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tv   Day 9 of Trial for Derek Chauvin Accused in Death of George Floyd  CSPAN  April 8, 2021 5:30pm-6:18pm EDT

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you are watching live on c-span2 the senate will come to order. the clerk will read that medication to the senate. ifhe a late, 2020 20s ascendance provisions of row one paragraph the standing rules of this and i hereby appoint honorable senator from the commonwealth of virginia to perform the seat of the chair. under the previous order the senate stands adjourned until 3:00 p.m. on monday a april 12. 2021. >> the senate returns for legislative is this monday for more work on nominations and the covid-19 hate crimes bill per watch the senate live right here
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on c-span2. we return now live to the dark chauvin trial in the death of george floyd's. >> do you teach your students regarding some of these myths? >> yes strangulation is a form of asphyxia and it's part of every class i teach. what are the myths associate with strangulation and what you see and what you don't see and why you see something or why you don't see something. >> for example in the teaching of your students what do you teach them regarding inferences that can be made by the presence or absence of bruising on the body and an autopsy? >> bruising, you can be fatally strangled die of asphyxia have no bruising. the presence or absence of a bruise on the human body have multiple different variables.
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how much pressure is applied? how was that pressure applied? how frequently is that drescher applied? an example that i like to use is you can have someone put your biceps and forearms on either side of your neck squeezed rendering you unconscious and kill you and you will never ever see the bruise on the neck and the reason is you are applying a broad surface area, or broad surface area. it is different if i were to take a -- put it around somebody's neck and pulled it tight. i'm putting the same amount of pressure but in a smaller area and i would expect to see leg or marks or something. so there are lots of variables in predicting whether you have a bruise or you don't. medications can cause you to
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bruise, aspirin and other medications so you can be -- but you have to have ruses with strangulation? no, you don't. you can be strangled to death and have no bruises. so that is one of the big ones. >> can you tell us what they peer hemorrhage is? >> yes. batik you'll hemorrhage as there will ruptured capillaries. when you see them on a patient they are little red dots. what they come from is rupture of the capillary bed. the way i like to think about the hemorrhage of the psycholittle water bubble and what happens when i put too much water into the bubble in? the pops and what happens if i put too much blood and to
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capillary? it pops. >> what does the presence or absence of batik you'll hemorrhage tell us of if a person did or did not die of those asphyxia? >> it tells us nothing because in order to create that ruptured capillary bear to his illogic things that have to occur in the body. one, i have to have the venus returned and in the case of the neck the jagger vein block and how does that happen? and putting pressure on the neck. the second thing that has to happen is i have to have blood still being pumped into the area of the body of that capillary bed. if both of those two criteria are not at why can blood continue to be pumped and i will never ever get a petechial hemoorrhage. you can be fatally strangled and
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not have petechial hemoorrhage because of those two physiologic criteria are not met it will never happen. >> i want to show you a few of the video clips as it relates to your conclusion that mr. floyd passed away from asphyxia or lowered oxygen so i want to play the clip and tell me how was significant to your decision. if we could pull up exhibit 127 and evidence, 2021. >> yes stopping at 2021. i'm sorry. >> on the ground, on the ground.
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>> i can breathe. i can't breathe. i can't breathe. i can't breathe. >> stopped moving. >> mama, mama, mama. oh my god. i can't breathe. i can't breathe, man. mama i love you. >> is this a segment doctor smock that you listen to and observed? >> this is one of the segments.
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>> wises relevant to your assessment? >> what is important is the assessment is what's happening over the entire length of the video. in particular this first section what we are looking at is listening to mr. floyd's voice. he is speaking with full volume. and then i want you as we go through these different segments compare what we are hearing now to what we hear later and how his voice changes. so i want you to also look at the positioning of mr. floyd and where is the? where do we see pressure being applied to his neck, to his upper back and his lower back. it's also very important that as this progresses and this is a progression over 4.5 to five
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minutes of mr. floyd gradually decreasing his ability to survive and what you will see and this is, does this were? >> it does. >> what i want you to also watch for is what is his right arm doing? you will see him pushing against the tire. you will see his right arm and elbow pushing. >> i'd like to noted here and you circled an area on this exhibit. what is this? >> i would like to know what is it showing us ex. >> this is very important because it showing what mr. floyd is doing to try and breathe, to get his -- up off the pavement. >> let's look at another segment. if we can start at 2021.
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>> i can't breathe. i can't breathe. >> relax. >> i can't breathe. please, i can't breathe. i can't move. mama, i can't. >> you can't win. [inaudible]
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>> please, please. i can't breathe officer. come on, man. i cannot breathe. i cannot read. i cannot breathe. [inaudible]
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>> why do we stop it there. >> .org smock as you listen to that and that was the one you chose to play for the jury what was significant about that? >> what we are seeing again and if you're listening to his voice it's not getting gradually weaker as we are going through this. he is telling the officers i'm about to die. he is watching his body move turning his face into the pavement to try to get more oxygen. this is the progression as we does that i step and deeper into lower levels of oxygen in mr. floyd lungs. we also have, using his elbow to try and leverage his chest up.
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>> doctor in addition to the restraint we see there in the video was there other evidence including physical evidence that supported your conclusion that mr. floyd died of low oxygen or 60 a? >> yes and i think it will be in the next session -- section as we go through, we hear his voice get weaker and weaker. you will see him lose facial expression. you will hear him make sounds of trying to breathe. he then goes unconscious. he will then see in the next section he has what is called an anoxic feature a fancy word for his brain is going without
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oxygen, his legs shake and you will see and you can hear the handcuffs shaken you will see the body shake when he has an anoxic seizure further on down the line. sparrow for their visible injuries to him as well that you could see doctor smock? >> yes. his left shoulder was ground into the pavement from the pressure from behind and the left side of his face had deep abrasions from his face being pushed into the pavement. >> in the interest of time this afternoon i want -- i won't show additional 81 i want to ask you about a different subject that relates to cbr. could you tell us about the importance of timing with respect to performing cpr? >> a sooner we start impressions
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and ventilation's the higher, the more successful the resuscitation rates will be. >> at what point should cpr have been commenced with respect to mr. floyd? >> way before it was. as soon as mr. floyd is unconscious he should have been rolled over. we have documentation on the video that the officer said i can't find a pulse. that is clearly when we look at the video it should have been started way before. he should have been rolled over checked his respirations but clearly when they can't find a pulse cpr should have been started. >> thank you. or smock. no further questions.
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>> good afternoon doctor smock. thank you for being here with us this evening. you say you are not pathologists. >> that is correct sir. >> you are not trained in anatomic pathology? >> it's part of my frantic training but i don't consider myself in anatomic pathologists. >> and you are not trained in forensic pathology.
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>> that is part of my training so yes i am trained in forensic pathology as it applies to the living patient. >> and you are not ford's certified in forensic apology? >> that is correct. >> you practice emergency medicine correct? >> that is correct sir. >> and you have experience in forensics and -- that is correct >> du in addition to your practice -- in terms of forensic apology? >> i do get the journal of frantic medicine. >> and how many autopsies have you performed? >> physically performed what is called -- 100 how many autopsies have i attended? thousands. >> okay. you would agree that methamphetamine and fentanyl when combined produces a
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different result. >> it made depending upon the level. >> so there are variables but essentially methamphetamine and fentanyl combined is different than a reaction to fentanyl? >> that is correct sir. >> and you would agree in emergency rooms of late the number deaths we relate to methamphetamine and fentanyl combination have increased? >> i can't speak of as of late but it wouldn't surprise me sir. >> and that type of the death methamphetamine and fentanyl and is different and the death of a simple, not a simple fentanyl but it do to my exclusive to have? >> depending on the level you sir. >> the loveland individual person right?
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>> that is right sir. >> there is no state-level love -- >> they are is a safe level of amphetamine. >> in terms of street levels street purchase methamphetamine there would be no valid medical basis? >> that is correct for methamphetamine. >> now you talk a little bit about the, state and did what you would expect what was the duration you expect to see a coma state in the fentanyl overdose? >> it depends on how much fentanyl is and that can individual system and how quickly do we get in our cam on board -- narcan onboard. lots of variables. >> lots of variables. you talk about positional asphyxia and you have reviewed the autopsy. did you see any medical autopsy
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were any physical evidence from the autopsy that can point to mr. floyd airway being obstructed? >> no sir not in the autopsy. >> and while mr. floyd initially was on the ground he was talking, right? >> he was sir great. >> india one point raised his head. >> yes sir. >> and he for some period of time was alert, correct? >> yes sir he was. >> he was coherent and he was making sense. >> yes sir. >> what is the evidence on the autopsy of significant force that was used to keep him in the prone position and? >> the evidence was not on the autopsy was on the videotape sir. >> okay. >> you're talking about how mr. floyd maintained for stated that he could not breathe well
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in the prone position. >> that is correct sir. >> you stated that before being in the prone position as well correct? >> that is correct. >> several times. >> is correct sir. >> at that point when you -- when he stated that he can't read that he was in the back of the car there was no one on his back, right? >> that is correct sir. >> there was no evidence to suggest there is a respiratory suppressant such as fentanyl on board? >> no sir. >> i know you prepared a report. have you've been advised that partially ingested cells were located in the back of squad 325 contained mr. floyd's dna? >> yes sir i was. >> you are advised that those
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pills were methamphetamine and fentanyl combination. >> that is correct sir. people who have their respirations suppressed as a result of fentanyl don't necessary die. >> that is correct sir. >> treating people in the er you treat people with cardiac disease is? >> yes sir i have. >> in terms of your treatment of people with cardiac diseases have you encountered people who have a combination of methamphetamine and fentanyl?
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>> yes sir i have. >> obviously every single person is unique, correct? >> yes sir. >> you have experienced a blonde methamphetamine and to know -- passed away? >> not necessarily does but maybe something else. >> sometimes it could be just fentanyl right? >> we expand. >> you treat people with covid at the er? >> i don't think i have treated the to lease officers of covid sir. >> very aware that people who were in the icu with covid are often held in the prone position and? >> yes, sir. >> and that assist them in their oxygenation, correct? >> that is correct sir. >> they don't necessarily suffer sudden death, right? >> that is correct.
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>> people may not be moving around very much. >> they are probably not moving around very much. >> methamphetamine certainly has an effect on the heart come or write? >> yes sir. >> you are aware that methamphetamine can be prescribed, correct? >> amphetamine can be prescribed >> amphetamine can be prescribed. one of the side effects of prescription amphetamine is sudden heart arrhythmias, right? >> at the pens upon the level. it is a rare side effect but it's possible. >> you talk about the pressure that somebody may have for the lack of bruising, right? the surface area of the pressure that is applied, right?
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>> that is one sir that is correct. >> dennis has a relatively small surface area compared to the entirety of the arm, right? >> actually few think about the size of any on a neck that's comparable sir. >> you would agree that in this particular case you met with prosecutors, right? >> yes i have sir. >> and you would agree that generally speaking mr. chauvin did not block both carotid arteries, right? >> yes correct sir. >> he may not locked one of the carotid arteries, right? >> it is hard to know. he could have locked one of the arteries. >> even if he had it would stop collateral flow, correct?
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>> that is correct sir. >> so it would be very difficult to render someone unconscious by the locking one carotid artery? >> that is correct sir as long as they have carotid flow meaning one of the other arteries in the neck. >> generally speaking in order to render someone unconscious by blocking the carotid artery you have to block both carotid arteries and when that happens it happens very quick he? >> that is correct sir. >> less than 10 seconds? >> that is correct sir. >> you ever viewed the videos many times? >> i have sir. >> spent a lot of time studying and analyzing the video's? >> yes sir. >> how many hours would you estimate you have spent analyzing the video's?
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>> 10. >> and you were able to see this incident from multiple different camera perspectives, right? >> that is correct sir. >> if mr. chauvin's knee was placed at the posterior taste of the neck, right? base of the neck it wouldn't have my defect on his diaphragm write? >> no sir. >> you work with police officers quite regularly? >> yes sir. >> and i'm assuming because you work with s.w.a.t. tactical places or two arrests, right? >> yes sir. >> i assume you have seen the prone handcuffing technique and
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i assume you have observed police officers using the prone control techniques? [inaudible] >> it's a within the scope of expertise. >> part of your expertise and training with police officers, you train them in terms of how to properly train people in terms of positional asphyxia? >> yes sir i do. >> and how to avoid positional asphyxia from occurring quite. >> a police officer -- [inaudible] >> so based on your experience and training police officers you experience it accompanying police offers to areas arresting you have observed police officers in the prone -- use the prone handcuffing technique like
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>> yes i have for sure. that time. >> you have scene them place their knee on the host or your part of the neck? >> yes sir for sure period of time. >> obviously it depends on every circumstance and situation, right? >> i don't understand your question sir. >> i will withdraw. was there bruising on mr. floyd's bat that you are aware of? bruising in his neck? >> no sir. >> above the skin or below the skin and? >> no sir there was not. >> there's unquestionable evidence of mr. floyd had cardiovascular disease, right? >> that is correct sir. >> do believe the pathologists who perform to autopsy found that 90% blockage of the right coronary artery? >> yes sir. >> and your experience as an emergency room physician you could refer to someone to have a
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procedure to open that up, right? >> in times of a heart attack or cardiac ischemia not getting the oxygen to that hard of a heart. >> that is called a stent. >> that is correct sir. >> the purpose of that is to increase or improve the blood flow to the artery write? >> that is correct sir. >> if you have a locked vessel that can lead to a heart attack right? >> that is correct sir. >> it can lead to a cardiac arrest, right? >> if it's completely blocked that is correct sir. >> when it's not completely blocked it forces the heart to work harder? >> yes sir. >> oftentimes people go through substantial risk of heart surgery to have that fixed, right?
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>> to have the partial blockage fix. >> that is correct sir. >> you ever viewed all of this his previous medical records that were made available to you? >> yes sir i have. >> and high blood pressure from these hospital admissions were noted, correct? >> that is correct sir. >> there is no dispute that methamphetamine was in his system at the time of this incident? >> he had a very low-level sir he. >> and that increases the heart rate? so again it increases the demand on the heart, right? >> absolutely it can sir. >> if you had, i will strike that. you are aware that mr. floyd had engaged in a struggle with police before he was placed in the prone position, right? >> yes sir i did.
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>> that type of physical exertion puts a certain demand on the heart, right? >> it can. >> when you observe that struggle you could observe his vein pulsing? >> no sir i did not. >> the kind of physical exertion of struggling with a couple of police officers, would you say that summer to something a putting the heart to the disick will exertion? >> that is not purple to a stress test. the stress test is when you are put on a treadmill and you are hooked up to monitors and then you go faster and faster and the level of the treadmill can go up, up-and-up. >> so similarly when you are
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struggling with police officers your heart rate can go up-and-up and up, right? [inaudible] >> people have had cardiac arrhythmias during struggles with police before? >> yes sir. >> what is the physiological mechanism of a person suffering brain injury from hypoxia? >> within the brain, levels of oxygen start going down. certain things will happen. their level of consciousness begins to decrease and when they get to the point where their oxygen level is very low then they will have that anoxic seizure as you saw with the shaking of the leg and the
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shaking of the rest and then as time goes by more brain cells die. for every second the brain goes without oxygen, millions of neurons and cells will die so what happens when you get to that state, you have rain damage and whatever the cause is, you die. >> so then brain damage can occur from low oxygen? >> that is correct sir. >> when mr. floyd was speaking to the police officer, as he was in the prone position do you see any evidence that his brain was injured at that point? >> which barred because he speaks in full sentences were full boys early but later on his
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speech gets weaker and weaker until there is no speech so which window are you talking about? >> at any point when he is speaking with police officers would there be brain damage at that point? >> not while he is speaking sir. >> and people suffer brain injuries while they are conscious? >> depending upon the mechanism, stroke would be an example, he hit in the head would be another example. >> one question i want to ask you, you talk a little bit about tolerance, right? and how people can build a
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tolerant particularly to opiates relatively quickly, right? >> i didn't say quickly. >> will people build a tolerance right? you are not a toxicologist, correct? >> no sir i'm not. >> they have a general familiarity based on your extremes within emergency doctor people have tolerance. >> that is correct sir. >> when someone stops using a controlled substance for a period of time that tolerance lessons. >> that is correct sir and with certain types of controlled substances tolerance dissipates very quickly? >> i'm not familiar with how quickly it decreases or increases. >> so a person's tolerance is situational, right? let me rephrased.
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that tolerant could happen over an extended perry of time. tolerance, once a person stops with that controlled substance the tolerance dissipates? >> that is correct. >> over some period of time. >> that is correct. >> it could be days, could be weeks, it would be months. >> my experience it's weeks to months, not days sir. >> someone not using a controlled substance for several months, two or three months and they are going to lose that tolerance, a great? >> some part of it, they may depending upon the substance. >> and then if they start using again and they start to build that tolerance up to some degree. >> that is correct sir. >> they have a chronic use for some period of time decrease their tolerance to some degree and once they start using again they aren't going to instantly
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jump up to the same tolerance level. [inaudible] >> overruled. >> the tolerance is occurring in the rain as you see different levels that tolerance will change over time. >> did you see any evidence in terms of his autopsy or medical records that he had any history of lung disease, mr. floyd that is? >> i believe he had a history of covid. >> other than covid any other -- essentially he would have had healthy lungs? >> i don't recall specifically.
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>> but there was evidence of heart disease, right? >> that is correct sir. >> when someone is experiencing based on your your experience experiencing a rythmia they would experience that sensation of shortness of breath? >> it depends on the nature of the arrhythmia. >> when someone is experiencing a heart attack, right, their vessels are blocked and the stress of their heart has increased they would describe a shortness of breath. >> objection. [inaudible] >> overruled. >> the patient can complain of shortness of breath while they are having a heart attack, is that correct? >> you heard the officers asked him if you are aren't controlled substances?
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>> i believe it was are you on something? >> is a person at a greater risk for respiratory effects if they are under the amp funds of methamphetamine? how about a combination of methamphetamine and fentanyl? annika depends upon the level sir. >> cardiac disease have any relation to methamphetamine use, chronic methamphetamine use? >> yes sir. >> i have no further questions your honor.
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>> doctors smock you're asked quite a few questions about heart disease or high blood pressure. i want to bring this home to mr. floyd and that is whether we are talking about blockage of the artery, high blood pressure, any of those was there any evidence that you saw that george floyd had a heart attack? >> they are was hopefully no evidence in the autopsy of anything that suggested mr. floyd at a heart attack. >> there is no evidence of a blood clot in no evidence of hemorrhage from the ruptured plaque and no evidence mr. floyd had a heart attack. >> what about on the autopsy report was there any evidence that george floyd had a heart attack? >> no sir there was not.
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>> u.s. questions if there was a lethal or fatal arrhythmia. if somebody has a fatal arrhythmia that they die from is at the sudden-death? it is sir. >> they have the arrhythmia and that's its? >> they have the arrhythmia and. >> to george floyd have a sudden death that look like an arrhythmia? >> no sir via the gradual decrease levels of oxygen over the course of minutes. wasn't sudden, as gradual because the pressure being applied was to his back and neck. >> u.s. questions about her this or floyd sang i can't breathe when he was in the back of school squad three remember that? in the videos that you saw to deter mr. floyd saying i am getting choked? did you see anything that suggested the struggle in the back of the car that anybody had a hand on his neck or throat? >> not in the car. mr. chauvin did put his hands around his neck as he was
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getting out of the car but not in the car sir. >> if there is someone getting choked that's the reason i couldn't breathe. >> yes sir. >> you were asked questions about whether or not the restraint of mr. floyd on the ground was a -- can you think of from annie's stretch of the imagination you could refer to being subdued and constrained on the ground for nine minutes and 20 seconds until the pulse was gone as a stress test? so was the restraint on the ground a stress test? >> no sir it was not. >> you're asked whether or not there was any evidence of area destruction on the autopsy.
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was there any evidence of low oxygen on. top secret. >> it only gives -- sir. >> do you recall mr. nelson asking the question relating to mr. floyd on the ground was the alert in making since when he was on the ground? >> or member that? >> yes sir i do. >> if someone is over to making sense out of the officer be. >> that's a good question. >> finally you were asked questions about the combination of methamphetamine in and to know as whether they make a difference dangerous combination. be clear with the jurors did you see any evidence that mr. floyd died of the methamphetamine overdose? >> no sir he did not. did you see any evidence he died of a fentanyl overdose? >> no sir he did not.
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>> no further questions. did you observe any of the events that he was choked from the front of his neck? >> no sir. >> you would agree struggling with voice officers put stress on the heart? >> yes sir it could. >> and with no other evidence of airway obstruction, correct? >> other than the asphyxia event, other than not being able to breathe that was the airway obstruction. >> you were asked to redirect about how could someone who is alert and making sense be intoxicated, do you recall that?
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>> yes sir. >> people lord tolerant of that particular controlled substance showed fewer signs, correct? of intoxication? >> that is correct sir. >> the more someone is used to taking a particular drug [inaudible] and someone who gets arrested for a chronic other like hypothetically who gets arrested for driving under the influence may not exhibit the same physical symptoms or speech difficulties that a naïve drinker may correct? >> the same level of alcohol that is correct sir. >> i have no further questions. >> no further questions your honor. >> thank you doctor. you work skus. thank you for your patients. we will start around 9:15 tomorrow. thank you.
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