A snake-handling pastor who appeared on a television reality show has died after being bitten during a weekend church service in Kentucky.
Jamie Coots was handling a rattlesnake at his Full Gospel Tabernacle in Jesus Name Church in Middlesboro when he was bitten on the hand on Saturday night, fellow preacher Cody Winn told WBIR-TV.
After the bite, Mr Coots - who appeared on National Geographic's Snake Salvation show - dropped the snakes but then picked them back up and continued. Within minutes, Mr Winn said Mr Coots headed to the bathroom.
"He had one of the rattlers in his hand, he came over and he was standing beside me. It was plain view, it just turned its head and bit him in the back of the hand ... within a second," Mr Winn said.
When an ambulance arrived at the church, they were told that Mr Coots had gone home, the Middlesboro police department said in a statement. Contacted at his house, Mr Coots refused medical treatment.
Emergency workers left and when they returned about an hour later, Mr Coots was dead from a venomous snake bite, police added.
The snake-handling pastor's son, Cody Coots, told the television station that his father had been bitten eight times before, but had never had such a severe reaction. The son said he had thought the bite would be just like all the others.
"We're going to go home, he's going to lay on the couch. He's going to hurt. He's going to pray for a while and he's going to get better. That's what happened every other time, except this time was just so quick and it was crazy," Cody Coots said.
In January 2013, Mr Coots was caught transporting three rattlesnakes and two copperheads through Knoxville, Tennessee. Wildlife officials confiscated the snakes and Mr Coots pleaded guilty to illegal wildlife possession. He was given one year of unsupervised probation.
Mr Coots said in February 2013 that he needed the snakes for religious reasons, citing a Bible passage in the book of Mark.
National Geographic said in a statement that it was struck by Mr Coots's "devout religious convictions despite the health and legal peril he often faced".
In 1995, 28-year-old Melinda Brown, of Parrottsville, Tennessee, died after being bitten at Mr Coot's church by a 4ft-long timber rattlesnake.