A stunning new development has changed the Christa Pike case overnight: Tennessee was unable to complete Pike’s scheduled September 30 execution even after the U.S. Supreme Court cleared the way for the state to proceed.

The day had already taken an extraordinary legal turn. Pike was scheduled to receive a lethal injection at 10:00 a.m. CDT, but the U.S. Court of Appeals for the Sixth Circuit issued a last-minute stay, saying it needed additional time to consider claims involving Pike’s childhood sexual abuse and whether those circumstances were adequately presented during her original sentencing.

Tennessee immediately sought emergency relief, and later Wednesday the U.S. Supreme Court vacated that stay, once again allowing the state to carry out the death sentence. Justices Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson dissented from that decision.

According to witnesses cited by the Associated Press, Tennessee officials ultimately were unable to complete the lethal-injection process. Pike reportedly received two doses of pentobarbital and began snoring audibly, but the procedure did not reach completion. Emergency vehicles were later observed at Riverbend Maximum Security Institution.

Pike’s attorneys had warned months earlier that her medical condition could make intravenous access and the execution procedure unusually difficult. Her lawyers specifically raised concerns about her small veins and thrombocytopenia, a condition associated with increased bleeding risk, following Tennessee’s earlier failed attempt to execute another prisoner in May.

Pike’s legal team is now alleging that she experienced “unnecessary agony” during Wednesday’s attempted execution and sought medical intervention after the procedure failed. Those claims are allegations from her attorneys and will likely become part of the next round of litigation.

The development also prolonged the ordeal for the family of Colleen Slemmer, the 19-year-old Pike was convicted of murdering in 1995. Members of Slemmer’s family had travelled to Tennessee expecting the sentence to be carried out after more than three decades of litigation.

The biggest question now is what Tennessee does next. Pike remains under a death sentence, but Wednesday’s failed attempt could trigger new legal challenges to the state’s lethal-injection protocol, especially because Tennessee had already experienced another failed execution attempt earlier this year.