tv Day 6 of Trial for Derek Chauvin Accused in Death of George Floyd Part 1 CSPAN April 6, 2021 1:42am-3:06am EDT
video. mr. nelson this is your motion. nelson: good morning your honor. last week we did submit the entirety of the body more cameras for the three officers involved he skews me the four officers involved we want that only to include the entirety of mr. chauvin by the one camera in connection with this case. as the court of the aware it is the totality of what a reasonable police officer would have done ine similar circumstances. i d believe after the way the state presented it it was a lot more that happened after certainly mr. chauvin process continues to investigate the original forgery. so it shows his actions. it also shows what is happening with the civilians
and bystanders at the same time similar to what was happening at the time they had mr. floyd restrained. i think it is ultimately goes to totality of the circumstances analysis it shows his reactions. you can hear his voice and ultimately becomes an important piece to present to the jury. i believe with respect to the milestone camera we are reserving that at this point. >> i have reviewed all the videos the defense provided i think the milestone parties have to figure out what is it and what is not before we go further. we will deal with that either tomorrow or wednesday. most likely wednesday because tomorrow we have to deal with mr. hall's implication. mr. frank what is the state's response to this motion?
>> good morning your honor. i will try to be expedient but i do want to be precise and thorough. we had submitted as you know, mr. chauvin body camera video already. therefore videos that came from mr. chauvin body wornin camera each is labeled with a distinctive number that represents the time it starts. the first one we put in was 2011. that is essentially the drive there. we put all of that in. 2017. that is the next video i believe we put all of that in.
2034. we put in through the timestamp on the video of 2036, 42. it's my understanding the defenses asking to put in the remainder of that video from that point forward and to describe a little bit what happened man officer keung comes up and discusses with mr. chauvin some information he learned somebody in the store dealing with the bill he has the bill an officer chauvin at the time confirms they were goods and services provided. officer keung indicates that's our guy. that obviously all presents two levels of hearsay from the store manager then officer
keung. and then they continue a discussion about the car keys. officer keung talks about getting the security camerara videos going in there is a discussion about the vehicle. in addition to the obvious hearsay problem there is also a relevance problem. the totality of circumstances of course from a reasonable police officer at the time. this is all subsequent by investigation that of course could have been done trying to force mr. floyd into the backseat. its relevance because it has no bearing on what the officers knew or believed at the time force was used. so it is all relevant if mr. floyd actually knowingly passed a bill it is simply irrelevant to the officers use of force.
that is why we object to the remainder of thatt video. the fourth video your honor is 2045. we put in through, a short piece of that video the interior of that video is a conversation in which sergeant pleoger talks to mr. chauvin and mr. keung and mr. lane with a rundown of what happened it is lane and keung speaking and mr. chauvin stands are not making many corrections or additions. so obviously again, a hearsay problem. and that is aware of any hearsay exceptions that would allow those statements by the non- testify as to come in.
also to the extent your honor it is admitted, we word argue the adopted admission we want to be clear about that on the record there is the obvious hearsay problem there. it is essentially seeing this in the service as a judge it simply trying to get in self-serving hearsay a defense without having to testify. that is very clearly what is beingot attempted all you cannot do that through hearsay. so we think that is relevant as well. and prohibited by the hearsay rule. >> onle the 2045 video, that discussion is primarily about what happened with mr. floyd, the use of
force, is that correct? >> correct. >> is there anything beyond that in the 2045 or mr. nelson'sny or anything beyond the discussion of what happened for use of force? >> yes your honor. discussions who will go to the hospital and who will stay behind and things of that nature. >> that's correct. >> as far as the 2034, you put in through 2036 and 42 seconds. is there anything beyond that on the 2034 video that specifically relates to use of force or dealing with mr. floyd? >> not that i recall. >> thank you. >> we will reserve argument andat decision on the milestone camera and tell wednesday when
we have another legal issue to deal with tomorrow morning. the 20 ready for video. i am going to allow that because defense is not really offering defendant statements for that matter for the truth of the matter therefore it's not hearsay. being offered more to show it is relevant it shows mr. chauvin demeanor and his actions immediately following mr. floyd being we move to the hospital. i think that is relevant for the juryem to see his demeanor and actions he took afterwords. the remainder of the 2034 video will be put in. the 2045 video will not be allowed. that is hearsay and it does appear it is primarily
officers lane nt forgiving their side of the story so to speak it does not fall in into any ofo the eight oh four exceptions were available witness to allow is hearsay. i do not find it was the adaptive admission by the defendant. he is there but mere presence does not constitute adoption of what is being said. presently 2485 video will not be allowed. >> are the conversations allowed? >> which one specifically?nv , pierce we can go over that. >> specifically after that commentary additional conversation about who was going where what is happening or who is going to the hospital. >> any objection to that
mr. frank? it is just decisions and why people did in my people did not. >> we will allow that. >> so the recollections that are being reported with mr. floyd are not in their. the jury is here.. we can bring them in. just for the record the next hearing will be on the record with spectators present but we will go off audio and off video it will not be broadcast outside this courtroom. i will make a record as to why we are doing that when we go to jury. [sidebar]
>> good morning members of the jury. you have a handout today. we will do this hearing entirely off the record on the record but off audio and video. i will ask you several questions that first of all i need everybody to raise your right hand. [swearing in witness] we would do that immediately after. we are back on the record on audio and video we had a short hearing with the jurors regarding a matter. to make sure there is no juror misconduct and that the jurors were credible in their responsible send accordingly no action will be taken.
anything else? mr. nelson. you made objections before lieutenant zimmerman testimony. we said you could preserve it with the objection on the record later. >> yes. for the record, last thursday we had a hearing with sergeant pleoger outside of the presence of the jury to his assessment on the use of force in this particular case. i made those friday morning in chambers discussion with the same objection. with reference to the motion in them in a to prevent every single officer coming to give their two cents of the reasonable notice of the use of force i made the same
objections to lieutenant zimmerman's testimony. i just want the record to be clear that objection continued for that testimony as well. >> given the involvement with a case of pleoger and zimmerman. based on their training andng experience i did allow them the limited opinion the amount of restraint i think lieutenant the remaining said it was uncalled for and not appropriate. so i denied the defense motion to suppress the opinion. nelson: i note that today because we have at least three officers coming in to testify. i understand the chief will be in and his policymaking decision is for employment purposes but there o are two other officers katie blackwell and who oversees the training
and to know that she has opinions and was in the crisis intervention program. i am concerned what would happen with the use of force experts that are coming in. i am concerned the state is pigeonholing expert testimony to the officers writing they should just be allowed to testify these are the training materials these are training policies. this is what we do. >> i am allowing the chiefs testimony the use of force was contrary to policy. lieutenant blackwell? that opinion, inspector blackwell. i am allowing that opinion.
with crisis intervention. i we trying to get mr. floyd state of mind through the back door? >> no your honor. the proper testimony of the sergeant is regarding any applets police department crisis intervention training that they provide to officers. the 40 hours scenario -based training course that paid actors come in and they go through various scenarios such that officers can recognize people who are emotionally and behaviorally disturbed. and tend to be able to understand some people are unable to comply with commands versus unwilling to be compliant that is the reasonableness of the police officer the action that they take.
>> sergeant yang is not offering any opinions? >> he ise' not just describing the training. >> youou have evidence mr. chauvin took the training? >> yes your honor. nelson: that was my understanding of sergeant yang's testimony limited to the crisis intervention program and training that officers go through. it is within the policy part of the de-escalation policy. what it also include what officers are specifically trained to do to identify the difference somebody that is intentionally resisting arrest versus someone who is having an emotional. >> so there is no video showing if this was in emotional distress. >> that's correct. >> if it is simply a summary of the training provided to mr. chauvin was present and he did the training, that's
fine. no video or opinion i will not allow. >> getting this touches on something technically reserved during motions in limine. so which training is admitted because inspector blackwell, both parties intend to introduce trainingpa records at minneapolis police department has prepared. determe state or defense needs to prove officer chauvin experience that direct training or is this a general policies and training materials of the minneapolis police department. >> that's what we tried to work out and it's not that we have
the conversation on the back burner. >> all this give you my thoughts and if there's any questions that you have, my analysis of this, we said mr. floyd state of mind is not relevant if the defendant state of mind in his acknowledge and his intent, part of his knowledge is based on training he's received a summary of the crisis intervention that he's received is appropriate. were not getting into the psychiatrist testimony about what was mr. floyd's, was not truly anxiety or whatever, i will not let a trainer say look at the video and give those answers. but evidence regarding what mr. chauvin new and what he was trained on in the may 25, 2020 were irrelevant and allowed. i guess one of my missing mr. nelson that still needs to
be forward. >> before we get into problems in terms of a connection does mr. chauvin actually go through this specific powerpoint presentation. and this goes how to the disclosures were given to me. >> let's switch places here. >> thank you your honor. >> against into certain issues, officer chauvin a 19 year veteran with the minneapolis please department has committed 940 for some odd hours of training, and aware of our continuing education i go on the co e and report i attended this all day long seminar but with all day long seminar there is 5 - 6, seven presentations and
that's ultimately what we see we look at mr. chauvin's workforce records and eisai he attended the 2020 use of force phase one defensive tactics presentation, what does that consist of has been virtually impossible to reconstruct and it goes to primarily how it was original disclosed to the defense, how it was disclosed from the police department, the b.c.a., the b.c.a. to the defense and that formed the basis in my earlier motion in earlier proceedings to get a copy of the b.c.a. drive, when i originally received the training materials for example the training materials are 20 - 30000 pages of pdf format and you can look at pdf of a powerpoint presentation and it says use of force academy,
whatever the topic, no frame of reference as to when this was given and there is no title, no dates and no information, who talked of the course and who attended the course, some of the information contained very important statements on part of the minneapolis police department. when i received the b.c.a. drive much later and i look at them in their native formats, the reason i was not seeing the title of the presentations were the dates of the presentations is because that's how they were saved on the drive. so let's say 2018 phase one defensive tactics, you know that is the training material from 2018 from the defense tactics course or it will say 2018 crisis intervention training, whatever to thousand 18 human factors of force training, the
date and title of these courses were given on that drive. now again you can look in sienna's workforce director program that he got credit for the eight hour day but again which presentation were given on that particular day, there is literally no way to put this together, i don't know if the state would disagree with that. >> if they do can you type a specific training module to the date that mr. chauvin actually attended? >> your honor, what we can do is first show the workforce director training which memorializes what particular trainings in-service trainings the defendant has attended in the titles of those different
trainings. >> then we can have the trainer specifically talk about the materials and curriculum that they developed for those blocks of training. >> for example if it's going to be the fall in-service there is a powerpoint presentation that is developed from the curriculum from the fall service and they can say that powerpoint training was in fact presented. in these materials get recycled from year-to-year and there's nothing markedly different in my view from one to the other they cover in the same generalized concept so from a foundational standpoint i think is pretty clear the training and the content was imparted in this particular class and the defendant attended that class. >> and unnecessary foundation we
agreed that this is the training provided on this date as the defendants records show he attended. even if it's embedded with eight hours of over training i think that would make it relevant, if your training where you cannot connect to the training that mrt say you lay the foundation. but it sounds like you have the foundation, am i correct. >> i think it's pretty clear your honor despite the other issues mr. nelson identified, you can cross-examine and say this is a powerpoint in the midst of eight hours training on other topics and that's plan because it goes through the evidence as opposed to invisibility. mr. nelson one last comment. >> i guess your honor i'm not objecting to the admissibility of this training, the question becomes -- i think i don't think
it's as easy as presented it's because some of the things that they said that they intended to introduce that are clearly from the academy, from the police academy there not from in-service records but it contains the information that may have been a part of some other training, there is a powerpoint presentation from the minneapolis police academy about nerve manipulation and basically joint manipulation nerve ending and how to gain compliance through crossing someone through marriage. it's clearly a training material from the police academy from 2017 or 2018 officer chauvin was not in the police academy in 2018 will ultimately it is part of their training, where did
that come from when was it presented to him, i do not know and i don't think there is no other record of that type of training, the training materials into levels the minneapolis police department comes in and says we never trained our officers to do x. insert ask. but there are training materials that contradict that testimony that undermine that testimony and i'm not questioning the foundation for these records, these records exist they all come from minneapolis police department, whether or not i need to show that mr. chauvin had that specific training is one question. >> it seems like there's two levels and i think the foundation for this training material is one level and in
certain training and the defendant has been exposed the part about training for the certain knowledge, that seems admissible. if it's training provided by mpv but no indication that mr. chauvin took it and this is not the version he was trained on that does not seem relevant all. the only way that i see training that he had not attended which might be relevant is to impeach, i don't know if this is true or not, i just know that lieutenant zimmerman said in his 40 years roughly on minneapolis police department the use of force training every year, he was never trained to do x. as you have use of force training that impeach is that statement i think that is appropriate impeachment but aside from that i don't see why testimony that the defendant has not been a part of should be admissible at all. >> that was a concern that i had
and raised in terms of why i thought it was important that each side identified the training materials that needed to be or intended to be introduced. again i agree with the court's analysis, it's an impeachment question on one hand and lieutenant zimmerman says we were never trained to put our knees on the neck but there's a minneapolis police department policy this is otherwise an ample training materials that will contradict that statement. that is impeachment of testimony and certainly should be admissible for those purposes. >> and this is training the defendant didn't have, is not admissible. >> i think that goes to some of the broad problems that i raised you can have every single
officer common and say this was wasn't the using entered reasonable use of force in the training that he had may be different than the training that zimmerman had. >> from lieutenant singerman and use of force we're going to hear from the commander or the then commander of the training unit about it and beyond that we have a expert witness from the state and the defense, is that correct? >> to expert witnesses from the state your honor. >> we are getting to the point of being cumulative, were not asking every officer because that is accumulative. by having to that might be accumulative all the without leader. when a be able to ask every officer what would you have done differently, when i go through that i give any good leeway of
the lieutenant that was involved in this case in a peace officer for 40 years in his opinion nygren of the training unit and the two experts, that is it, we're done with it about the use of force. >> you can ask about the intervention. >> this is where i don't know if the state is intending to call any, inspector blackwell is a top dog in the training unit but there's actual use of force instructors, the people who teach these trainings and at least two of them have been repeatedly interviewed by the state i don't know if intending to call the actual trainers as well which is commander blackwell she's not as far as i
could tell teaching these classes and administering and maintaining the training. >> she's a foundational witness to get the records in, i would've expected with the training people but maybe that's not what they intend to do with the state asking inspector blackwell regarding the use of force in the state. >> the state is going to be calling inspector blackwell to describe the training facility and how it's developed, how would set up, how it's administered, she will offer the opinion, i guess it's not an opinion, the fact that the mpd did not train its officers to play sydney on the subjects neck and strained on that position for as long as it happened. and mainly go through the records and describe the
curriculum and the facility and the trainers and how it's staffed and the individual trainers will impart the knowledge from the disciplines. we had the crisis intervention and procedural justice training in the use of force trainer and probably johnny, i don't know if i need to have both testified on the tactic side in the medical training that the officers received from officer mckenzie and those are her trainers, will go into a practitioner level expert and the academic expert but not immediately. >> my main concern is the medical training that they received, again mr. chauvin what was his training and experience, will we start getting into the
opinion how many use of force opinion do we have is accumulative possibly already but i think as you go through each of those it's gotta be talking about training that the defendant receives. here is training that we have because if he didn't take the training it doesn't go to his intent of knowledge. >> understood your honor, the work force records specify what in-service training the defendant has attended and then we have the curriculum of the materials that were presented during those training blocks. >> crisis intervention seems to be relative, use of force training is relevant to this case, medical training is relevant to this case. all of the summaries of the training that the defendant received according to his records and the curriculum.
i think when we start getting into opinions about use of force, i think we should visit about that before we start blurting out opinions, we already had several and need to go carefully because whether our opinion is something that is an appropriate topic for expert testimony, some of the stuff within the jury's knowledge and they should be able to do without an expert. i think let's just go without for now. >> as for accumulative discussion, to add to that, first seen mr. nelson being able defense attorney, i would anticipate by words if you simply tried to prove my case with experts, he would say the state hired experts to say this is unreasonable but what do the people to actually do the work say in.
>> and that is the reason, i need to cover the appropriate notice of use of forced from every angle from the reasonable officer, i understand that some point enough is enough. >> that may be a little bit more clear i think you have the right to somebody who has done the use of force training or whatever to give their opinion about this case. but not everybody, not every trainer and you can see who's done the training, and other curriculum and mr. chauvin participated in say give my opinion there. they were done with mpd people is. >> regarding the defense of tactic use of force. does that make a little more sense. >> it does, i think that was my plan. >> always good to have a plan that's consistent. >> of the court will let me
know. >> let's go in the midst of all of this because everything is fluent. >> arete mr. blackwell. >> in morning your honor, counsel, ladies and gentlemen the state calls doctor bradford. >> raise your right hand. >> to swear and affirm and testimony to talk to the truth and nothing but the truth. have a seat please.
>> before we begin a couple things if you feel comfortable taking the mask off we prefer you that you do that but as a doctor i tell you i've had both of my shots. but we would like you to state your full name. >> doctor bradford. >> we can just call you doctor lang and phil, did you provide emergency care to the body of george floyd who was taken to henderson county on the evening of may 25? >> i did.
>> just for the introduction are you the physician who officially pronounced him dead that night. >> that is correct, yes. were you one of the physician to try to save his life. >> sustain. >> to do a minister care to george floyd on may 25, 2020. >> yes. >> what we tried to do. >> we were trying to resuscitate mr. floyd. >> to save his life? >> correct. >> why don't we learn a little bit about your background doctor langenfeld, where are you currently employed? >> i'm working at the clinic and hospital in grand rapids minnesota is my primary practice and i also work in laconia minnesota richfield medical center. >> laconia is in carver county.
>> it several hours driving away from you. >> that's correct. >> by grand rapids? >> i was born there, that is my hometown. >> is also the hometown of judy garland. >> are you licensed in emergency medicine? >> i have a minnesota state medical license and practice emergency medicine. >> would you tell the ladies and gentlemen of the jury what is emergency medicine as a practice of not. >> it's a very broad practice but primarily it involves taking care of patients suffering from critical illness such as strokes, heart attacks, car accidents, other emergencies such as that but also less emergent conditions sore throat, urinary tract infections, things like that.
>> when were you first licensed. >> may of 2020. >> would you tell the ladies and judgment of the jury a little bit about your educational background. >> i attended medical school at the university of matter under minnesota twin cities and residency at hesitance county medical center and when did you finish your residency? >> last summer. >> have you ever had any occasion to testify in a court before? >> no i have not. >> this is the first time? >> that is correct. >> let's go to monday may 25, 2020 last year memorial day. do you recall whether you were working that evening? >> i was, yes. >> where were you. >> i was in the emergency department. >> at the medical center? >> that is correct. >> what is your position or title there? >> it was one of the senior
residents involved with direct patient care including critical care and overseeing some of the junior residents. >> to recall a time your shift again and ended. >> and began about 1:00 p.m. that day and ended at approximately 11:00 p.m. >> as a senior resident, what was your role. >> my role primarily direct patient care, i work underneath attending physicians as a resident. >> did you also oversee any other residents. >> yes. >> which residents would you have overseen. >> more junior residents earlier in the residency training. >> was care administered to george floyd on may 25 by yourself? >> yes. >> it was a person primarily responsible for george floyd's
care in the medical center emergency department questioning. >> i provided the majority of direct patient care under supervision of doctor ashley strobel who is my attending physician at the time. >> were you the primary decision-maker. >> i was. >> were you the person responsible for the direct patient care? >> yes. >> was mr. floyd's body when it was brought in would you describe as an emergency situation. >> yes, absolutely. what was his condition in terms of his cardiac condition. >> he was in cardiac arrest. >> his cardiac arrest mean he had had a heart attack or what does that mean. >> not necessarily. >> what does cardiac arrest technically mean. >> cardiac arrest is defined in
sudden sensation of blood flow to the tissues of the body when the heart stops pumping, typically as evidenced by absence of a carotid pulse. >> in late people's terms if we were to say cardiac arrest means a heart stop without the accurate. >> yes. >> what was your immediate objective when mr. floyd comes in when he's in cardiac arrest, what were you immediately trying to do. >> find a way to get the heart to pump on its own again, the primary goal in cases such as this is to achieve ross which means return of spontaneous circulation and part of that process involves trying to identify the cause of the arrest to see is there is any reversible causes and continuing cpr and other lifesaving measures. >> is time of the essence.
>> yes. >> how did you first learn mr. floyd was being transported to the emergency department at the medical center. >> i received exhibit page and ems notification. >> first tell us what ems is. >> emergency medical services. >> exhibit is that a text message or how would you describe. >> it's sort of like an encrypted text. >> what time did that come in. >> i do not recall exactly maybe around 8:50 p.m. >> what information was provided to you for his care of treatment. >> the information was a 30-year-old unidentified male who was in cardiac arrest and
that's as much as i can recall at this time. >> do you recall whether any information was given to you as to what may have happened to him ahead of time before he got there to explain the cardiac arrest? >> not at the time, not before he got there. >> did you know at the time that he arrived that the patient was in fact george floyd? >> i did not. >> so you learn that at some point later that it was george floyd. >> yes. >> did you also know at the time that there was a video or any videos that detected what it happened to mr. floyd before he was transported to the medical center on may 25? >> no. >> you can answer we aware of any existence of any videos what may have happened before he
arrived at the medical center on may 25? >> no. >> did you subsequently learn about videos? >> yes. >> were you able to evaluate your assessment about george floyd in light of the videos questioning. >> yes. >> will talk about those a little bit later. when you received this zip it what did you do in response too? >> we prepared a bay and our stabilization room which is essentially a large room with a lot of critical care resources, we sorta prepped the teams and got ready to take care of the patient when he arrived. >> to recall what time mr. floyd would've arrived in the emergency room. >> approximately 8:55 p.m. >> when he arrived, had cpr been
started? >> yes. >> any mechanical devices or other things being used to help to stabilize? >> yes there was a lupus cpr device which is basically a mechanical device that sits across the body with something that looks like a plunger and pushes against the chest to provide cpr and chest compressions. >> so this device was on mr. floyd when he arrived at the hospital. >> correct. >> did you ever observe at any point in time that his heart was beating on his own? >> not to a degree sufficient to sustain life. >> do you recall who brought mry department questioning. >> i do recall two paramedics
and possibly one or two other people but i don't remember exactly. >> to recall whether there was any police officers also? >> i do not recall that. >> did the paramedics who arrive at the emergency department give you a report. >> they did. >> do you recall what they said for purposes of treating mr. floyd? >> i do, the report that they gave us they were called to the scene of someone who is suffering from medical emergency as i recall and this is what i was told at the time they were initially called for a lower type of acuity event of facial trauma and that was upgraded to an individual in distress, they reported on their arrival the individual did not have a polls and cpr was started.
they placed a super quantic airway device basically. >> a super wet. >> a super quantic airway device which is the tube that goes under the throat and can ventilate the lungs and then they gave medications including epinephrine and sodium hi carbonate to try to resuscitate mr. floyd as cpr was ongoing. >> did they tell you that mr. floyd was in police custody? >> they did mention that he was being detained at the time. >> did you recognize either one of the paramedics who came in? >> i did recognize both of them and i've worked with one of them several times before.
>> did you know a derek smith. >> i believe so, yes. do recall having worked with a derek smith before. >> i do. >> how often. >> several times throughout the course of my training. >> when the paramedics bring a patient in to the emergency department, is it standard protocol for them to tell you why they're bringing the patient and, what's emergency. >> yes. >> and what the paramedics told you in regarding to mr. floyd did they also give information when they brought mr. floyd in? >> they did they essentially gave the report that i just told you. >> did they say to you for purposes of carrying or giving treatment to mr. floyd that they felt he had suffered a drug overdose. >> not any information that they
gave no. >> did they tell you in the information that they gave that they felt mr. floyd had a heart attack? >> no. >> did you receive any information or indication from the paramedics when they brought mr. floyd in that anyone had attempted cpr on mr. floyd at the scene? on may 20 for 2020. >> i did not receive a report that mr. floyd had received by standard cpr, no. >> did you receive a report that he had received cpr for many of the officers will nab it on the scene may 20 to 2020. >> no.
>> is the administration of cpr right away important for you to know when you're dealing with the patient who was suffered cardiac arrest, is it important to know about that? >> it is in the sense that it informs the likelihood of survival. >> what you mean by that. >> it's well-known that any amount of time that a patient spends in cardiac arrest without immediate cpr it decreases the chance of good outcome of approximately 10 - 15% decrease in survival for every minute that cpr is not a minister. >> did the paramedics tell you anything that they had administered to mr. floyd? >> yes. >> and they tell us what they told you.
>> that they had started cpr in place the airway device and started begging the patient in providing breast and ministering the drugs. >> when you talk about bagging the patient, could you describe what that is. >> is called a bbm mask it is essentially a device that is hooked up to oxygen on flow to simulate giving a breath or mouth-to-mouth as it might be more better understood. >> did the paramedics start something that is referred to as the acl s. >> yes. >> would you tell the ladies and gentlemen of the jury what is the acl s algorithm. >> acl s stands for advanced cardiac life support, it's basically a standardized way of
taking care of patients in cardiac arrest. >> these are protocols or the checklist process that you go through when somebody shows up in cardiac arrest? >> correct. >> a little broader than that but a big part is for folks in cardiac arrest, yes. >> does it help you determine why the person might be in cardiac arrest so you know how to treat them. >> yes had the paramedics try to reset the tape mr. floyd. >> yes. >> you recall how long. >> the report that we received was for approximately 30 minutes. >> you had mentioned to us a moment ago that they had sodiumcarbonate would you tell m what are those administered for. >> snf room is adrenaline, it's
a drug that has been studied extensively in part of standard protocol for acl s, the evidence on it is somewhat controversial but as part of the standard protocol. sodium bicarbonate is a medication that may provide buffering of the acidic environment in the blood that occurs during cardiac arrest and that is perhaps more controversial medication. >> to the paramedics tell you whether they check mr. floyd's heart function. >> yes. >> let me ask a different way. >> i want to talk to you about to enter two different heart functions and if you can describe what they are to the jury and if they relate to mr. floyd will. the first when we refer to is
pea, do you know what pea refers to? >> yes. >> pea refers to electrical activity, it is basically the situation where someone is in cardiac arrest and do not have a polls as we previously discussed and they do have some electrical activity on the monitor and that suggest certain underlying causes that are known to be more common the most common cause of someone being in pea arrest the most common cause or hypovolemia which are typically bleeding or hypoxia or low oxygen is. >> we will talk about those in more detail but was mr. floyd in pea status polls list electrical
activity when you saw him on ma? >> he was. >> there is another term i would like to talk about and have you explain to the jury of sicily i think it's called, am i pronouncing that right. >> would you spell that for the ladies and gentlemen of the jury. >> and what is that. >> is probably best known as flatlining where there is no cardiac activity on the cardiac monitor and the patient is in cardiac arrest. >> was mr. floyd in this status also when his body was brought into the emergency department on may 25? >> at some point yes there was report that he was felt to be in that prior to arrival. >> and meeting flatlined was
there any point in time during your treatment on may 25 that mr. floyd was anything other than flatlined during your treatment? >> there were times for the majority of his time and are emergency department he was in pea arrest and that did dissolve into asystole. >> is pulseless electrical activity pea arrest, are those conditions of the heart where you can simply apply a shock and potentially bring the patient back? >> no. >> what are as we refer to shock ebola rhythms, is there such a thing a shock ebola rhythm. >> typically these are either central or ventricular sacral ration which are abnormal rhythms of the heart.
. . . rhythm. >> that mr. floyd didn't have ventricular cardia? >> correct. >> because his heart wasn't pumping. >> yes. in both situations, it's a little more complicated than that, but yes. he wasn't in defib. a. >> do you recall where there still handcuffs on mr. floyd when he was brought into the department? >> i do not specifically recall if they were on when he arrived, but it would be unlikely because
he had the lucas cpr device on and i recall his hands being at his sides. >> do you recall with his hands at his sides if they were marks on his wrists? >> at the end of the case, yes. after he was declared dead. >> in terms of any indentations on his wrist or markings -- >> i inferred that it was from handcuffs. >> so, let's talk about then the care that you provided once the paramedics brought mr. floyd to the emergency department. what did you do? >> so, immediately on arrival, we took reports from the paramedics. mr. floyd, as we knew him at the time only as an unidentified individual, was transferred over to the bed in the emergency department.
as i recall, multiple things typically will happen simultaneously in these cases, but we achieved additional access. i placed a lien in his bone in his leg. >> can you tell the ladies and gentlemen what this is? >> it's basically a type of iv in the bone in the leg and injects medication directly to the bone marrow essentially. it's a type of access easier to achieve in someone in cardiac arrest. >> and did you also go through the advanced cardiac life support protocol? >> yes, simultaneous to that and obtaining the blood draw and continuing chest compressions, et cetera, went through various different things that could be
the t's, which were part of the protocols for advanced cardiac life support, could you briefly explain to the jurors what the ages and teens are? >> so, these are common reversible causes in cardiac arrest and individuals with cardiac arrest a lot of these are perhaps best done with an ultrasound based approach but i can go through all of these. hypovolemia typically hemorrhage or bleeding, so we would think of that war in a traumatic cardiac arrest. hypoxia is low oxygen, again the two most common causes of the arrest. hydrogen ions, acidosis can be from any number of causes but essentially where the ph in the
blood gets so low that the heart cannot function. ipo hyperkalemia can be extreme and lead to cardiac arrest. toxins there's a lot of different toxins that can cause cardiac arrest. >> and that his plays and potentially through drugs. >> correct. tampa not his fluid around the heart, it can prevent the heart from filling and then lead to the heart stopping. tension pneumothorax is air around the lungs between the lungs and the chest wall. essentially it expands to the point where it prevents blood from returning to the heart and
therefore leading to cardiac arrest. cardiac thrombosis specifically can refer to a heart attack or ruptured plaque in one of the coronary arteries of the heart. and then pulmonary thrombosis or embolism is a blood clot in the pulmonary arteries that prevents blood from flowing from one side to the other of the heart and therefore leading to the heart no longer functioning. >> you mentioned ultrasound. what is the role of ultrasound in studying or trying to assess the cause of the cardiac arrest? >> ultrasound can be used to evaluate many of the different causes. i think people would most be familiar with ultrasound in movies where they look at the baby using an ultrasound device on the abdomen but it is the same technology.
so, we can look at the heart directly and see if there is fluid around the heart for example. we can evaluate for the right ventricle that might be suggested of the pulmonary thrombosis due to increased strain on that side of the heart. we can look for hemorrhage by looking in the abdomen to see if there is any bleeding or bleeding elsewhere. we can look for evidence of tension pneumothorax, for example, we can evaluate the sliding signs on both sides of the chest that would suggest the lungs are up and there is no air between the lungs and the chest wall. >> and the lungs are properly inflated. >> right. we can use it to evaluate for a large number of ideologies. >> so, you went through the
protocols of the h's and the t's. did you have any kind of leading theories for treatment purposes as to what the most likely causes were for mr. floyd's cardiac arrest? >> i felt that i was able to determine some ideologies or causes were less likely based on the information that i had both from the paramedics and also the information that i was able to obtain from my exam and ultrasound et cetera. at the time, based on all the information i had, i thought that it was less likely the patient had suffered from, for example, cardiac tamponade. at one point in the case i was concerned he may have developed tension pneumothorax, but we did
perform bilateral things where we entered the chest -- >> [inaudible] >> i will ask another question. >> you were explaining to the jury that you thought it wasn't likely a cardiac tamponade. explaining why you thought the tension pneumothorax wasn't likely and help the jurors to understand how you might have e. >> essentially used a scalpel to cut into the chest and create a hole between the chest and the space around the lungs. we didn't appreciate any large gush of air that might suggest that there was air in that potential space. >> was there anything that you looked at to determine whether or not the cardiac arrest was likely or unlikely to be related
to mr. floyd having had a heart attack? >> a lot of that is based on the history that we received from paramedics. there was no report that for example, the patient complained of chest pain or was clenching his chest at any point or having any other symptoms to suggest a heart attack. that information was absent. also, the fact that he was in pe asystole as i was told on the initial rhythm check further decreases the likelihood of that possibility. at the time, it was not completely possible to rule that out but i thought that was less likely based on the information that was available to us. >> did the ultrasound play any role in the question of whether or not he did or did not or was likely not to have had a heart attack? >> no, not especially in this case, no, did not.
>> did you consider the possibility of toxins, for example? being responsible for mr. floyd's cardiac arrest including potentially drugs? >> in the sense that it might have informed our care, yes. there was no report that this patient had, for example, overdosed on a specific medication such as calcium channel blocker or any other medication for which there might be a very specific antidote. and so, in that sense i didn't feel that there was a specific tocsin that we could give a medication for that would readily reverse his arrest. >> and what about hypoxia?
>> hypoxia being again one of the most common causes of pe asystole, just in general, i did as i mentioned use the ultrasound to look in the abdomen and didn't see a sign of hemorrhage. there was no trauma that he had suffered anything that could produce bleeding to lead to a cardiac arrest and so based on the history that was available to me, i thought that hypoxia was one of the likely possibilities. >> and hypoxia has an explanation meaning oxygen insufficiency? >> correct. >> did you have any other theories why mr. floyd's heart we have stopped other than
oxygen deficiency? >> yes. i also considered and acidosis in particular excited delirium which is a controversial diagnosis but it was in the differential in this case. >> and were you able to make any assessments about the so-called excited delirium based on your examination? >> again the patient had been in cardiac arrest in 30 minutes. it can be difficult based on the examination. certainly there was no report that the patient was ever very sweaty which is often the case when thinking about excited delirium. there was no report that the patient had ever been, that mr. floyd had ever been
extremely agitated in my experience i've seen a lot of cases of mental health crisis or drug use leading to severe agitated states that is almost always reported by paramedics and so the absence of that information was telling me that i didn't have any reason to believe that that was the case here. >> so, how long was mr. floyd in your care in the emergency department? >> approximately 30 minutes. >> and at the end of the 30 minutes, did you pronounce him formally dead? >> yes. >> at the time that you pronounced him dead, was he still in some degree pea or a systole in terms of describing his heart?
>> i think it is probably best to think of these as sort of a spectrum where it is some degree of activity running through the heart but the heart isn't pumping, and then eventually that will evolve into a systole where the heart isn't pumping and the electrical activity stops. at the end of the case, mr. floyd was still in pea but there was no cardiac activity and at that point, in the absence of any apparent reversible cost and because mr. floyd had been arrest 60 minutes, i determined that the likelihood of any meaningful outcome was far below 1% and we would not be able to resuscitate
mr. floyd so i then pronounced him dead. >> and was your leading theory then for the cause of mr. floyd's cardiac arrest oxygen deficiency? >> that was one of the more likely possibility i thought at the time, based on the information i had, it was more likely than the other possibilities. >> and is there another name for oxygen deficiency? >> asphyxia is commonly understood. >> thank you, doctor langenfeld. no further questions. >> [inaudible]