Derek Chauvin is on trial for George Floyd’s death

Three medical experts testified today about why they believe George Floyd died and what was found in his system in May 2020.

Here’s what they said today during the trial of former officer Derek Chauvin:

Dr. Martin Tobin, a physician in pulmonary and critical care medicine, testified after having reviewed the medical records in the Floyd case.

“Mr. Floyd died from a low level of oxygen,” Tobin testified. “And this caused damage to his brain that we see and it also caused a PEA arrhythmia, that caused his heart to stop.”

PEA means pulseless electrical activity, “which is a particular form of abnormal beat of heart — an arrhythmia,” he explained.

He also shared his opinion on the cause for the low level of oxygen in Floyd. “The cause of the low level of oxygen was shallow breathing. Small breaths. Small tidal volumes. Shallow breaths that weren’t able to carry the air through his lungs down to the essential areas of the lungs that get oxygen into the blood and get rid of the carbon dioxide.”

Tobin also testified that fentanyl did not have an effect in “causing depression of the respiratory centers” in Floyd. Tobin said that with fentanyl, Floyd’s respiratory rate should have been 10, instead the rate was at 22, which is normal.

“Basically it tells you that there isn’t fentanyl on board that is affecting his respiratory centers. It’s not having an effect on his respiratory centers,” Tobin told the prosecution.

Tobin noted that the normal range for a respiratory rate is between 12 and 22. Tobin testified that Floyd’s respiratory rate was 22 just before he lost consciousness.

Dr. William “Bill” Smock, emergency medicine physician with specialized training in forensic medicine, testified that Floyd died because of a lack of oxygen in his body.

“Mr. Floyd died from positional asphyxia. It is a fancy way of saying he died because he had no oxygen left in his body,” Smock said. “When the body is deprived of oxygen, in this case from his chest pressure and back, he gradually succumbed to lower and lower levels of oxygen until it was gone and he died.”

Smock also discussed the nature of strangulation and whether bruising is something that always occurs. “You can be fatally strangled, die of asphyxia, and have no bruising. The presence or absence of a bruise on a human body, is dependent upon a multiple different variables. How much pressure is applied? How is that pressure applied? How frequently is that pressure applied?” Smock said.

Dr. Daniel Isenschmid testified that fentanyl and methamphetamine were found in the blood taken from Floyd at the hospital. Floyd’s fentanyl concentration was 11 nanograms per milliliter, Isenschmid said. Norfentanyl, a drug that it breaks down into, was recorded at a level of 5.6, he said.     

The norfentanyl concentration could indicate fentanyl was taken and then some of it had already broken down, or it could indicate someone took a dose of the drug, then later took another dose, Isenschmid explained.  

The impact of fentanyl on someone can vary person to person, due to tolerance, he said.

Court is adjourned until tomorrow morning when testimony is expected to resume in the trial of former Minneapolis Police officer Derek Chauvin.

Dr. William “Bill” Smock, an emergency medicine physician with specialized training in forensic medicine, wrapped up his testimony this afternoon.

He told the court that there was no evidence that George Floyd had a heart attack.

Smock said Floyd died because of a lack of oxygen in his body.

Dr. William “Bill” Smock, an emergency medicine physician with specialized training in forensic medicine, testified that officers should have begun administering CPR (cardiopulmonary resuscitation) to George Floyd the moment they couldn’t feel a pulse.

Smock’s comments were made following a question from prosecuting attorney Jerry Blackwell during the trial of former police officer Derek Chauvin.

Dr. William “Bill” Smock, an emergency medicine physician with specialized training in forensic medicine, testified about the nature of strangulation today and whether bruising is something that always occurs.

Smock added: “You can be strangled to death and still have no bruises.”

Dr. William (Bill) Smock, emergency medicine physician with specialized training in forensic medicine, testified today that George Floyd died in May 2020 because of a lack of oxygen in his body.

Fentanyl and methamphetamine were found in the blood taken from George Floyd at the hospital, a forensic toxicologist testified in the trial of former Minneapolis Police officer Derek Chauvin.   

Floyd’s fentanyl concentration was 11 nanograms per milliliter, Dr. Daniel Isenschmid, from private testing company NMS labs told the jury. Norfentanyl, a drug that it breaks down into, was recorded at a level of 5.6, he said.     

The norfentanyl concentration could indicate fentanyl was taken and then some of it had already broken down, or it could indicate someone took a dose of the drug, then later took another dose, Isenschmid explained.  

The impact of fentanyl on someone can vary person to person, due to tolerance, he said.

Looking at a collection of fentanyl tests conducted in DUI cases for comparison, Isenschmid said the level found in Floyd’s blood was in the top quarter, the 80th percentile.  

The amount of methamphetamine in the blood was low, he testified. It was consistent with what someone would receive in a single, legally prescribed, dose.  

Morphine was found in Floyd’s urine, but not in his blood, Isenschmid testified, which could indicate the drug had been taken earlier since it remains in urine longer than blood.   

The opioid addiction treatment suboxone was found in Floyd’s blood, as well as generic Narcan, THC, nicotine and caffeine.

On cross examination Isenschmid discussed reporting limits and traces of drugs that were found but were not reported because they were so low. 

Defense lawyer Eric Nelson noted if a representative of the state crime lab testified and refused to acknowledge the possibility of the presence of a drug, that could, theoretically, be because of those threshold rules.

Since fentanyl on the street is not manufactured in a controlled environment, it can vary from dose to dose, Isenschmid testified.   

He agreed that the comparisons he cited for the prosecution did not include certain information, including if other drugs were present and what happened to the person.

On re-direct examination Isenschmid compared the ratio of fentanyl to norfentanyl in Floyd’s blood tests, and says it was more similar to a collection of patients that were alive instead of dead.

Dr. Daniel Isenschmid, a forensic toxicology from NMS Laboratory in Horsham, Pennsylvania, testified today about why the lab he works at didn’t report the ratio of methamphetamine to amphetamine in George Floyd following the May 2020 incident.

In a cross examination by prosecutors, Isenschmid said that Floyd’s methamphetamine were indeed lower than 94% of the driving under the influence population.

Some context: Three forensic scientists on Wednesday testified that several white pills containing fentanyl and methamphetamine were found in Floyd’s vehicle, and a smaller pill with Floyd’s saliva on it was found in the back of the police squad car.

Today, Dr. Martin Tobin, a renowned pulmonary critical care doctor, testified that fentanyl did not play a role in Floyd’s death.

After observing body-camera footage, Tobin calculated Floyd’s respiratory rate at 22 breaths per minute, within normal range. People who overdose on fentanyl generally have a respiratory rate of about 10, so Tobin concluded that fentanyl was not affecting Floyd’s breathing.

“Basically it tells you that there isn’t fentanyl on board that is affecting his respiratory centers. It’s not having an effect on his respiratory centers,” Tobin said.

Forensic expert witnesses have testified about fentanyl, which has come up several times during the trial of former police officer Derek Chauvin.

Three forensic scientists on Wednesday testified that several white pills containing fentanyl and methamphetamine were found in George Floyd’s vehicle, and a smaller pill with Floyd’s saliva on it was found in the back of the police squad car.

Today, Dr. Martin Tobin, a renowned pulmonary critical care doctor, testified that fentanyl did not play a role in Floyd’s death.

After observing body-camera footage, Tobin calculated Floyd’s respiratory rate at 22 breaths per minute, within normal range. People who overdose on fentanyl generally have a respiratory rate of about 10, so Tobin concluded that fentanyl was not affecting Floyd’s breathing.

“Basically it tells you that there isn’t fentanyl on board that is affecting his respiratory centers. It’s not having an effect on his respiratory centers,” Tobin said.

The pulmonologist also said that any pre-existing health conditions Floyd suffered from prior to the incident in May 2020 did not cause his death.

Why this matters: During the trial, defense attorney Eric Nelson has focused on Floyd’s use of fentanyl and methamphetamine and his resistance to the arresting officers.

The next witness to testify at the trial is Dr. Daniel Isenschmid. He is a forensic toxicology from NMS Laboratory in Horsham, Pennsylvania.

Any pre-existing health conditions George Floyd suffered from prior to the incident in May 2020 did not cause his death, Dr. Martin Tobin, a physician in pulmonary and critical care medicine, testified today during the trial of former officer Derek Chauvin.

Tobin’s comments were prompted by questions from prosecuting attorney Jerry Blackwell following defense attorney Eric Nelson’s cross-examination.

Earlier today: Tobin said a healthy person would have died under the same conditions Floyd was subjected to.

Asked if he had “an opinion of reasonable degree of medical certainty as to whether a person who had none of those pre-existing health conditions, a healthy person, would have died under the certain same circumstances of Mr. Floyd?” Tobin responded:

Defense attorney Eric Nelson questions a witness on April 8 in the trial of former Minneapolis police Officer Derek Chauvin at the Hennepin County Courthouse in Minneapolis, Minnesota.

Defense attorney Eric Nelson is now questioning the prosecution’s witness, Dr. Martin Tobin, on the stand.

Tobin, a pulmonary expert, testified earlier that the lack of enough oxygen caused damage to George Floyd’s brain and ultimately made his heart stop.

He told the court that Floyd died as a result of a “low level of oxygen” caused by shallow breathing that was the result of the three officers restraining him.

The court has returned from its lunch break and the testimony of Dr. Martin Tobin, a pulmonary expert, has resumed.

What happened earlier: Tobin said George Floyd died as a result of a “low level of oxygen” caused by shallow breathing that was the result of the three officers restraining him.

“A healthy person subjected to what Mr. Floyd was subjected to would have died as a result of what he was subjected to,” Tobin said. The expert witness who studies the mechanics of breathing said he was not being paid to appear in court.

The lack of enough oxygen caused damage to Floyd’s brain and ultimately his heart to stop, Tobin told the jury.

The court is in a lunch break until 1:30 p.m. local time (2:30 p.m. ET).

Dr. Martin Tobin, a pulmonary expert, will resume his testimony when the court reconvenes.

Pulmonary expert Dr. Martin Tobin testified that fentanyl did not have an effect in “causing depression of the respiratory centers” in George Floyd.

Tobin said that with fentanyl, Floyd’s respiratory rate should have been 10, instead the rate was at 22, which is normal.

“Basically it tells you that there isn’t fentanyl on board that is affecting his respiratory centers. It’s not having an effect on his respiratory centers,” Tobin told the prosecution.

Tobin noted that the normal range for a respiratory rate is between 12 and 22. Tobin testified that Floyd’s respiratory rate was 22 just before he lost consciousness.

Watch Dr. Tobin’s testimony:

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Dr. Martin Tobin, a pulmonary expert, testified that George Floyd’s final moments of his life can be seen in the bystander video of the May 25, 2020 incident.

While reviewing the video in court in front of jurors, Tobin said, “At the beginning you can see he’s conscious. You can see slight flickering. And then it disappears.”

“You can see his eyes, he’s conscious, and then you see that he isn’t. That’s the moment the life goes out of his body,” Tobin said.

Floyd, he said, struggled and tried to breathe as officers restrained him.

The expert said the restraints on Floyd continued even after he stopped breathing.

“No, the restraints continued after that — he has the cessation of respiratory efforts. When you last take a breath the knee remains on the neck for another 3:27 after he takes his last breath. There’s the knee remains. After there’s no pulse, the knee remains on the neck for another 2:44 after the officers have found themselves, there’s no pulse, the knee remains on the neck another 2:44,” Tobin said.

Watch Dr. Tobin’s testimony:

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Prosecuting attorney Jerry Blackwell told Dr. Martin Tobin that the jurors may have heard one of the officers say, “if you could speak, you can breathe” during the trial. Blackwell asked Tobin, a pulmonary expert, if that is a true statement.

Tobin added: “Certainly, at the moment that you are speaking, you are breathing. But it doesn’t tell you that you’re going to be breathing five seconds later.” 

Tobin said that Floyd speaking during the incident was important to his analysis of the medical records in this case.

“Because it tells us that for the time that he is speaking, and he continues to speak for 4 minutes and 51 seconds from the time the knee is placed on his neck, and tells us that there could not have been completes compression,” he said.

Asked by the prosecutor if the brain is sensitive to oxygen deprivation, Tobin said, “The brain is the most sensitive area to needing oxygen.”

Dr. Martin Tobin, a pulmonary expert, acknowledged that George Floyd had pre-existing conditions but said a healthy person would have died under the same conditions Floyd was subjected to.

The prosecutor asked Tobin if he had “an opinion of reasonable degree of medical certainty as to whether a person who had none of those pre-existing health conditions, a healthy person, would have died under the certain same circumstances of Mr. Floyd?”

Tobin responded:

Dr. Martin Tobin, a pulmonary expert who reviewed medical records in the case, testified that he determined that at one point while Derek Chauvin was on top of George Floyd there was “not an ounce of oxygen left in his body, in his entire body.”

“There is not an ounce of oxygen left in his body. And again … you can figure this out with very precise science, looking at once somebody stops breathing, what will be the rate of decline in oxygen, how long it will take to reach zero,” Tobin said.

Asked if Chauvin removed his knee from Floyd’s neck at the point that there was no more oxygen in his body, Tobin said, “No, the knee remained on the neck for another 3 minutes and 2 seconds, after we reached the point where there was not one ounce of oxygen left in the body.”

Dr. Martin Tobin, a pulmonologist who reviewed medical records in the case, testified that George Floyd’s oxygen levels significantly decreased while ex-cop Derek Chauvin was on top of him.

“He has to try to fight against the small volumes he has, and he has to try to lift up the officer’s knee with each breath,” Tobin testified.

He continued that Floyd “has to try and also lift up the effect of the other officer pumping in his arm with a handcuffed arm. They are pushing it in, into his chest. So he has to make all of these efforts to try and breathe against that.”

Tobin said that it was his analysis that Floyd saw a “43% reduction in his oxygen reserves.” He testified that reduction was due to a drop of “24% from being prone and another 19 from the knee on the back.” 

Dr. Martin Tobin testifies on April 8 at Hennepin County Courthouse in the trial of former Minneapolis police Officer Derek Chauvin.

Most jurors appear to be engaged and taking notes during testimony from pulmonologist Dr. Martin Tobin this morning in the Derek Chauvin trial, according to reports from two courtroom pool reporters. 

“The jurors and court seem attentive and engaged by the visual aids,” according to one report. The reports say most of the jurors have been taking notes during Tobin’s testimony.

The reports also noted that almost all of the jurors followed along and did what the doctor asked when Tobin invited members or the jury to feel their necks during his testimony. After the judge told jurors they don’t have to follow the witness’ instructions, most of the jurors continued to do it to themselves. 

As the doctor explained how officers Chauvin and J. Alexander Kueng were holding Floyd, “all jurors were watching the video, not taking notes,” the report said.