, according to witnesses, as the lethal chemicals coursed through his veins. Whether Branch's final acts that February night were theater or a response to severe pain has fueled new death row appeals in the 10 months since.
Florida is the only state that uses etomidate as the lead drug in its executions. Critics say the drug is capable of causing severe pain and that it doesn't last long enough to ensure the prisoner won't feel the excruciating effects of the other two drugs in Florida's execution protocol.
The state's old combination of execution drugs included midazolam, a drug that in recent years has become more difficult to acquire from pharmaceutical companies for use in executions.
In January 2017, Florida made a change, adopting what has been dubbed the etomidate protocol. In a letter to Gov. Rick Scott that month, Corrections Secretary Julie Jones wrote that the procedure "is compatible with the evolving standards of decency that mark the progress of a maturing society, the concepts of the dignity of man, and advances in science, research, pharmacology and technology."
"The process will not involve unnecessary lingering or the unnecessary or wanton infliction of pain and suffering," Jones wrote.
Classified as a hypnotic, etomidate is administered in a massive dose intended to render the condemned inmate unconscious. After that comes rocuronium bromide, a paralytic meant to stop breathing. The final drug, potassium acetate, disrupts electrical activity in the heart, bringing on cardiac arrest.
"In general, the use of etomidate is a terrible idea," said Dr. David Lubarsky, an anesthesiologist and the vice chancellor of human health sciences at the University of California-Davis.
Lubarsky is one of several doctors who have weighed in on the effects of etomidate as part of the ongoing legal challenges to Florida's execution procedures.
"The pain from etomidate is significant, real pain," Lubarsky wrote in a court document, "and the prisoner will feel it at the injection site and will continue to feel it as the entire 200 mg of etomidate is pushed into his veins or until he loses consciousness."
The doctor also wrote that etomidate is an "ultra short-acting" sedative, meaning there is a substantial risk it could wear off as the second and third drugs are administered. The prisoner would experience a sensation "akin to being buried alive," Lubarsky wrote.
Court filings have noted signs of movement during some of the four executions that preceded Jimenez.
But lawyers for the state said that there is no evidence any of the four felt any significant pain. That includes Eric Branch.
"There were no irregularities in Branch's execution," Assistant Attorney General Lisa-Marie Lerner wrote in a court filing as part of the Jimenez case. "If there had been, the state would have conducted an inquiry into the execution."
Jimenez was the 28th inmate put to death under Gov. Rick Scott, who will leave office having presided over more executions than any governor since the death penalty was reinstated in 1976.
His successor, Republican Ron DeSantis, takes office Jan. 8.
Contact Dan Sullivan at [email protected] or (813) 226-3386. Follow @TimesDan.