Derek Chauvin Trial 4/9/21: Medical examiner says heart disease, drugs contributed to but didn't cause George Floyd's death

Baker testified he did not find bruising on Floyd's neck or back, above or below the skin. Answering questions from defense attorney Eric Nelson, Baker testified that he would "more often than not" see bruises in someone who was fatally strangled, but demurred when asked whether he would expect to see bruising to the back of someone's neck from a knee.

"I would expect to see bruising but I don't know that lack of bruising excludes that," he said.

Baker said Chauvin's knee appeared to be compressing Chauvin's neck, but qualified that this was his impression from looking at the video, not from conducting his autopsy. He said did not believe the pressure from the knee would cut off Floyd's airway.

Multiple times Baker noted in his answers that he does not treat living patients and is not a pulmonologist.

Baker also testified that methamphetamine increases the work of the heart, and that the drug is "not good" for someone with heart disease. He said he had certified overdose deaths from fentanyl in people who had lower levels of fentanyl in their system than Floyd.

Baker said he recalled telling the Hennepin County Attorney's Office on May 26, after conducting the autopsy, about a physical lack of anatomical findings to support that Floyd was asphyxiated. Later, he said he recalled telling the office that under other circumstances, he believed the level of fentanyl in Floyd would be fatal. But in court, Baker said that opinion would be if Floyd had been "locked in his residence with no evidence of trauma."

Baker then said he recalled telling federal investigators his opinion of how Floyd died, which is that "it was the stress of that [police] interaction that tipped him over the edge given his underlying heart disease and his toxicological status."

He agreed he called Floyd's death a "multifactorial process." 

On redirect questioning from prosecutor Jerry Blackwell, Baker stood by his original findings for cause of death and said he still would classify the death as a homicide.

On cross-examination, Baker said he believed both Floyd's heart disease and the drugs in his system "played some role" in Floyd's death. That's why, Baker said, he listed "other significant conditions" as "arteriosclerotic and hypertensive heart disease; fentanyl intoxication; [and] recent methamphetamine use" on Floyd's death certificate.

"You put things on there you believe are relevant; you don't put trivial things on there that didn't play a role," he said.

He told defense attorney Eric Nelson he did not see the widely viewed bystander video of Floyd's death before he conducted his autopsy.

"I don't want to go into autopsy with a preconceived notion that I already know what happened," Baker said. "That might tempt you to skip certain steps or not do certain things that might turn out to be relevant."

Baker said he did know that Floyd had died while being restrained by police and that pressure had been applied to his neck. He said, "I did see the video the entire world saw" after completing the autopsy but before releasing Floyd's body, meaning he still would have been able to access the body had he seen something on the video that prompted further examination.

Describing his examination of Floyd's heart, Baker said he didn't find any damage, but found the heart was enlarged and several of his arteries to be "significantly narrowed" by plaque. 

When asked what he believed caused Floyd's death, he pointed to what he called "severe underlying heart disease" and said Floyd's heart already would require more oxygen than normal. He said in the context of an altercation or restraint, he said adrenaline would ask the heart to beat faster and the heart would require more oxygen. He said the law enforcement subdual, restraint, and neck compression "was just more than Mr. Floyd could take by virtue of those heart conditions."

Baker said he took a series of photographs as he conducted his autopsy on Floyd so other pathologists would be able to review his work. Baker identified hard copies of the autopsy photos, which were also passed to the jury to view. They were not displayed in court.

Going through the photos, Baker described abrasions to Floyd's face he said would be "entirely consistent" with being pinned against the asphalt. He also pointed to photos of a bruise with scraping on Floyd's right shoulder and an abrasion on Floyd left shoulder, which he said was also consistent with Floyd being prone on asphalt.

Baker noted damage to the skin on Floyd's hand which Baker said would be consistent with the hand banging into something.

Dr. Andrew Baker, the Hennepin County Medical Examiner who performed an autopsy on George Floyd, has taken the stand. Baker's autopsy report found that Floyd died of "cardiopulmonary arrest complicating law enforcement subdual, restraint and neck compression." 

The manner of death was ruled homicide, but the medical examiner's office has said that "is not a legal determination of culpability or intent."

Baker's autopsy said Floyd had "other significant conditions" including "arteriosclerotic and hypertensive heart disease; fentanyl intoxication; [and] recent methamphetamine use." 

Baker's testimony will be key because Floyd's death has been a major point of dispute. The defense has focused on Floyd's heart disease and drug use as contributing factors. But three experts called by the prosecution have said Floyd died of oxygen deprivation under the pressure of officers on his neck and back, not a drug overdose.

Nelson asked Thomas about the fentanyl and methamphetamine found in Floyd's system and asked whether she would believe Floyd had died of a drug overdose had it not been for the police restraint.

"In the absence of any of these other realities, yes, I would consider that to be an overdose," Thomas replied.

On redirect questioning, prosecutor Jerry Blackwell asked Thomas, "Aren't those questions a lot like asking, 'Mrs. Lincoln, if we take John Wilkes Booth out of this...?'" After an objection, Blackwell rephrased the question, asking if Thomas would ever approach an assessment by "taking out of it facts you found relevant and highly pertinent." She replied she would not.

Blackwell again asked Thomas to confirm her opinion that Floyd's death was caused by law enforcement officers subduing him, and not by a fentanyl overdose. Thomas did, and said she saw no signs that Floyd died of a fentanyl overdose, during which people are described as "just falling asleep."

"If there's no signs of fentanyl overdose it makes no sense to conclude there was an overdose from fentanyl," Thomas replied.

Thomas was then excused and court recessed for a lunch break.

On cross-examination, defense attorney Eric Nelson asked forensic pathologist Dr. Lindsey Thomas whether she knew Andrew Baker, the medical examiner who conducted Floyd's autopsy, to be a competent medical examiner from her time working with him in Hennepin County. Thomas agreed he was competent. Nelson then asked Thomas what she believed Baker meant by "complicating" in his finding that Floyd's death was caused by "cardiopulmonary arrest complicating law enforcement subdual, restraint and neck compression." 

Thomas said she believed it meant "both things were present" and that the cardiopulmonary arrest was due to the law enforcement restraint. She agreed the term can mean different things to different forensic pathologists.

Nelson then zeroed in on Floyd's pre-existing conditions, and Thomas confirmed Floyd had an enlarged heart, two narrowed arteries and a history of high blood pressure. Nelson then asked what Thomas would believe Floyd to have died of if he was found in his home without the law enforcement restraint.

"In that very narrow set of circumstances, I would probably conclude the cause of death was his heart disease," Thomas said.

Thomas agreed that the physiological stress Floyd was experiencing would require his heart to "work very hard."

Before proceedings began for the day Friday, Judge Peter Cahill questioned a juror during a brief hearing that was not broadcast via audio or video. According to a pool reporter, the judge asked the juror, a White woman, about having seen any potential outside information about what's going on in the trial.

The juror said she turned on her television to watch a show she records, and saw a show featuring a courtroom and a lawyer. She said she turned the TV off. The woman also confirmed she had received a text from her mother-in-law that said it looked like a bad day. Cahill asked, "No book deal in the works?" And the woman replied, "No. I don't know what to expect."

Asked whether she had had any other outside contact, the juror replied, "No, and if anyone approached me, I would report it."

The juror was excused, after which the judge indicated he did not believe any misconduct occurred.

The pool reporter had earlier reported that the text from the juror's mother had referenced a bad day for the defense, but later sent out a correction indicating the text had referenced a bad day.

"There was a report there might have been some outside media. I find that she was genuinely surprised," Cahill said. "There was not inappropriate conduct by her or from anyone on the outside."

The report from the pool journalist also noted there was a woman sitting in a seat reserved for members of the Chauvin family for the first time. 

Dr. Lindsey Thomas testified Floyd would not have died on May 25, 2020 if it weren't for the police restraint.

"There's no evidence to suggest he would have died that night, except for the interactions with law enforcement," Thomas said.

Thomas said she believes a contributing factor to his cause of death was physiological stress, giving an example of the rush of adrenaline and increased heart rate someone experiences when they narrowly avoid a car crash. But rather than momentary stress, in Floyd's case, "this goes on for minute after minute after minute, for nine minutes, where you are terrified, and you can't... there's no recovery."

Thomas said physiological stress was not a direct cause of Floyd's death.

She agreed with a county medical examiner who found Floyd's manner of death to be a homicide. The Hennepin County medical examiner's office has said that "is not a legal determination of culpability or intent."

Thomas testified that there sometimes might be tell-tale signs in an autopsy that a person died because of low oxygen — for example, bruising on the neck of a person who had been strangled. Those are helpful to pathologists in determining the cause of death when they do occur, Thomas said, but the absence of such evidence shouldn't be used to rule out low oxygen as a cause of death.

"Strangulation is a great example — sometimes there's all kinds of bruises you see on the neck, and other times in a strangulation case they don't have a single mark on their neck," Thomas said. "There's all kinds of reasons bruises may or may not occur."

Thomas testified in this case she believed scraping on Floyd's face, shoulder and hand were consistent with her opinion that he died from low oxygen that resulted from the restraint. She said Floyd also suffered abrasions on his wrists where he was pulling on his handcuffs. The jury was given hard copies of autopsy photos to show the scraping, but the photos were not displayed on the screen in court or published as exhibits.

Thomas testified she was able to use the video to help her rule out other causes of death, including a heart arrhythmia and a fentanyl overdose, two causes the defense has suggested.

Thomas said someone who died of a heart arrhythmia would typically experience a sudden death. She described an example of someone shoveling snow, clutching their chest and falling over fairly quickly. But in Floyd's case, she said, "There was nothing sudden about this death."

Likewise, she said she was able to use the video to rule out a fentanyl overdose, during which someone would typically become sleepy and their breathing would gradually slow. Thomas said she "felt comfortable" ruling out both of those causes of death.

Thomas said the county autopsy in this case "didn't tell me the cause and manner of death." She said she reviewed a huge amount of other information — most importantly the multiple videos — to determine her opinion.

"The actions of the law enforcement officers resulted in Mr. Floyd's death — specifically, those actions were subdual, restraint and neck compression," Thomas said.

Thomas said the amount of video in the case is unique. She said it was primarily the video showing Floyd being restrained in a position where he couldn't get enough oxygen that led her to come to her conclusion.

"There's never been a case I've been involved with that had videos over such a long time frame and from so many different perspectives," she said.

Dr. Lindsey Thomas is a former medical examiner with Hennepin County, where Floyd died, and retired in 2017. Thomas testified that over the course of her decades-long career, she has been the medical examiner for eight counties and has personally conducted about 5,000 autopsies.

Thomas said she volunteered her time to prosecutors, who asked her to review the case and determine Floyd's cause and manner of death. When asked why she didn't ask to be paid, Thomas said: "I knew this was going to be important, and I felt like I had something to offer, and I wanted to do what I could to explain what I think happened," Thomas said.

Thomas did not perform the autopsy on Floyd. She said she agreed with the Hennepin County Medical Examiner, Dr. Andrew Baker, who found Floyd died of "cardiopulmonary arrest complicating law enforcement subdual, restraint and neck compression." 

She said the mechanism of Floyd's death was "asphyxia or low oxygen." The law enforcement restraint ultimately caused Floyd's death, she said.

Testimony has resumed with Dr. Lindsey Thomas, a forensic pathologist, on the stand.

Court has resumed session with attorneys and Judge Peter Cahill holding a hearing that is not being broadcast via audio or video. The jury has not yet been called in to the courtroom.

A series of Minneapolis police officials took the stand earlier this week to testify that Chauvin violated department policy and didn't follow training. The most high-profile voice was Minneapolis Police Chief Medaria Arradondo, who condemned Chauvin's actions in his testimony on Monday.

Arradondo said there was an "initial reasonableness in trying to just get [Floyd] under control" in the first few seconds of the May 25 encounter. But when Floyd had stopped resisting, and "clearly when Mr. Floyd was no longer responsive and even motionless, to continue to apply that level of force to a person prone out, hands cuffed behind their back — that in no way, shape or form is anything that is by policy," Arradondo said. "It's not part of our training and it's certainly not part of our ethics or values."   

In order to convict Chauvin of second-degree murder, prosecutors will need to prove beyond a reasonable doubt that Chauvin caused Floyd's death while committing or attempting to commit a related felony, in this case third-degree assault. To convict the former officer of third-degree murder, prosecutors must convince the jury that Chauvin caused Floyd's death during an act that was "eminently dangerous to others and evincing a depraved mind, without regard for human life." 

The third-degree charge was initially dropped by Judge Cahill, but was re-instated earlier this month after an appeals court handed a win to prosecutors.

To convict Chauvin of second-degree manslaughter, prosecutors will need to prove beyond a reasonable doubt that Chauvin caused Floyd's death by "culpable negligence," meaning he created unreasonable risk and consciously took a chance of causing death or serious harm.

Prosecutors do not need to prove that Chauvin intended to cause Floyd's death. Since police officers are authorized to use force, prosecutors must prove that the force Chauvin used against Floyd was unlawful.

In Minnesota, second-degree murder carries a maximum sentence of 40 years in prison. Third-degree murder is punishable by up to 25 years. Second-degree manslaughter carries a maximum prison term of 10 years.