George Floyd died because when police restrained him on the ground for more than nine minutes with knees on his back and neck, it was more than he “could take” with his “very severe” pre-existing heart conditions, the county medical examiner who conducted Mr Floyd’s autopsy testified on Friday.
“In my opinion, the law enforcement subdual, restraint and neck compression was just more than Mr Floyd could take by virtue of those heart conditions,” Dr Andrew Baker said in the Derek Chauvin murder trial on Friday.
In other words, police directly caused Mr Floyd’s death, but other factors like his recent drug use, pre-existing heart condition, and high blood pressure contributed as well. These were “not direct causes” though, Mr Baker explained.
“Mr Floyd’s use of fentanyl did not cause the subdual or neck restraint,” he said. “His heart disease did not cause the subdual or the neck restraint.”
Assessing what exactly killed Mr Floyd — whether it was police officers, as the state argues, or other factors, according to the defence — is one of the main questions in this landmark case, where former Minneapolis police officer Mr Chauvin faces multiple murder charges after Mr Floyd, an unarmed Black man, died during an arrest for a counterfeit $20 bill on 25 May last year.
Despite extensive video of the encounter between police and Mr Floyd, Mr Baker says he didn’t watch any before his analysis so it wouldn’t “bias” his work.
“I did not want that to be in my mind when I physically performed his autopsy on the morning of the 26th,” he said.
Defence attorney Eric Nelson, meanwhile, pointed out a number of factors he thought complicated the medical examiner’s conclusion.
During his autopsy, Mr Nelson noted, Mr Baker didn’t document any damage to Mr Floyd’s neck and back, nor to his brain, and later told prosecutors he would have suspected the death was an overdose if Mr Floyd hadn’t also been involved in a physical struggle with officers.
Additionally, Mr Nelson noted that the county medical examiner has said he had seen fatal cases where individuals had even less fentanyl in their systems than Mr Floyd did at the time of their deaths.
But the county medical examiner, perhaps the trial’s most important witness so far, stuck with his initial finding from last summer, that police detaining George Floyd caused his heart and lungs to stop.
“My opinion remains unchanged,” he said. “It’s what I put on the death certificate last June. That’s cardiopulmonary arrest complicating law enforcement subdual, restraint, and neck compression. That was my top line then. It would stay my top line now.”
Much of the week was consumed with testimony from medical experts called by the state to analyse what killed Mr Floyd, although Dr Baker was the only one who worked directly with his body.
Others went even further in discussing Mr Floyd’s moment-by-moment medical situation. Dr Lindsey Thomas, a Minnesota-based pathologist, agreed that police restraining Mr Floyd caused his body not to get enough oxygen, leading to an “anoxic reaction” that damaged his brain.
She said that most cases don’t have such thorough video evidence of what happened before a death, and police body camera and bystander footage captured the moment when Mr Floyd’s body began to twitch and seize involuntarily as the anoxic reaction began.
“That’s the point at which you can tell by looking, that’s where he no longer is getting oxygen to his brain,” Dr Thomas said. “Then the restraint and subdual and compression continue for many minutes more, even after someone checks and says there’s no pulse, they maintain the position. At that point his heart has also stopped.”
Others, like Dr Bill Smock, an emergency doctor and forensic medical specialist who also trains police officers, testified that despite the substantial pressure on Mr Floyd, his life may have been saved with timely CPR.
“As soon as Mr Floyd is unconscious, he should’ve been rolled over,” Mr Smock said. “We have documentation on the video that the officer says, ‘I can’t find a pulse.’ That’s clearly, when you look at the video, it should’ve been started way before.”
Officers remained on top of Mr Floyd for more than nine minutes, until the moment paramedics moved his motionless body onto a stretcher.
All the experts, in one form or another, ruled out the defence’s main argument, that a fentanyl and methamphetamine drug overdose was a primary cause of death.
Dr Martin Tobin, a lung expert who testified on Thursday, said that fentanyl is a powerful opioid that causes people to slow their breathing and appear woozy just before an overdose. Mr Floyd, however, continued taking breaths at a normal rate until the moment he passed out, Mr Tobin said.
“It tells you that there isn’t fentanyl on board that is affecting his respiratory centres,” Dr Tobin said.
Before the trial moved to focus on medical issues, a number of policing experts testified to the other main question in this case: did Mr Chauvin use a legal and reasonable amount of force on Mr Floyd, according to his police training.
Four senior Minneapolis police officers, as well as Jody Stiger, a use of force expert from the Los Angeles Police Department, argued that Mr Chauvin crossed the line. They explained how police are taught to use force that’s proportionate to the situation, only escalating to potentially deadly manoeuvres like pressing against someone’s neck in cases where officers or the public were at high risk.
“There’s an initial reasonableness in trying to get him under control in the first few seconds,” Minneapolis police chief Medaria Arradondo testified on Monday. “Once there was no longer any resistance, and clearly when Mr Floyd was no longer responsive and even motionless, to continue to apply that level of force to a person proned out, handcuffed behind their back, that in no way shape or form is by policy, is not part of our training, and is certainly not part of our ethics or values.”
And they noted that in most counterfeit bill calls like the one that brought Mr Floyd into contact with police, arrests and jail, let alone the use of force, are uncommon.
With many of the state’s experts finished testifying, the defence will soon move to call its own witnesses to the stand.