NASHVILLE, Tenn. (AP) — Tennessee is gearing up for an execution on Tuesday that experts say would likely mark the first time a man has been put to death with a working defibrillator in his chest.

Gov. Bill Lee declined Monday to grant a reprieve, clearing the way for Byron Black’s execution after a legal battle and ongoing uncertainty about whether the implantable cardioverter-defibrillator will shock his heart when the lethal drug takes effect.

The nonprofit Death Penalty Information Center said it’s unaware of any other cases in which a person on death row made similar claims to Black’s about defibrillators or pacemakers. Black’s attorneys said they haven’t found a comparable case, either.

Lee said the courts have “universally determined that it is lawful to carry out the jury’s sentence of execution given to Mr. Black for the heinous murders of Angela Clay and her daughters Lakeisha, age 6, and Latoya, age 9.”

The U.S. Supreme Court on Monday rejected Black’s appeals. The execution would be Tennessee’s second since May, after a pause for five years, first because of COVID-19 and then because of missteps by state corrections officials.

Twenty-seven men have died by court-ordered execution so far this year in the U.S., and nine other people are scheduled to be put to death in seven states during the remainder of 2025. The number of executions this year exceeds the 25 carried out last year and in 2018. It is the highest total since 2015, when 28 people were put to death.

Black’s condition

Black, 69, is in a wheelchair, and he has dementia, brain damage, kidney failure, congestive heart failure and other conditions, his attorneys have said.

The implantable cardioverter-defibrillator he has is a small, battery-powered electronic device that is surgically implanted in the chest. It serves as a pacemaker and an emergency defibrillator. Black’s attorneys say in order to be sure it’s off, a doctor must place a programming device over the implant site, sending it a deactivation command, with no surgery required.

In mid-July, a trial court judge agreed with Black’s attorneys that officials must have his device deactivated to avert the risk that it could cause unnecessary pain and prolong the execution. But the state Supreme Court intervened July 31 to overturn that decision, saying the other judge lacked the authority to order the change.

The state has disputed that the lethal injection would cause Black’s defibrillator to shock him. Even if shocks were triggered, Black wouldn’t feel them, the state said.

Black’s attorneys have countered that even if the lethal drug being used, pentobarbital, renders someone unresponsive, they aren’t necessarily unaware or unable to feel pain.

Kelley Henry, Black’s attorney, said the execution could become a “grotesque spectacle.”

The legal case also spurred a reminder that most medical professionals consider participation in executions a violation of health care ethics.

Black’s case

Black was convicted in the 1988 shooting deaths of his girlfriend Angela Clay, 29, and her two daughters. Prosecutors said he was in a jealous rage when he shot the three at their home. At the time, Black was on work-release while serving time for shooting Clay’s estranged husband.

Linette Bell, whose sister and two nieces were killed, recently told WKRN-TV: “He didn’t have mercy on them, so why should we have mercy on him?”

Intellectual disability claim

In recent years, Black’s legal team has unsuccessfully tried to get a new hearing over whether he is intellectually disabled and ineligible for the death penalty under U.S. Supreme Court precedent.

His attorneys have said that if they had delayed a prior attempt to seek his intellectual disability claim, he would have been spared under a 2021 state law.

Nashville District Attorney Glenn Funk contended in 2022 that Black is intellectually disabled and deserved a hearing under that 2021 law, but the judge denied it. That is because the 2021 law denies a hearing to people on death row who have already filed a similar request and a court has ruled on it “on the merits.”

In Funk’s attempt, he focused on input from an expert for the state in 2004 who determined back then that Black didn’t meet the criteria for what was then called “mental retardation.” But she concluded that Black met the new law’s criteria for a diagnosis of intellectual disability.

Black also sought a determination by the courts that he is incompetent to be executed.