In the January execution of Dennis McGuire, Ohio used a two-drug combination of 10 milligrams of midazolam and 40 milligrams of hydromorphone. In response to an outcry after McGuire took 24 minutes to die, the state has increased its dosages to 50 milligrams of both drugs. At the same time, a state review declared that “there is no evidence that McGuire experienced any pain, distress or anxiety.” When used in a clinical setting for sedation, the state noted, only 1 or 2 milligrams of midazolam are typically used. An anesthesiologist who testified for the defense disagreed, saying the 10-milligram dosage “was insufficient to cause general anesthesia.”
Virginia is relatively secretive about its drug protocols, although Freedom of Information Act requests show that the state has for years bought drugs from Cardinal Health, a pharmaceutical distributor in Ohio. The VDOC approved used of midazolam in February after a failed legislative effort to allow use of the electric chair in executions when lethal injection drugs are not available. Like Florida and Oklahoma, Virginia would use midazolam as part of a three-drug protocol rather than the two-drug protocol used in Ohio.