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Key Moments on Day 9 of the Derek Chauvin Trial

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The trial of the former officer Derek Chauvin will continue on Thursday after a day of testimony focused on Mr. Floyd’s drug use on the day of his death. Mr. Chauvin’s defense has tried to argue that Mr. Floyd died from a possible overdose, but the prosecution blames the actions of Mr. Chauvin, who pinned Mr. Floyd with his knee for about nine and a half minutes.

Here are some key takeaways from recent testimony.

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Pulmonologist Says George Floyd Died From a ‘Low Level of Oxygen’

Dr. Martin J. Tobin, a world-renowned expert on breathing, testified on Thursday that George Floyd died from a “low level of oxygen.” His testimony also highlighted how force from Derek Chauvin’s knee and Mr. Floyd’s position on the concrete obstructed Mr. Floyd’s airways.

“So let’s talk about your opinions with respect to this case, have you formed an opinion to a reasonable degree of medical certainty on the cause of Mr. Floyd’s death?” “Yes, I have.” “Would you please tell the jury what that opinion, or opinions, are?” “Yes, Mr. Floyd died from a low level of oxygen, and this caused damage to his brain that we see. And it also caused a P.E.A. arrhythmia that caused his heart to stop. 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 — that’s the alveoli at the bottom of the lung. The main forces that are going to lead to the shallow breath are going to be that he’s turned prone on the street, that he has the handcuffs in place combined with the street, and then that he has a knee on his neck, and then that he has a knee on his back and on his side. All of these four forces are ultimately going to result in the low tidal volume, which gives you the shallow breaths that we saw here. And so the air will not be able to reach those air sacs — we just saw in the video where the oxygen is exchanged and the carbon dioxide is removed. What you’re seeing is the orientation of Officer Chauvin, his body build is quite erect here. But in particular, what you’re seeing is that the toe of his boot is no longer touching the ground. This means that all of his body weight is being directed down at Mr. Floyd’s neck.”

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Dr. Martin J. Tobin, a world-renowned expert on breathing, testified on Thursday that George Floyd died from a “low level of oxygen.” His testimony also highlighted how force from Derek Chauvin’s knee and Mr. Floyd’s position on the concrete obstructed Mr. Floyd’s airways.CreditCredit…Still image, via Court TV

A veteran lung doctor testified on Thursday that George Floyd’s death was caused in part by Derek Chauvin’s knees pressing against his neck and back, making it impossible for him to breathe, and that Mr. Floyd showed signs of a brain injury about four minutes before Mr. Chauvin lifted his knee from his neck.

Dr. Martin J. Tobin, a pulmonologist and critical care doctor in Chicago, said in court that the combination of Mr. Chauvin’s pressure, the handcuffs pulling Mr. Floyd’s hands behind his back and Mr. Floyd’s body being pressed against the street had caused him to die “from a low level of oxygen.”

Dr. Tobin was adamant that Mr. Chauvin had caused Mr. Floyd’s death on May 25. He said that based on Mr. Floyd’s visible respiratory rate before he went unconscious, any fentanyl in his system was “not having an effect” on his breathing.

“A healthy person subjected to what Mr. Floyd was subjected to would have died,” Dr. Tobin said.

After analyzing videos of the arrest, Dr. Tobin said he determined that Mr. Chauvin had pressed his left knee on Mr. Floyd’s neck for more than 90 percent of the time that Mr. Floyd was on the ground, and that he had kept his right knee on Mr. Floyd’s back for the majority of the time as well. That pressure, combined with having his hands cuffed behind his back and pushed into the street facedown, had cut off oxygen and caused his heart to stop, Dr. Tobin said.

“He was being squashed between the two sides,” he said.

Mr. Floyd was so desperate for air at one point that he tried to lift himself off the ground by pushing his right knuckle against a police car’s tire, Dr. Tobin said.

“This is his only way to try to get air into the right lung,” the doctor said.

Dr. Tobin outlined four factors that he said had caused Mr. Floyd to lose oxygen and die: The left knee of Mr. Chauvin on Mr. Floyd’s neck, Mr. Chauvin’s right knee on Mr. Floyd’s back and side, Mr. Floyd being handcuffed as he was lying in the street, and Mr. Floyd being held in the prone position. These factors had combined to only allow Mr. Floyd to take small breaths, which were not enough to bring air to the parts of the lungs that allow oxygen to get into blood.

Fentanyl and methamphetamine were found in Mr. Floyd’s system, and the possibility that they caused his death is a crucial argument for Mr. Chauvin’s defense as the trial enters a phase in which medical testimony is front and center.

Mr. Chauvin’s lawyer, Eric J. Nelson suggested on Thursday that Mr. Floyd could have died of a fentanyl overdose if he had taken the drug in the moments before police officers pushed him to the ground. Dr. Tobin said that, unlike someone who died of a fentanyl overdose, Mr. Floyd had never gone into a coma. Mr. Nelson also sought to portray the medical care that Mr. Floyd received from paramedics as lacking; it took them nine minutes to insert a tube down Mr. Floyd’s throat after they arrived on scene, he said, but the nearest hospital was a five-minute drive away.

Mr. Nelson also noted that even doctors sometimes have trouble understanding that a patient who can talk is having trouble breathing. Mr. Floyd told police officers that he could not breathe, and in response, one officer told him that it takes oxygen to talk, implying that he must be able to breathe, something medical experts have said is false or misleading.

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Police Surgeon Says George Floyd Died of Asphyxia

Dr. Bill Smock, a surgeon for the Louisville Metropolitan Police Department, testified on Thursday that he had found no evidence to support claims that George Floyd died of an overdose.

“Mr. Floyd died from positional asphyxia, which is a fancy way of saying he died because he had no oxygen left in his body. When the body is deprived of oxygen — and in this case, from his chest, pressure on his chest and back — he gradually succumbed to lower and lower levels of oxygen until it was gone. And he died.” “Have you ever encountered a situation of a fentanyl overdose where a person was in the overdose displaying air hunger and essentially crying out for their life or crying out in pain?” “No, sir.” “Based on your experience in training police officers and your experience accompanying police officers to various arrest locations, you have observed police officers use a prone handcuffing technique.” “Yes, I have, for short periods of time, sir.” “And you’ve observed them place their knee in the posterior of the base of the neck, right?” “Yes, again, for short periods of times.”

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Dr. Bill Smock, a surgeon for the Louisville Metropolitan Police Department, testified on Thursday that he had found no evidence to support claims that George Floyd died of an overdose.

Dr. Bill Smock, the surgeon for the Louisville Metropolitan Police Department, also testified on Thursday, saying he saw no evidence of an overdose. “Mr. Floyd died from positional asphyxia, which is a fancy way of saying he died because he had no oxygen left in his body,” he said.

Mr. Floyd was alert and had a keen sense of space, which both indicate that he was not overdosing, Dr. Smock said. In addition, Mr. Floyd was begging for air — Dr. Smock called it “air hunger” — and said a person overdosing on fentanyl would typically have the opposite response, more like someone who falls asleep or slips into a coma.

Asked whether Mr. Floyd was suffering from a fentanyl overdose, Dr. Smock said, “That is not a fentanyl overdose. That is somebody begging to breathe.”

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Toxicologist Challenges Claim of Floyd Overdose

Daniel Isenschmid, a forensic toxicologist, testified on Thursday at the trial of Derek Chauvin that the level of norfentanyl in George Floyd’s system was not consistent with a typical fentanyl overdose.

“Can fentanyl levels vary widely, depending on an individual?” “Yes, they can.” “And why would that be?” “Because of tolerance.” “And could you just explain how an individual’s drug tolerance might affect the impact a particular drug like an opioid or fentanyl might have on them?” “So, I mean, if a person becomes tolerant to a drug, you need to have more and more of the drug to get the desired effect. So with chronic use, to get the same feeling that you would at a given concentration of fentanyl, you need to take more to get that effect.” “And so if someone is regularly using opiates or opioids would that individual, then develop a tolerance to an opioid like fentanyl?” “Yes.” “And you indicated that the amount of norfentanyl found in this, the hospital blood in this case was 5.6 nanograms per milliliters. Is that right?” “Yes.” “And what is significant about that amount of norfentanyl?” “Well, it shows that some of the fentanyl was metabolized to norfentanyl. It also could mean there was pre-existing norfentanyl with additional fentanyl given on top of that. But basically shows that when we see, when we see very recent deaths with fentanyl, we frequently see fentanyl with no norfentanyl whatsoever, because after a very acute fentanyl intoxication, the body doesn’t have time to break it down.” “And you describe when you see a fentanyl overdose, typically, you may not see any norfentanyl or low levels of norfentanyl.” “Correct.”

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Daniel Isenschmid, a forensic toxicologist, testified on Thursday at the trial of Derek Chauvin that the level of norfentanyl in George Floyd’s system was not consistent with a typical fentanyl overdose.CreditCredit…Still image, via Court TV

A forensic toxicologist who testified on the issue of drug use provided the jury with data about fentanyl and methamphetamine, the two substances found in Mr. Floyd’s system after his death. The toxicologist, Daniel Isenschmid, who works at N.M.S. Labs in Pennsylvania, said that the drug profile found in Mr. Floyd’s system appeared to be more consistent with patients who were still alive, rather than those found in autopsies.

Dr. Isenschmid indicated that Mr. Floyd’s body had already processed a substantial portion of fentanyl, bolstering prosecutors’ argument that he had not overdosed. The same amount of fentanyl, he said, can have very different effects in a new user as opposed to someone who is addicted to the drug. Mr. Floyd’s girlfriend has said she and Mr. Floyd both struggled to stop using opioids.

“If a person becomes tolerant to a drug, they require more and more to get the desired effect,” Dr. Isenschmid said.

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