A Tennessee death row inmate, Byron Black, 69, cried out in pain during his execution on Tuesday after the state declined to deactivate his implanted heart defibrillator, despite concerns raised about possible suffering.

Black was executed by lethal injection at Riverbend Maximum Security Institution for the 1988 murders of his girlfriend, Angela Clay, and her two daughters, Latoya, 9, and Lakeisha, 6.

As the lethal drugs began flowing, Black appeared visibly distressed, multiple witnesses reported, according to the Daily Mail.

He was heard sighing heavily and breathing heavily, he then repeatedly lifted his head and told his spiritual advisor, “It’s hurting so bad,” before passing away about ten minutes after the process began.

She then responded: “I’m so sorry. Just listen to my voi

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