The Unspoken Problems With George Floyd’s Independent Autopsy

On June 1, 2020, the attorney for the family of George Floyd released a statement regarding the independent autopsy of George Floyd. As of this writing on June 2, 2020, neither the official Medical Examiner’s autopsy nor the independent autopsy has been released in full.

Additionally, there is an “updated” statement from the Medical Examiner’s office regarding George Floyd’s cause of death, which will require a separate post.

Here is the link to watch the full new conference discussing the independent autopsy findings. This post will primarily discuss the statements of the doctors and will not dwell on the words of the lawyers.

The first medical expert to speak is Dr. Alicia Wilson of the University of Michigan. She began her remarks in this way:

Good afternoon. We acknowledge that additional medical information, including toxicology and further investigation are necessary for a final report. However, the evidence is consistent with mechanical asphyxia as the cause of death, and homicide as the manner of death.

To translate, the word “asphyxia” means to stop the pulse. Therefore, mechanical asphyxia means to stop the pulse by some physical force or mechanism.

Also, it is important to note that that “homicide” is not the same thing as “murder” or “manslaughter.” A death from COVID19 is not a homicide. A justified self-defense is a homicide. An accidental gunshot-wound is a homicide. A suicide is not a homicide. All that “homicide” means is that one person caused another person’s death. It says nothing conclusive about legal or moral guilt.

What is also significant is that in the legal realm “is consistent with” is far less than “this is what happened.” In plain terms, it means this is one of the things that is not ruled out by the evidence in front of us. A dead body with a pistol in the right hand with a gunshot wound to the head is “consistent with” a suicide. But that fact does not prove the death was a suicide. Depending on the bullet holes in the area, it could also be “consistent with” a gunfight.

Her statement continues:

Second-up autopsies in certain cases can be very important to confirm and-or dispute the original diagnosis, to answer those unanswered questions, to collect and document evidence, and most importantly, to determine the cause and manner of death.

Second autopsies have their limitations, as we are not seeing the tissues in their original state, and some items may have been kept by the original pathologist. With that acknowledgement, we feel those items will not change or alter the primary cause of death of mechanical asphyxia.

In other words, second autopsies like this have limitations. The first autopsy has better evidence than the second autopsy, but the second autopsy is still valuable.

Noteworthy is the fact that there is no toxicology report.

Underlying Medical Conditions

The statement we have from Dr. Michael Baden begins this way:

Thank you, Ben. The autopsy shows that Mr. Floyd had no underlying medical problem that caused or contributed to his death. This is confirmed by information provided to Dr. Wilson and myself from the family. He was in good health.

Before we move on, lets recognize two things.

First, it is probably best that his underlying medical conditions are not seen as the “cause” of his death. But it seems inconclusive to say that there were no underlying medical problems that “contributed” to his death when we do not even have a full toxicology report.

Though normal people don’t talk in this way, when it comes to precise medical specificity, something as random as an allergy can be an “underlying medical condition” that contributes to someone’s death by asphyxiation. Saying there are NO underlying conditions that even CONTRIBUTED to his death is quite immature, especially since significant facts (toxicology report? tissue samples?) are left out of the review. Therefore, this seems to be overstatement to make a point rather than any verifiable fact. This is especially the case when the source of the information the lawyer gives is information provided by the family and not anything measured or observed. That is not a good look for a medical expert.

However, this is a minor point, as George Floyd’s underlying medical conditions are the LEAST relevant issue related to his cause of death, but a relevant point, regardless.

New Cause of Death

The statement continues:

The compressive pressure of the neck and back are not seen at autopsy because the pressure has been released by the time the body comes to the medical examiner’s office. It can only be seen — serious compression of the neck and back — while the pressure is being applied — or when, as in this instance, it is capture on video.

This is huge. As I described in my previous post, the Minneapolis Police Department explicitly authorizes Neck Restraints like the one used on George Floyd. None of the authorized neck restraints allow the trachea (airways) to be cut off. The only difference between an authorized and unauthorized Neck Restraint is the amount of pressure applied. The independent medical examiner here has told us that the ONLY evidence of the pressure to the neck is what we see on video.

However, as the extent of the video evidence determines and as I explained earlier, the video does NOT show how hard or how much weight was being pressed on George Floyd. The only witnesses of this fact are the people subduing George Floyd. This is going to be very bad for any prosecution.

How can you prove a fact to convict someone of a crime when the ONLY witness of that fact is the person you are trying to convict?

The Source of Dr. Baden’s Information

The statement continues:

And in this instance, we can see after little bit less than four minutes, that Mr. Floyd is motionless, lifeless, and when the EMS arrive and put him in the stretcher without any CPR at that time, during the ambulance trip, he did not respond to CPR and did not respond to cardiac shot.

There is a slight inaccuracy with this statement. Based on my review of the video, George Floyd looked like he stopped breathing at the 4:25 mark on that video. Perhaps this was a mistake in saying “a little bit less” instead of “a little bit more.”

However, the key problem with this statement is that the video does not show when George Floyd was restrained. Therefore, it is NOT TRUE that we know George Floyd was motionless a “little bit less [or a little bit more] that four minutes.”

In contrast to this statement is the prosecution’s complaint:

  • The first officers arrived on scene at 8:08 pm.
  • Mr. Floyd walked to the squad car at 8:14 pm and stiffened up and refused to enter the car on the driver’s side, moving himself to the ground.
  • Mr. Floyd was moved to the passenger side of the vehicle at 8:19:38 pm.
  • Mr. Floyd stopped moving at 8:24:24 pm.
  • At 8:25:31 pm, Mr. Floyd appears to have stopped breathing.
  • At 8:27:24 pm, the ambulance arrived.

This means that contrary to this doctor’s statement, Mr. Floyd was held for almost six minutes (five minutes and fifty-three seconds) before he appears to have stopped breathing, not “after a little bit less than four minutes.”

Though that difference may not seem like a long time for an average observer, this is not an average observer. This is a star witness. It is his job to be absolutely precise.

Astonishingly, this seems to suggest that the independent medical examiner is getting his chronology from the limited cell-phone video and not from any of the body-worn-cameras of the officers. That is huge.

An expert’s opinion in Court is only as good as the information they are given to make their decision.

The Ability to Breathe and the Eric Garner Comparison

The statement continues:

The cause of death in my opinion is asphyxia due to compression of the neck which, as Mr. Crump indicated, can interfere with blood flow and oxygen going to the brain, and compression of the back which interferes with breathing.

When he said “I can’t breathe,” unfortunately, many police are under the impression that if you can talk, that means you’re breathing. That is not true. I am talking and talking and talking without breathing in front of you.

So the concept that a person says I can’t breathe like Mr. Garner, like in this instance, means you should take it seriously. And I think that, um, I’ve finished. Thank you.

And that was the end of his statement. While his last point about talking and the ability to breath is true, it is not as relevant as it appears at first sight.

The death of Eric Garner is the prime example of a suspect being arrested and dying while telling officers “I can’t breathe.” Though it is difficult to watch, it is notable about how much more quickly and how much more labored Eric Garner’s “I can’t breathe” is to those officers.

It is also clear that the choke hold use against Eric Garner obviously cut of the trachea while the knee of Derek Chauvin obviously did not cut off the trachea of George Floyd.

Now, in question time, the death of Eric Garner came up again, when a reporter asked how the autopsy of Eric Garner compared to the autopsy of George Floyd. This is what the answer to that question was:

Thank you, yes. I was asked by the family of Eric Garner to do a second examination. But what is different is the initial autopsy in the New York City Medical Examiner’s office concluded on day one that there was enough evidence to show that he died of asphyxia, that he couldn’t breathe because of the compression on his neck and back, as opposed to this situation, which is the more common situation where things are left pending while additional studies are done that will not reflect on the cause of death that will not reflect on the cause of death, but which will affect the circumstance um… of the cause of death. But with Eric Garner with the video that is still on the internet, the two minute interview of Eric Garner on the internet, showing him asking, saying “I can’t breathe, I can’t breathe” many times, and that he becomes lifeless as Mr. Floyd, and dead, within 45 seconds from the moment the four police touch him until they get away because they know he’s lifeless is about 45 seconds.

And so there are similarities, and in that instance, there was a waiting time between the justice department and the New York City police department without any charges being brought, with no criminal charges being brought against the officer that did most of that compression.

That is an important detail that is going to be very bad for the prosecution. Eric Garner went limp and lifeless in 45 seconds. On the other hand, Derek Chauvin’s knee and the other officers’ restraints were on George Floyd for 8 minutes and 45 seconds.

In other words, this is strong evidence that George Floyd was able to breathe. This strong evidence has arisen before we’ve heard a single peep out of the defense. This strong evidence came from the star witness for the family of George Floyd.

According to the video review, George Floyd’s body went limp and lifeless about 6 minutes after he was restrained, and that restraint never involved pressure on the trachea. That is significantly different.

The Problem of Bias

But then there is this final coda to Dr. Baden’s answer to the reporter:

And it just goes to show that no matter how much video you have, there are many obstacles in the criminal justice system in this country, especially when it comes to black people who die while being restrained by black police, unfortunately.

And I’m somebody who for 50 years who have worked with city and state police in New York, and I am very pro-police work in general, but there are more than a few rotten apples that come up in deaths that occur during police restraints, and that has to be further addressed, and hopefully this will help do that.

Though this statement is a perfectly fine one to have, it is extremely troublesome for the legal case against the officers and for the family of George Floyd.

If I were the defense attorney for Derek Chauvin or any of the other officers, I would frame this statement for the jury. This expert in the medical field, whose opinion only matters because of his medical expertise, and yet, he went beyond his medical knowledge. He is not a political representative, nor is he an expert of policing.

Here, not only does he he explicitly say on national television that “more than a few rotten apples” need to be “further addressed,” he terribly adds “hopefully this will help do that.”

Yikes. Regardless of whether you think that is a true statement, in the legal realm, that is called “bias.”

This man is supposed to be talking about this case alone, but instead he has brought up his opinion about policing in general across the entire country. He expressly stated how he hopes this case will change police policy.

Unfortunately for the case of George Floyd’s family, whatever help it may give to change policy across the country, it could absolutely destroy whatever case exists here.

Inconsistencies Among the Experts

The next question was directed to Dr. Williams, about whether the doctors were basing the cause of death solely on the video and not the autopsy:

When looking at the tape, the entire investigation, including the autopsy, are very important. The determination of cause and manner of death are determined on the circumstances surrounding the death, which does include the video, but also additional findings that were determined at our autopsy. We do have physical evidence that supports that there was pressure applied to his neck, and it has been this combination that this medical information that we have, including examination of all of the other organs that were available to us in making our determination of cause of death.

This is a little strange, because before in the question time, Dr. Michael Baden made the following claim:

while additional studies are done that will not reflect on the cause of death that will not reflect on the cause of death, but which will affect the circumstance um… of the cause of death.

That’s a difference. Dr. Baden made a claim about the difference between “cause” of death and “circumstances” of death. But Dr. Williams says that the cause of death is determined from the “circumstances surrounding the death.” One of the circumstances that they would use is the toxicology report.

The problem with this is that open-ended soft-ball questions by reporters have exposed a hole in the message of the independent autopsy team. At trial, the questions will not be open and will not be soft-ball.

The Pressure on George Floyd’s Neck

After this, the attorney directs the following question to Dr. Boedin about that physical evidence:

Dr. Boedin, could you speak to just the physical abrasions to his head and face and how that contributed to your determinations.

Yes, as Dr. Wilson said we take everything we have into consideration. The forensic autopsy starts at the scene. Much time in most homicide cases relates to reconstructing the scene. The act of going out and interviewing people, all kinds of forensic science, while picking up trace evidence. In this instance, the video tells you what the scene is. The video is real. The multiple videos are real. And those multiple videos show pressure that can cause death and his calling out like Eric Garner, but also including calling out for his mother who had been dead for 3 years. None of this caused the release of the pressure. And that is very disturbing. Now, what was the question?

The Abrasions.

Thank you. There were rough abrasions around the left eye, the left cheek, and a little bit on the front of the nose and mouth areas that are due as we can see in the video to the left side of his face being rubbed against the pavement while the left knee of the officer is squeezing down on the left side of the neck which would be… the neck is a small area with many vital organs arteries, veins, nerves, and the windpipe, all of which are compressed with the knee activity as seen on the video.

So that the abrasions on the side of the neck and the nose would also indicate that a component of the interference of breathing could be– was also some pressure some pressure that were placed on the nose or mouth. And these are also very painful kind of scrape marks.

There were also some severe scrape marks on the back of his left shoulder which is part of the activity that was causing him to rub against the officer’s knee as well as the face being on the ground. And those occurred while he was still alive and breathing. That is evidence of severe pressure on the face, large areas of scraping abrasions on the face in particular the left side of the face, which is evidence of his face being rubbed severely against the ground.

This is quite interesting but also worrying for the prosecution. He does not come across very well in this exchange when he doesn’t remember the question and gives off some strange information that is more emotional than medical. (More on that below).

The key take-away is that the only physical evidence for the pressure on the neck (which is the only evidence for “mechanical asphyxia”) is the abrasions (meaning “scrapes”) on the face.

But that’s obvious. That’s just repetitive information of what we already knew. In other words we have no knew information.

What’s also important is that we still have no evidence of any trauma to the nose other than “a little bit” of abrasions on his nose. Yet the crowd still says “his nose is bleeding” several times. That sounds like drugs.

The Mental State of George Floyd

What’s also very troubling that we learn from this press conference is that George Floyd called out for his mother who has been dead for three years. As heartbreaking as that is, it does not reflect an ordinary mental state.

We could say that his altered mental state is due to the death inflicted by the officers. The problem is that this cry comes only about one minute into the video. It comes when he’s having a conversation with a sympathetic bystander and not the cops. He is coherent, having conversations, speaking, and breathing for several more minutes before becoming unresponsive.

In contrast, Eric Garner did not last more than 45 seconds before he became limp. This is evidence that will be used to push against the conclusion that mechanical asphyxia (choking) was the reason for George Floyd’s death.

This means that rather than cry out to the bystander that was speaking to him, George Floyd cried out to his dead mother. Rather than call out to the passengers in his vehicle who were nearby, he called out to his mother who is no longer alive.

This is strong evidence of an altered or diminished mental state.

As information has shown, as early as the 911 call, observers were noting that George Floyd was “really drunk” and others noted while he was being restrained “don’t do drugs, kids!” and commented on his bleeding nose. There are many pointers at this moment to the fact that George Floyd’s mental state was altered due to drugs in his system.

The Real Problem with the Case Against the Officers and the Civil Case of George Floyd’s Family.

Despite whatever inconsistencies may or may not be present in the independent autopsy, the real issue is something else. The actions of the officers and the statements in the Complaint, and the strategic silence of the independent examiners point to the conclusion that George Floyd was experiencing Excited Delirium (EXD) due to “potential intoxicants” as the medical examiners have called them, in his system.

This is the real reason that, as was described before, the officers — either Derek Chauvin whose knee was on the neck of George Floyd or the other officers who held his back and legs — will almost certainly be declared innocent.

The following 2011 medical article on EXD reviews a great deal of literature on this syndrome, and gives an overview of the extreme danger of EXD, as well as the inconclusive proof about weight alone (whether on the neck or back) leading to death by “mechanical asphyxia.”

Since it is so relevant to the facts we know, the “Outcomes” portion of this article is worth quoting at length:

Approximately two thirds of EXD victims die at the scene or during transport by paramedics or police. Victims who do not immediately come to police attention are often found dead in the bathroom surrounded by wet towels and/or clothing and empty ice trays, apparently succumbing during failed attempts to rapidly cool down. It appears that in all cases, victims died of either respiratory arrest or fatal cardiac dysrrhythmia. Diagnoses were supported by postmortem exams showing pulmonary and cerebral edema with nonlethal self-inflicted injuries. The few who live long enough to be hospitalized often succumb to disseminated intravascular coagulation, rhabdomyolysis and renal failure. These fatal cardiopulmonary changes are thought to be the result of increased catecholamine stress on the heart, myocardial hypertrophy, microangiopathy and fatal arrhythmias. The proposed cause of these changes is debated.

Since the victims sometimes die in police custody, the most widely publicized proposed causes of death in EXD are taser use and positional asphyxia. No study thus far has been able to demonstrate a causal relationship between Taser use and subsequent individuals’ deaths. In one study of 32 healthy police volunteers, a 12-lead electrocardiogram was performed at baseline and then repeated within 60 seconds post-exposure to a one to five second shock by the Taser X26. The authors reported no instances of dysrhythmia nor ectopy among the subjects. Furthermore, no statistically significant changes were noted in the QRS duration, QT and QTc intervals. These results corroborate with previous reports using single-lead monitoring to assess cardiac changes before, during, and after Taser activation.

As mentioned before, people experiencing EXD are highly agitated, violent, and show signs of unexpected strength so it is not surprising that most require physical restraint. The prone maximal restraint position (PMRP, also known as “hobble” or “hogtie”), where the person’s ankles and wrists are bound together behind their back, has been used extensively by field personnel. In far fewer cases, persons have been tied to a hospital gurney or manually held prone with knee pressure on the back or neck. Supporters of the positional asphyxia hypothesis postulate that an anoxic death results from the combination of increased oxygen demand with a failure to maintain a patent airway and/or inhibition of chest wall and diaphragmatic movement. This explanation has been further supported by coroners’ reports of “positional asphyxia” as the cause of death in multiple fatal EXD cases.

The positional asphyxia theory has been refuted by a series of articles by Chan et al exploring the effect of PRMP on ventilatory capacity and arterial blood gases. In one study of fifteen healthy male volunteers, the authors found a small, but statistically significant decline in forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximal minute ventilation (MVV) comparing sitting to restrained positions. However, there was no evidence of hypoxia (mean oxygen tension [PO2] less than 95 mmHg or co-oximetry less than 96%) in either position, nor was there a significant difference in PCO2, heart rate recovery or oxygen saturation. In another study, the authors sought to determine the effect of adding 25 and 50 pounds weight force on respiratory function of healthy volunteers in the PRMP. Validating earlier results, they found FVC/FEV1 was significantly lower in restrained positions versus sitting, but not significantly different between restrained positions with and without weight force. Furthermore, they found mean oxygen saturation levels were above 95% and mean end-tidal CO2 levels were below 45 mmHg for all positions, regardless of weight force. Based on these findings, PMRP may result in a transient pattern of restricted pulmonary function, but the lack of evidence for hypoxia or hypoventilation suggests that factors other than body positioning appear to be more important determinants for sudden, unexpected death. Nonetheless, respiratory muscle fatigue resulting from exertion and struggle against restraints (exertion vs. position asphyxia) cannot be excluded nor can potentially fatal pre-existing problems with central cardiac output, oxygen saturation, or oxygen use.

In other words, even in non-nationally charged cases of police killings of individuals being arrested, there is not a clear answer as to whether being subdued under a great deal of weight leads to death. Though that idea cannot be ruled out, it also cannot at this time be proven.

And we haven’t even heard a single word from the defense or gotten any insight into exactly how hard the knees on the back of George Floyd were being pushed down.

While it is true that we now have two medical reports that disagree on the question of mechanical asphyxia (choking), the standard to convict anyone of a criminal offense is “proof beyond a reasonable doubt.” When two expert medical sources disagree on the cause of death, that is almost the purest textbook case of a “reasonable” doubt.

And as of this writing, we still do not know whether or how many “potential intoxicants” were in George Floyd’s system.

Conclusion

Regardless of whatever facts come out about potential intoxicants in George Floyd’s system, we have still suffered a loss by his death. In the final minutes of his arrest and life, we may have seen him at his worst. But even then, he wasn’t all that bad. Because of how exponentially more he would have been at his best, we’ve lost something very important.

Let’s pray we can overcome this present challenge in our country.

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