Broom, 53, a convicted killer from Cleveland, is slated to die Tuesday, a week after Ohio prisons personnel abandoned efforts to start lethal-injection IV lines following two hours of frustration and futility. Gov. Ted Strickland granted a one-week reprieve.

The big question: What will be different the next time?

Ohio has no alternative to lethal injection in capital punishment. The electric chair, "Old Sparky," was permanently unplugged in 2001.

The state does have a few options on the injections, said Dr. Sean Collins, an assistant professor of emergency medicine at the University of Cincinnati.

Radiology equipment could be used to locate a vein farther under the skin, or a line could be inserted into the vein in Broom's neck.

However, those procedures are typically done at hospitals -- usually by physicians. Ohio's execution team is made up of emergency medical technicians.

State prisons spokeswoman Julie Walburn said officials are assessing what the EMTs are qualified to do -- including possible "additional access points" that could be used for lethal injection.

They are not allowed to do most medical procedures and "will not work outside the scope of what they're trained to do," she said.

"We have absolute confidence in the execution team. We don't believe it (the failed attempt) reflects on their skills and ability. We are not adjusting because of yesterday (Tuesday)."

Prison officials said Broom was a past drug user. Veins of drug users can be the most difficult to access.

On the legal front, Broom's attorneys, S. Adele Shank of Columbus and Timothy Sweeney of Cleveland, said they almost certainly will file legal challenges to block round two. Sweeney said Broom needs time to heal from what Broom told his attorneys were 18 different needle sticks in his arms and legs.

The attorneys will consider filing an appeal based on the Eighth Amendment prohibition on cruel and unusual punishment.

"Ohio has a special statutory provision that requires executions to be 'quick and painless,'  " Sweeney said. "This execution team has demonstrated clearly they're incapable (of) providing a quick and painless execution to Mr. Broom."

Broom abducted 14-year-old Tryna Middleton of Cleveland as she walked home from a football game on Sept. 21, 1984, then raped her and stabbed her to death.

Richard Dieter, executive director of the Washington-based Death Penalty Information Center, said he is not aware of any other time in the modern history of capital punishment when an execution was started, then stopped.

"It's a dramatic example of problems with lethal injection in Ohio and elsewhere," Dieter said. "This is not a reliable process. Everybody would want this done in a more reliable and humane way. It's going to require some soul-searching."

Dr. Jonathan Groner, a pediatric surgeon at Nationwide Children's Hospital and a death-penalty opponent, agreed that halting a lethal injection is unprecedented.

Groner said the EMTs assigned to do the IV work on lethal injections are under-trained and inexperienced.

"The ball's clearly in the governor's court now. This is not golf. There's no mulligan. There's no do-over."

Strickland said yesterday that the Broom case presented a "very unusual set of circumstances" that does not warrant an overall review of capital punishment in Ohio.

"The EMTs, my understanding is, are adequately trained," the governor said. " ... My understanding is that the problem is associated with the physical condition of the inmate, not the inability of the EMTs to perform as they were required to perform."

But like anything in medicine, it takes practice to get good at inserting an IV line.

Nurses at Ohio State University Medical Center, for example, can insert at least two IV lines a day. And if they have trouble getting one in after two tries, they'll ask someone more experienced.

"It's a thing you have to keep doing and doing, and over time you get a feel," said Shirley McCoy, nursing staff-development specialist at the OSU Medical Center. "You can decide by looking and feeling the vein; it's just really a skill that nurses build up over time."

The EMTs on the state's execution team are primarily corrections employees who may work part time on local fire departments.

The last U.S. case somewhat similar to the botched Broom execution happened in Louisiana on May 3, 1946, death-penalty experts said.

Condemned killer Willie Francis survived an execution attempt when the electric chair, nicknamed "Gruesome Gertie," was incorrectly connected and provided a jolt but not a lethal shock.

"I'm not dying!" the teen-age inmate reportedly said.

Francis' attorney filed an appeal saying that a second execution attempt would violate his client's constitutional rights to avoid double jeopardy and cruel and unusual punishment.

The U.S. Supreme Court rejected the appeal in a 5-4 decision. Francis was executed May 9, 1947.

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