The state of Tennessee carried out the execution of Byron Black on Tuesday morning. The 69-year-old was convicted of killing his girlfriend and her daughters in 1988. The execution was carried out despite uncertainty about Black’s heart implant.
Black was in heart failure, so he had an implant that would shock his heart if his pulse got too low or his heart went out of rhythm. That second function, defibrillation, had Black’s attorneys concerned he could be jolted by painful shocks as he dies.
Black died at 10:43 a.m., prison officials said.
Reporters who witnessed the execution said that Black seemed to be in distress during the procedure and said “it’s hurting so bad.” Journalists spoke at a press conference following the execution and said that Black was breathing more heavily and moaning more than the execution of Oscar Smith in May.
More: Timeline: Tennessee is planning its first lethal injection in years. How did the state get here?
Defense attorney Kelley Henry called the execution “the result of pure, unbridled bloodlust and cowardice.
“It was the brutal and unchecked abuse of government power. It was the result of a failed criminal legal system that countenanced, even rewarded, attorneys who told half-truths and untruths,” Henry said.
After 25 years representing him, she described Black as “a gentle, kind, fragile, intellectually disabled man” and described the execution as eroding the rule of law.
Prior to the execution, a county court ordered the Tennessee Department of Correction to disable the implant, and TDOC turned to Nashville General Hospital, who was managing Black’s care. A week before the execution, Nashville General told WPLN News it never agreed to deactivate the device.
The nonprofit Death Penalty Information Center said it’s unaware of any other cases in which an inmate was making similar claims to Black’s about ICDs or pacemakers. Black’s attorneys said they haven’t found a comparable case, either.
Black also has an intellectual disability, as well as dementia and schizophrenia. He was sentenced under old competency rules, and had exhausted his appeals by the time new ones took effect. That’s why disability rights organizations asked the governor for a reprieve.

Black’s conviction dates to the 1988, when prosecutors said Black was in a jealous rage and shot his girlfriend Angela Clay, 29, and her two daughters, Latoya Clay, 9, and Lakeisha Clay, 6. He was on work-release at the time after shooting the woman’s estranged husband.
Angela Clay’s family provided a written statement to TDOC, and a victims services coordinator read it at the post-execution press conference.
“His family is going through the same thing now we went through 37 years ago,” it reads in part. “I can’t say I’m sorry because we never got an apology. He never apologized and he never admitted it, even on his dying bed, he took it to his grave with him. And he knows he did it.”
Black’s execution was the second since May, after a five-year pause.
In January, Tennessee released its latest lethal injection protocol. It uses one massive dose of the sedative pentobarbital, in place of the traditional three-drug cocktail that uses a sedative, a paralytic, and a drug to stop the heart.
This article was updated at 1:43 p.m. Tuesday to include a statement from Angela Clay's family.