Last week I wrote in part 2 of this series:

Whenever I write about these cases I am instructed that George Floyd killed himself by a fentanyl overdose. I wasn’t persuaded of that by the evidence introduced at the trial of Derek Chauvin, not even to the level of a reasonable doubt. It is not clear to me that the defendants in this case even raise an issue of fact regarding the cause of Floyd’s death.

In any event, the cause of death is a matter of evidence (including expert opinion) beyond comment at the level of barroom banter. The prosecutors representing the United States here will draw on the identical evidence introduced by the prosecutors representing the State of Minnesota in the case against Derek Chauvin.

It is not at all obvious to me that Floyd might not have been saved if the officers had understood that Floyd was dying. If they had understood (or did understand), they certainly would (or should) have undertaken remedial measures in addition to calling for EMS Code 2 and 3.

One of the difficulties in the defense of these cases is that everyone witnessing Floyd’s detention seemed to know Floyd was dying under the three officers except the three officers and Tou Thao, who held off the crowd and interacted with some of the observers….

In response I heard from two readers whose comments are worthy of note. First, from a reader in law enforcement:

Every time I’ve tried to weigh in, the armchair law enforcement experts all know better. Sometimes, I’d rather pick up after the dogs then offer an opinion.

What do I know? I spent 35 years as a police officer, 20 years of which as a line supervisor. I spend several years as an attorney, and consequently got pulled into academy instruction for 27 years. The last 5 years of my career I supervised a regional academy.

You are spot on. The role of law enforcement officer is to be prepared for situations like the one presented by Mr. Floyd in their totality, and to do the proper, professional thing under the circumstances. A person having trouble breathing, especially someone Mr. Floyd’s size, is never left face down, handcuffed, with someone pressing on their back. Everyone, including Mr. Chauvin, is taught about positional asphyxia, and what to do when it becomes apparent. One of the officers on scene reminded Mr. Chauvin, to no avail. If indeed the fentanyl ended up killing him (for the sake of argument), he needed more timely medical intervention for a chance to save him.

What would have happened had Mr. Floyd been rolled on his side, reassured that help was on the way and still died? My guess is Mr. Chauvin might not be in prison. Oh… A totally uneducated guess – Mr. Thao didn’t know what to do, so he chose to do something he knew, which was to turn his back on the whole thing and restrain the crowd.

What do I know.

And then from a Minnesota physician who does not want to be identified:

I am a physician. You are right that fentanyl had essentially nothing to do with George Floyd’s death. Fentanyl kills by depressing the CNS, causing progressive lethargy and depression of breathing that eventually results in a degree of hypoxemia that creates a fatal arrhythmia. In a chronic a narcotic user, the blood levels of fentanyl don’t necessarily tell you what the effects on the individual are(you see the similar development of tolerance in alcohol abuse). The videos did NOT exhibit this scenario. Instead of CNS depression, he exhibited CNS excitation.

As you know, at the time of a previous arrest, he had a degree of hypertension that concerned the EMS so much that he was sent to the hospital [on a previous occasion]. This was probably related to methamphetamine use, although whatever the cause, that put him at risk of stroke or cardiac ischemia/arrest. Fortunately, he did not suffer such a tragic event, but methamphetamine use is like Russian roulette and you don’t want to pull the trigger too many times!

The post-mortem tox screen, based on methamphetamine and it’s metabolites, showed that he had recently ingested significant methamphetamine. The post also showed that he had significant multi-vessel coronary disease, including, as I recall, a 90 percent right coronary artery occlusion. The symptoms of malignant hypertension include anxiety, confusion, restlessness, shortness of breath and chest pain, sometimes a crushing chest pressure. He was exhibiting all of these. With the crushing chest pain of severe myocardial ischemia, people sometimes get a sense of impending doom. This leads to the clinical sequence of events.

He had no claustrophobia sitting in his vehicle, but several minutes later he did have claustrophobia when the officers tried to place him in the squad car. He kept saying “I’m not that kind of guy” as they tried to put him in the squad. Once in the squad car, you can hear him say “I’m gonna die” twice (impending doom). Listen to it carefully, it is a little hard to hear, but count the syllables. It is NOT a repeat of what he said before going into the squad!

Once on the ground, only one officer was on his torso/chest, not enough weight to cause significant restriction of breathing in such a large and very muscular man. One officer was on his legs, which had no effect on breathing. The officer on his neck did not cause significant obstruction of breathing, as evidenced by no trauma being found to Floyd’s trachea, larynx or hyoid bone. Also, there was no edema fluid in the trachea or bronchi that would be indicative of upper airway obstruction (remember, he was an extremely muscular man), i.e. negative pressure pulmonary edema. “I can’t breathe” was from his evolving cardiac event.

In essence, Floyd died of a cardiac arrest related to his methamphetamine use, his coronary disease and his physical struggling. This is the same etiology as the death of Eric Garner… also no damage to his neck structures and significant co-morbidities.

I cannot comment as a physician as to at what point the officers should have checked on Floyd as to whether he was faking compliance or actually in distress. I would imagine that cops always have to be aware of their environment and the very real threat of assassination. It does not appear that the crowd distracting the cops was helpful, even though they turned out to be correct in their observations.

I don’t believe that cops can get a fair trial when there is the kind of mob outside the courthouse as occurred with Chauvin and Potter and others in past years. I certainly understand why the defense has trouble getting good witnesses and why physician witnesses for the prosecutors massaged their testimony in order to protect their families.

I am not a hero or a fool. If I were a juror in the Chauvin or Potter trial, it would have been very difficult for me to vote not guilty, knowing what the lynch mob did on Lake Street in 2020 and knowing that they even vandalized a house in California that was previously owned by a defense witness.

I appreciate your work to make Minnesota and our whole country a better place. If you feel that this will be useful to the officers, please share it. Just knowing this sequence of events and cross-examining a defense witness who is honest should result in an admission that the above is very plausible and should generate significant doubt in the minds of a jury.

I myself want to be totally anonymous.


Concerned Anonymous Physician

There is no mob outside the courthouse in St. Paul where the three officers are on trial and “very plausible” is different from persuasive. Indeed, I don’t find the concededly speculative analysis persuasive, but I offer it for the consideration of interested readers.

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