Attorneys for a death row inmate in Tennessee who’s scheduled to be executed Aug. 5 warn that his implanted heart device will repeatedly shock him during his execution, torturing him by trying to keep him alive as he’s killed by lethal injection. A judge ordered the device deactivated, but a local hospital in Nashville now says it won’t participate, according to a report from the Associated Press.

Byron Black, 69, received an implantable cardioverter-defibrillator (ICD) in May 2024, which works as a pacemaker and a defibrillator to electrically shock his heart in an emergency. Black is scheduled to be injected with a high dose of pentobarbital, which is designed to slow down his heart rate. And Black’s attorneys worry the heart device will shock him over and over to combat the drug’s effects, causing extreme pain and suffering. The Eighth Amendment to the U.S. Constitution prohibits cruel and unusual punishment.

A judge ruled July 18 that Black’s heart device would need to be deactivated before he is killed by the state, and the Tennessee Department of Correction (TDOC) indicated in court filings that it had an agreement with Nashville General Hospital to accomplish that. But the hospital told the Associated Press it never agreed to turn off Black’s pacemaker, stating it “has no role in State executions.” The hospital has a contract with the state to provide medical care to prisoners, but deems the request to stop Black’s heart device “well outside of that agreement.” The hospital didn’t immediately respond to questions from Gizmodo on Thursday.

Kelley Henry, an attorney for Black, told Gizmodo in an emailed statement that her client will be tortured if the state goes through with its execution without deactivating the device.

“Unless the ICD is properly deactivated at the moment of execution, Byron Black’s execution will be a gruesome spectacle,” said Henry. “The TDOC implanted this device, and it now wants to torture Mr. Black to death as his heart restarts, prolonging the execution and increasing the likelihood of excruciating pain due to flash pulmonary edema.”

Black’s attorneys tell Gizmodo that he suffers from other health problems, including a broken hip, congestive heart failure, and end-stage kidney disease. Black, who’s in a wheelchair, also has an intellectual disability along with advanced dementia and serious brain damage. Black’s attorney filed a motion for a stay of execution with the Tennessee Supreme Court on Thursday, calling it a “modest, targeted stay” to address the issues relating to his heart implant.

Court filings note the implantable cardioverter-defibrillator that Black was fitted with is the Boston Scientific Dual Chamber ICD Resonate HF EL (model number D533). Black’s attorneys argue that it can only be deactivated by a cardiologist or technician trained by Boston Scientific and supervised by a cardiologist trained in the company’s proprietary software and hardware. They also contend that a general physician is not qualified to perform a deactivation of the device.

Tennessee’s Department of Correction referred Gizmodo to the local Attorney General, but noted in court filings it doesn’t believe it needs to deactivate the heart device before the execution. The state argues Black wouldn’t feel the shocks, something his attorneys contest.

“The first sequence of shocks (up to 8 shocks per sequence) will very likely succeed in restoring Mr. Black’s heart rhythm,” Black’s attorneys said in a court filing from June 30. “Indeed, studies have demonstrated that an ICD’s first shock sequence is effective in 89–100% of cases.”

The filing notes that these shocks are “extremely painful and distressing,” and the entire back and forth between the heart device and the lethal injection could last over 30 minutes before Black is finally successfully killed. The argument that Black would be unaware and unable to feel pain was countered by his attorneys, who note some studies “confuse unawareness with unresponsiveness.”

Black was convicted of shooting his girlfriend, Angela Clay, and her two daughters, 9-year-old Latoya and 6-year-old Lakeisha, in 1988. Black was on work release at the time after shooting and injuring Clay’s estranged husband, according to the AP, and Black was in a “jealous rage.” Black’s attorneys are asking for the governor to commute his sentence to life in prison.

“Byron’s execution carries so many risks,” his attorney said in an emailed statement. “He is elderly, frail, and cognitively impaired; there’s no principled reason to move forward with this torturous procedure. But if Tennessee is going to kill this fragile old man, TDOC must bring in a trained professional to properly deactivate the ICD at the moment the execution is carried out.”