Christa Pike remains unconscious nearly a week after Tennessee tried to execute her — leaving unanswered questions about whether she will survive, whether she could ever be deemed competent for execution again and whether the state could make another attempt.

Pike, 50, survived two rounds of the lethal injection drug pentobarbital during the failed Sept. 30 execution at Riverbend Maximum Security Insтιтution in Nashville. She remains critically ill and has not regained consciousness, her attorney Stephen Ferrell said over the weekend.

Her attorneys have said Pike is intubated and on a ventilator and suffered swelling, burns and blistering to both arms during the execution attempt.

Tennessee Gov. Bill Lee has since ordered a comprehensive third-party review of the failed execution and halted the state’s remaining execution scheduled for 2026. Tennessee Department of Correction Commissioner Frank Strada has also submitted his resignation and is expected to step down this month.

But Pike remains under a sentence of death — and Tennessee law specifically contemplates what happens when an execution is not completed.

Under Tennessee Code § 40-23-117, when “from any cause” an inmate sentenced to death has not been executed, “the sentence stands in full force, and shall be carried into execution by the court in which the inmate was tried.”

So what happens now?

Will Pike survive?

For now, no one publicly knows.

Ferrell said Sunday that Pike remained critically ill and on a ventilator and that her prognosis might not be known for several days. He said she had not regained consciousness as far as he was aware.

Ryan Marino, M.D., a medical toxicologist and ᴀssociate professor at Case Western Reserve University School of Medicine, tells PEOPLE that it is impossible to predict Pike’s survival based on the information that has been made public.

“If she were legally brain ᴅᴇᴀᴅ, she would not be receiving ongoing medical care,” Marino tells PEOPLE. “But not meeting the legal criteria for brain death does not necessarily mean someone is capable of surviving.”

Marino, who is board-certified in emergency medicine, medical toxicology and addiction medicine, says that based on similar cases and his experience with barbiturate overdoses and poisonings, Pike may have sustained significant brain injury and could potentially experience multiple organ failure.

He says she may require interventions such as mechanical ventilation, feeding tubes or hemodialysis to remain alive.

“I can only speculate on the exact details, but her long-term prognosis is not good,” Marino tells PEOPLE. “Per her legal team, she has not regained consciousness, which likely indicates very severe brain injury.”

Could Pike be medically cleared to be executed again?

There is no indication that Tennessee is currently preparing to make another attempt. Lee has paused the state’s remaining execution scheduled for this year while the failed procedure is independently reviewed.

And whether Pike will recover enough for the question to arise remains unknown.

Marino tells PEOPLE that Pike’s potential injuries could have lasting consequences.

“At this time, the type of injury potentially sustained from this failed attempt would not be expected to resolve or significantly improve beyond this point,” he says.

Pike’s attorneys have said hospital staff were working to clear pentobarbital from her body. The extent of any neurological damage she may have suffered has not been publicly established.

Would Pike still be legally competent to be executed?

That could become a separate question if Pike survives.

The U.S. Supreme Court has held that the Eighth Amendment prohibits executing a prisoner who cannot rationally understand the reason for their execution.

Marino tells PEOPLE that it is impossible to determine Pike’s cognitive condition without additional information, but says there is “a very good chance that she suffered brain damage from this kind of failed lethal injection attempt via mᴀssive barbiturate overdose, which would be permanent.”

Pike’s current condition therefore does not itself establish whether she could ultimately be legally competent for execution. That issue would depend on her recovery and, if her competency were challenged, further legal proceedings.

When could Tennessee try to execute Pike again?

There is currently no new execution date.

Tennessee law makes clear that Pike’s death sentence did not disappear when the Sept. 30 attempt failed. Under Tennessee’s code of criminal procedure, a death sentence remains “in full force” when an execution has not been carried out “from any cause.”

A new execution date would have to be set before Tennessee could try again.

Kelley Henry, chief of the capital habeas unit in the Federal Public Defender’s Office, previously told The Tennessean that because Pike was not executed by the end of Sept. 30, the Tennessee Supreme Court would have to set another execution date. Henry is not involved in Pike’s case.

There is also precedent for a state making a second attempt.

In 1946, Louisiana tried to execute 17-year-old Willie Francis in the electric chair, but the execution failed because of an apparent mechanical problem. The U.S. Supreme Court ruled 5-4 the following year that another attempt would not violate consтιтutional protections against double jeopardy and cruel and unusual punishment.

Francis was executed in the electric chair in May 1947.

But Pike’s case differs significantly from that of Francis: His execution failed because of an apparent mechanical problem, while Pike received the drugs intended to kill her and was left critically ill after surviving the attempt.

David Raybin, a Tennessee attorney who helped draft the state’s current death penalty statute, addressed that distinction in an Oct. 5 opinion column for The Tennessean.

Raybin noted that some have suggested Pike cannot be subjected to another attempt because her sentence has already been “carried out,” but wrote that the Supreme Court has rejected that argument in previous cases.

“I suggest the jurisprudence may be different here if Pike survives,” Raybin wrote.

Pike’s attorneys have already argued that the Sept. 30 procedure violated her Eighth Amendment rights, potentially setting up further consтιтutional challenges if the state seeks another execution.