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Around 11 a.m. Thursday morning in the execution chamber at Riverbend Maximum Security Institution in Nashville, a medical doctor stepped in and attempted to place a central IV line in Tony Carruthers’ chest.
By that point, the prison staff had spent some 30 minutes trying unsuccessfully to insert a backup IV line that would allow them to proceed with the lethal injection. According to Carruthers’ attorney Maria DeLiberato, who was in the room, after asking a staff member to attempt inserting a line through Carruthers’ jugular vein, the doctor moved on to the central line, which is identified as the last resort in Tennessee’s lethal injection protocol.
At one point, DeLiberato, objected to the doctor proceeding. In an exchange heard by media witnesses on the other side of a door, she questioned his qualifications for carrying out the procedure.
“I am qualified,” he responded bluntly.
As he was attempting to place the central line into Carruthers, the inmate’s attorneys rushed to the state Supreme Court asking them to stop the proceeding. Before they could rule, Gov. Bill Lee deferred Carruthers’ execution for a year.
In a federal court filing Thursday afternoon, and in a subsequent statement to the media, attorneys from the federal public defender’s office in Nashville said the doctor’s name is Mark Walton Fowler and that he is not qualified.
“Most medical professionals do not participate in lethal injections because it violates their ethical obligation ‘to do no harm,’” Assistant Federal Public Defender Amy Harwell, who also represents Carruthers, said in a written statement. “As such, states with the death penalty are left with no choice but to scrape the bottom of the barrel — hiring individuals with inadequate training and minimal conscience.”
The American Medical Association’s Code of Ethics says explicitly that physicians “must not participate in a legally authorized execution,” including by “starting intravenous lines as a port for a lethal injection device.”
The Tennessee Department of Health’s website shows a Dr. Mark Walton Fowler of Union, Tenn., with an active medical license.
Harwell went on to note that many states, including Tennessee, have enacted laws to keep secret the identities of medical professionals who take part in executions. Fowler’s name, however, was revealed first by Riverbend Warden Kenneth Nelsen when he spoke it during last year’s execution of Byron Black.
Fowler was deposed in 2025 as part of a lawsuit brought by people on death row challenging the state’s lethal injection protocol. During that questioning, Fowler said that he had placed a central IV line “a dozen or more times,” but that he had not done so since he stopped working as an emergency room doctor in 2013. He later confirmed that he has no hospital privileges, meaning no hospital has authorized him to practice or perform procedures at its facility.
Citing DeLiberato’s account from the execution chamber, Harwell’s statement explained that the execution team tried to establish an IV line through Carruthers’ jugular vein using a vein finder device, which was unable to detect the anterior jugular vein.
DeLiberato told reporters after the execution was called off that Fowler’s hands were shaking as he repeatedly failed to establish the central line in Carruthers’ chest. She described seeing blood coming out of multiple puncture wounds. Although Fowler had given Carruthers the local anesthetic lidocaine, DeLiberato said her client was in “agony.” Media witnesses could hear him groaning in pain.
“We are asking Governor Lee to launch yet another investigation into TDOC’s execution practices to determine how the Department came to rely on such incompetent, unethical, and unqualified medical professionals,” Harwell said in her statement.
In the office’s district court filing Thursday, they asked the judge to block the state from executing Carruthers “through intravenous methods unless performed by an individual established on the record to be qualified, licensed, and presently authorized by a legitimate medical facility to establish a central IV line.” They also asked that prison officials be required to allow a “physician designated by Mr. Carruthers to observe the execution.”
In a Friday press release, the ACLU asked Gov. Lee to pause all executions until the issues can be resolved.
This article first appeared on Nashville Banner and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
As we honor those who have served our country and made the ultimate sacrifice, it is also heartening to see the military right a wrong. Chris Davis brings us the moving story of a Purple Heart ceremony two decades in the making. It's worth a watch.
A heartfelt thanks to all who bravely serve.
- Carrie Sharp
