A Tennessee death row inmate who had a working defibrillator in his chest was executed by lethal injection.

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

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According to the AP, Black looked around the room as the execution began and could be heard sighing and breathing heavily.

The U.S. Supreme Court rejected Black’s final appeal, and Tennessee Gov. Bill Lee declined to stop his execution.

The Tennessee Supreme Court ruled on July 31 that Byron Black could be executed without deactivating his implanted defibrillator, with the high court noting that requi

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