The Eleventh Circuit has ruled that the state of Georgia can proceed with the lethal injection of a man who claims that the execution method would cause him extreme pain because his veins cannot support intravenous access, making it cruel and unusual punishment.

The three-judge panel ruled Thursday that Michael Wade Nance failed to prove that the process for administering the lethal injection drug pentobarbital would be so difficult because of his compromised veins that it would violate his rights under the Eighth and 14th amendments.

"Nance contends that the judgment of the district court rests on clearly erroneous findings of fact. But we disagree. Nance's medical records alone make the findings 'permissible,'" U.S. Circuit Judge William Pryor wrote for the panel in the opinion. "Medical professionals obtained peripheral access to Nance's veins three times less than two and a half years before the trial, and the medical records reveal no complications in either obtaining intravenous access or delivering a steady flow of fluids into his veins."

Nance filed his lawsuit in January 2020, claiming that Georgia's lethal injection method violated his civil rights under 42 U.S.C. § 1983. Nance suggested that in lieu of injection he be executed by a firing squad, a method that is not allowed under Georgia law.

The case made its way through the federal court system before eventually landing in the U.S. Supreme Court, which was asked to rule if his claims could be addressed under Section 1983. The high court ruled 5-4 in 2022 that requesting an alternative execution method can be handled under the federal law and does not require a separate habeas corpus petition.

The case was sent back, and a federal district court in Georgia continued to hear Nance's claims that because of the nature of his veins, lethal injection would be a cruel method of execution. Nance and Georgia prison officials provided competing medical experts, and Nance sought testimony from the execution team who would inject him, according to the Eleventh Circuit opinion.

Georgia state law requires that identifying information about a person who administers an execution or death sentence must be kept confidential. The law, known as the Georgia Secrecy Act, created unique challenges for Nance when he attempted to call the execution team as witnesses, the opinion said.

Prison officials told the court that under the law, they were required to take steps such as having the witnesses appear remotely via a camera that was turned off. The officials also sought to use voice modulation software to ensure that the identity of the team was kept secret, the opinion said.

Nance objected to obscuring the identity of the witnesses, but the district court ruled that it had a higher need to protect the identity of the witnesses under state law, even if that meant it made evaluating their credibility more difficult, the opinion said.

The prison system also sought to require Nance to receive a physical evaluation by its expert medical witness the day before trial was set to begin. Nance initially disagreed because the request was after the close of discovery, but he agreed once a district court allowed Nance's attorneys to conduct a "follow-up" deposition of the medical expert.

The prison's expert concluded that Nance's veins would not result in any undue difficulty for the execution team to locate and place an IV. The medical expert also found that the size of the needle needed to execute Nance was similar to one used by medical staff during a colonoscopy treatment Nance received in 2022, which was administered without issue, the opinion said.

The district court ultimately decided that Nance had failed to prove that an IV used in the lethal injection process would cause him severe pain. The district court found that the prison's medical expert was more credible, and it said the method would not violate Nance's constitutional rights, the opinion said.

The panel held Thursday that under Eleventh Circuit precedent, the district court is not required to rule on whether the state is required to use an available alternative method of execution. The court is only required if a person set for execution can prove that the state's proposed method would cause substantial risk of harm, which Nance did not do, the judges said.

The district court's use of Nance's medical records and the medical expert provided by the Department of Corrections was also not erroneous, the panel found. The district court is allowed to consider whether it will credit a specific witness's testimony, and in this case it chose to believe the state's expert, the opinion said.

Cory Isaacson, the legal director for the American Civil Liberties Union of Georgia, who represents Nance, said they plan to continue fighting to prevent the state from using lethal injection.

"Because of Mr. Nance's medical issues, an attempt to execute him by lethal injection risks prolonged and painful suffering," Isaacson said. "But Mr. Nance didn't get a fair trial to show that. Instead, the trial court allowed, and now the appellate court has sanctioned, the state of Georgia to ignore basic trial rules — including witnesses testifying anonymously and out of sight, and new evidence being generated way outside of the required timeline. If the state wants to fight to execute people, it should at least be required to do so fairly. We will continue to fight for Mr. Nance's basic rights, and against state overreach."

A spokesperson for the Georgia Attorney General's Office who defended the state declined to comment.

,A spokesperson for the Georgia Department of Corrections did not respond to a request for comment.

U.S. Circuit Judges William Pryor, Kevin Newsom and Barbara Lagoa sat on the panel for the Eleventh Circuit

Nance is represented by Cory Isaacson, Andrés López-Delgado of the American Civil Liberties Union of Georgia; by Anna Arceneaux, Vanessa Carroll and Victoria Olender Hellstrom of the Georgia Resource Center; by Matthew David Friedlander of Webb Daniel Friedlander LLP and by Ryan M. Christian, John P. Hutchins, Jacqueline T. Menk and Kristen Rasmussen of BakerHostetler.

The government is represented by Beth Attaway Burton, Sabrina Graham, Clint Christopher Malcolm and Elijah J. O'Kelley of the Georgia Attorney General's Office.

The case is Nance v. Commissioner, Georgia Department of Corrections et al., case number 25-11890, in the U.S. Court of Appeals for the Eleventh Circuit.

--Editing by Haylee Pearl.