Heart disease, fentanyl were not the direct cause of George Floyd’s death, medical examiner says
George Floyd’s heart disease and use of fentanyl were not the direct cause of his death, the medical examiner who performed his autopsy testified in the trial of former police officer Derek Chauvin.
Hennepin County Chief Medical Examiner Dr. Andrew Baker ruled Floyd’s death last May a homicide and identified the cause as “cardiopulmonary arrest” that occurred during “law enforcement subdual, restraint, and neck compression.”
On Friday, asked about the autopsy and Floyd’s death certificate, Baker dismissed other potential causes of death.
“The top line of the cause of death is really what you think is the most important thing that precipitated the death,” Baker said, referring to the cause of death listed on Floyd’s death certificate. “Other things that you think played a role in the death but were not direct causes get relegated to what’s known as the ‘other significant conditions’ part of the death certificate.”
“For example,” Baker added, “Mr. Floyd’s use of fentanyl did not cause the subdual or neck restraint. His heart disease did not cause the subdual or the neck restraint.”
Baker’s testimony comes on the 10th day of Chauvin’s trial, the culmination of a week filled with expert testimony by not only medical experts, but also policing experts who testified Chauvin violated policy and used excessive force on Floyd. Chauvin has pleaded not guilty to second-degree murder, third-degree murder and third-degree manslaughter charges.
Baker testified that he did not watch any videos of Floyd’s death prior to performing the autopsy the morning after.
“I was aware at least one video had gone viral on the internet. But I intentionally chose not to look at that until I had examined Mr. Floyd,” he said. “I did not want to bias my exam by going in with preconceived notions that might lead me down one pathway or another.”
The Hennepin County Medical Examiner’s official autopsy made no mention of asphyxiation as a cause of death, which has been a key pillar of prosecutors’ case. In contrast, an independent autopsy commissioned by Floyd’s family said he died of “asphyxiation from sustained pressure” when his neck and back were compressed by officers, cutting off the blood flow to his brain.
Prosecutors on Friday first called forensic pathologist Dr. Lindsey Thomas, who has worked as a medical examiner herself, including in the Hennepin County Medical Examiner’s Office, and who was part of Baker’s training.
Thomas — who has reviewed various records, including the medical examiner’s autopsy — agreed with Baker’s finding in the cause of death, adding she believed the “primary mechanism of death is asphyxia or low oxygen.”
Because of the restraint and his position, she said, Floyd was “unable to get enough oxygen in” to support his body’s functions.
Thomas explained the technical wording of the medical examiner’s finding in the cause of death, saying, “What it means to me is that the activities of the law enforcement officers resulted in Mr. Floyd’s death. And that specifically those activities were the subdual, the restraint and the neck compression.”
“There’s no evidence,” she later added, “to suggest he would have died that night except for the interactions with law enforcement.”
Doctor rejects drug overdose
Thomas said she would not have used the word “asphyxia” in Floyd’s death certificate, saying it does not offer much additional information and requires more explanation. While a death by hanging is a type of asphyxial death, she explained, she wouldn’t say “asphyxia due to hanging” — she’d just say “hanging.”
During her testimony, Thomas underscored the importance of the video evidence in reaching her conclusions, saying she would usually simply review a medical examiner’s case file that would tell her about the cause and manner of death.
“But in this case, the autopsy itself didn’t tell me the cause and manner of death,” Thomas said. “And it really required getting all of this other additional information, specifically the video evidence of the terminal events, to conclude the cause of death and the manner of death.”
Thomas and the jury reviewed photos of Floyd’s injuries, including those she described as “superficial injuries” to his face, shoulders and wrists that support what she saw in the videos of his death: that Floyd was trying to push his body into a position where he could breathe.
Among the photos were pictures of Floyd’s face, with scrapes over his left eyebrow and on his left cheek, according to a report from one of the reporters inside the courtroom. Other photos showed a large abrasion on Floyd’s left shoulder that was evidence, Thomas said, of Floyd trying to push himself up.
Additionally, Thomas said her review of the case, including the toxicology reports, allowed her to rule out other causes of death, including a drug overdose.
Floyd’s death was not “sudden” like it would be with a methamphetamine overdose, she said. And it was not slow like one would see with fentanyl, where “the death is slow, it’s peaceful, they fall asleep.”
Jurors appeared “relatively well-engaged” during Thomas’s testimony, according to reports from two courtroom pool reporters. When she said she believed asphyxia or low oxygen was the “primary mechanism” of Floyd’s death, “nearly all jurors were seen writing this down.”
One pool reporter observed all jurors looking through the photos. Some were seen “flipping ahead looking at all the images.”
Juror questioned about outside influences
One of the jurors was questioned Friday morning by Judge Peter Cahill about “some concerns expressed” over outside influences, per the reports from two reporters inside the courtroom.
Before testimony began, the woman juror told the judge she had “turned on a television and briefly saw coverage” and “saw an image of the courtroom with a woman with dark hair.” Her volume was off, the woman said, and she quickly turned off the TV, the reports said.
The judge also asked the woman if she’d had contact with any family members about the case. The woman said a relative texted her but she said she did not respond, the reports said.
“Any book deal in the works?” Judge Cahill asked.
“The woman became slightly flustered or surprised,” one report said.
“No, I don’t know how this case is going to go,” she said, reiterating she hasn’t talked to anyone about the trial.
Judge Cahill asked if attorneys wanted to make any motions after the woman left the courtroom. Defense attorney Eric Nelson declined. Prosecutor Steve Schleicher said he would like the record to note the woman’s demeanor. Judge Cahill noted the woman seemed “surprised.”
Jurors are released each day with instruction to avoid media coverage and to report to the court any efforts to contact them. This is to keep jurors free from outside influence that could impact deliberations and the outcome of the case.
Two men initially selected to be on the jury were excused after they told the court that news of Minneapolis’s $27 million settlement with Floyd’s estate affected their ability to be impartial.
Floyd died from ‘low level of oxygen,’ doc says
At the trial on Thursday, a pulmonary critical care doctor testified that Floyd died from a “low level of oxygen” when Chauvin pinned him to the street with his knee, restricting Floyd’s ability to breathe.
Dr. Martin Tobin of Chicago identified four main reasons why Floyd died: the handcuffs and the street acting as a “vise;” Chauvin’s left knee on his neck; Floyd’s prone position; and Chauvin’s right knee on Floyd’s back, arm and side. Combined, these limited Floyd’s ability to expand his lungs and narrowed his hypopharynx, a part of the throat that air passes through.
“The cause of the low level of oxygen was shallow breathing,” Tobin said. “Small breaths. Small tidal volumes. Shallow breaths that weren’t able to carry the air through his lungs down to the essential areas of the lungs that get oxygen into the blood and get rid of the carbon dioxide.”
Floyd’s preexisting health conditions and drug use were not relevant to his death, Tobin said.
“A healthy person subjected to what Mr. Floyd was subjected to would have died,” he said.
The medical analysis is important to the prosecution’s case that Chauvin was a substantial cause of Floyd’s death when he put his body weight on Floyd’s neck and back for over nine minutes — causing death by “positional asphyxia.” Nelson has argued that Floyd died of a drug overdose and preexisting health conditions.
Tobin rejected the theory that fentanyl played a role in Floyd’s death, along with Dr. Bill Smock, an emergency medicine physician and police surgeon for the Louisville Metro Police, who also testified Thursday.
People who overdose on fentanyl become listless and stop breathing, while Floyd was desperately trying to breathe, Smock said.
“That is not a fentanyl overdose,” he said. “That is somebody begging to breathe.”
