Chief medical examiner: with underlying heart conditions, arrest 'was just more than Mr. Floyd could take'

Hennepin County's chief medical examiner testified in Derek Chauvin's murder trial Friday that George Floyd's underlying heart disease contributed to his death at the hands of Minneapolis police officers, and that being held down on the street outside Cup Foods was "just more than Mr. Floyd could take."

Dr. Andrew Baker's testimony came after three other medical experts had already testified in Chauvin's Hennepin County District Court trial on second-degree murder, third-degree murder and manslaughter charges. Cause of death is a pivotal point for prosecutors and the defense.

Baker's findings, based on his autopsy the day after Floyd died, determined he died from "cardiopulmonary arrest complicating law enforcement subdual, restraint, and neck compression." He did not cite a lack of oxygen, or asphyxia, a cause found by three prior prosecution experts, including Dr. Lindsey Thomas, a medical examiner who worked on Baker's staff from 2013 to 2017.

"In this case, I believe the primary mechanism of death is asphyxia, or low oxygen," said Thomas, a medical examiner of 37 years who retired from Hennepin County.

Questioned further by prosecutor Jerry Blackwell, she said, "There's no evidence to suggest he would have died that night except for the interactions with law enforcement."

The prosecution is trying to show that Floyd died from a lack of oxygen caused by police holding him prone and handcuffed on the pavement. Defense lawyer Eric Nelson is trying to sow reasonable doubt, raising the prospect that Floyd died by heart attack brought on by illicit drug use and health problems.

Baker, who has been the county's chief medical examiner since 2004, said the 46-year-old Floyd had "very severe" hypertensive heart disease, meaning his heart weighed more than it should, requiring more oxygen.

While earlier medical testimony doubted that Floyd's physical condition or his drug use played a role in the death, Baker said under questioning by defense attorney Nelson that "in my opinion, yes," they were factors.

Asked by Nelson whether Floyd died of asphyxiation, Baker said: "That's something we don't really see, pressure to the back of the neck resulting in strangulation."

Nelson also asked again about the amount of fentanyl found in Floyd's body during the autopsy.

The lawyer had Baker disclose what he told prosecutors earlier about whether Floyd overdosed, and Baker replied, "I don't recall specifically what I told the county attorney, but it almost certainly went something like this: Had Mr. Floyd been home alone in his locked residence with no evidence of trauma, and the only autopsy finding was that fentanyl level, then yes, I would certify his death as due to fentanyl toxicity."

Baker began his testimony by saying he was aware of little more than Floyd had died in police custody at the hospital, but he avoided videos of Floyd's arrest and death until after the autopsy. "I don't want to go into autopsies with a preconceived notion about what already happened. It might cause me to skip something," he said.

The doctor said one image showed bruises and scrapes to Floyd's left eyebrow area. He said Floyd suffered those while "pinned against the asphalt."

Prosecutor Blackwell asked, "In the prone position?" Baker responded, "Yes."

Blackwell earlier questioned Thomas, Baker's former assistant.

She said that although Floyd's heart stopped, he didn't die from a heart attack. She also said Floyd died from subdual restraint and neck compression.

Thomas said she agreed with Baker's determination on the cause of death. However, Thomas' declaration runs counter to Baker's assessment in a meeting with the FBI that he could not say whether Floyd would have lived "but for" the officers' use of force, according to documents obtained in the case.

He also listed hardening and thickening of the artery walls, heart disease and illicit drug use as "other significant conditions." Fentanyl and methamphetamine were found in Floyd's system, Baker's autopsy results noted.

Thomas, however, testified that the physical stress of being prone must be taken into account.

"Mr. Floyd was already in a position where he was experiencing difficulty breathing and getting enough oxygen in this body," she said. "On top of that, now there's the physiological stress that's putting increased demand on his heart, lungs and muscles. … He's using his strength to get himself into a position where he can breathe."

In cross-examination by Nelson, he said to Thomas, "Let's assume you found Mr. Floyd dead in his residence, no police involvement, no drugs, the only thing you found were these facts about his heart. What would you conclude is the cause of death?"

She responded, "In those very narrow circumstances, I would probably conclude that the cause of death was his heart disease."

In the end, Baker stood firmly behind his initial ruling. "My opinion remains unchanged," Baker said as his testimony concluded. "That was my top line then, [and] it would remain my top line now."

Prosecution testimony continues Monday.