Chauvin trial: Police restraint on Floyd 'tipped him over the edge,' medical examiner says

MPR News is streaming live coverage of the trial. Some images or material discussed during the trial will be disturbing to many viewers. Watch the morning proceedings here. Watch the afternoon proceedings here.

3 things to know:

• Medical examiner who ruled George Floyd’s death a homicide said stress of police restraint was too much for Floyd given underlying health conditions, drugs in system

• Pathologist says Floyd’s death due to police restraint; pulmonologist compares Floyd restraint to a “vise” that kept him from taking in enough oxygen to survive

• Case expected to hinge on responsibility for Floyd’s death; defense points to Floyd’s health conditions, drugs; prosecution points to Chauvin’s actions

Updated 4:24 p.m.

The actions of Minneapolis police to restrain and subdue George Floyd as they arrested him “tipped him over the edge” from life to death, Hennepin County Medical Examiner Andrew Baker testified Friday in the murder trial of Derek Chauvin.

Floyd's enlarged heart and narrowed arteries left him short of oxygen while his stress level jumped as he lay handcuffed and pinned to the pavement on May 25, said Baker.

“In my opinion, the law enforcement subdual restraint and the neck compression was just more than Mr. Floyd could take by virtue of those heart conditions,” Baker told jurors during his highly anticipated testimony.

Baker, who conducted the autopsy on Floyd’s body, ruled the man’s death a homicide last year, saying Floyd went into cardiopulmonary arrest as then-officer Chauvin kept his knee pressed on the neck of the prone, handcuffed man.

Baker's report also identified “hypertensive heart disease,” “fentanyl intoxication” and “recent methamphetamine use” as other “significant conditions.”

On Friday, he stood by his findings and described Floyd’s health problems and the drugs in his system as contributing — not direct — causes of his death.

“He experienced a cardiopulmonary arrest in the context of law enforcement subdual restraint and neck compression,” Baker said, recalling what he told the FBI and U.S. Attorney’s Office. “It was the stress of that (police) interaction that tipped him over the edge, given his underlying heart disease and his toxicological status,” Baker testified.

Baker said Floyd's brain and lungs looked normal under inspection in the autopsy.

Bystander video showed Chauvin with his knee pressed against Floyd’s neck for more than nine minutes as the man lay handcuffed and face down on the pavement, pleading that he couldn’t breathe. He was arrested for allegedly trying to use a counterfeit $20 bill to buy cigarettes.

Chauvin, who was fired from the force, faces murder and manslaughter charges in Floyd’s killing.

The defense has argued that Floyd’s underlying medical problems and the drugs in his system were responsible for his death. Prosecutors say Chauvin’s actions to subdue Floyd killed him, so Baker’s testimony is expected to be crucial in the jury’s decision-making.

Baker did agree with Chauvin defense attorney Eric Nelson that Floyd’s heart disease and drug use were factors in Floyd’s death. 

Baker also said he found no bruising on Floyd that he would typically associate with cases asphyxia that his office deals with, but resisted Nelson's efforts to pin him down on whether he found any general symptoms of asphyxia, saying it depends on how the person died.

But Baker repeatedly responded to Nelson by saying he's not a pulmonologist and can't comment on questions about breathing because he doesn't work with live people. 

‘This was not a sudden death’

A forensic pathologist told jurors Friday morning that after reviewing all the materials and videos, she agreed with the Hennepin County medical examiner’s findings, concluding the officers' restraining and subduing of Floyd, specifically the compression on Floyd's neck, caused his death.

“This is a death where both the heart and lungs stopped working. And the point is, it is due to law enforcement subdual, restraint and compression," said Dr. Lindsey Thomas, who reached her conclusion after reviewing the medical examiner’s report as well as body camera and bystander videos of the fatal confrontation.

Floyd’s death did also not appear to be caused by a drug overdose or prior health conditions such as high blood pressure, said Thomas. 

When asked by prosecutor Jerry Blackwell if Floyd was in danger of dying on his own on May 25, Thomas said, “There’s no evidence to suggest he would have died that night, except for the interactions with law enforcement.”

“This was not a sudden death. There was nothing sudden about his death. That’s what I would have expected if it was a cardiac arrhythmia,” she told the court, adding that it was also not the type of death seen in a fentanyl overdose, “where someone becomes very sleepy and then calmly stops breathing.”

Earlier, before court proceedings began, the judge brought in a juror for questioning about potential outside contact.

The juror told Judge Peter Cahill that she had received a text from her mother Thursday saying "looks like it was a bad day," according to reporters in the courtroom. The juror said that she hasn’t talked to anyone about the case, and Cahill said she could go back to the jury room.

According to pool reporters, a woman also accompanied Chauvin into court Friday morning and sat in the seat reserved for his family. It appears to be the first time the seat reserved for a member of Chauvin's family has been occupied.

‘That’s the moment the life goes out of his body’

Thursday’s testimony featured experts in pulmonology and forensic medicine called by the prosecution who told the court that the restraint used to keep Floyd pinned to the pavement eventually made it impossible for Floyd to take in the oxygen he needed to survive.

In a deep Irish accent that kept jurors rapt by his testimony, Dr. Martin Tobin delivered a brief anatomy lesson in measured tones, explaining how pressure on the neck affects the ability to breathe.

“The knee on the neck is extremely important because it’s going to occlude the air getting in through the passageway,” he said.

He likened Floyd’s positioning to being in a vise and said “a healthy person subjected to what Mr. Floyd was subjected to would have died.”

Countering defense arguments that fentanyl in Floyd’s system contribute to his death, Tobin said Floyd’s respiration appeared normal until he stopped breathing. Had Floyd been impacted by fentanyl, Tobin said, his respiratory rate would have been suppressed.

Jurors were shown a still image from the bystander video showing Chauvin putting nearly all his weight on Floyd's neck. In a subsequent graphic, Tobin explained that he estimated more than 90 pounds of force was being applied.

Tobin said a close-up photo shows Floyd trying to use his face to push back and get more air into his lungs.

In his analysis, Tobin said that Chauvin continued to apply his weight on Floyd for at least three minutes after there was zero oxygen left in his body. Watching the bystander video, Tobin identified 8:24:53 p.m. as the moment Floyd died.

“You can see his eyes. He's conscious, and then you see that he isn't,” he said. “That's the moment the life goes out of his body.”

‘That is not a fentanyl overdose’

Forensic toxicologist David Isenschmid testified Thursday that the levels of fentanyl and methamphetamines found in Floyd’s blood was much lower than in cases where people were driving under the influence.

He also said a metabolized version of fentanyl was found in Floyd’s blood that is rare in overdose victims.

The prosecution also called Dr. Bill Smock, a forensic physician who works for the Louisville Police Department. He told the court that he had concluded that “Mr. Floyd died from positional asphyxia, which is a fancy way to say that he died because he had no oxygen in his body.”

Smock said Floyd showed no signs of a condition called “excited delirium,” a condition that’s controversial in medical circles, but can lead to unpredictable behavior and excessive strength.

He also said that a fentanyl overdose would have made Floyd appear to fall asleep. But Floyd was exhibiting signs of asphyxia, said Smock, including what he termed “air hunger” as he pleaded for air.

“He’s saying, 'Please, please get off me. I want to breathe. I can’t breathe,' " Smock testified. “That is not a fentanyl overdose. That is somebody begging to breathe.”

Nelson questioned Smock about Floyd’s health problems. Under cross-examination, Smock admitted that wrestling with officers could put extra stress on a heart, but said later that Floyd didn’t show signs of a heart attack.

Trial basics

Who’s who: A look at the key players in the trial.

Need to know: Key questions about the trial, answered.

What we know about the jurors: The 12 jurors and two alternates picked to review the case include a chemist, a youth volunteer, a cardiac nurse and an IT professional.

Chauvin's lawyer is outnumbered, but has help: No fewer than four attorneys have appeared for the prosecution so far, compared to a single attorney to defend Derek Chauvin.

Legion of Chauvin prosecutors, each with own role: Viewers may be struck by the array of prosecutors taking turns presenting their case. The choice of who does what is no accident.

MPR News on its coverage: Nancy Lebens, the newsroom’s deputy managing editor, answered audience questions about our reporting plans.

George Floyd and his legacy

Remembering George Floyd, the man: Before he became a symbol in the fight for racial justice, friends say George Floyd was a “gentle giant” who sought a fresh start.

Making George Floyd Square: Here’s how the site of George Floyd’s killing — 38th Street and Chicago Avenue in Minneapolis — is being reshaped.

Rescuing the plywood — and memorializing a movement: Two Black women are leading the effort to preserve the murals painted on storefront boards in the Twin Cities.

Calls for change: Here’s what some activists tell MPR News about their experiences with race in Minnesota, why they march and what they hope for the future.

Read more

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Could mask hamper Chauvin's image with jurors? The face mask that Derek Chauvin has been required to wear during his trial has hidden his reaction to testimony. That includes any sympathy or remorse that legal experts say can make a difference to jurors. (The Associated Press)

Questioning blurs meaning of 'lawful but awful': The phrase typically refers to police shootings when the officer is found to have reasonably feared for their life and fired. Legal observers say Derek Chauvin's defense will have a hard time making that case. (The Associated Press)

Trial breaks 'blue wall of silence,' but will it transform policing? "My hope is that it leads to results in terms of transforming the way that policing happened in Minneapolis," said civil rights attorney and activist Nekima Levy Armstrong. (NPR)

What is excited delirium? Derek Chauvin's attorney has raised the concept of excited delirium as testimony examines whether reasonable force was used on George Floyd. (The Associated Press)

Racism is making us sick. How can equity in medicine help us heal? Two doctors and a medical researcher talk about how racism affects their patients’ health — and how racism in medicine leads to inadequate medical education and poor care. (Sahan Journal)

NPR’s live blog: The latest from the murder trial of Derek Chauvin.

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