Medical examiner, forensic pathologist blame police pressure for George Floyd’s death

The medical examiner who ruled George Floyd’s death a homicide and a forensic pathologist who is a former chief medical examiner testified Friday that the way police held him down and compressed his neck was more than Floyd could handle, given the condition of his heart.

Chief Hennepin County Medical Examiner Dr. Andrew Baker took the stand at the murder trial of former Minneapolis police officer Derek Chauvin, who pressed his knee on or close to Floyd’s neck for what prosecutors said was as much as 9 1/2 minutes as the 46-year-old Black man lay pinned to the pavement last May.

Asked about his finding that police "subdual, restraint and neck compression" led to Floyd’s death, Baker said Floyd had severe underlying heart disease and an enlarged heart that needed more oxygen than normal to function, as well as narrowing of two heart arteries.

Baker said being involved in a scuffle raises adrenaline, which asks the heart to beat even faster and supply more oxygen.

"Mr. Floyd had no visible or microscopic previous damage to his heart muscle," he noted. It has been persuaded by the defense that Floyd may have had such damage from prior heart issues and his drug history.

"If a person dies very, very quickly from a coronary artery event, we can only infer what happened … we wouldn’t expect the heart muscle to look abnormal," Baker added. The medical examiner also stated he did not note any injury "in the sense of it being deprived of blood or oxygen" regarding Floyd’s brain. He also did not find any "pill or pill fragments" inside of Floyd in his autopsy report.

Chief Hennepin County Medical Examiner Dr. Andrew Baker takes witness stand as Chauvin trial continues

Baker also addressed Floyd’s prior COVID-19 diagnosis.

"In Mr. Floyd’s specific case, the fact that he had been coded positive seven or eight weeks before he passed away could not factor into my cause of death determination because I didn’t see any signs of COVID at his autopsy," Baker said in court.

During the court session Friday, autopsy photos were distributed to the jury and two legal teams only. No photos were shown during the live stream to the public.

Other medical experts, including a leading lung specialist, have gone further, testifying that Floyd ultimately died from a lack of oxygen because of the way he was restrained on his stomach with his hands cuffed behind his back, his face jammed against the ground and Chauvin’s knee in his neck.

Chauvin, 45, is charged with second and third-degree murder and second-degree manslaughter in Floyd’s death May 25. Floyd was arrested outside Cup Foods in south Minneapolis after being accused of trying to pass a counterfeit $20 bill.

Chauvin’s attorney Eric Nelson has argued that the now-fired white officer did what he was trained to do and that Floyd’s illegal drug use and underlying health conditions, not Chauvin’s knee, killed him. An autopsy found fentanyl and methamphetamine in Floyd’s system.

Baker testified that neither Floyd’s heart problems nor drugs caused his death: "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."

However, under cross-examination, Baker agreed with Nelson that Floyd’s heart disease and drug use "played a role" in the death.

A medical expert who testified Thursday said a healthy person subjected to what Floyd endured would also have died.

Nelson asked Baker whether he has certified deaths by fentanyl overdose at levels lower than that seen in Floyd’s blood, and Baker said yes. But Baker also noted that levels of fentanyl must be considered in the context of how long someone had used the drug, any tolerance built up to it, and what other substances may be involved.

Baker testified that his examination of Floyd’s heart found no "visible or microscopic previous damage" to the heart muscle. And he said he did not notice any pills or pill fragments in Floyd’s stomach.

Baker also said he did not watch the harrowing video of the arrest before examining Floyd so that he would not be influenced by what he saw.

"I was aware that 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 any preconceived notions that might lead me down one pathway or another."

Other medical experts called as prosecution witnesses have likewise blamed Floyd’s death on the way he was pinned down on the ground.

Dr. Lindsey Thomas, a forensic pathologist who retired in 2017 from the Hennepin County Medical Examiner’s Office and did not work on Floyd’s case, testified earlier Friday that she agreed with Baker’s findings, but appeared to go further, saying the "primary mechanism of death" was asphyxia, or insufficient oxygen. She said she reached that conclusion mostly from video that showed Floyd struggling to breathe.

Friday AM Chauvin trial: Forensic pathologist says cause of death for Floyd is ‘physical restraint, compression’

Thomas also has experience as the chief of the Minnesota Regional Medical Examiner’s Office for 13 years. She was also involved in an autopsy protocol that was ultimately published by the United Nations that’s still in use today.

"This is a death where both the heart and lungs stopped working. The point is, it’s due to law enforcement subdual, restraint and compression," Thomas said.

During cross-examination, Nelson asked Thomas about what could cause a heart to suddenly stop beating, noting that Floyd’s bigger heart needed more blood and was working hard in a moment of stress and adrenaline, and that one of his arteries had a 90% blockage.

Thomas said any blockage over 70% to 75% could be used to explain death, in the absence of another cause. But she also said some people can live just fine with an artery that is fully blocked.

The defense attorney pressed Thomas by posing a hypothetical question.

"Let’s assume you found Mr. Floyd dead in his residence. No police involvement, no drugs, right?. The only thing you found would be these facts about his heart. What would you conclude to be the cause of death?" Nelson asked.

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

In response to another hypothetical posed by Nelson, she agreed that she would certify Floyd’s death as an overdose if there were no other explanations.

But during re-questioning, prosecutor Jerry Blackwell ridiculed the defense attorney’s hypotheticals and quickly got Thomas to repeat that the cause of Floyd’s death was the restraint by police.

"Aren’t those questions a lot like asking, ‘Mrs. Lincoln, if we take John Wilkes Booth out of this …" Blackwell began, before Nelson objected.

For the first time, a seat designated for Chauvin’s family was occupied Friday, by a woman. She wasn’t immediately identified.

Also on Friday, Judge Peter Cahill called in a juror and questioned her about whether she had been subject to any outside influences. She replied that she briefly saw TV coverage with the sound off and said that her mother-in-law had texted her, "Looks like it was a bad day" but that she didn’t reply.

The judge allowed her to remain on the jury.

The Associated Press contributed to this story.