On Wednesday, an Arizona man convicted of killing a college student in 1978 became the first person to be executed in the state after a nearly eight-year hiatus in the state’s use of capital punishment. The execution followed a botched 2014 execution that lasted nearly two hours.

Clarence Dixon, 66, was put to death by lethal injection at the state prison in Florence, Arizona for his 2008 conviction in the killing of 21-year-old Arizona State University student Deana Bowdoin. The state executed Dixon even though he was blind, physically frail, and had a history of mental illness. He is the sixth inmate to be put to death in the United States this year.

Witnesses to Dixon’s execution said the medical team had trouble finding a vein to administrate the lethal drugs, dragging the process on much longer than necessary. The staff first tried Dixon’s arms before making an incision in Dixon’s groin area. Witnesses said Dixon appeared to be in pain and the whole process took about 25 minutes. After the drugs were injected, Dixon’s mouth stayed open and his body did not move. The execution was declared completed about 10 minutes after he was injected with the drugs.

In the weeks leading up to his execution, Dixon’s lawyers filed multiple appeals to stay the execution, but judges denied the argument that he was mentally ill and had no rational understanding of why the state wanted to put him to death. The US Supreme Court rejected a last-minute delay of Dixon’s execution less than an hour before the execution began.

In arguing against his execution, Dixon’s defense team pointed to his documented history of mental illness, and membership in the Navajo Nation, which opposes the death penalty on cultural and religious grounds.

In 1977, Dixon was charged with assault for hitting a stranger with a metal pipe but was soon diagnosed with severe depression and schizophrenia, and sent to a hospital for treatment, court records show. According to Slate magazine, one of Dixon’s doctors wrote, “I have a strong feeling that without presence of the mental disturbance, the act of violence would not have taken place.”

The next year, Dixon was found not guilty by reason of insanity by then-Maricopa County Superior Court Judge Sandra Day O’Connor, almost four years before her appointment to the Supreme Court. O’Connor ordered that Dixon remain in custody to await civil commitment proceedings, but he was instead released without any supervision or treatment for his mental illness.

Two days later, Deana Bowdoin was raped and murdered. Dixon, who lived across the street from Bowdoin, had been charged with raping Bowdoin, but the rape charge was later dropped on statute-of-limitation grounds.

While Dixon was serving a life sentence for sexual assault and other charges from a case in 1985, state prosecutors in 2001 claimed they found DNA evidence that linked Dixon to Bowdoin’s death and he was charged with capital murder. During his trial in 2008, Dixon was allowed to fire his court-appointed lawyers and represent himself. His defense was based on his delusional belief that his arrest was part of a government conspiracy. The jury, which never learned Dixon was determined to be legally insane at the time of the crime, convicted Dixon in less than an hour.

Dixon’s death was announced late Wednesday morning by Frank Strada, a deputy director with Arizona Department of Corrections, Rehabilitation and Reentry.

Strada relayed Dixon’s last statement: “The Arizona Supreme Court should follow the laws. They denied my appeals and petitions to change the outcome of this trial. I do and will always proclaim innocence. Now, let’s do this [expletive].”

Dixon earlier declined the option of being killed in Arizona’s gas chamber that was refurbished in 2020—a method that hasn’t been used in the US in more than two decades. As prison medical staff put an IV line in Dixon’s thigh in preparation for the injection, he said, “This is really funny—trying to be as thorough as possible while you are trying to kill me.”

Arizona’s last execution was in July 2014, when it killed Joseph Wood with 15 doses of an expired two-drug combination over two hours. Witnesses to Wood’s execution reported that he snorted repeatedly and gasped more than 600 times before he died. The process was so controversial and dragged on for so long that the Arizona Supreme Court held an emergency hearing during Wood’s execution to decide whether to let it proceed.

US states have struggled to buy drugs used in lethal injections after American and European pharmaceutical companies began blocking the use of their products in lethal injections. Despite the unpopularity of capital punishment, and some federal attempts to restrict the practice, many states go to extreme measures to carry out the barbaric practice. After a federal judge barred the import of drugs to be used in executions, Arizona officials attempted to obtain the drugs from a small company housed in the back of a London driving school.

More than 1,500 people have been put to death in the United States over the last 46 years. Frank Atwood, another death row inmate in Arizona, is scheduled to be executed on June 8 for the killing of 8-year-old Vicki Lynne Hoskinson in 1984.. Arizona currently has 112 prisoners left on the state’s death row