Case 5:14-cv-00665-F Document 223-3 Filed 08/18/15 Page 1 of 5

Exhibit 3

OKLAHOMA DEPARTMENT OF CORRECTIONS
Correctional Service Log

(=

Institutional Unit

Institution/Facility

Period Covered

H Vi'I;+

05p

Housing Unit/Post/Duty Assignment

Hour

Hour Jo

1-lvri\+
Staff Member

Time
Arrived

Staff
Initials

Time
Departed

Date

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Staff
Initials

Staff Member
(Last, First M.I. and Title)

L-lS- LS'
Time
Arrived

Time
Departed

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L

(Last, First M.I. and Title)

Date 1--1s-1s-

15'00

Occurrence/Action Taken: Events, Activities, Disciplinary Violations, Maintenance Requirements,
Safety/Health Hazards, Other Information Received and Action Taken, etc.

Time of Day

Staff
Initials

Special Operations and IV Teams assembled for execution of offender:
Last:

15"00

15 ')7

t>D

Audio, visual, and medical equipment inspected. -

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IV Team Leader checked and verified the flow of each gauge and confirmed there are
no obstructions in the manifold or lines

R

Commence the preparation of chemicals and syringes.

R

Complete preparing, labeling, and affixing syringes to the manifold.

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First:

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Execution table is prepared at least two hours prior to scheduled time execution.

R

Special Operations Team Leader verified that all syringes are properly labeled and
affixed in the correct location on the manifold.

R

Comments: (Notes or comments concerning entries above; comments deemed appropriate)

c__:
Page 1of5

Revised 1/7/2015

OAG/JDH/Warner v Gross - CIV-14-665/015582

 Case 5:14-cv-00665-F Document 223-3 Filed 08/18/15 Page 2 of 5

Exhibit 3

OKLAHOMA DEPARTMENT OF CORRECTIONS
Correctional Service Log

l le L/

0

~·i~fµ

Occurrence/Action Taken: Events, Activities, Disciplinary Violations, Maintenance Requirements,
Safety/Health Hazards, Other Information Received and Action Taken, etc.

Time of Day

llaS'

All items are removed from the offender's cell (Linen, property, etc.)

~

R

H-Unit Section Chief advises Director that offender is ready for search and restraint;
request permission to proceed. Director grants permission to proceed.

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Offender placed in upper and lower restraints by restraint/escort team after strip
search.

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L

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A

R

Restraint Team Leader notifies H-Unit Section Chief that offender is restrained and
the team is ready to move the offender to the execution chamber.
~

11 00

Director makes initial call to the Governor's office to ascertain if there are any reasons
to not proceed with the execution. Per Governor's General Counsel, at this time, there
is no reason to not proceed. /l/n r-eo.. !>.,'"' " ! ) \- 4';, oruc.-eed

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TI

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Offender escorted to the Execution Chamber.
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Initial blood pressure: I S-::2 I

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EKG leads, Pulse/Oxygen monitor, and blood pressure cuff attached.

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The 'Director informs H-Unit Section Chief (proceed with the movement of offender
to the execution chamber).

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Director makes initial call to the Attorney General's office to ascertain if there are any
reasons to not proceed with the execution. At this time, there is no reason to not
proceed. Pu A+1 """' ,. • Ciu...frd vJg.;1-i· ... ~ dn '), P('p.ft.fR.Ct ..A j, I'll+
I
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H-Unit Section Chief advises the Director the offender is secure on the table and ready
for the IV procedure. Director grants permission to proceed.
~

IV procedure commenced. i>er.

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Comments: (Notes or comments concerning entries above; comments deemed appropriate)

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Page 2 of 5

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Revised 1/7/2015

OAG/JDH/Warner v Gross - CIV-14-665/015583

 Case 5:14-cv-00665-F Document 223-3 Filed 08/18/15 Page 3 of 5

Exhibit 3

-'
OKLAHOMA DEPARTMENT OF CORRECTIONS
Correctional Service Log

(~

Staff
Initials

Occurrence/Action Taken: Events, Activities, Disciplinary Violations, Maintenance Requirements,
Safety/Health Hazards, Other Information Received and Action Taken, etc.

Time of Day

Orf'U".d.or

I 'rlf 6)

Acting upon the advice of the IV Team LeadeTh The Director determines the catheter
site( s ). Primary IV catheter placed in offender's 1 g i a"'+ Ar N'I - 13,.,.., K \2.,
Backup IV catheter placed in offender's ®

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k

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H-Unit Section Chief advises Director all witnesses are m place and request
permission to proceed.

R

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Director makes a phone call to the Governor's office to ascertain if there are any
reasons to not proceed with the execution. Per Governor's General Counsel, at this
time, there is no reason to not proceed.
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NC> \t'o.!'>.O""

R

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l

Director makes a phone call to the Attorney General's office to ascertain if there are
any reasons to not proceed with the execution. Per Attorney General's office, at this
\'(:'
time, there is no reason to not proceed.
No lf't:>..50.,....,. ..... ...,+- tv Proc.~~,..(

The Director informs H-Unit Section Chief "we may proceed."

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TI

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Restraint/Escort Team Leaner and H-Unit Section Chief positioned in ljxecution'""
Chamber. Special Ops Team Leader inside the Operations Room. Offender is secured
R
to the table with IV flowing, EKG functioning.

D

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'¥ of"fu--du O\..*~J>t- '1'1> .j." (> .......\.( \'C'~4 \..-o..,.,d., :CV OLA.\
H-Unit Section Chief advisd Director that IV procedure is complete and request
permission to begin movement of witnesses to the H-Unit witness room.

135'-/

r

60.r-.\L

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N
FI

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R

With permission from the Director and confirmation to proceed, H-Unit Section Chief
opens the curtains.
R

H-Unit Section Chief reads the Execution Order.

R

Comments: (Notes or comments concerning entries above; comments deemed appropriate)

-

CJ
Page 3 of 5

Revised 1/7/2015

OAG/JDH/Warner v Gross - CIV-14-665/015584

 Case 5:14-cv-00665-F Document 223-3 Filed 08/18/15 Page 4 of 5

Exhibit 3

OKLAHOMA DEPARTMENT OF CORRECTIONS
Correctional Service Log
Occurrence/Action Taken: Events, Activities, Disciplinary Violations, Maintenance Requirements,
Safety/Health Hazards, Other Information Received and Action Taken, etc.

Time of Day

I°!

ID

Offender makes his/her last statement.

e:io.." K p,

•
•
•

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IC\ I )

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Syringe 2/)r, 250mg Midazolam, Green

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Syringe 3M 60ml Heparin/Saline, Black

R

Confirmed 5 minutes have elapsed smce
5 minute point: l:t I~
Commencing the administration of chemicals.
K

IV Team Leader verified the offender is sedated and informs Director.

H-Unit Section Chief advises witnesses the offender has been sedated.

FI

•
•
•
•
•
•

~

50mg Rocuronium Bromide, yellow

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02.

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1£1c9.~

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Syringe 6¥, 60ml Heparin/Saline, Black

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K

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1°119'

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Syringe 41(, 50mg Rocuronium Bromide, yellow
Syringe

R

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Pr:foF'.C.:of\-f
'
Director instructs Special OPs Team Leader to complete drug protocol:

19 I fa

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Syringe lX, 250mg Midazolam, Green

'

1'1.IC:>

01·, IV"1 ~ r '-I

Director instructed Special Ops Team Leader to commence with drug protocol:

lq 11

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TI
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~

H-Unit Section Chief asks offender if he/she would like to make a last statement.

L

I "I/) S'

Staff

Initi~fS'

Syringe 7f..., 120 mEq Potassium Chloride, Red
Syringe 8.K, 120 mEq Potassium Chloride, Red

K'..
R

Syringe 9A(, 60ml Heparin/Saline, Black

IV Team Leader pronounced death.

R

Comments: (Notes or comments concerning entries above; comments deemed appropriate)

,1")
Page 4 of 5

Revised 1/7/2015

OAG/JDH/Warner v Gross - CIV-14-665/015585

 Case 5:14-cv-00665-F Document 223-3 Filed 08/18/15 Page 5 of 5

Exhibit 3

OKLAHOMA DEPARTMENT OF CORRECTIONS
Correctional Service Log

(~ Time of Day

Iq

rl..q

IC\~9

I(

Director advises witnesses that the execution is concluded.

H-Unit Section Chief closes the curtains.

R

L

I '1 ..:9- Cf

Director informed of death by IV Team Leader

12.

D
EN
TI
A

l°l~t

Staff
Initials

Occurrence/Action Taken: Events, Activities, Disciplinary Violations, Maintenance Requirements,
Safety/Health Hazards, Other Information Received and Action Taken, etc.

H-Unit Section Chief notifies command to proceed with removal of witnesses from HUnit witness room.

R

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fCj'c.J~

JC) y s-

H-Unit Section Chief instructs IV Team to cut lines to IV's.

~

Inspector General Investigator examines the body.

e

Coroner/Medical Examiner examines the body.

R

Team enters and removes restraints from the offender and places offender on a
gurney.
'iC
Restraint/Escort Team assists Coroner in the removal of the offender's body.

CO

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FI

1°1l/o
.

Command notifies H-Unit Section Chief that all witnesses have been removed.

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All Teams perform clean up duties.

R

The IV Team and Special Operations Team participate in an informal debriefing with
{Z
the Director.

H-Unit Section Chief gives directives to secure the Execution Facility.

[Z

End Log.

Page 5 of 5

f_
Revised 1/7/2015

OAG/JDH/Warner v Gross - CIV-14-665/015586