Sharonda Page, left, a cousin of the victims of convicted murderer Byron Black, waits with other relatives of the victims in the area reserved for pro-death penalty advocates outside Riverbend Maximum Security Institution in Nashville, Tennessee. AP

NASHVILLE, Tenn. — Tennessee executed an inmate Tuesday without deactivating his implanted defibrillator , despite uncertainty about whether the device would shock his heart when the lethal chemicals took effect.

Byron Black died at 10:43 a.m., prison officials said. Shortly after the lethal injection started, witnesses said Black told a spiritual adviser in the room that he was hurting so badly.

Black looked around the room as the execution started and could be heard sighing and breathing heavily.

Black was executed after a back-and-for

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