Skip to main content

tv   Day 10 of Trial for Derek Chauvin Accused in Death of George Floyd  CSPAN  April 9, 2021 2:32pm-4:55pm EDT

2:32 pm
>> well, it -- i guess i would consider it a contributory to the cause of death. it's another contributing mechanism. >> so the direct cause is what and then the secondary cause is what? >> there's sort of primary neck system is asphyxia and -- or low oxygen and the secondary -- >> for our next witness the study calls dr. andrew baker. [witness sworn].
2:33 pm
if we can statute your full name, spelling each anytime. >> my full name is andrew michael baker, andrew, michael, baker. >> m-blackwell. >> thank you, your honor, good afternoon, dr. baker. >> good afternoon. >> you conducted the autopsy on mr. george floyd. >> i did. >> before we get into the specifics of the autopsy, why don't we explore your background a bit. you're the chief hen minimum county medical examiner. >> that's correct. >> can you tell what that means. >> i've been the chief medical examiner for hen minimum county since 2004. i'm the chief medical examiner for hennepin, da totta -- my
2:34 pm
office provides services to all three counties, third of the state in our area. being the chief medical kearn means i supervise the rest of the staff in particular my other physicians. i have six other doctors as well as a doctor in train that work under me. >> so, before becoming the chief, you were the assistant chief. >> correct. >> and that was in roughly 2002. >> correct. i waffles the assistant chief medical examiner for two years. >> awful in it's been going on 19 years as either assistant chief or the chief. >> correct. >> what did you do before joining the hennepin county medical examiner's office. >> are you asking me to go back to eye indicateas background or my post graduate training. >> the air force. >> oh, prior to coming to the county knock 1998 do 2002 i was major on active duty in the united states air force. served as a forensic pathologist for the department of defense. our unit was known as the armed
2:35 pm
forces medical examiner and at that time we were headquartered the washington, dc area. >> are you board-certified in any areas. >> i am. >> which ones. >> i am board-certified in an tommic and clinical pathology and i hold subappreciatety next forensic pathology. >> tell us what the national association of medical examiner is is. >> yes. the national association of medical examiners is the professional organization for people who do what i do for a living. i want to say we have 800 o. 900 memberes, many are fellows like me, meaning fully board-certified forensic pathologist. we have other categories for support personnel in the profession. >> you are former president of the national association of medical examiners. >> yes. >> in fact, at least as of to date you're the youngest president -- were the youngest
2:36 pm
president ever to hold that position with the name. >> i don't actually know that's true but i will take your word for it, counsel. did not know that. >> so, you have been the president of name. >> yes. >> so, let's move now to the specific autopsy of mr. floyd. could you give us some sense of what you knew about the circumstances surrounding his death before you started your work on mr. floyd. >> yes. so, i was aware that mr. floyd had become unconscious while in police custody. he had been transported to the hennepin health-care and where he was pronounced dead. i believe at the time i started the examination my staff was probably still working to confirm mr. floyd's identity and properly notify his next of kin. that what's background i had. >> had you seen any of the
2:37 pm
videos before you started you work. >> i had not. i was aware one video had gone viral on the internet but i close not to look at that until i examinedmer employed did want to go in with preconceived notions. >> so it was in several days after you had done your work on the autopsy you saw the videos. >> one video i saw shortly after the autopsy and that was the one i think most of the public had seen through facebook or other social media. the other videos such as the swindle and the body worn cameras i decide not see until three or four days after the autopsy. >> could you give us an overview how you conduct autopsies. what is your approach to them. >> sure. so, in a case that is believed to be a homicide or a potential homicide, there's a few more steps involved than a typical natural death or accidental death. we start every exam with a very
2:38 pm
thorough external examination hoff the body in as as-is condition, the medical devices still in place. i if if the decedent lat clothe the clothing would be in place. those things could be evidence to us as the medical examiners, and many cases we will also collect trace evidence, for example, if the decedent's fingernails are long enough we'll collect fingernail clippings and collected some pulled head hairs as exemplars in skis needed. instant wouldn't apply in are in flied's case but other circumstances we shoot a fair number of x-rays before the occupancy start its with looking for things like bullets or stab wound, broken knife tips. then we set the clothing aside carefully, very carefully remove the medical devices and then we examine the body again from head to toe, front and back. we're document this with copious photographs as we go. and then the final step in the external examination is we clean the body very, very thoroughly because we don't want any blood,
2:39 pm
any foreign material, i any plant material, anything that might be on the body to obscure the injuries or diseases that we're look are for and then photograph the body head to toe, front and back. once that part of the exam is done we proceed to the internal exam which is what most lay people think of when the hear the word autopsy. we make careful ex-immigrations that allow to us removal the organs one by one so look for evidence of natural deers, internalled of injury and we're collecting specimen for toxicology, blood and urine. we do remove all of the organs from the tip of the tongue to the gladder and the brain, also remove all of the structures from the front of the neck look for any injury or evidence of disease. in the case like mr. floyd's there are some additional steps we will take that wouldn't occur in most autopsies. for example, in mr. floyd's case i did make incisions of this
2:40 pm
wrists and dissected around the skin underneath to look for evidence of what we would call subcutaneous bruising. >> [inaudible] >> overalled. >> then the last thing i was woo say is in mr. floyd's case i made a special incision from the back of his head to hit but tox and die vetted tout the side of his neck and shoulders shoulderd flanks. we do that because sometimes fresh bruises can be difficult to see in some people so we look underneath the skin to make sure we haven't missed something. the last few steps are not part of a typical autopsy but in circumstances like this it's a generally accepted practice we do that. >> dr. baker is the autopsy part of a broader death investigation? >> yes. the autopsy is just one piece of the medical examiner's death investigation. >> could you characterize the
2:41 pm
umbrella, the death investigation entail overall. >> so, the medical examiner's ultimate mission in addition to properly identifying people is ascertain their cause of death and manner of death. the autopsies one component and has a great deal to do to inform the cause of death and manner of death but we also need to know the decedent's past medical history, get ahold of the decedent's next of kin to see i the decedent could be a donor. we on cotenant the primary physician and get hospital records, if an ambulance was dispatched and took them to the hospital we get the ambulance run sheet as part of the investigation because to get the cause and manner of death right you need to assemble all of those things for the whole picture. >> let's go back to the autopsy aspect of it. how important is it to have a detailed documentation of what you do?
2:42 pm
>> in terms the autopsy? >> yes, sir. >> it's critically important that the autopsy be detail terribly if the death is potentially a homicide because it could end up in court and the work you're doing would be evidence. >> do you create what we might refer to as a robust data set, documenting what you do? >> yes. >> what is all included in that? >> so wheneye the term robust data set i mean i have dictated the most detailed autopsy report i can, describing all the scars, all the tattoos, all the birthing marks, all the injuries, in many cases it's the pertinent negatives meaning the lack of injury, place outside might expect an injury but not there. all of those are carefully dictatedded in a narrative autopsy report but you have to take copious photography as well. me goal is to create asset of photos that is so robust that another pathologist could take my photos and almost feel like
2:43 pm
they'd been there for the autopsy. they have enough data to look at my work and reach their own conclusions. don't have to take my word for it because it's in the photos. >> and the case of mr. george floyd, that's what you did. >> that is certainly my goal, yes. >> your honor, at this point, i'm going to ask dr. baker to identify the photographs from the autopsy. still have them here in hard copy. >> may i approach dr. baker?
2:44 pm
>> dr. baker, i've hand you a number of photographs that should have exhibit numbers 186, 235, 185, 236, 187, 188, 189, 190, 191, and 192. i represent to you that's what you have. >> okay. >> if you could just look through the set and just confirm for the record that those are photographs that you took during your autopsy of mr. george floyd. >> so these are in fact autopsy photographs of mr. floyd and were taken by me. >> thank you. i'd like to redistribute them to the jury, your honor.
2:45 pm
>> dr. baker let me just ask you generally first about documented
2:46 pm
injuries that you saw with respect to mr. george floyd and i'll ask you about specific parts of the body. >> okay. >> did you note injuries to mr. floyd's back. >> i did not. >> didn't see any bruises, scrapes, et cetera. >> correct. >> what beaut injuries to mr. floyd's face? >> yes. mr. floyd has self injuries to his face. >> if you could, dr. baker, look at exhibit 186. and exhibit 235. >> i'll represent to you that jurors have seen these two photos but is the first -- what
2:47 pm
do we see in the two photos. >> these are photographs of the left side of mr. floyd's face. this would be after i have removed or cut away any medical intervention. had there been any blood or foreign material on the body they were cleaned up before the photographs were taken and these were specifically taken to illustrate the injuries you see on the corner of his left eyebrow and left cheek. you seek the bruising and abrasion. that's fans where medical lingo for the scrape on the left side of this forehead and you seek the scrape or abrasion on theft side of his change it's common on post motor tell to take on the dark color. they tend to dry out and look a little bit more like this. >> do you have an opinion as to how mr. floyd would have incurred these abrasions. >> these are the entirely consistent with the left side of this face being pinned against the as fault of the road surface he was on the night before.
2:48 pm
>> in the prone position. >> correct. >> if you, would dr. baker, look at exhibit 185. >> what do we see on exhibit 185. >> this is a flagstaff of mr. floyd lazy face taken early on the post motor tell examination. you can see the scale in the forecast. that's all the photos with the case number and scale allows you gauge the size of what you're looking at. this is a photograph i would take but you can put a face with the decedent's name and the deseed depth's case number and see the injuries we el straight -- you can see the photographs and a small abrasion on the left side of his forehead, the pointpoint --
2:49 pm
pinpoint thing. you can see a laceration, tearing of the skin on his upper left and subtle bruising of his nose and a couple of small abrasions on the right side of his nose and you can see a few small abrasions under the left corner of his mouth. >> dr. baker what is the tube in his mouth. >> the tube is in the endotracheal tube put in during the attempt to resuscitates himself do leave those tubes in place and cut them off before we start the autopsy. that's some quality control we do for the hospital and the paramedics so we can confirm the tubas in the right place when we do our exams. >> dr. baker if you would go to exhibit 187. >> what do we sunny exhibit 187. >> a closeup photograph of
2:50 pm
mr. floyd's right shoulder, centers in the photograph just above the scale you can see what i would call an abraded contusion which is a fancy medical lingo for a bruise that has scraping superimposed on it. >> and exhibit 188. >> exhibit 188 is the closeup photograph of mr. floyd's left shoulder. you can see occupying most of the photograph there is an abrasion, the deep red, and slightly less red and pink injury you see. again, it looks darker thanking you might envision on yourself. teen include these dry out of death and takes the darker appearance. >> is this an injury that is consistent with mr. floyd laying prone on asphalt? >> yes. >> let's look at exhibits 189 and 190.
2:51 pm
what do we sunny exhibits 1891190. >> exhibit 189 is a photograph oneighborhood side of mr. floyd's left hand, exhibit 190 is a photograph thereof he back side of mr. floyd's right hand. in the case we think has the potential to be a homicide we examine the hands very carefully and photograph the hands very carefully. our hand largely the way we interact with the world around us and injuries own the honda sometimes lack thereof can tell us something about what happened. specifically in mr. floyd's case you can see a none of scar-like areas on his knuckles on the left and scattered across the back of his aren't right hand. dose know what those are from. they obviously predate the events of his death and i don't know where those came from. the more acute injuries in the photograph right above the scale in each picture you can see patterned bruise that looks like a train track. the parallel marks. that's typical of handcuff marks
2:52 pm
at autopsy. >> dr. baker, exhibit 191. >> exhibit 191 is a closeup photograph of the back of the index and third fingers of mr. floyd's right hand. he has some injuries of his knuckles. just for orient television if i used my own right hand we're looking at an injury right here and an injury right here on the back of the two fingers. >> did you have an opinion what may be the cause of those injuries. >> these are blunt force injuries, abrasions and lacerations, again, that's damage to the skin from blunt trauma, entirely consistent with if happening been in an altercation with another person and could be from the asphalt or just about anything his hand could have banged into. >> thank you, dr. baker, and put the photos away.
2:53 pm
>> now i'd like to takive you but your examination of mr. floyd's heart. >> okay. >> did you take a photograph of mr. floyd's heart still intact? >> no, i did not. >> would you tell to the jury why not. >> i don't normally photograph organs that appear to be perfectly normal unless there's some reason to. i don't have a photograph of mr. floyd's spleen or live either because those were also grossly normal. his heart was enlarged by weight but that wouldn't really be something you could cap noor a photograph unless it would so excessively enlarged it would be obvious from a picture. >> win we talk about the concerns of the heart -- the
2:54 pm
officers the heart can you describe them 'generally, end dough cardium, it's. >> shirks. >> would you tell the jurors what those are. >> dissecting the heart is one of the most important things we do in every autopsy because the heart is involved in so many of the deaths we investigate. so the first think we do is we carefully remove the heart from the lungs. the next thing is you carefully make sure that there's no blood or clot left in the heart because you want to get a very accurate weight. turns to the weight of the heart is a very good predictor whether the heart is normal. people with high blood pressure their heart gets heavier like any muscle that its worked hard. the heart will degree response to that kind of stress. so we weigh the heart first. then you very carefully dissect the coronary arteries and when i say that you take a scalpel blade and cut every two-three, four millimeters in very fine slices along every one of the
2:55 pm
coroner arteries. normal adult heart will generally be described as having two coronary art riz left and right. the left branches into the left anterior descending descending e die ticketed those carefully and then look at the right coronary artery. so usually you hear people describe three coronary arteries the, the sir kim flux, left and right. we want to make shower they're in the right place and make sure they have normal openings where they connect to aorta and then go tiny slice by tining slice make sure none of the arteries have narrowings or blockages in them. after that, then we typically will carefully slice the heart, meaning the whole organ where we're now cutting through the muscle, and as you're making those slices what you're looking for is evidence of previous heart damage. is there a scar in the heart? is there hemorrhage in the heart, suggesting a more recent heart attack.
2:56 pm
there's many more rare conditions of the heart that we're also looking for. none of those apply in mr. floyd's case because all in the back of our minds as we do this and then the last thing is on we have cut the thank you muscle of the heard we -- through the muscle of the heart we open the valves and make sure the valves are normal no infection, no calcification, so we now looked at the outside of the heard, coroners, muscle of the heart and the valves. >> so having done that did you find any previous damage to his heart muscle? >> no. mr. floyd had no visible or microscopic previous damage to his heart muscle. >> and i apologize to you, dr. baker and the jury but there's one other photograph i want to look at. >> okay. >> so if we could pull out just number 192, the heart valves.
2:57 pm
>> would you tell us what we see. >> exhibit 192 is cross certifications of the what i would describe as the worst or the narrowest lesions i found in mr. employed's coronary arteries. above the three mark on the ruler you've. see fleeces of coronary artery that are fairly close together elf upper most one in the photograph -- odd -- that means that's pretty close to the aorta, oorigin of the artery, and in most adults the left anterior descending this largest of the three coronary art riffs so you can see mr. floyd's arrest anterior descending
2:58 pm
artery is quite narrowed. i would put that at 75% narrowing. the cut that you see right below that, the middle of the three, that's another section through mr. floyd's left anterior descending coronary and that is very tight narrowing is there. 75%. and then the third one you see in that series of three, the one close toast ruleres the first branch off of his left anterior descending coronary artery. that is called the first diagonal branch. that can be a big one in some people. it was good sized in mr. floyd's case but quite narrowed. and i should back up and explain that when i say norioed i mean the yellow plaque that you see lining those coronary arteries like a partially clogged plumbing pipe. that's the cholesterol, the fiberrous tissue, the scar that you don't want on your coronary arteries. that's why your doctor checks your cholesterol and asks you not to smoke and watch your
2:59 pm
weight and blood pressure. they're trying to prevent the black build -- the plaque buildup. they should be wide open. you should be seeing a round hole in each but they're pretty severely narrowed. so getting back to he description of the forecast. the fourth cross-section close to the one on the scale, that's mr. floyd's right coronary artery. most adults that would be this second largest of the three coronaries. you can see that one is also signaturant linierowed by plaque as well. >> so, dr. baker, you kind of familiar with the concept of acute changes in plaque buildup? >> yes. >> would you tell the jurors what that means. >> so there are times that autopsy when we can tell that a plaque has suddenly changed because it has fractured. these plaques can be kind of hard. known as hardening of the core near arteries. sometimes they fracture and you can see clot or -- filling the
3:00 pm
plaque and the flag is bigger than it used to be quickly. sometimes you can even get hemorrhage into a plaque as it fractures and the plaquing degree very quickly. we can see that with the naked eye at autopsy, sometimes natural the microscope as well. to get to the heard of your question i did not see those changes in mr. floyd's coronary arteries. looked me to be i guess you call the stable plaques. ... >> or what that look like if you had such an effective heart muscle? if we find an acute clot, a from
3:01 pm
us, if the person dies very quickly, which is entirely possible, we will not see anything abnormal in the heart muscle, it depends on the point of survivor. people can survive for hours before we can see any changes in the heart either under the microscope or with the naked eye. so if the person dies quickly from a coronary artery situation, we can only infer on the basis on the circumstance of their death. we would not expect the heart muscle to look abnormal. and if the heart muscle does show damage from a clot, what does that look like? >> that depends on how long it's been there and how long the person has survived. there is a generally greater progression of changes that we see very, very early. all you may see some of the heart else starting to look a little bit lazy and abnormal.
3:02 pm
shortly after that they start started take on way more pigments under the microscope and the surrounding heart cells and they look much brighter and then they start to die or necrosis, that necrosis and brings in an inflammatory reaction and so you see they are set to come and clean up the dead heart cells and then the body will bring in granulation tissue, which is new 11 tissue and scar tissue, if the person survives, the area will turn into a scar. that heart cells do not grow back. how long a person survives, we will see anything from this changes all the layout to a scar. >> you did not see any damage to the heart muscle? >> let's talk about the brain. did you know any injury damage to the brain tissues? >> i did not. there is no acute note of this
3:03 pm
order a decline in blood oxygen that was noted. >> did you know anything regarding his lungs? >> mr. floyd's longs had a lot of fluid and congestion in them, but other than that they were generally normal. >> it is possible to get. [inaudible] from the resuscitation of mr. floyd after he was taken from the scene? >> what kinds of fluids have caused back? >> well, basically what we are seeing is this called a protein fluids examined the blood, edema fluid, it fills up the breathing spaces, we have seen that with people that i've had protracted
3:04 pm
cpr, but their heart is not working very well, but they are still getting a lot of fluid put in them in the emergency room, so we can see that pulmonary edema from that. and it's a fairly nonspecific finding. >> with respect to ms. or >> with respect to mr. floyd, could you pinpoint the source? >> i don't think i can pinpoint a because given that he got cpr, there are multiple explanations for his pulmonary situation. >> what about the prospects of a pulmonary embolism? what is a pulmonary embolism? >> that is when you have a clot forming another part of your body, most commonly in the pelvis although it can warm and other places and it breaks up and it goes straight to the lungs because that is where your heart pumps the blood as it
3:05 pm
returns to the body. a massive embolism can be almost fatal, and i mean that blocks the artery that goes to the longs, smaller can go into smaller branches of the longs and sometimes completely asymptomatic and sometimes they are symptomatic and sometimes they can be life-threatening if the person has an underlying condition, we do always look for this in the autopsy. >> did you see any pulmonary emboli in the case of george floyd? >> no, he did not have any pulmonary emboli. >> let's talk about that toxicology. i think it's called a toxicology screen. can you tell the jury what is a toxicology screening? >> we actually determine the expanded panel because the laboratory we use, that is the terminology, but in essence when
3:06 pm
what we do is we send tubes of blood and in some cases here and to our toxicology labs and they run a comprehensive panel looking for a variety of drugs as well as scores and prescription drugs. i expect that we may have heard from a toxicologist, and that includes a specific category of drugs like morphine and related compounds, and such as impedance, barbiturates and so far and another chromatography, aspect chromatography and things like that, they have the potential to detect hundreds of medications that way. that is the expanded panel and that is typically what we ask for in most situations. >> and that is the lab europe with typically?
3:07 pm
>> yes. >> how long have you worked with a slap? >> about 13 or 14 months. >> would that be the lab that you would be sending out the screening to to the hennepin county medical examiner's office? >> yes, all of it goes to them. >> is the toxicology doctor's name dr. issersmith? >> yes, that is correct, i know him. >> he testified here yesterday were two days ago. >> he has been great to work with so far.
3:08 pm
[inaudible] >> sustained. >> you know the doctor. >> yes,. >> did you examine the stomach? >> yes, i did. >> what did you notice of the content? >> entrée to a third of the report. >> i'm simply going to quote what i dictated in the exam, containing approximately 450 milliliters of darvon fluid with innumerable saw fragments of gray and white fruit matter resembling bread. >> did you notice anything resembling pill or pill fragments? >> no, i did not. >> did you do any testing of the contents of his stomach as part
3:09 pm
of the toxicology assessment for mr. floyd 2. >> so it is possible that we could send it to a lab but i did not request that. >> were you aware of whether or not he had tested positive or covid-19? >> yes, i was aware of that, not at the time that i did the autopsy, but leader. >> was that significant to you in any way we met. >> that he had tested positive for covid-19? >> i guess it depends on what you mean by significant. this was early, we were still scrambling to figure out safety protocols and what we should beware of and so in that sense it was significant. in the case of mr. floyd, the the fact that he had been covid positive seven or eight weeks before did not have a cause of death germination because i didn't see any signs of it at his autopsy and is lungs do not have any of what i would expect to see under the microscope.
3:10 pm
>> so was he symptomatic from your point of view? >> i did not know him when he was alive, so to the best of my knowledge he was generally healthy on may 25 been on unaware that he was suffering from any acute conditions at that time. >> also he had sickle cell trait. what can you tell us about that? >> it is carried by about 8% of americans of african heritage. what it means is that one of the genes for the chain of hemoglobin has an abnormal substitution in it. if you just had sickle cell trays, chances are you will go through life and never have any symptoms because you make plenty of normal hemoglobin which is different than sickle cell disease which means that both of that genes have that substitution and then you have the disease.
3:11 pm
people can give very severe anemia, they can subject to a variety of infections and other complications, the mr. floyd did not have that coming he just had one gene for the sickle cell trait. i never would've known that except that with people that have these traits, when you take a biopsy of one of the tissues and put it in from aldehyde, which is what anthologist do, it can cause the cells of postmortem artifact. and so when i saw that on the slide, i immediately called hospital and said you have a blood smear and it turned out that they had made one and so i had a path all of this that specializes in blood disorders and there was no evidence that he was sick on his peripheral smear. and also there was a quantitation of sickle cell, that means they actually quantify the hemoglobin in the blood and sure enough that came back with the exact number that
3:12 pm
would be consistent with him having the trait. so it's really just a fluke that it was picked up at the autopsy. and they really didn't have anything to do, in my opinion, as to why he died. >> what about that kind of tumor. i will ask about the pairgain glioma. >> the short answer is i don't feel that i have anything to do with his death and what happen was an incidental to me that i have enough time in the autopsy and the most likely diagnosis is a paraganglioma, but i don't believe that had anything to do with mr. floyd's death. >> okay, so switching and talking about the death certificate, so we could pull up the exhibit 194 and first i would like to talk about the press release reported. and ask you if you would
3:13 pm
identify what this is for us, please. >> yes, what you are looking at is the final press release that my office put out once i had reached my conclusion as to the cause and manner of mr. floyd's death. >> can you explain to the jury what it means to certify a death? >> certifying a death means that you've deal this was the cause of death in the manner of death and if the manner of death is other than natural, you also have to fill in how the image reoccurred on the death certificate. the death certificates are relatively standard in the united states, most of what is on them is largely dictated by the cdc centers for disease control and that includes from state to state, but that's pretty much the same in every jurisdiction. most of it is actually filled in by family members and so what is
3:14 pm
the name of their parents, where were they born, do they serve in the armed roses, there's all sorts of things that are captured. the medical examiner rule is the manner of death and how injury occurred. and most in the united states are actually filled out by clinicians, meaning the primary care doctor that you see, that person filled out death certificates for their patients that die of routine match on transnational conditions. medical examiners involved one death appears from unnatural causes. >> okay, doctor, if we could look at exhibit 193. for the record, can you tell us what this is? >> yes, this looks to be a state of minnesota death certificate for mr. george floyd. the death certificates are
3:15 pm
actually produced by the state and not the medical examiner. we fill in the cards that we are responsible for and then the death certificate is issued by the state. so that is why you see state of minnesota on the top. but the other intervening conditions, that is what i am responsible for, and that is right in the middle of the display. >> zooming in on this, showing this to the jury. >> yes. >> looking as a cause of death as immediate and underlying of contributing conditions, this would be the section you filled out reign. >> yes, correct. >> so that indicates what does homicide mean to you as a medical examiner? >> as an examiner when the actions of other people are involved in an individual's death, it is one of five minutes
3:16 pm
of death that we can choose from, the other for being accidents, suicide, natural or undetermined and homicide in my world is a medical term and it is not a legal term. so vital health and publics to take this point of view, it's critical that they get this death certificate. so you won't know how many people committed suicide of your state, and accidents in a year. so it's public health data, but we don't use it in legal terms. >> if exhibit 918 is a list of manners of death, with what you just talked about, homicide, natural accident, homicide and then undetermined, would you please tell us, doctor, your point of view, what is natural
3:17 pm
mean in a. >> that means the person died exclusively of natural diseases. >> so an example of a natural disease might be a heart attack or a fatal arrhythmia is a cause of death? >> those are actually pretty vague terms, so to your point, counselor, arthur lauro a brain in terrorism there is some would be a natural cause of death. >> when we look at acronyms as an accidental cause of death and is a drug overdose an example of an accidental cause of death. >> yes, it can be accidental, most are suicide from a but yes tomorrow in some cases we don't
3:18 pm
believe that the person intended to die and we regard those as accidents. >> doctor, what does undetermined means? >> that means despite the best efforts of law enforcement and medical examiners and the investigators, we simply never could pin down the circumstances in which the individual died. in any good operas there will be a small percentage of cases every year, most of those are people that died of drug toxicity and based upon persons known history, we just don't have enough data to know if this is suicide on accident. so it's often undetermined. more dramatic but a slightly less common example is the skeleton a skeleton nice body in the woods, you have no idea the person was there for how long, there's very little to work with, a case like that could go undetermined as well. much less common, but undetermined essentially means that we never really did figure out what happened.
3:19 pm
>> in the list of immediate cause of death as cardiopulmonary arrest complicated law enforcement restraint and neck compression. >> correct. >> what does cardiopulmonary arrest means? >> that is fancy medical lingo for the heart and the lungs stopped, no pulse and no breeding. >> so with respect to this, and my right to understand that this occurs in the setting up of things? in other words, cardiopulmonary arrest, law enforcement and compression? >> yes, correct. >> doctor baker, can you tell us how it is that it caused his death? >> in my opinion the physiology of what was going on with
3:20 pm
mr. floyd on the evening of may 25, is you have party scene the photograph of the coronary arteries, you know that he had severe heart disease. i don't know that he specifically got to a counselor, but he also had hypertension, meaning that his heart weighed more than it should. so he has a heart that needs more oxygen by virtue of size, and it's limited in its ability to step up and provide more oxygen when there is demand due to the narrowing of his arteries. in the context of an altercation with other people involving things like physical restraint and things like being held to the ground and the pain that you would incur an abrasion on her shoulder, those are things that will cause stress hormones to point your body, specifically things like adrenaline, which is going to ask your heart to beat faster, it is going to ask your
3:21 pm
body for more oxygen so that you can get through that altercation, and in my opinion the law enforcement restraint of the neck compression was more than what he could take by virtue of the heart condition. >> making a point of clarification, as they forensic apologist, is part of what you do in your job, to try to calculate what his lung volumes or oxygen reserves and that sort of thing would then? >> i think what you're getting at, counselor, is the thing that i would refer to a pulmonologist. those are things that we cannot measure postmortem, clearly that is something a pulmonologist can look at. >> so we did find from the toxicology amounts of fentanyl
3:22 pm
and results from the lab? >> yes, that is correct. >> you didn't mention other substances in mr. floyd system, but you don't list either of them on the top line as causes. why is that? >> well, the top cause of death is the most important thing that precipitated the death, the other thing that you think played a role that were not direct causes relegated to the other significant conditions part, so the other significant conditions played a role in the death but did not directly cause the death, so for example his use of fentanyl did not cause the neck restraint, his heart disease do not cause this restraint. >> okay, so these are items that may have contributed to or not
3:23 pm
the direct cause? >> that is correct. >> no further questions, doctor.
3:24 pm
>> we are going to take a 10 minute break. >> the derek chauvin former police officer continues here on day 10 of the trial come at the end of the second week they are taking a 10 minute break, until about 3:35 p.m. eastern, they have been hearing from doctor andrew baker, the chief medical examiner from hennepin county, the court case happening at the hennepin county courthouse and we will resume the live coverage when they are back in the we will re-air the coverage beginning at 8:00 p.m. here on c-span2 and of course, all of our coverage of today and the
3:25 pm
prior sessions are available at so during these 10 minutes we will please some of the earlier testimony. >> thank you, your honor. >> doctor thomas, going back to exhibit 918 that we discussed.
3:26 pm
and then we would like to resume our discussion on homicide after that. just to clarify for the jurors what these various classifications are, if we talk about this as you discussed it with a handy example is a heart attack. if we talk about an accidental cause of death, where would drug overdose fit in general is a cause of death? >> usually drove overdoses are accidental unless there is evidence of intent. >> so we know what suicide is, and undetermined, as the medical examiner cannot tell which of these it is or what it is, it is undetermined is what was indicating when max. >> yes, exactly. >> so if the manner has been determined to be homicide, in
3:27 pm
your opinion as a medical examiner does that rule out death by accidental drug overdose? >> yes. >> going back over to exhibit 952 per demonstrative purposes. >> doctor, we are talking about the designation of homicide. can you tell us what this is as to is how it relates to how we define homicide? >> homicide is defined in the most broad sense is at the hands of another. it goes into more detail if we would like to look at that. >> if this is guidance given from the national association of examiner's to medical examiner's, and if the guidance and guidelines on how to designate that as homicide.
3:28 pm
if we could go to the next slide, please. >> so doctor, could you read this and for the record? , site occurs when death results from a volitional act committed by another person to cause fear or harm or death. intent to cause death is the common element that is not a wired for classification as homicide. it has to be emphasized that the classification for the purposes of certification is a neutral term and neither indicates what inspires criminal intent, which remains a determination within the province of legal processes. >> you agree with this? >> yes, i do not is that a guideline that you follow? >> no. >> have you followed this for the years they have been a medical examiner? >> yes. >> is there more guidance given
3:29 pm
from the national association of medical examiner guidelines on what constitutes a voluntary act? >> yes. >> so doctor please go ahead. >> in general as a person's death results at the hands of another who committed a harmful and volitional act, the death could be considered homicide from the standpoint of the death investigation. although there may not have been intent to kill the victim, the victim died because of the intentional act committed by another person. but it may be classified as homicide because of the intentional or volitional act and not because it was intent to kill. >> so when you agree with the conclusion, is this the definition that you are applying that we saw on the two sides?
3:30 pm
>> yet. >> thank you, doctor. >> i would like to ask you about a new subject, and this has to do with certain studies that talk about whether or not the restraint is dangerous from this point of view. so i would like to get your perspective in this way. are you aware of this? >> yes. >> you agree with the research that comes to the conclusion that it is not dangerous for respiration? >> in certain laboratory faces that could be true, but i do not agree with their applicability to realize the situations. >> if you could characterize for the jurors, what do they show?
3:31 pm
>> well, they purportedly show that putting someone in a prone position even from restraint and with weight on their back is perfectly safe. >> you find them reliable or controversial. >> well, i think that they are fine for laboratory purposes, but there is no resemblance to real world situations. so i think that they are relevant for purposes we are talking about here. >> so how do they not relate to the real world? what is artificial? >> i would say for starters these are volunteers who have now agreed to be put in a dangerous position of a prone restraint. but they know perfectly well at any point if they feel scared or
3:32 pm
uncomfortable that all they have to do is say stop, and that has happened in some of these studies with a couple of volunteers would say wait, i cannot tolerate being in this position. so to me, that immediately takes out that element that we are talking about when it comes to the physiological stress. so that is number one. number two is are they healthy volunteers? these are young people, mostly young people, mostly healthy, who have agreed to be part of this study. so it does not relate to someone who may have other underlying factors that may contribute. and third they are put on a gymnastics mat to be face down, so it is completely different when you are squished between a person and the hard ground
3:33 pm
versus having an evenly distributed weight on your back and you are on a mat. and third, fourth, i guess, -- and perhaps most significantly here, none of them went on and on and on beyond the point where the person stopped breathing and where their heart stopped, so they were being monitored the whole time, if at any point they had significant respiratory or cardiac ot is, the study would've stopped, the person volunteering knew that. so to me at this time, it gives a resemblance. >> did any of the studies involving the almanac of any of the volunteers? >> anything longer than nine minutes 29 seconds? >> no 2 you know of any studies measured the decrease in lung volumes as part of the study, a
3:34 pm
decrease in oxygen reserves? >> not that i know. >> any relevance to george floyd at all? >> not my opinion, no. >> doctor thomas, have you done any measures of your own on me on the neck and the back of george floyd, what would done to his oxygen reserves or lung capacity? >> no, that would be something that i would defer to a pulmonary doctor to address. >> are you able to tell the ladies and gentlemen of the jury if you have an done so whether the forces that he was subjected to would have even killed a normal healthy person? >> in the way that you phrased
3:35 pm
it,, based on lung volume and i kind of nutty, from watching the video, i certainly would not want to be in that position, but that is a different answer. >> thank you, doctor, no further questions. >> good morning, doctor thomas, how are you? >> i am well. >> it's nice to see you. so you described being a forensic apologist is sort of being a doctor is doctor. >> yes,.
3:36 pm
>> and the forensic pathologist in terms of the investigation, you've have to wear many hats? >> yes. >> you have to have a broad familiarity with multiple medical conditions? >> yes. >> sometimes medical conditions may appear as something you have never seen before? >> yes. >> some strange disease that you have never seen. >> yes. >> and you will speak to other doctors. >> yes. >> you are will gather information and share information with you to help you conclude and make conclusions. >> yes. >> and you also described how being a medical examiner is more than just the autopsy. >> yes. >> the autopsy is one small part of the investigation. is that right? >> yes. >> we described reviewing videotapes in certain circumstances, past medical
3:37 pm
records. >> yes. >> interviews with friends and family members and people that knew the deceased. >> yes. >> ultimately the medical examiner's office compiled a massive amount of information in itself about the cause and the manner of death. >> yes. >> and you have had an opportunity to review a lot of that information. >> yes. >> have you reviewed all of the interviews of witnesses? >> probably not all of them. >> after you prepared your report, have you been provided with additional materials that may be relevant to your considerations? >> good afternoon, mr. nelson.
3:38 pm
>> doctor baker, thank you for being with us this afternoon, just some follow-up questions that i would like to break up into different sections, one about the autopsy and then some other questions as well. >> okay. >> you understand, doctor baker, that you testified in hennepin county, dakota and scott county as well? >> not nearly as much as hennepin but yes as well. is a part of process of exchanging information, the defense receives copies of everything, reports, meeting notes, prior statements and things of that nature. >> yes. >> have you had opportunities to
3:39 pm
review all of that information prior to the testimony today? >> to the best my knowledge, yes. >> ultimately what you testified is in a death investigation it is much more than just an autopsy. >> yes. >> and in fact, if we pull the file it usually ends up being a few into this. >> yes, i guess if you print it out, that is correct. >> well, that's what we did. and i guess i have to get with the program. and ultimately that file contains your autopsy report. >> correct. >> death certificate, the paperwork that you fill out for the state of minnesota? >> yes, we don't get a copy from the state, but everything we put on the death certificate is on a file. >> also you keep track of conversations that you have with people. >> generally, yes, that is usually more my investigators
3:40 pm
their treating physicians, the hospital records departments and so forth. >> so it's sort of a law, today the investigator spoke with so-and-so. >> again, i don't personally do that so much, but my investigators you. >> and it's all part of the file enact. >> yes. >> in addition you obtained no medical records that may factor into your analysis as well. >> yes. >> and you had received some hospital records regarding this report, is that correct? >> correct. >> but you don't go out and try to search for every provider or that something that any person may have seen. >> yes, there would not be a lot of point in trying to get every of medical records generated.
3:41 pm
only things it would help me understand the cause and manner of death better. >> okay, fair enough. so want to talk to you first about the word complicated. how do you define the word complicated in regards to the cause of the death of mr. floyd. >> i would use the word complicating in the word that most physicians use complications. it means that an intervention occurred and that there was an outcome that was untoward on the heels of the intervention. for example, someone he goes to the hospital for hip surgery and they develop a blood clot in her leg, that is a complication. you get started on a new medication for heart condition and then you have an allergic reaction and that is a complication. it isn't untoward event on the heels of intervention that happen. that is how i look at it as a physician. >> and it could be during an
3:42 pm
incident or as a result of an incident? >> again, we don't use the word incident in medical practice, but it could be immediate complication as a result of therapy or it could be a delayed complication. >> there are certain circumstances that preceded those complications. agreed? >> that is a little vague. a i'm wondering if you can clarify. >> in any death investigation, you are trying to determine the cause and manner of death. >> correct. >> in this particular case you obviously took into consideration the police restraint, but you also took into consideration heart disease. >> yes. >> as well as toxicology results. >> yes. >> manufactured those in in the cause and manner of death and then there is the second thing the left blank, and then there is the contributing causes were
3:43 pm
contributing factors. >> yes. >> that is simply something that you have to do for the cbc or do you take this into contributing to his cause of death? >> is when you put those on a death certificate, what you are saying is that i think that it has played a role in his death. i'm unaware of how the cbc would mandate that. presumably you put things on there that you believe would be a part of that. you don't with trivial stuff. >> been a good something is significant enough you put it on, but if it's not, you leave it off? >> generally, yes. >> so with heart disease as well as a history of hypertension and the driver, or drugs in his
3:44 pm
system, that played a role in his death? >> in my opinion, yes. >> in terms of your autopsy report, you do not generally note negative. if something is normal you might just say that it's normal. >> that is a really long question, but i think i can give you a reasonable answer to that. for most organs we have a description of what that is spirit of the spleen is normal, i will give a normal description with the weight of that spleen. and the same for a liver. depending on the nature of the particular case, there are pertinent negatives, means that are based on the body, you specifically seek those things out and if they are not there, you document them because the
3:45 pm
fact that they are not president really means something. i don't know that answers your question, but they are almost always normal and we go to the next death of the autopsy, some things depending on the complexity of the case, you are going to take a picture and whatever you need to do to document looking for something that wasn't there before. >> in that regard if you know something, whether it is on or irregular workers the negative, you take special precautions to know those things in your autopsy. >> yes, not only in a narrative report, but you take a picture of things in your document things that people might have expected to be there. >> it is interesting that you made a conscious decision not to watch any videos before you performed the autopsy.
3:46 pm
>> correct. >> that was to prevent? >> in general, yes. i don't want to go into not topsy with a preconceived notion that i know what happened because that might tempt you to skip certain steps for things that may turn out to not be relevant that i did see the video that the entire world saw later that day after his autopsy. i did not release his body until the following morning. so i had i seen something, i would have a chance to act on it. i do not want that to be a on my mind when i perform his autopsy on the morning of the 26. >> that you had received some briefing from law enforcement or from somebody to say here is generally what we know about what happened reign. >> it was ready high-level, but
3:47 pm
i got a call that a man had been in police custody as he was being restrained and then he died at the hennepin county medical center and that was largely going into the autopsy. then beyond that is pretty much what i knew going into the autopsy. >> you have learned that there was potential pressure to the neck, is that correct? >> yes. >> and because of that you did this unique incision to lift the skin to look under the surface. >> that is correct. >> we will come back to that in a second. >> when we focus on the heart a little bit, you noted that the heart was violated. what causes that?
3:48 pm
>> dilated is fancy medical lingo for it's gotten a little bit bigger than it was before, like a balloon dilates the lack of a better description. so it was in the report count, sir. >> it was. and so i described the ventricles, which are the two main pumping chambers of the heart is mildly dilated in his case. i would interpret that as being part of parcel of the high blood pressure, a manifestation of the targeting bigger and heavier as it works over a period of time. >> you also took note of the size? >> is actually the way count. >> that was 540 grams? >> yes, that is correct and you are familiar with the papers on
3:49 pm
the normal heart size? >> i am familiar, although the one that i usually use is the paper from the mayo clinic. >> what is the maximum size of the heart. >> usually it functions as your body length and weight. a very large person is going to have a larger part. so in mr. floyd's case the upper limit is normal for his body length the upper limit would be 521 grams. and he was 540 grams, outside the upper limit of normal. the double shaped distribution for a man his size he is on the tail ends. >> okay. all of these various standards in terms of the weight of the
3:50 pm
heart are peer-reviewed? >> as far as i know, yes, i use the mayo clinic proceedings. >> okay, right. and so with the northwestern study is or anything else? >> i believe the paper was published in the american journal of american medicine and pathology which i believe to be true. >> and he would agree that the larger the heart is, the more blood than it needs to provide adequate oxidant optimization? >> yes, i believe that is true. >> the most common cause are far in adults in the developed world is high blood pressure. there are a number of far less common causes, the aortic valve disease could do it, the heart pumping against a defective
3:51 pm
valve, genetic causes, which we can typically tell those by looking at those microscopically, those are much farther down the list. >> a history of highbrow -- high blood pressure. >> yes, that is correct. >> can you describe the narrowing of the coronary artery in more detail in a rack counselor, if i may refer back to that. >> when i was describing a photograph, he had 75% narrowing of the coronary artery, again those people that would be the largest of the coronary arteries. he had 75% narrowing of the first ranch of his left hand descending coronary artery in his right ordinary artery, which
3:52 pm
in most people is the second largest of three, he had 90% narrowing. >> and what do pathologists consider to be enough narrowing of the arteries to cause a sudden death? >> we look to 75% or greater as capable of causing sudden death. >> are you familiar with myocyte necrosis? >> yes. >> and you have to have myocyte necrosis to have sudden death enact. >> no, you do not. he met with arrhythmia there would be no necrosis? is that correct? >> an arrhythmia is an electrical phenomenon. so i can really diagnose it postmortem. we just have to infer that from the condition of the coronary artery. >> when we described hypoxia of the heart, that's the reduction of the heart? >> yes, correct.
3:53 pm
>> can it cause sudden death by other means. >> there's many ways that could cause death. one goes from a normal beat to a non-regular beat, and the person classes in front of you, depending on the it could be a thrombus, chest pain, sweating, difficulty breathing, that's a different method of just death. >> sometimes people can survive that for a longer time? >> survived? >> the thrombosis you described? >> yes, i don't know the
3:54 pm
numbers, but honestly people do survive, that is why we have this and cardiologist on call, for urging catheterization and stuff like that. >> and you generally describe the conduction system of the heart enact. >> it is basically the electrical system of the heart. >> there is a node that is a watching her heart that starts every heartbeat, you would be able to see what he could do on the ekg is it was conducted to the ventricular node and then also be ventricles. you can actually see the system under the microscope if you take it out and look for it in on very rare occasions we do that.
3:55 pm
and that's basically what the system does. >> i would have to defer to a cardiologist on now. there's so many ways it can be impaired, some ways it is completely denied, sometimes a person may need a defibrillator or pacemaker and on the nature of the arrangement. >> which of the artery supplies, when it comes to the atrial node? >> i believe it is a small branch at the right coronary artery. >> is that the one that was 90%? >> not the branch, but yes, the main right coronary artery was narrowed. >> you are aware also of the methamphetamine found in his system?
3:56 pm
>> yes. >> does it further constrict the vessels and the ventricles in the arteries? >> you know, i don't know and i'm not an expert, it's certainly hard on your heart that it can drive up blood pressure. and i don't know if it's a best of vasoconstriction. >> does the amount or the level of the toxicological findings impact whether or not it's good or bad for the heart? >> i don't know if there's an there is an answer because i'm not sure that there's a vague level of this. >> especially this versus other
3:57 pm
uses. >> i'm unfamiliar of any other use, i am aware that an amphetamine is part of it. and then exertion also causes it as well. >> it causes the heart to work harder? >> correct? and it requires more oxidant? >> correct in that more blood has to send it to the rest of the body? >> correct. >> in this particular case, we have his heart which is about average size. >> that is correct? he has a heart with narrowed coronary arteries and there was
3:58 pm
an evidence of a timeframe of exertion. >> there was a period of exertion. >> in terms of your investigation you ultimately did watch the videos? >> correct. then is that in terms of surveillance videos or additional bystander videos were things of that nature. >> no, i did not have that. >> have you ever certified a death due to.
3:59 pm
>> what you're going for is hypo cardio. we use hypo sensitive cardiovascular disease because it little bit more accurate, but we had to use that or similar terminology. >> have you ever certified a death due to atherosclerosis cardiovascular disease with similar narrowing of the arteries compared to mr. george floyd? 2 yes. >> in terms of the injuries, the abrasions and things of that nature, obviously they appear to be fresher, and you agree with that? >> i would like to be very clear
4:00 pm
that there's not any literature that allows you to date those kinds of injuries with any precision, presumably there is contextual data that would allow us to know that he didn't have those abrasions an hour before he died or whatever. if you just showed those who blindly, the answer is no, not without any decision. >> in terms of the abrasions that we look at, they could have been from the time that he was on the ground. agreed? >> yes, agreed 2 also he was taken to the ground were brought to the ground. correct? >> well, that would be true as long as there is something that would explain the abrasions. some of those would take a fairly rough surface to produce. >> if you are in the midst of a struggle, with police officers and the police officers got into
4:01 pm
the ground, a moment of impact hitting the ground, resulting in some of those abrasions. >> would you mind repeating the question? >> sure. some of the abrasions that we look at. it would also be consistent with him being taken and put on the ground? >> yes, depending on how he made contact, and if there is enough abrasive force. >> would you agree with the general? .. ..
4:02 pm
you don't have any section in your autopsy report to describe any injuries whatsoever to mr. floyd neck and back like you do other areas of the report? >> that's not true, there's a special paragraph specifically describing his back. i'm not finding. >> you took pictures of the as well? >> correct. >> all the procedures were documented in the normal course of when you conducted an
4:03 pm
autopsy? >> yes, all were photographed. >> you did that so others would have opportunity to review your work? >> correct. >> you understand people have done that? >> yes. >> you have, i'm assuming, conducted many autopsies in your career? >> i have. >> if you were to venture to guess, how many autopsies? >> never kept a spreadsheet but i would say probably maybe 2900 -- 3000. >> other autopsies a 60 asian was a suspected cause of death? >> yes, it's a very common cause of death in my line of work. >> you see it manifested in many ways? >> correct. >> there are certain things you look for in the course of your autopsy to determine whether or not it would be consistent with asphyxiation?
4:04 pm
>> yes and no, it depends on the type of asphyxia you're talking about, there are many ways so we want to make sure we know the type of asphyxia we are talking about because the signs you see will vary from one to another. >> including you look at signs of lack of oxygen? >> we do but to be fair, the person has to survive the brain injury for a considerable period of time before we can see anything. in most we investigate we are not going to see big changes in the brain. >> do you look for musculoskeletal changes to the body? >> again, depending on the nature, yes. >> so you may look for asphyxia from front to back, the highly phones for example? >> correct, specifically looking at the muscles of the neck, cartilage and things like
4:05 pm
speculation and hanging. >> okay, you informed some opinions about the amount of pressure and whether a pressure was applied to the neck? >> could you be more specific? >> ultimately, you have described your cause of death, right? >> correct. >> part of cause of death is neck restraint? >> i believe i used the term neck compression but that is top line of my cause of death. >> in the course of your many conversations you've had with various prosecutors and law enforcement officers, after watching the video, you made statements about where you saw mr. chauvin need, would you agree? >> yes. >> did you feel his knee was compressed against his neck? >> yes did you describe it as more on the back or in the lower
4:06 pm
base part of the neck? >> my impression from the video, i want to be clear, i have no special expertise looking at videos, i'm just looking at them as another person trying to figure out what happened. in my opinion, it appears that mr. chauvin's niece was primarily on the back or side or the area in between on mr. floyd neck. >> did you see any evidence that he was occluding the carotid artery? >> it did not appear on the video is would have been able to include the carotid artery. normally there is to and the unaccrued carotid artery would not be able to get it to the brain, the action. >> when you look at death by manual strangulation, are you also looking for bruising? >> yes.
4:07 pm
>> you see bruising in the majority of your cases or not majority? >> keep in mind that my patience are all deceased so if my patients were strangled, it was still that they died. i say that because if you were to ask her experience looking at living strangulation, you might get a different answer. in my world we typically see bruises on the outside of the neck, abrasions on the neck, bruises to the small muscles of the neck, depending on the type of strangulation, we either see fractures of the thyroid and hyoid bone. little tiny blood spots on the lining of the eyes, the face and other side of the lips and inside of the mouth. >> did you observe any of those signs in this case? >> i did not. >> in terms of when you think
4:08 pm
about the classic translation, fingers and hands and applying pressure to your neck, even those, he would expect to see bruises consistent with my fingers, right? >> in my line of work, we, he did say the sides of your fingers, that might be true on television but real world, there's not a lot of correlation between the size of bruises and the assailant hand but we are looking for in terms of physical, the knee, placement of the knee being a bony, hard and around objects, right? >> yes, it's pretty concentrated at the knee cap. >> and of course the shinbone is just below the skin, right? >> yes. >> sort of triangular in nature? >> yes.
4:09 pm
>> so is a substantial amount of force was being used by the knee or shinbone on the neck or back area, in your line of, if the force was sufficient him will expect to see bruising? >> i would expect bruising but i don't know lack of bruising exclude that. when i pivoted which is pressure to the front of the neck to the back of the neck that is not something we see medical examiners explaining regulation more asphyxiation. >> correct signing in your autopsy shows suspicion significant, find injuries to
4:10 pm
mr. floyd fact. at the outset of his body to make sure i didn't miss anything but i didn't find bruising on his back. >> did you find changes to mr. floyd bring? >> i did not but again, a person has to survive many hours before we could see those. >> you generally are familiar with hypoxia and how that occurs? >> it really depends on the nature of the asphyxia, in my world asphyxia is hanging, regulation, carbon monoxide poisoning, all different ways somebody can be asphyxiated, it depends on the mechanism. >> douglas of the mechanism, would you generally see symptoms consistent with hypoxia? what a person exhibit certain symptoms? >> symptoms is a little outside my work because we are talking about living people and i don't treat living people suffering
4:11 pm
from hypoxia. >> who just testified that you may see confusion from somebody going into hypoxia state back objection -- not. >> your role as a medical examiner, you take into consideration information from lots of different sources? >> true. >> there may be cases where you don't know what is going on, right? you can't figure something out. >> could you be more specific? >> if you have your medical examining table and there appears to be a tropical disease, i am assuming you're not an infectious disease
4:12 pm
expert? >> certainly not an expert in tropical diseases, we do diagnose a lot of infection. >> but if there is an infectious or tropical disease, you may go to another person and ask that person, are you familiar with this? >> object -- the question is irrelevant. [inaudible] >> you rely on the expertise of other physicians when you conduct an autopsy? >> always but i am never above reaching out to clinical colleagues for other pathologies if they have an area of expertise. >> part of your job is to attempt to determine whether there is asphyxia in a particular case, right? >> is completely dependent upon the case but if it appears to be the 60th death, try to get to the root of how it occurred. >> as a physician, a forensic
4:13 pm
pathologist, you are familiar with what happened to the human body when someone is 68? >> in general, yes. again, i don't actually see living people asphyxia, i don't treat living victims of different types of 60th in. >> in the context of your research or education, you may go to a conference and they say here is an asphyxia death, let's talk about that, right? here is a picture of someone hanging all the way from suspended versus someone on their knees suspended forward with a belt or something? [inaudible] >> irrelevant. >> are you familiar with the symptoms of? it would be very general symptoms and i don't know would be. >> with general symptoms be?
4:14 pm
>> of hypoxia? probably some form of mental status in the form of confusion or disorientation. >> incoherent speech? >> the difference is so long, but explained that? yes, there are many others that could as well. >> when someone toxic, does it cause that person to reach back. >> i honestly don't know, it probably depends on the nature of the asphyxia, i would defer further questions to a pulmonologist because they are the experts in breathing. >> would you, based on your understanding, reviewed toxicology of mr. floyd? >> yes. >> you what a great it's a joy
4:15 pm
to present? >> that's my understanding. >> it slows breeding resulting in lower oxygen levels? >> they can, yes. >> similarly increasing the carbon dioxide? >> what it would do to carbon dioxide is the outside of my scope of expertise. >> methamphetamine, correct? >> yes. >> meaning it causes the heart to beat faster? >> yes. >> causing the heart to work harder? >> yes. >> causes constriction of the arteries? >> i believe he already asked that and the answer was i don't recall for that specific mechanism but i would acknowledge it increases your heart rate. >> so have you certified death by overtime overdose? >> hundreds of times a year. >> have you certified deaths as an overdose where the level of functional was similar to the level of parental in mr. floyd?
4:16 pm
>> yes. >> have you done where levels are lower? >> yes. >> or higher? >> yes. >> was the little lowest level you certified? >> without doing a search, i am not prepared to give an answer on that. i know i've seen as low as three and possibly lower. like all death investigations we do if it involves, you want to piece together their history and how long they have been using it and their tolerance, there is a lot of variables that go into it but i've seen levels as low as three in some cases even lower if there's other toxins on board such as alcohol. >> the combination of drugs and present systems is irrelevant consideration? >> i'm sorry, irrelevant or a relevant?
4:17 pm
>> relevant. >> yes, they can be relevant. >> that's why you included both the heart condition of mr. floyd as well as toxicology findings, other contributing issues to his death? >> correct. >> i want to review with you the history of your involvement in this case. >> okay. >> obviously mr. floyd february -- may 25, 2020, correct? >> yes. >> you performed an autopsy on the 26th? >> yes. >> after the autopsy you had a meeting with county attorneys? >> correct. >> may 26? >> yes. >> do you recall telling them the autopsy revealed no physical evidence, mr. floyd died of a
4:18 pm
speciation? >> i don't know of my specific language but yes that was the lack of anatomical findings we support that conclusion. >> you told them you voided watching the videos? >> until after i performed the autopsy. >> all right. >> do you recall telling them certain factors that you thought contributed to the death? [inaudible] >> the jury should consider any statement made outside the cour- [inaudible] mr. nelson, you may. >> you recall telling the attorney's office may 26 after conducting your autopsy what you
4:19 pm
thought intervening factors worked to his death? >> i don't recall specifics of that conversation, the only narrative record of that conversation would be what they wrote down, i'd be shocked if they did not tell about mr. floyd heart condition because obviously i knew that the moment the autopsy was done. i could not have known the toxicology report because i wouldn't have those back for seven more days. >> you found initially his heart condition was pretty significant? >> yes, you'd know that walking out of the autopsy. >> he received the toxicology june 1 of 2020? >> could i refer to my record and see if that is correct? >> yes. >> on or about june 1. >> that is correct. going off the toxicology report, it appears it was issued the morning of june 1, 7:04 a.m.
4:20 pm
>> you recall having a conversation with the prosecutor's about the significance of the toxicology report? >> i recall having the conversation, i don't recall specifics but i am certain i would have relayed the findings to them. >> do you recall describing the level of fentanyl as a fatal level? >> i recall describing it in other circumstances, it would be a fatal level, yes and other circumstances. >> you agree one of the causes of the pulmonary edema that you communicated to the county attorney is also fentanyl? >> it can certainly be a cause of pulmonary edema, i indicated earlier confounded by the fact that mr. floyd had quite a bit of cpr so i find the idea much less specific given that he survived in the hospital for a period of time. >> you recall counting the attorney office the had you
4:21 pm
found mr. floyd under different circumstances, you would have determined it to be a fentanyl overdose? >> i don't recall specifically but it certainly went something like this, had he been home alone with no evidence of trauma and the only autopsy finding was the fentanyl level then yes, i would certify his death due to toxicity. the interpretation of drug concentration is context dependent. >> you then were interviewed by federal bureau of investigation on or about july 8 of 2020? >> i believe it was federal bureau of investigation and/or u.s. attorney, a lot of these took place over video calls and i wasn't entirely sure who but i believe it was those two groups, yes. >> that occurred july 8 of 2020? >> to the best of my recollection, yes.
4:22 pm
>> were you asked those questions? and were you able to form an opinion on the involvement of law officers whether mr. floyd died under these circumstances? [inaudible] >> not legal standards of the diagnosis. >> i'll answer the question, earlier i mentioned there were multiple people on the video calls and if at some.there was more than one person asking questions of the time, i don't normally think of things in that paradigm, perhaps that is a legal thing but it's not normally i think of as a toxicologist so i clarified the investigation was my opinion as to what happened to mr. floyd and that is he experienced cardiopulmonary arrest in the context of restraint and neck compression.
4:23 pm
the rest of the interaction took him over the edge given his underlying heart disease. that was also clarified in a letter from the head returning to the u.s. attorney, because of the confusion around how the meeting was in the way the questions were asked. >> thank you. again, lately the death as homicide that is a medical determination you made, correct? >> correct. >> not the same standard as legal standard. >> i don't even know the legal standard but they are two different worlds. in terms of your involvement in this case, have testified twice
4:24 pm
in connection with other proceedings, right? >> yes. >> regarding the death of mr. floyd. >> yes. >> the first of those testimonies occurred 20th of august 2020? >> yes. >> you understand they were under oath? >> correct. >> and you have had the opportunity to review the transcripts? >> i have. >> the first time you testified in connection with the death of mr. floyd at any time you recall saying i have to defer to another specialist. >> i believe i said that multiple times. >> first time or second time? >> i recall it was much more frequent. the second time i don't recall how often battle. [background noises]
4:25 pm
>> in terms of mr. chauvin's knee placement, would that explain anatomically why mr. floyd, that anatomically cut off his airflow? >> in my opinion, it would not testify extensively about the significance of the coronary arteries and heart disease? >> i'm not sure what you mean by extensively, if we need to pull up the transcript, we can. i don't understand what it means in this context. >> you talked about issues surrounding mr. floyd death involving his coronary arteries, right? >> yes, i have no -- i can't quote you the transcript, if
4:26 pm
you'd like to pull out, i'd be happy to refresh my memory. >> may i approach the witness? >> to reflect his recollection as requested. [inaudible] >> in this proceeding, did you testify, you recall testifying how the coronary arteries were relevant to provide the heart with that? >> i'm almost certain i would have, but i don't recall how extensively, i have to look at the transcript with looking at the transcript reflect your collection. >> may i approach?
4:27 pm
>> 44314. >> what date? [background noises] [background noises] [background noises] [background noises]
4:28 pm
was a problem with the coronary. >> i believe essentially the same answer i gave the jury earlier, because of the narrowing of mr. floyd coronary arteries, they have a limited ability to supply extra blood and oxygen to his heart muscle when he needs it. on top of that, he got a larger part than a man his stature would have because he's hypertensive so the heart is going to need more oxygen which the corners have limited ability to deliver. >> how do you think the introduction of methamphetamine in that scenario impacts this? >> again, i don't have a high-level answer. i don't treat living people who have met and threatening toxicity but it's hard on the heart from my understanding. it's going to increase the work of the heart because of the
4:29 pm
stimulant. >> in the circumstances of this particular case, in terms of a person with a enlarged heart and how does the introduction of methamphetamine affect that? >> as i said, it increases heart rate and work of the heart, it not something i would want to see in the blood of someone who has heart disease. [background noises] >> did you describe the process in the death of mr. floyd? >> certainly sounds like something i would have said. >> you testified a second time, correct? >> to the federal grand jury? >> yes. >> i did. >> that was february 2021? >> yes. >> ultimately, you deferred
4:30 pm
experts far more extensive in the second testimony in the first? >> the short answer is yes, the long answer i believe i deferred to a pulmonologist repeatedly because there were so many questions about things like chest wall movement and this, that or the other thing impair the person's ability to breathe and i clearly said look, this is outside my expertise, i think pulmonary expertise would be better. i think i said that at least a half-dozen times emergency medical experts? >> it would depend on the context of the question but i know i did reference emergency medicine shoppers, when do you think mr. flick really glad? >> how about cardiology? >> yes, specific to an area that would be clearly for a
4:31 pm
cardiologist, i'm sure i would have preferred that. >> thank you, i have nothing further. [background noises] >> i am going to be brief. if we could look at this section on cause of death -- doctor baker, take into account the entire exchange you had with mr. nelson on mr. floyd's medical condition on money gave, to
4:32 pm
bring back to exhibit 193 taking all that into account, what remains your opinion as to cause a it's what i put on the cardiopulmonary arrest, restraint and neck compression now. >> we look at the other country condition, the other when shooting conditions are not conditions you consider direct cause? >> not direct causes of mr. floyd. >> in terms of spanish of death, to stand by today that the men
4:33 pm
the -- the manner of death was homicide? >> i would still classify it as homicide today. >> thank you. >> nothing further. [background noises] [background noises] [background noises]
4:34 pm
[background noises] and what. >> we are going to take 815 minute break. [background noises] >> 815 minute break and this is the end of the second week of the trial of 2020, george floyd. they just finish the chief medical examiner the county. fifteen minute break, armida we will re- air the entire proceeding today coming up tonight at 8:00 eastern on c-span2. you can find all proceedings from today the past we will show you next month the earlier testimony as we wait for them to return.
4:35 pm
[background noises] >> thank you. >> next witness, doctor andrew baker. background noise. [background noises] [background noises] >> you swear or affirm -- [inaudible] >> i do. [background noises] >> if we could begin by having you state your full name. >> andrew michael baker.
4:36 pm
>> thank you. good afternoon, doctor baker. first of all, who conducted the autopsy on mr. george floyd. >> i did. >> before we get into specifics of the autopsy, when we go over your background, chief medical examiner? >> correct. >> would you tell us what it means to be the chief medical examiner there? >> i've been chief medical examiner since 2004. i am chief medical examiner for dakota in my office provides service to all three counties which is about 1.85 million minnesotans, or a third of the state. being the chief medical examiner means that i supervise the rest of the staff in particular other positions, i have six other doctors and training at work under me. >> before coming chief, he will
4:37 pm
assistant chief? >> correct. >> roughly 2002. assistant chief medical examiner for two years. >> nineteen years assistant chief moore chief? >> correct. >> what did you do before joining the medical examiner. >> are you asking me to go back to my medical background? >> maybe to the air force. >> prior to coming from 1998 -- 2002, i was a major on active duty in the united states air force and served as forensic pathologist and the department of defense. our unit was known as the army forces medical examiner and at that time were headquartered in washington d.c. area. >> are you board-certified? >> i am. >> tell us which one. >> i am board certified in anatomic pathology my certification in forensic pathology. >> would you tell us with the national association of medical examiner does?
4:38 pm
>> national association medical examiners professional organizations, people who do what i do for a living. i want to say we have about eight or 900 members, many are fellows like me, meaning fully board-certified forensic pathologist, we have a variety of other membership categories as well for investigators, administrative personnel and other support personnel and profession. >> you are former president of the national association medical examiners? >> i am. >> at least as of to date, you're the youngest president or were the youngest president ever to hold that position. >> i don't actually know that that is true but i take your word for it, i did not know that. >> just listening to you, doctor baker. [laughter] you have been the president that? >> yes. >> let's move now to the specific autopsy of mr. floyd,
4:39 pm
could you give us some sense of what you knew about the circumstances surrounding his death before starting your work on mr. floyd? >> i was aware mr. floyd had become unconscious while in police custody, transported to the healthcare and that was where he was pronounced dead. i believe at the time i started the examination, my staff was probably still working to confirm mr. floyd's identity and properly notify his excess can but i was basically the background information i had. >> had you seen any of the videos of the start? >> i was not, i was where at least one video had gone viral on the internet and intentionally chose not to look at it until i examined mr. floyd. i did not want to bias my exam with the preconceived notions. >> several days after you worked on the autopsy that you saw the video then? >> one video i saw shortly after
4:40 pm
the autopsy and that was the one i think most of the public has seen through social media. the other videos, surveillance video and body worn camera videos, i did not see until three or four days after the autopsy. >> give us an overview of how it is you conduct autopsies? what is your approach? >> in the case believed to be a homicide or potential homicide, there's a few more steps involved a typical natural death or accidental death. we start every exam with a very sore external examination of the deceased body and the medical devices still in place. the deceased came in with clothing, the clothing would still be in place, all of those things potentially could be evidence as the medical examiner's. many cases we will collect trace evidence, for example of the deceased fingernails on long enough, we were collecting
4:41 pm
enough clippings head hairs in case they are needed to match to anything it wouldn't apply in mr. floyd's case but other circumstances, we have a fair number of x-rays before the autopsy, bullet or stab wounds, broken knife tips, that sort of thing. once all of those are done, we carefully set clothing aside and carefully remove medical devices and examine the body again head to toe, front to back we document with copious photographs as we go and final step is we cleaned the body very thoroughly because we don't want blood or foreign material or plant material or anything that might be on the body to obscure injuries or diseases we are looking for and then again we photographed the body head to toe, front and back. once that part of the exam is done we proceed to internal exam which is i think what most people would think of when they hear the word autopsy and make
4:42 pm
careful incisions on the body and allow us to remove the organs one by one we have natural disease, internal evidence and while we do that, we collect specimens for toxicology, blood and urine are ideal specimens. we do remove all organs from the tip of the time to the bladder and remove rain and structures from the front of the neck looking for injuries for evidence of disease. in a case like mr. floyd's, there are additional steps we will take that wouldn't occur in most autopsies, for example, mr. floyd's case, i make incisions of his wrists and dissect around the skin to look for evidence of what we would call subcutaneous bruising or bruising under the skin from the handcuffs applied. >> overruled. >> the last thing i would say is also mr. floyd's case, i made a special incision on the back of his head all the way down to his
4:43 pm
buttocks and i dissected under his skin all the way to the side of his neck into his shoulders and his place. you might ask why, sometimes fresh bruises can be difficult to see in some people so we look under the skin to make sure we haven't missed something. the last few steps wouldn't be part of a typical autopsy but in circumstances like this, a general accepted practice to do. >> is the autopsy part of a broader death investigation? >> yes, the autopsy is one piece of the medical examiner's death investigation. >> could you characterize the umbrella? what is the death investigation and tail overall? >> the medical examiner's in addition to properly identify people, if the cause of death and manner of death. the autopsy is just one component and obviously has a great deal to do the cause of death and manner of death but we also need to know past medical
4:44 pm
history, we need to get a hold of next of kin to see if it could potentially have a daughter, if this family history we need to know about, will typically contact primary care physician as well as get the hospital record, if an analyst was dispatched to the hospital if the analyst run sheet as part of our investigation because to get the cause and manner of death right, you need to assemble all for the whole picture. >> let's go back to the autopsy aspect, how important is it to have detailed documentation? >> in terms of the autopsy? >> yes, sir. >> it's critically important the autopsy be very detailed, particularly if the death is potentially homicide because obviously it could end up in court and the work you're doing. >> do you create we might refer to as riposte data set documenting what you do?
4:45 pm
>> yes. >> what is all included? >> when i use the term robust data set, i have dictated the most detailed autopsy report that i can describing all scars, tattoos, birthmarks and injuries, in many cases a lot of injuries, places we might expect to see it injury but you don't. all those things are carefully dictated the narrative autopsy report but that is not enough, you have to take copious photography as well. the goal is to create a set of photos so robust, no other proctologist take my photos and feel like they were at my autopsy. they could reach their own conclusions and they don't take my word for it because it's in a photo. >> in the case of mr. george floyd, that is what you did? >> that was certainly michael, yes.
4:46 pm
>> at this time, i'm going to ask doctor baker to identify the photographs from the autopsy. may i approach doctor baker? back on raises. >> doctor baker, i handed you a number of photographs that should have exhibit numbers 186, 235, 185, 236, 187, 188, 189, 190, 191 and 192.
4:47 pm
if you could look through and confirm for the record that those are photographs you took during your autopsy of mr. george floyd. >> is a autopsy photographs of mr. floyd and they were taken by me. >> thank you, i'd like to go to the jury with this background noise was background noise is actually noise is background noise is[background noises]
4:48 pm
[background noises] [background noises] [background noises] >> all right. let me ask you first about documented injuries you saw with respect to george floyd and i'll ask you about specifics of the body. did you know injuries to mr. floyd's back. >> i did not. >> no bruises, scrapes, etc.? >> correct. >> what about injuries to mr. floyd's face? >> yes, several injuries to his
4:49 pm
face. >> if you could look at exhibit 186 and exhibit 235 in. [background noises] represent to you jury has seen these photos but is -- first, tell us what we see in these photos. >> these are photographs of the left side of mr. floyd's face. this would be after i cut away medical had there been blood or foreign material, we clean up before the photographs were
4:50 pm
taken. these were specifically taken to illustrate injuries you see on the corner of his left eyebrow and left cheek. you can see bruising and abrasion, medical lingo for a big scrape on the left side of his forehead and you can see the scrape or abrasion on the left side of his cheek. it's common for abrasions to take on the dark black color after death, the moisture would be an abrasion on you or me isn't there anymore so they dry out and look more like this like you see in the photo. >> do you have an opinion how mr. floyd have incurred these abrasions? >> these are linked with the left side of his face against the asphalt of the road. >> in the prone position? >> correct. >> if you would look at exhibit 185. [background noises]
4:51 pm
>> audit. >> which we see in exhibit 185? >> an overall photograph of mr. floyd's face taken early on the examination, you can see with this case number, the scale allows you to gauge the size you are looking at, this is a photograph you can put a face to a student's name case number, you can see injuries we illustrate in the previous two photos on the left side of his head and left cheek and you can see a small abrasion on the left side of his forehead, the pinpoint, an inch above his eyebrow. you can see laceration, the tearing of the skin on the right side of his upper left and also subtle bruising of his nose. >> one more witness and by best estimates, we will not be done by 4:30 p.m.
4:52 pm
[inaudible] probably be here past 5:00 and it's been a long week for everyone so is also home and have a good weekend, don't read any media. we'll see you monday. actually, at least 9:30 a.m. because we have legal issues to talk about before the big your usual routine. [silence] >> the former minneapolis police officer derek chauvin continues
4:53 pm
this week, charged in the death of george floyd who died while being arrested by officers. if you miss live coverage of today's trial, watch tonight beginning 8:00 p.m. eastern on c-span2 or anytime at ♪♪ >> book tv on c-span2 has top nonfiction books and authors every weekend. saturday 8:00 p.m. eastern, columbia university law professor looks at america's approach to individual, how rights went wrong white obsession with rights cares america part. saturday 9:00 p.m. eastern, state university professor talking about free speech and free exchange of ideas. in his book, why it's okay. sunday 9:00 p.m. eastern on "afterwards" in her new book, every day is a gift, denmark, illinois democratic senator
4:54 pm
talking about her life and career in military and u.s. senate, she's interviewed by congressional editor alana sure. watch tv this weekend. ♪♪ tune in to in-depth sunday may 2 noon eastern on the tv on c-span2. ♪♪ ♪♪ >> c-span2, unfiltered view of government grade by america's cable television company. today brought to you by these television companies, c-span2 to viewers as public service. ♪♪ >> u.s. special climate, john kerry and world financial peter talking about climate change during an event by the world bank. climate change critical fight for all of us, mr. carey focus on i


info Stream Only

Uploaded by TV Archive on