tv Day 10 of Trial for Derek Chauvin Accused in Death of George Floyd CSPAN April 9, 2021 8:00pm-9:26pm EDT
and we will be here, all of us together. >> that is the best way to end it, thank you so much for a lively and topical conversation. and thank you to our panelists and the audience, have agreed evening. >> c-span2 is your unfiltered view of government. funded by these companies and more. ♪ ♪ ♪ >> support c-span as a public service along with these other television providers. giving you a front of seed to democracy. >> coming up next, the 10th day of testimony in the trial of
>> dr. thomas, that he felt comfortable. please state your full name. >> my name is lindsay carol thomas. >> thank you. >> good morning. >> good morning. >> would you tell us what kind of a doctor you are? >> i'm a forensic pathologist. >> what is a forensic apologist? >> it is a branch of medicine in which medicine and law overlap. so it could be anything with medical and legal components, it could be toxicology, in some cases it could involve patients. but a lot of this is practice and it involves what is called
medical and legal investigation. >> does it involve taking care of patients? >> no, a pathologist could be consulted to help with the evaluation and interpretation of injuries, but not in the treatment or clinical sense. >> so most of your work is not on deceased people? >> yes, correct. >> the state statute with the types of deaths that have to be reported to the medical examiner, briefly they tend to be unnatural deaths like accidents, suicides, homicides, unexpected suspicious deaths, that type of category of death. >> do you give special training in how to determine the cause of death? >> yes. >> can you tell us about the special training we received? >> well, back in medical school?
>> yes. >> i did a fellowship in forensic typology which is a training program for doctors who want to be forensic apologist to learn how to do medical and legal investigations. >> so would you tell us more about it. >> yes, sometimes they are considered the doctor's doctor, because we don't directly treat patients, but we provide information to doctors who do treat patients. so for example if you've ever been to a lab and had your blood drawn, that goes to a laboratory that is run by a path colleges, a clinical graphologist. so we are talking about blood count, chemistry, things like that or if you've ever known anyone that was diagnosed with
cancer, that is the type of topology that is done by an anatomic apologist. so you look at tissue under the microscope. >> in minnesota a medical examiner is a forensic apologist appointed by the county board of commissioners to be the county medical examiner. >> so it is a public official? >> yes. >> so when you talk about the medical and legal investigation, is that a fancy way of describing what pathologist do? >> yes, it is what the medical examiner's office does, again, there is a medical component and also there can be a legal component. >> is a different from a death in the hospital? >> yes, if someone dies in the
hospital, those are usually due to natural causes, they may have a medical investigation in the sense that a hospital graphologist may do an autopsy, but they would not do the full scope of the medical and legal investigation due to natural diseases. >> what is the investigation entailed? >> welcome the way that the examiner's office performs a death investigation, i think a lot of people assume that it's all about the autopsy, the physical examination of the body, and that is really just a tiny part of the death investigation. it really begins at the very beginning when a death is found and a person is found deceased, or the office is notified of a debt. as medical examiners we would like to know about the person, what is their medical history,
family history, social history, so we will do whatever we need to do. then we would like to know what word the terminal events, what would happen around the time of their death, were they complaining of something, were they interacting with someone, were they using machinery or something like that and then looking at the physical examination and that part of the exam could include x-rays, it could include toxicology or cultures, all kinds of other laboratory tests, including looking at things under the microscope and so the physical exemplar it, then looking at the laboratory results, that would be usually toxicology, but as i said it could be blood cultures or more recently covid-19
testing, that kind of thing, and then looking at the microscopic element and then putting that together with the history, the terminal events, the findings, the laboratory findings and then that is how the medical examiner reaches the conclusion about the cause and the manner of death. >> so all of that goes to a investigation? >> yes. >> do you interview people as a part of it? >> yes committee investigators that go through the scene may talk to family members, we will certainly speak to medical providers as well to get someone's past medical history and we will often talk with law enforcement officers if they are the people that responded, it could be paramedics, it could be troopers, it just depends. >> i would like to ask you about a break.
could you explain to the jury what is a terminal event? >> sure, so when we are investigating a debt as medical examiners, as i mentioned, we want to know as much as we can about the person leading up to their death because oftentimes it will provide us information about how they died. when i am talking about terminal events, i am talking about what happened in the time frame around their debt shortly leading up to their death. for example he was shoveling snow, he came in, he clutched his chest and he fell over. that is an example of a terminal event, or we know that someone was driving the car and went off the road. that would be a terminal event. >> also do rely on training and expertise on how injuries occur? >> yes, as a forensic apologist, that is one of the things we look at and learn about is when
we see this type of injury, we associate that with this type of event. >> what is the medical examiner then do at the conclusion of a death investigation enact. >> so the ultimate goal is to complete the information needed on the death certificate, specifically the cause in the manner of death. >> is a report generated a max. >> yes. >> what is the nature of the report a max. >> well, one of the main ones is the autopsy report of the physical examination, but ultimately the death certificate is the final report. >> so you have told us as a forensic apologist you don't treat living patients. so if we want to have a discussion about measuring your reserves in someone, that would
not be you. >> no, that would not be me. by the time i see them, none of that applies. >> so doctor, are you currently employed? >> welcome i am semiretired and i do consulting and then i also work part-time at the medical examiner's office in reno, nevada, in salt lake city, utah. >> i like the way the office runs and i like to be involved as a medical examiner. >> what did you do before you were semiretired. >> well, right before i was retired i was at the hennepin county medical examiner's office is a medical examiner, and would you like me to go before that? >> yes, if you could tell me
your work experience. >> shirt. initially i started after my training at the medical examiner's office, i was there for many years and then in 1997 i joined the minnesota regional examiner's office based in hastings and then i was chief of that office for 13 years and we were the largest of which were dakota ansgar county and we have offices in wisconsin and even michigan and that is when dakota
ansgar county merged enough i came back and. >> for how many years have you performed work or services as a transit cop colleges? >> well, let's see, 37 now we met. >> and in minnesota, how many counties? >> well, i have been a direct medical examiner for a counties and i have work in offices that have been consultants to dozens of other counties. >> how have you also perform those services? >> yes, i have. >> when did you stop working at the hennepin county medical examiner's office? >> it was early 2017 i retired. >> and how many autopsies would you estimate you have performed over your career? >> probably about 5000.
so whether you supervise or not, you determine the cause and manner of death? >> actually will more than that because as medical examiners, we do not just certify this for the cases that we do autopsies on, there are numerous other cases they get reported to in examiner's office where we don't do a physical examination. so, for example, an elderly person falls in a nursing home and gets a hip fracture and then dies a couple of months later, that that has to be recorded with the medical examiner's office, we will investigate it by looking at medical records and doing all of what i spoke
about was getting family input and medical and provider input, but generally we will not do a physical examination, but by law we have to sign the death certificate. >> so you are determining the cause and the manner of death at this time. >> correct, we are just not using the medical records part of it. >> are you licensed? >> yes, i am. licensed within minnesota, tennessee, nevada and utah. >> do you hold any board certifications? >> yes, i am board certified by the american board of pathology in anatomic clinical pathology and forensic pathology. >> have you worked with any professional organizations over the years related to forensic topology we met. >> yes, a number of
organizations, the american college of the american academy of forensic sciences and then on the board of the medical examiners association probably 30 plus years and there is a member of their executive committee as well. >> and that goes by the acronym, is that right? what does this that do? >> well, there is a professional organization of medical investigators, specifically forensic apologist and medical examiners and organizations provide support to medical examiners as well as providing
information and guidelines and accreditation programs and an inspection program and lots of ways of assisting medical examiners. >> dr. thomas, have you done any teaching? >> yes, i have been a clinical instructor here at the minnesota department of pathology. i have also done law enforcement training here in minnesota as well, as well as teaching everything from middle school, science, high school and college and all kinds of professional, whether it is forensic topology or law enforcement, you name the organization that comes in contact with the investigation and i have probably talked to some of them at some point. >> you have any publications?
>> that has not been the main focus of my career, but i have several, and early on i was involved in the protocol that was ultimately published by the united nations that is currently still in use. >> okay, switching dockets, talking about your experience testifying. have you testified before the court 2. >> yes, probably over 100 times. >> and has that predominantly in your role as a medical examiner been part of that we met. >> it is mostly in my role as a medical examiner where i did the autopsy and then the prosecution would call me to testify at to my finding and i also testified as an expert witness consultant in cases where did and do the autopsy but i was called within a civil case, if they thought it
was a wrongful death or some question about medical malpractice or something like that and then also i have done consulting and testifying and again, not where i did the autopsy but where i refused someone else's work and then i consulted with the defense. >> have you testified in minnesota courts? >> minnesota, iowa, with thompson, north dakota, south dakota, pennsylvania, i think those are the big ones. >> still dr. thomas, are you being paid or your time and services for this case? do not know. >> can you tell us about that? how does that, about your not not being paid for your time and services here 2. >> well, i did not ask to be paid.
>> so did you reach out to the state or did they reach out to you. >> no, no, it they reached out to me and, you know, i knew that this was going to be important and i felt like i had something to offer and i wanted to do what i could to help explain what i think happened. >> so what were you asked to do in this case? >> i was asked to review a lot of the materials and come to an independent conclusions about what i thought caused the manner of death and the mechanism of debt. >> could you give the jurors a general sense or an overview of the kinds of materials that you reviewed? >> so i looked at the hennepin county medical examiner and the
microscopic flags and things like that and i looked at the hennepin county records and the past medical history from their as well as health partners medical records. as well as a lot of interviews and many videos and surveillance videos and some photographs and a timeline and then some medical literature as well. >> so were you the medical examiner that investigated or did the autopsy around the death of george floyd? >> no, that was the doctor of the hennepin county medical examiner. >> do know doctor baker? >> yes, i do, he was a path balaji resident when i was on staff at hennepin county many
years ago. then when he did his fellowship i was one of the staff, and after the offices merged i worked again with him. >> would you have been part of his training and his early formative years? >> yes. >> do you consider him a friend? >> yes. >> have you talked to him about this case? >> yes. >> did you review the history of terminal events for may 2020? >> yes. >> what was kind of unique in this case was the volume of materials that i had to review, i have never had a case like this that had such thorough documentation.
>> by way of thorough documentation, what makes it so terrible in your opinion reign. >> well, the use of videos is unique in this case. certainly as medical examiners, we use videos, but there's never been a case that i've been involved with that had videos over such a long time frame and from so many different perspectives. >> are you aware then of the conclusions on the manner of death? >> yes. >> your honor, i would like to show exhibit 193 that has been stipulated through the foundation. >> okay, dr. thomas, what we see with exhibit 193 reign. >> this is a copy of the certificate of death of mr. george floyd. >> so if we could highlight
through the word underlined. just to make it bigger to see. >> based on your view of the evidence and the death certificate, do you agree with the doctor's cause of death? >> yes, i do. >> and is that immediate here? >> yes, dual restraint and neck compression. >> have you spoken about the mechanism of death? >> yes. >> would you tell us what that is? >> in this case, i believe the primary mechanism of death is asphyxia or low oxygen. >> we will come back to the mechanism in just a moment. can you explain to the jury what the cause of death means and why you agree to it?
>> well, it is in two parts, so there's cardiopulmonary arrest, which does not provide a lot of additional clarifying information because in a way everyone dies when your heart stops and your lungs stops, that is cardiopulmonary arrest, but as a friend the graphologist, i would use it when to differentiate it from a cardiac arrest. so this is not a sudden cardiac death or arrhythmia. this is one where both the heart and the lungs stopped working. the point is that it is due to law enforcement restraint and compassion and that is kind of what ultimately is the immediate cause of death. >> just so it is clear, it means heart attack reign.
>> no. >> doesn't mean fatal arrhythmia is a common cause of death? >> no. >> so means the heart and lungs have stopped 2. >> yes. >> so to stop death itself. >> correct. >> can you explain what is referred to here looking at the terms of some dual restraint neck compression. >> yes, those are activities by the law enforcement agency officers who were involved, some restraint, that includes handcuffing him and his positioning on the ground, and the neck neck compression is the
knee on the net specifically, it additionally being compressed by the officer. >> so if you put all this together, the cardiopulmonary arrest complicated, law enforcement subdual restraint and neck compression, what does that mean? >> well, what it means to me is that the activities of the law enforcement officers resulted in the death of mr. floyd and that specifically those activities were the restraint and neck compression. >> also representing your own conclusion, a conclusion that you have reached to a degree of reasonable certainty? >> yes. >> would you tell us what we have reviewed to reach this conclusion? >> all of those things that i mentioned earlier, and again, what is sort of unique about this case is that oftentimes we
could review the medical examiner case file that will provide information about the cause and manner of death is. in this case, the autopsy results did not tell me the cause and manner of death, which really required getting all of his other additional information, specifically the video evidence of the terminal event to conclude it. >> when you make reference to something called the mechanism of death, could you tell us what mechanism of death means? >> so cause of death, what is the disease or injury or the process that causes somebody's death, but the mechanism is what is going on in the body at that time. so the cause of death could be a gunshot wound, but the mechanism
might be blood loss related to that gunshot wound or, you know, an infection that complicated it down the road, something like that. so it is more what was actually happening at the level of the body that resulted in the cause of death. >> so folk and focusing on the mechanism of death here, how is the neck compression causing his death? >> so i mentioned i think the primary mechanism is asphyxia or low oxygen, basically it is mr. floyd being in a position because of the subdual restraint and compression where he was unable to get enough oxygen in him to maintain his bodily functions. >> what is required for normal breathing? >> what is required?
well, they're kind of three components, you have to be able to get air in, so you have to have a their way of nose, mouth, soft tissues of the net, but where next in the trachea, all of those things have to be open. and at the level of the lungs there has to be adequate air exchange between oxygen coming in and carbon dioxide going out and then finally, the way that the lungs work as a whole is kind of like when you take in air you have a diaphragm that is dropping and pulling air in and then when you relax, your diaphragm collapses and pushes air out. .. ..
then their error way is obstructed so there isn't adequate air coming in or in an environment where there isn't enough oxygen so for example in a closed garage which a car's been running their maybe high carbon monoxide and in that case they are perfectly able to prevent an out but there just isn't enough oxygen and the third would be if they are some kind of restriction such that your chest can't expand, your diaphragm can't expand so the function isn't working and if any one of those components is a working then the result will be this mechanism of inadequate air.
>> how does narrowing of the hypothermic in? >> well people are most familiar with sleep apnea or snoring. if you yourself are have a partner who snores you know especially in certain positions what happens is the hypothermic which is at the back of your throat will collapse because there's inadequate air either forcing it out or forcing it in which is why as cpap machine works because it forces air through that area and if that collapses then it makes it difficult to get air in. >> dr. thomas what do you rely on to reach your conclusion that low oxygen was the mechanism? >> in this case it was primarily
the evidence from the events and the video evidence that showed mr. floyd in a position where he was unable to adequately breathe. >> how does the autopsy report itself assist you are not? >> so the autopsy really helps. it's great for ruling things out. in this case the autopsy ruled out for example underlying lung disease. mr. floyd had a history of covid but there was no evidence in his lungs at the time of his death that he had any lung disease that would impair his ability to breathe. and it ruled out injuries to the neck. the bones in his neck had been broke and for example in a ruled out a stroke. he didn't have a stroke so it wasn't like his love pressure was so high that he ruptured a
vessel in the brain. he didn't have an aneurysm. or ruptured vessel. he didn't have an embolism which is a blood clot. he didn't rupture is hard. he didn't have an old heart attack or a recent heart attack or what is called myocardial infarction so the biopsy is great for ruling things out. see that to focus on one of those he said the autopsy ruled out a recent myocardial infarction. how did he do that? >> well when a forensic ethologist examines the hard one of the things they look at is the coronary arteries which are the vessels that supply blood and nutrients to the heart muscles and then the pathologists will examine the muscle of the heart and if someone has had a recent heart
attack there may be evidence in the heart muscle of that damage or they have had it prior in older heart attack there would be scarring in the heart muscle that shows that area of damage. >> thank you doctor. is it part of your in-depth investigation to look at the video? >> yes, oh yes. >> in this case is there any particular video footage that struck you as more significant than others? >> oh in this case there were so many. the body worn camera videos were very instructive because they started, well and the cup foods video because they showed how mr. floyd was behaving long before law enforcement interaction and then the body
worn camera shows early interactions before there was any of this dual restraint and compression and then they showed the interactions during the dual restraint. the bystander videos are really instructive as well as the surveillance videos from the scene at showing during the time of their restraint. so there were lots. >> in terms of the video footage in ruling in a cause or out of cause how did inform your assessment about the cause of death? >> well it helps me rule in a cause and rule out causes i would say. >> so did it help you determine whether this was what i might refer to as the lights out kind of doubt? >> right, so what i observed
from all of these videos is this was not a sudden death. mr. floyd did not come its not like the snow shoveling when i told the somebody comes in and collapses and falls for it. there was nothing sudden about his death so that is what i would have expected if it was a cardiac arrhythmia or abnormal beating up of the heart. typically those are someone really falling over pretty quickly in this was not that. likewise, it was not the type of death that has been reported in a fentanyl overdose for example where someone becomes very sleepy and then just sort of gradually calmly and peacefully stops breathing. this was not that kind of a death so i felt comfortable ruling out those as causes of death and then on the flip side
i could clearly see from watching the video what happened to mr. floyd during this tool restraint and compression and what happened to his breathing is gradually becomes more difficult. >> doctor tell us what is the bellows function? >> well it is what your diaphragm does along with the muscles and between your wrist so when you take in a deep breath what is happening in your ribcage is expanding and that then or since the lungs to open up and that is what draws air in so when someone is integrated in surgery or something it's the opposite of that because your diaphragm is sterilized -- paralyzed so someone has to arras aaron but under normal breathing circumstances it's the
bellows, the pulling air in. >> what did this video tell you? what did you see in it that had to do with the bellows function? >> right, well mr. floyd is in a position so first of all he is prone or with his head to the side and he has his arms handcuffed behind his back so that is already up there bit of a difficult position to be in being prone and handcuffed and then at times at least three officers are on top of him whether it's his neck or his back or his lower back or leg. it are then some from moving his body into a position where he can adequately use the bellows function and his chest is sort
of compressed and position in such a way that he can't adequately expand and get enough oxygen. >> over what period of time was this? >> nine minutes. >> what did you see in those nine minutes that led you to conclude that the mechanism was asphyxia? >> well initially mr. floyd is able to struggle vigorously when he is in a position that he recognizes that it's simply hard for him to breathe in that position. >> the last part of the answer about mr. floyd state of mind is stricken as speculative. >> so initially when he's in the prone position he is breathing and speaking and he is at that
point getting enough air exchange but over time you can see that his breathing is getting more and more difficult and he is saying less and less and then about halfway through the whole restraint dual compression process he stopped breathing. well he first stopped speaking entirely and then again shortly after that there is movement that i believe is what is called an anoxic brain reaction which is, looks like kind of a twitch. something that the body does when the brain no longer has enough oxygen so that's the point at which you can tell by looking, oh that's where he no
longer is getting enough oxygen to his brain and then their restraint and dual compression continues for many minutes more even after someone test and says oh there is no pulse. they maintain the position so at that point the heart has also stopped so he stopped breathing and his heart stopped. >> dr. you mentioned anoxic rain reaction varied is also known as anoxic -- [inaudible] is that something that a person does consciously and voluntarily? >> oh know no. something that your body just does when your brain doesn't have enough oxygen. in lots of cases people who are witnessing something dying they will say oh they had a seizure and died. no, what actually happened is
they basically died. their brain didn't have enough oxygen and they have this muscle twitch that looks like a seizure. see i can we go back to exhibit 193 i want to ask you about the other contributing conditions and if we could just highlight that perhaps. so do you see where i'm referring to the other contributing conditions? >> yes. >> and what are those? >> in this case there arterial sclerotic and hypertensive heart disease fentanyl intoxication in recent methamphetamine use. >> would you explain for the jury what does it mean other contributing conditions? >> oh the way forensic examiners usually use this is people often think of it as a death
certificate as for that gerson, that specific person who died in their family and that is true. it does serve a very useful purpose for life insurance, whatever. but forensic pathologists are also using death certificates for public health data purposes and so in any given case we aren't just thinking about this particular person and their manner of death. we are also thinking of the state and the federal government collects data on why do people die and what is the cause of the? it's how we now is a country that we have, how many people die of covid for example. death certificates state that. so one of the things we used as other contributing conditions for us to list disease processes or drugs that are present at the
time of death but we don't erect we, we don't believe directly contributed to the cause of death but if someone is looking at data years from now and says okay we want to do an evaluation appauled death all deaths during law enforcement and how did death involves involve someone who had drugs on board because that they be something that is relevant and trying to prevent these deaths in the future for example. or the case where i used other concerto being can -- conjure being factors for hip fracture where someone dies of a hip fracture due to a fall but they are 84 years old and they also have hypertensive heart disease arterial sclerotic heart disease asthma, diabetes so i will list
those as other contributing conditions. now in no way do those things the fall in a hip fracture and resulting ammonia or whatever but again someone from a data perspective might want to know you know how many 84-year-old women die of hip raptures what are senator thune underlying heart disease because again from a data collection standpoint does that provide useful public health information that can be used in the future to try and prevent these deaths. so that's how i would view this. it's very long-winded. >> no, and dr. thomas. in understanding this further other contributing conditions are conditions that may have contributed but were not the direct cause? >> exactly. >> did you consider these other contributing conditions in your assessment of the cause and
mechanism of death of george floyd? >> yes. >> how did you consider them first of all? >> well i wanted to look at each one and asked the question is this the cause of death? is arterial sclerotic heart disease the cause of death? we have narrowing of his coronary arteries and in many cases that is the cause of someone's death so i looked at that but again it comes down to what was the history of the terminal event and does this look like the type of death we see and i'm not a clinician so i don't see it that forensic apologist from hundreds of families describe what happened at the time of death that this death does not fit what has been described him someone who died of a cardiac arrhythmia from art. a sclerotic heart disease and likewise hypertensive heart
disease. those tend to be cardiac arrhythmias and cardiac deaths but this was not that kind of death. likewise for internal intoxication as i described and again i don't see living people but what i know from family members to describe that later turned out to be from fentanyl that death was slow. it was peaceful. they fall asleep in a may hear snoring erred deep heavy breathing. there is no struggle. lots of them are found just slumped over, a very slow death so again totally different than what is seen in george floyd's death. methamphetamine is a cause of death generally is again much more of a sudden death. it may cause a cardiac arrhythmia. it a cause a seizure and by that i don't just mean a terminal and
anoxic twitch like a full-blown seizure and again looking from what i know about mr. floyd's death because it's so well-documented that does not fit with a methamphetamine death. >> thank you used toxicology. how would you characterize the amount of methamphetamine in mr. floyd's system? >> well it was not particularly high. from the deaths that i have attributed to methamphetamine have been much higher but it's not like there is any safe level of methamphetamine. this was a very low level. >> was a methamphetamine significant in your assessment in the cause of death? >> no. >> so then based on the view of the video and applications in your work experience and
knowledge did you rule out a drug overdose as a cause of death? >> yes. >> and that's the opinion you hold to a reasonable degree? >> yes. >> i want to clarify this with you. does the medical examiner also complete the death certificate? >> yes. we don't issue it. it comes from the county or the state but as the medical examiner we fill out all the b. how the injury occurred and so forth. >> him a death certificates have you filled out? oh gosh, thousands and thousands. >> sofie look here again at the exhibit in front of you, 193 in the left margin we see a reference here to underlying. will you tell the jury what that
means? >> sure. so let's go back to that hip fracture that i was referring to that but for example someone who dies of a hip fracture generally doesn't -- what happens is someone gets a hip fracture they get it surgically repaired, they may get pneumonia or something like that. then in that kind of case we look at the immediate cause of death was pneumonia or the underlying cause of that is the hip fracture but the underlying cause of the hip fracture was the fall. they fell, they got a hip traction they gotten ammonia so it's something that is used when you have a death that has made the multiple sequences of events but in a case like this you don't need an underlying because it's all included in the first line. it's all due to the law enforcement restraint and the net compression.
>> the death certificate does not use the word asphyxia are in a reference to low oxygen. >> no. >> would you have used the word asphyxia this case? >> rob a play not pretty tend not to use the word asphyxia much because it requires a lot of explanation. doesn't really offer much additional information unless you have a chance to have a discussion like we have had about what asphyxia means so i tend if someone dies of hanging well that's an asphyxia death but i wouldn't say necessarily it's due to hanging. i would just list hanging as the cause of death trades to make so2 to asphyxia are low oxygen it doesn't tell you anything about why there is a sexier loss like. >> right. >> are their findings that
suggest low oxygen as a cause of death? >> no, there's nothing on low oxygen. sent there's no test that can be done for low oxygen? >> no. >> or their physical findings that sometimes may be found or maybe consistent with low oxygen? >> so there are no physical findings that show low oxygen but there may be physical findings that are consistent with the cause of death that may result in low oxygen so for example the hanging. let's use hanging. if someone is partially hanged and by that i mean they are only partially suspended so there's only some pressure on her neck, they may have what are called
petechiae or pinpoint hemorrhages in the eyes because lead is still going into their head but not able to drain out because of the pressure on the neck so that autopsy we would see the petechiae and we could say based on the investigation in the history that finding is consistent with hanging and a mechanism for hanging is a type of this pixie a or strangulation we might see some bruising or we might see roe can bones in the neck. and the mechanism of death in strangulation is low oxygen but the finding that we are seeing is consistent with strangulation so it kind of a fine line between findings. it doesn't go low oxygen we see it at a knocked out said that sometimes, not always but sometimes in cases where the death is the result of low
oxygen we see specific findings related to the cause. >> so if you see petechiae it would lead you to the conclusion that it was death by low oxygen? >> yes. >> but if you don't see petechiae what can you conclude? >> nothing. so it's one of those things that when present if there is petechiae or broken bones in the neck or bruising that's very helpful in putting together a picture of what might have happened but if you don't have them it doesn't help you one way or the other. >> and helping you one where the other means you can't conclude from that alone that a person did or did not die of low oxygen? >> exactly. >> and you pinch in losing that contact. >> right, given for example strangulation is a great example. sometimes in strangulation you have all kinds of bruises in the neck but other times there's a
strangulation case and they don't have a single mark on her neck and i mean they are all kinds of reasons that bruises there may not occur but again it's one of those things that is very very helpful if it does. >> were there their findings in a death investigation that supported your conclusion on the positive mechanism of george floyd's death? >> yes. >> would you tell us what those are? >> so mr. floyd had superficial injuries what would be described as superficial injuries is typically on the days, on his shoulder and on his wrist and what that does is it supports what i find in the video which is that he is being forcibly restrained and subdued and he is trying to move into a position by rubbing his face against the concrete, against the ground, by
pulling against his handcuffs. you can see the injury to his wrists from the handcuffs and by pushing with his shoulder and he also has some scrapes on his knuckles, on his right hand and again that was from him pushing to try and get into a position where he can breathe. >> dr. thomas other photographs that depict what you are describing? >> oh yes thank you. >> your honor we stipulate that we have visual packets for the jurors. >> there are stipulated photographs that will be shown to you or as we call it as you've heard me say public viewings. were going old school this time. we are putting everything out on monitors that everyone in an accord will will have access to it including yourself essentially a packet for that. we collect them afterwards to
maybe get a close-up of the same area. >> okay, yes, here we go. yes, that is a close-up of the left cheek and the left forehead, and you can see for example above his left eyebrow there is a dark area of dry scrape as well as there is some discoloration of this, and then on his left cheek you can see the dark area as well as a light orange paint area and those are again screwed.
the dark areas are where a script has dried. >> what does it tell you about the cause and mechanism of death? >> it is consistent with the impression from watching the video that his face was on the ground and he was moving his face in an effort to get into a position where he could actually breathe. >> looking at exhibit 188. >> this is a photograph of mr. floyd's left shoulder. >> what do we see here? >> again, this is an area of scrapes and it indicates to me that there was some force between his shoulder and a rough surface, in this case the ground, and again it is consistent with what it looks like on the video, that he is
struggling to push himself into a position where he can breathe. >> looking at exhibit 187. >> this is a photograph his right shoulder and you can see a little bit of discoloration and then where the skin is scraped, so there is less injury impact here in that sits again with what you see in the video of what side was down and which side had more contact. >> let's look at exhibit 189. >> this is a photograph of mr. floyd's left hand.
>> if you look at his hand over his wrist, there are areas of red discoloration and there's kind of a tail area in between. and that is consistent with handcuff marks. you can also see the outer edge there is some material that is dry skin, that is an area where his skin has been rubbed up from the handcuffs. >> back to exhibit 190, a photograph of his right hand and wrist and in this case you can see more clearly the double lines and indicates pressure
against handcuffs. again, on the outer edge you can see that there is a little bit weird starker and then there is some light skin. that is an area where it has been scraped and also on this photograph you can see on the knuckles of his index finger and middle finger there is some skin that has scraped off and that is consistent with what you can see where he is pushing against the rim of the car tire or something to try to push his body into a position where he can breathe. >> if the jurors could please put the photographs away.
that scrapes and bruises can actually happen. it is only useful in the context of what is seen in the videos. >> was there any evidence to suggest that mr. floyd was suffering from a fatal condition on the evening of may 25, 2020? >> no. >> do you have an opinion to a degree of medical certainty if he would've died that night had he not been subject to subdual restraint of the police. >> there is no evidence to suggest he would die that night except for the interaction with law enforcement. >> were there other mechanisms that you felt contributed to his death? >> yes. >> could you characterize what those were?
>> yes, so i think a second mechanism in this case is what i would refer to as physiological stress and by that, i do not mean the stress of somebody being a type a personality and they have a deadline and they are really stressed about it. i'm not talking about that kind of stress that the kind of physical stress that you feel when you are driving along and all of a sudden a car swerves any slam on the brakes and you realize oh, my gosh, if i had not reacted, if that would've in the second earlier, i would have been in a car crash. and so you can kind of feel that. the car then speeds on anything okay, i'm okay, everybody is okay, and then your heart rate slows order even worse you are at the beach and suddenly realize i have an in my toddler,
oh, my gosh, where is my toddler and that rush of adrenaline you get to feel flushed and you get short of breath and your heart races and then there they are. anything okay. i'm okay. but it takes a minute for your heart to slow down and her blood pressure to regulate and to take a deep breath and recover yourself well. so that is the kind of physiological stress, only instead of a second for a moment, this goes on minute after minute after minute for nine minutes in total, where you are absolutely terrified and you cannot -- there's no recovery. so it's that kind of ear of life that i'm talking about of physiological stress. >> are you able to tell us what is going on in the body under physiological stress mx 2 so it
is -- the reaction is you get chemical release, you get adrenaline, epinephrine or norepinephrine, those are the things that make your heart rate and blood pressure so, and you require more, where your muscles get ready to act, you are willing to do whatever you need to do, therefore you start to need more oxygen in your muscles, you need to take more brass, you need more oxygen for your heart rate because your heart is even faster and there may be other chemicals as well that are released, cortisol, stress hormones, things like that and there could be lactic axid that is produced when you have a heavy workout and it's
your muscles working, so all of those physical things, those chemical things, they can cause reaction within the body that spikes additional stress primarily on your heart, and also on all of your bodily systems because your body will buyers your chemistry to be in a fine balance. when there is too much lactic acid or too much -- not enough and no ability to compensate for that elevated lactic acid, then all of your body organ will suddenly be in trouble. >> you consider that stress as you are describing it as a direct cause or mechanism of death or is it secondary? >> i guess i would consider it a
contributory factor to the cause of death. it is another contributing mechanism. >> so the secondary causes what? >> so the primary mechanism, i think, is a 60 a and the secondary is low oxygen is an annex to his physiologic stress, but ultimately the subdural restraint and compression. >> so this physiological stress, but we are discussing, is that something that can be observed on an autopsy? >> no. >> why is that? >> well, it is a chemical reaction in the body. it is increased heart rate, which we don't see at autopsy. chemicals that we cannot test
for. so none of it is anything that can be seen physically. so it is a functional mechanism. >> yes, that's a good way of describing it. so low oxygen is also a functional mechanism. >> yes. >> could you tell us how you felt that the physiological stress was significant to the cause of death for mr. floyd? >> so mr. floyd was art in a position where he was experiencing difficulty breathing and getting enough oxygen in his body. on top of that now you have the physiologic stress that is putting an increased demand on his heart, increased demand on his lungs and on his muscles and
so all of the things that he is using, his muscles and his strength and his body, trying to get himself in a safe position, those are being stressed the bully by the position that he is in as well as the underlying chemical reactions that are happening in his body at that time. so it is kind of a double whammy to his heart and lungs and his entire system. >> said doctor thomas, showing you exhibit 194. worse, doctor thomas -- can you tell us what this is? >> yes, this is a press release that was outside the hennepin
county medical examiner's office at the time that they certified the death of mr. floyd. >> you understand that they generate this type of a press release in certain cases? >> yes. >> so there is a section in the report refers to manner that. >> yes and we see the word there homicide. >> yes. >> we can also in here, we saw information on the death certificate as well, the press release says also how the injury occurred. >> yes. >> would you read that for the record of? >> how it occurred is the cardiopulmonary arrest while being restrained by law enforcement officers. >> you agree with that?
>> yes. >> so let me show you exhibit 918. and homicide is a manner that. >> yes. >> would you explain to the jurors a little bit about what it is the medical examiners look to when they are trying to determine manner of death? >> sure. unlike cause of death which could be anything, we only have five options for manner of death. so it can be natural, meaning that all of the conditions that contributed to the death are due to innate processing, cancer, heart disease or things like that. the second is an accident, that would be something like a motor vehicle crash or an unintended drug overdose. and the third category is a suicide, which is debt that once owned hands, with the at least
some element of intent. and the fourth category is homicide, and that means death at the hands of another. and under this category is undetermined. and that means generally that we don't have enough information about the type of data to make a determination to fit it into one of the other categories. so we talked a lot about terminal events early on. and in some cases we have no idea what the terminal events were because the person is just found dead in their residents. so we don't know because they have been alienated from family, we don't know were they saying they were going to take their lives, did they have a history of using drugs, but they just got out of prison, you know, we are unable to get enough adequate information to sort it into was it accidental or intentional suicide death. so that would be an example of
where we could be undetermined and we just do not have enough information. >> doctor thomas, if you look at screen in front of you, does it show the manners of death. >> exactly. >> homicide is highlighted. >> yes. >> you agree with that finding? >> yes. >> in the case of george floyd. >> yes. >> exhibit 918. >> exhibit without the highlights? yes or no? >> yes.
>> ladies and gentlemen of the jury, these are the five methods of debt that you are describing, manners of death, homicidal has been highlighted with what doctor baker found in you agree with it. >> yes. >> is there any guidance given to medical examiners about how to select homicide as a manner of death? >> yes. >> there is a guy that is published by the national association of medical examiners that provides assistance and how to make a determination between these differences. >> i want to show you as what has been marked as exhibit nine 952. >> yes. >> is this the publication on
how to determine manner of death? with reference to exurbs from this, would that be helpful to your testimony? >> yes. >> interjection. [inaudible] >> we will take a break, let's come back around five after the hour. 1:05 p.m. >> entertaining to this particular exhibit, i don't think it is appropriate for it to be admitted as an actual exhibit because it contains what constitutes homicide.
including what the jury is instructed instructing, whether or not determining the legal definition of this case. and so in this particular instance, i think it would confuse the jury between the medical definition in the legal definition, i do not think it is appropriate. >> i can't see the whole exhibit. all i can see is the title page. >> nec that, your honor? >> you have any objection to this? >> no, i do not have it as being demonstrative but going back to the actual exhibit. >> can you have the jury follow
along and have doctor thomas speak? okay, that is fine. >> okay, we will be back at five after the hour. >> this weekend, watch the trial of derek chauvin charged in the death of george floyd at 10:00 a.m. eastern, saturday and sunday on c-span. hear testimony from the minneapolis police chief as well, and then from doctor martin tobin. the trial is saturday and sunday at 10:00 a.m. eastern on c-span2. >> saturday on the communicators, michael powell, the president of the internet and television association. >> at some point we should focus on the things that matter to
consumers. if you want to talk about lack of neutrality, let's examine the platform, the ones that put a lot of money in their own effort in trying to hamper the net neutrality rules so that they would be able to have unparalleled power and control and we are looking at the consequences of that today. >> watch the communicators on c-span. >> the influence liber johnson had only lbj presidency with julius wein, the senior research fellow at the school of public affairs at the university of texas, austin. >> i see her as a bridge between eleanor roosevelt and hillary clinton. she has the commitment to developing a policy agenda that
reinforces and elevates her husband like eleanor has. she has a not quite as broadly, because she didn't have a radio program, but this is a woman campaigning for her husband who was working hand in glove to elevate his presidency. and i basically in the white house much longer, i see lady bird modernizing the first person to do that since after world war two. >> author of lady bird johnson, hiding in plain sight, sunday, 8:00 p.m. eastern on "q&a." you can also listen to "q&a" is a podcast where you get your podcasts regularly. >> back now to the trial of the former minneapolis