Heart Device Failed to Deliver Shock During Tennessee Execution as Man Cried Out, 'I'm Hurting So Bad'
Byron Black, a 69-year-old Tennessee man, was executed by lethal injection on August 5, 2025, despite concerns over his implantable cardioverter defibrillator (ICD) remaining active during the procedure. The execution raised serious ethical and legal questions about how executions are handled for inmates with serious medical devices and conditions.
Black, who was suffering from various health conditions including dementia, brain damage, kidney failure, congestive heart failure, and other conditions, had an ICD implanted in his chest to regulate his heartbeat. The device was designed to shock his heart if it became too slow or irregular to prevent cardiac arrest.
Black's attorneys argued that administering the lethal drugs without disabling the ICD could trigger painful shocks and prolong the execution, causing unnecessary suffering. A Davidson County court initially agreed and ordered that Black’s ICD be turned off just before the execution to avoid these risks. However, the Tennessee Supreme Court later overturned this order, allowing the execution to proceed with the ICD active.
During the execution, witnesses reported Black appeared to be in distress, breathing heavily, groaning, and making sighing and heavy breathing noises. All seven media witnesses agreed he seemed to be suffering. Despite fears, post-execution assessments by Black’s defense team indicated that the ICD did not deliver shocks during the procedure.
Attorney General Jonathan Skrmetti stated that Black died with a spiritual advisor at hand and by a method of execution chosen to minimize his discomfort. However, Black's defense attorney, Kelley Henry, condemned the execution as cruel and an abuse of government power, critiquing the handling of Black's severe medical conditions and the failure to deactivate the ICD.
The case is unusual as the Death Penalty Information Center noted it is not aware of other executions involving active ICDs during lethal injection. The state argued that a "lethal dose of pentobarbital ensures that Black will not be conscious to experience any pain." The Tennessee Department of Correction referred a request to comment about the ICD findings to the attorney general's office.
Henry's team will be making public records requests to try to piece together what happened during Black's execution. Many questions about Black's execution remain unanswered, according to Henry. The case has sparked a debate about the ethics and legality of executing inmates with serious medical devices and conditions, and whether their suffering should be prioritized over the swift execution of the condemned.
The debate over the ethics and legality of executing inmates with serious medical devices and conditions, such as Black who had an implantable cardioverter defibrillator (ICD), has intensified due to concerns about their potentially increased suffering. The case has drawn attention to the handling of such medical conditions during executions and the prioritization of swift execution over potential suffering.
