ST. LOUIS (AP) — The fate of a condemned Missouri inmate rests with Gov. Mike Parson, who must decide if the risk posed by Russell Bucklew's unusual medical condition is grave enough to halt his execution.
Bucklew, 51, is scheduled to be put to death Tuesday evening for killing a man during a 1996 crime spree. The U.S. Supreme Court in April gave the go-ahead for Bucklew to be executed, so court appeals appear to be exhausted.
Parson, a Republican supporter of the death penalty, is still weighing a clemency request, a spokeswoman said Monday.
Bucklew suffers from cavernous hemangioma. The rare disease causes blood-filled tumors in his head, neck and throat. A permanent tracheostomy in his throat helps him breathe. His attorneys say in the clemency request that if one of the throat tumors bursts, Bucklew could suffer an excruciatingly painful death.
"These unstable tumors are highly likely to hemorrhage during the stress of the execution, causing Russell to cough and choke on his own blood," the clemency request states.
The execution would be the first in Missouri since January 2017.
The Russell Bucklew case
The Russell Bucklew case
FILE - This undated file photo provided by the Missouri Department of Corrections shows Russell Bucklew. Bucklew is scheduled to die by injection Oct. 1, 2019 for killing a southeast Missouri man during a violent crime rampage in 1996. Bucklew suffers from a rare medical condition that causes blood-filled tumors in his head, neck and throat, and he had a tracheostomy tube inserted in 2018. His attorneys say he faces the risk of a "grotesque execution process." Missouri Gov. Mike Parson, who is considering clemency in the execution for tomorrow. (Missouri Department of Corrections via AP File)
Russell Bucklew is seen in a police mugshot released by the Missouri Department of Corrections on September 30, 2019. Missouri Department of Corrections/Handout via REUTERS ATTENTION EDITORS - THIS IMAGE HAS BEEN SUPPLIED BY A THIRD PARTY.
FILE - A group of death penalty opponents hold a vigil outside St. Francis Xavier College Church hours before the scheduled execution of Missouri death row inmate Russell Bucklew Tuesday, May 20, 2014, in St. Louis. In the third top story, Missouri executed ten inmates, even as questions swirled about the lethal and increasingly difficult-to-obtain drug that was used. (AP Photo/Jeff Roberson, File)
Mike O'Connell, a spokesman for the Missouri Department of Corrections, speaks during a news conference at the Eastern Reception, Diagnostic and Correctional Center, Wednesday, May 21, 2014, in Bonne Terre, Mo. The U.S. Supreme Court on Wednesday halted the execution of Missouri death row inmate Russell Bucklew. (AP Photo/Jeff Roberson)
A group of death penalty opponents hold a vigil Tuesday, May 20, 2014, outside the prison where Missouri death row inmate Russell Bucklew was scheduled to be executed in Bonne Terre, Mo. U.S. Supreme Court Justice Samuel Alito has issued an order halting the planned execution of Bucklew scheduled for 12:01 a.m. Wednesday, but the order indicates that he or the high court will have more to say about the matter. (AP Photo/Jeff Roberson)
Opositores a la pena de muerte se manifiestan durante una vigilia en las afueras del colegio de Francis Xavier antes de la ejecución del prisionero Russell Bucklew el martes 20 de mayo de 2014 en San Luis, Missouri. Un juez federal ordenó la suspensión de la ejecución el martes por la noche. (Foto de AP/Jeff Roberson)
A group of death penalty opponents hold a vigil outside St. Francis Xavier College Church hours before the scheduled execution of Missouri death row inmate Russell Bucklew Tuesday, May 20, 2014, in St. Louis. A federal appeals court has granted a stay of execution for Bucklew, hours before he was scheduled to die for killing a southeast Missouri man in 1996. The 8th U.S. Circuit Court of Appeals on Tuesday cited concerns about Bucklews' rare medical condition, which raised the risk of "unnecessary pain and suffering by the inmate." (AP Photo/Jeff Roberson)
Death penalty opponents Charles Skaer, left, and Herve Deschamps, second from left, participate in a vigil with others outside St. Francis Xavier College Church hours before the scheduled execution of Missouri death row inmate Russell Bucklew on Tuesday, May 20, 2014, in St. Louis. A federal appeals court has granted a stay of execution for Bucklew, hours before he was scheduled to die for killing a southeast Missouri man in 1996. The 8th U.S. Circuit Court of Appeals on Tuesday cited concerns about Bucklews' rare medical condition, which raised the risk of "unnecessary pain and suffering by the inmate." (AP Photo/Jeff Roberson)
A death penalty opponent picks up a sign at the start of a vigil outside St. Francis Xavier College Church hours before the scheduled execution of Missouri death row inmate Russell Bucklew on Tuesday, May 20, 2014, in St. Louis. A federal appeals court panel granted a temporary halt to the execution of Bucklew on Tuesday evening citing concerns that he could suffer during lethal injection due to a rare medical condition. The panel's ruling could be overturned by the full appeals court, or by the U.S. Supreme Court. (AP Photo/Jeff Roberson)
A March 15, 2019 view of the Supreme Court in Washington. The Supreme Court says Missouri can execute an inmate who argued his rare medical condition will result in severe pain if he is given death-causing drugs. The justices are ruling 5-4 Monday against inmate Russell Bucklew, who is on death row for a 1996 murder. (AP Photo/Susan Walsh)
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Missouri uses a single dose of pentobarbital as its execution drug but refuses to say where it gets it. The source is believed to be a compound pharmacy since large pharmaceutical companies prohibit the use of their drugs in executions.
It wasn't known if the Missouri Department of Corrections planned any extra precautions to address the risk that Bucklew could suffer, in violation of the Eighth Amendment to the U.S. Constitution. A spokeswoman for the department said aspects of the state protocol are confidential, including what medical personnel are involved.
Human rights groups and death penalty opponents, including all four Roman Catholic bishops in Missouri and the American Civil Liberties Union, have urged Parson to intervene. The ACLU and Missourians for Alternatives to the Death Penalty presented the governor's office on Thursday with petitions that they say had more than 57,000 signatures.
Shortly after the 2018 reprieve, Bucklew contracted meningitis, requiring insertion of the tracheostomy tube , said one of his attorneys, Jeremy Weis. The tube is narrow and could fill with blood if the tumors burst, Weis said.
In 2017, the execution of twice-convicted killer Alva Campbell, who suffered from smoking-related breathing problems, had to be halted in Ohio when a usable vein couldn't be found to administer execution drugs. He died in 2018 at age 69.
In 2018, Alabama halted the lethal injection of Doyle Lee Hamm when the execution team had trouble getting the intravenous line connected. Hamm had damaged veins because of lymphoma, hepatitis and drug use. A doctor hired by Hamm's lawyers wrote in a report that Hamm had at least 11 puncture sites and bled heavily from his groin during the attempts to connect the line.
Horrific chain of events
Bucklew's girlfriend, Stephanie Ray, left him on Valentine's Day 1996. Over the next few weeks, according to court records, he harassed her, cut her with a knife and punched her in the face. Ray feared for her life and the lives of her children, so she moved into the Cape Girardeau County mobile home that her new boyfriend, Michael Sanders, shared with his children.
On March 21, after stealing his nephew's car and taking two pistols, handcuffs and duct tape from his brother, Bucklew followed Ray to Sanders' home. Sanders confronted Bucklew with a shotgun inside the home. Bucklew fired two shots, one piercing Sanders' lung. He bled to death.
Bucklew then shot at Sanders' 6-year-old son and missed. Court records say he struck Ray in the face with the pistol, handcuffed her and dragged her to his car. He later raped Ray before heading north on Interstate 55.
A trooper spotted Bucklew's car and eventually became engaged in a gunfight near St. Louis. Both men were wounded. Bucklew later escaped from the Cape Girardeau County Jail. He attacked Ray's mother and her boyfriend with a hammer before being recaptured.