The medical examiner who performed the autopsy on George Floyd after last May's deadly arrest explained how he concluded the death was a homicide at the hands of police in testimony on Friday at former Minneapolis policeman Derek Chauvin's murder trial.
As jurors studied graphic autopsy photographs, Dr. Andrew Baker, Hennepin County's chief medical examiner, said he stood by the cause of death he determined last year as protests in Floyd's name against police brutality spread around the world.
Baker is one of the most important witnesses as prosecutors from the Minnesota attorney general's office wrap up their case against Chauvin, a white man captured on video kneeling on the neck of Floyd, a 46-year-old handcuffed Black man, for nine minutes.
Chauvin's main defense to the murder and manslaughter charges has been to cast doubt on Baker's finding, with his lawyers suggesting Floyd may instead have been killed by a simultaneous drug overdose.
Baker ruled last year that Floyd's death was a homicide caused by "cardiopulmonary arrest complicating law enforcement subdual, restraint and neck compression." In short, he found that Floyd's heart stopped beating and his lungs stopped working because Chauvin, 45, and other officers compressed him against the road in a way that starved his body of oxygen.
Other medical experts called by prosecutors have spent the past two days pointing to the unusually large amount of video of the death, from multiple angles, saying it shores up Baker's finding, and contradicts the defense theory of an overdose.
Baker said he noted in his report that Floyd suffered from heart disease, and fentanyl and methamphetamine were found in his blood because those factors may have played a role in the death. Even so, he emphasized, they "were not direct causes."
"Mr. Floyd's use of fentanyl did not cause the subdual or the neck restraint, his heart disease did not cause the subdual or the neck restraint," Baker told the jury, using medical jargon to refer to the way police pressed Floyd face down against the street.
Envelopes containing the autopsy pictures were handed to everyone in the room, including reporters and spectators.
For the first time since the trial began in March, a person took the single seat reserved for Chauvin's friends and family. She paused before opening the envelope and looking at the photographs, and declined to speak to reporters who approached her during a recess.
One of Floyd's relatives has occupied the seat saved for his family almost every day since the testimony began on March 26, and on Friday it was Rodney Floyd, who held up the photos of his brother's body before his face to study them.
Under cross examination by Chauvin's lead lawyer, Eric Nelson, Baker discussed in general how the type of heart disease found in Floyd or his use of fentanyl, an opioid painkiller, can sometimes be deadly.
But he said neither directly caused Floyd's death, which he said he still believed was the holds and compression by the police officers arresting Floyd on suspicion of his using a fake $20 bill to buy cigarettes.
"My opinion remains unchanged: it's what I put on the death certificate last June," he said. "That was my top line then. It would stay my top line now."
'Laying by the Pool in Florida'
Dr. Lindsey Thomas, an assistant medical examiner in the Hennepin County medical examiner's office until she took semi-retirement in 2017, said the sheer volume of videos of Floyd's arrest helped support Baker's findings, and had a value beyond what can be learned from a physical autopsy.
"There's never been a case I was involved in that had videos over such a long time frame and from so many different perspectives," Thomas testified, saying the videos made it clear physical signs associated with opioid overdose were not present in Floyd's death.
She said the videos did not show signs of a fentanyl overdose "where someone becomes very sleepy and then just sort of gradually, calmly, peacefully stops breathing." Nor did they show a sudden death, as from a heart attack.
"There's no evidence to suggest he would have died that night except for the interactions with law enforcement," she said.
Nelson, Chauvin's lawyer, got Thomas to agree that being prone was not in itself sufficient to kill someone, noting that massage therapists often have clients lie face down.
"I could be laying by the pool in Florida on my stomach in the prone position – not inherently dangerous?" Nelson asked.
"Right," Thomas replied.
Nelson also asked her about hypothetical scenarios, with Floyd being found dead in different circumstances in which police were not involved.
Questioned later by Blackwell, the prosecutor, Thomas told the jury that hypothetical scenarios were not helpful to a pathologist trying to determine a cause of death.
"George Floyd was not laying by the pool on his stomach in Florida, was he?" Blackwell asked her.