Page:Glossip v. Gross.pdf/108

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GLOSSIP v. GROSS SOTOMAYOR, J., dissenting

that a low dose of midazolam may occasionally be toxic, see ante, at 27—an issue I discuss further below—Dr. Evans’ testimony seems to have been based on the Web site www.drugs.com. The Court may be right that “peti­ tioners do not identify any incorrect statements from drugs.com on which Dr. Evans relied.” Ante, at 27. But that is because there were no statements from drugs.com that supported the critically disputed aspects of Dr. Evans’ opinion. If anything, the Web site supported petitioners’ contentions, as it expressly cautioned that midazolam “[s]hould not be used alone for maintenance of anesthe­ sia,” App. H to Pet. for Cert. 6159, and contained no warn­ ing that an excessive dose of midazolam could “paralyze the brain,” see id., at 6528–6529. Most importantly, nothing from drugs.com—or, for that matter, any other source in the record—corroborated Dr. Evans’ key testimony that midazolam’s ceiling effect is limited to the spinal cord and does not pertain to the brain. Indeed, the State appears to have disavowed Dr. Evans’ spinal-cord theory, refraining from even mention­ ing it in its brief despite the fact that the District Court expressly relied on this testimony as the basis for finding that larger doses of midazolam will have greater anesthetic effects. App. 78. The Court likewise assiduously avoids defending this theory. That is likely because this aspect of Dr. Evans’ testimony was not just unsupported, but was directly refuted by the studies and articles cited by Drs. Lubarsky and Sasich. Both of these experts relied on academic texts describing benzodiazepines’ ceiling effect and explaining why it pre­ vents these drugs from rendering a person completely insensate. See Stoelting & Hillier 141, 144 (describing midazolam’s ceiling effect and contrasting the drug with barbiturates); Saari 244 (observing that “abolishment of perception of environmental stimuli cannot usually be generated”). One study further made clear that the ceiling