Despite Other Factors, Police Caused Floyd’s Death, Medical Examiner Says

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MINNEAPOLIS — In a trial where many key figures have spent hours on the stand, the prosecution whipped through one of their most anticipated witnesses, the doctor who performed George Floyd’s official autopsy, in a mere 50 minutes on Friday.

The reasons for their haste became clear as the witness, Dr. Andrew Baker, the Hennepin County medical examiner, refrained from placing the sole blame for Mr. Floyd’s death on the police as he testified in the trial of Derek Chauvin, a former officer charged with murder.

In his testimony, Dr. Baker said police restraint was the main cause of Mr. Floyd’s death, but he also cited drug use and heart disease as contributing factors, saying that Mr. Floyd died “in the context of” the actions taken by three police officers as they pinned Mr. Floyd to the street for more than nine minutes.

“In my opinion, the law enforcement subdual, restraint and the neck compression was just more than Mr. Floyd could take by virtue of those heart conditions,” he said.

The prosecution’s other medical experts have testified that the pressure that officers put on Mr. Floyd’s neck and back, not his underlying conditions, caused his death.

In most murder cases, the local medical examiner who performed the autopsy is a star prosecution witness, the most authoritative voice on the victim’s cause of death. But in the trial of Mr. Chauvin, prosecutors have regarded Dr. Baker as perhaps their most problematic witness — and possibly one who could help the defense raise reasonable doubt in the minds of jurors.

Throughout the investigation Dr. Baker has made statements that the prosecutors regarded as minimizing the impact of Mr. Chauvin’s use of force. He has said that if Mr. Floyd’s body had been found at home, his death could have been attributed to a drug overdose, and that he was unable to say whether Mr. Floyd would have died were it not for his encounter with the police.

Mr. Chauvin’s lawyer, Eric J. Nelson, seemed to score some points for the argument that he had been advancing throughout the trial, that Mr. Floyd’s poor health, drug use and resistance to arrest led to his death.

During Mr. Nelson’s cross-examination, Dr. Baker acknowledged that he saw no physical signs of asphyxiation; that Mr. Floyd had a level of fentanyl in his system that could have been called an overdose in other circumstances; and that his heart condition, combined with the exertion of struggling with the police, played a role in his death.

Mr. Floyd had an enlarged heart for his size, Dr. Baker said. It required more oxygen to continue pumping blood throughout the body, especially during a high-intensity situation like the one Mr. Floyd experienced when being pinned to the asphalt for more than nine minutes. “Those events are going to cause stress hormones to pour out into your body, specifically things like adrenaline,” Dr. Baker said. “And what that adrenaline is going to do is it’s going to ask your heart to beat faster. It’s going to ask your body for more oxygen so that you can get through that altercation.”

At other times, Mr. Nelson used his cross-examination to push back on Dr. Baker’s findings. Mr. Nelson urged him to elaborate on the fact that he found no bruises on Mr. Floyd’s back, and that the level of fentanyl found in Mr. Floyd’s system could have been fatal for some people. But throughout the cross-examination, Dr. Baker appeared to be uneasy with Mr. Nelson’s line of questioning.

On the issue of bruising, Dr. Baker said that death by asphyxiation — or the deprivation of oxygen — does not necessarily cause bruising. On drug use, Dr. Baker said the level of fentanyl found in Mr. Floyd’s system could be fatal in other circumstances but that, in Mr. Floyd’s case, it was a less likely cause of death than other factors.

The prosecution had the last word with Dr. Baker.

Under questioning from Jerry W. Blackwell, Dr. Baker acknowledged that the “heart disease, fentanyl intoxication and recent methamphetamine use” that he had listed as contributing factors were not “direct causes” of Mr. Floyd’s death.

“I would still classify it as a homicide today,” he said.

To convict Mr. Chauvin of murder, the jury needs to find that his restraint of Mr. Floyd was a “substantial causal factor” to his death, even if there were other factors.

Dr. Baker’s past statements made it clear why the prosecution wanted to sandwich him between other expert witnesses, including a forensic pathologist who helped train Dr. Baker and has performed thousands of autopsies.

The pathologist, Dr. Lindsey C. Thomas, said she agreed with Dr. Baker’s finding that the cause of death was “cardiopulmonary arrest complicating law enforcement’s subdual, restraint, and neck compression.” But she added that bystander video clearly showed that Mr. Floyd died of asphyxia, or lack of oxygen.

Dr. Baker’s phrasing caused some confusion in the months after it was issued, and Dr. Thomas agreed with a defense suggestion that “complicating” could mean different things to different experts. But Dr. Thomas said that in this case, she found it to mean that Mr. Floyd’s heart had stopped because of the police officers’ actions.

“Mr. Floyd was in a position, because of the subdual, restraint and compression, where he was unable to get enough oxygen in to maintain his body functions,” Dr. Thomas testified.

Crucially, Dr. Thomas said she believed that Mr. Floyd would have lived if Mr. Chauvin had not pinned him with his knees — a direct rebuttal of past statements attributed to Dr. Baker that he could not say if that would have been the case. “There’s no evidence to suggest he would have died that night, except for the interactions with law enforcement,” she said.

During the testimony of Dr. Thomas and Dr. Baker, jurors were shown autopsy photos of Mr. Floyd, although they were not seen by the public — presumably because Judge Peter A. Cahill thought they were too gruesome to be shown on television.

Dr. Baker said he did not watch the widely circulated video of Mr. Floyd struggling with police officers until after he performed his autopsy, saying he did not want it to bias his findings.

The state tried to diminish the importance of Dr. Baker’s autopsy findings as only a starting point in determining the ultimate cause of death. Dr. Thomas explained that Dr. Baker’s findings did not preclude asphyxia as a manner of death, since the signs of asphyxia are often undetectable in autopsies.

Mr. Nelson asked her and other witnesses if Mr. Floyd could have died from an overdose or a health condition if the police officers’ use of force were stripped away.

That earned a rebuke from Mr. Blackwell, who then said to Dr. Thomas — before being cut off by the judge after an objection from Mr. Nelson — that such questioning would be like asking Mrs. Lincoln if her husband would have died if it were not for John Wilkes Booth.

Reporting was contributed by John Eligon from Kansas City, Mo., Marie Fazio from Jacksonville, Fla., and Sheri Fink and Will Wright from New York.

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