The second week of Derek Chauvin’s trial came to a close with one of its most-anticipated witnesses on the stand — the medical examiner who performed an autopsy on George Floyd last year, ruling his death a homicide.

Hennepin County Medical Examiner Andrew Baker testified Friday that he thinks the stress of Floyd’s arrest overwhelmed his already-overburdened heart and “tipped him over the edge.”

“The law enforcement subdual restraint and the neck compression was just more than Mr. Floyd could take by virtue of those heart conditions,” Baker said.

The medical examiner did not point to asphyxia, however, in a contrast to other medical experts who spoke this week. Baker said that in his opinion, Chauvin’s knee would not “anatomically cut off Mr. Floyd’s airway.”

Here’s what to know:
9:06 p.m.
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Cross-examination of Baker focuses on heart conditions, drugs

Nelson, the defense attorney, pressed Baker on factors besides police restraint that Baker noted in his autopsy.

Under cross-examination, Baker affirmed that he found Floyd’s heart conditions to be “pretty significant” and did not point to asphyxia, in contrast to other experts called by the prosecution.

The medical examiner said he would expect to see bruising from force to Floyd’s neck sufficient for asphyxiation — “but I don’t know that the lack of bruising excludes that,” he said. He also did not report apparent brain damage from asphyxia but noted that in many cases a victim dies too quickly for it to show up.

Baker also addressed the methamphetamine and fentanyl found in Floyd’s system.

Earlier this week, the prosecution called an expert who assessed the level of methamphetamine in Floyd’s blood as “low” and on par with someone who had been prescribed the drug. Baker affirmed that methamphetamine is a “stimulant” that causes the heart to beat faster and “work harder.”

I’m not aware that there’s a quote-unquote safe level of methamphetamine,” Baker said.

Baker said Floyd displayed what could be a “fatal” level of fentanyl, but he emphasized that drug concentrations are very “context dependent” and need to be interpreted with other circumstances.

He said his conversations with local prosecutors about the drug findings “almost certainly went something like this: Had Mr. Floyd been home alone in his locked residence with no evidence of trauma and the only autopsy finding was that fentanyl level, then, yes, I would certify his death was due to fentanyl toxicity.”

Recounting his earlier statements to federal officials, Baker reiterated his belief that Floyd “experienced a cardiopulmonary arrest in the context of law enforcement’s subdual restraint and neck compression.”

“It was the stress of that interaction that tipped him over the edge,” Baker said.

8:46 p.m.
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Defense asks examiner whether Chauvin’s placement of knee cut off Floyd’s airway

During a cross examination, Chauvin defense attorney Eric J. Nelson asked medical examiner Andrew Baker for his impression of the video of George Floyd’s arrest, in particular whether the position of Chauvin’s knee had caused occlusion of the carotid artery.

Baker explained that from the images it appears that Chauvin’s knee was primarily on the back or the side of Floyd’s neck and that this position would not have been able to obstruct the artery, adding that even if it had done so, the second, unobstructed artery would have been able to supply blood to the brain.

Nelson further questioned whether the placement of Chauvin’s knee would “anatomically” cut off Floyd’s airway.

“In my opinion it would not,” Baker responded.

Chauvin’s defense previously asked Baker whether the methamphetamine found in Floyd’s system could have had an impact on his heart’s vessels and arteries.

“It is certainly hard on your heart in the sense that it does things like drive up the heart rate and drive up blood pressure,” Baker responded, adding that in general methamphetamine is not good for a heart with coronary artery disease.

8:21 p.m.
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Medical examiner says drugs, tumor found in Floyd did not cause his death

Medical examiner Andrew Baker said that even though the toxicology screen test of Floyd’s blood found amounts of fentanyl and methamphetamine, he concluded they were not a direct cause of Floyd’s death.

Baker explained that the drugs found in Floyd’s system were part of the “significant conditions” assessment of the death certificate, meaning they played a role in his death but were not direct causes.

Baker’s testimony refuted the Chauvin defense argument that Floyd died of a combination of intoxication, heart disease and high blood pressure.

“Mr. Floyd’s use of fentanyl did not cause the subdural or neck restraint. His heart disease did not cause the subdural or the neck restraint,” Baker said, adding these were elements that may have contributed to Floyd’s death but did not prompt it.

Earlier during his testimony Baker also ruled out covid-19, which Floyd tested positive for weeks before dying, or an “incidental tumor” he found in his pelvis during the autopsy, as having anything to do with his death.

7:51 p.m.
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Medical examiner: Restraint, neck compression were ‘more than Mr. Floyd could take’ because of heart conditions

Hennepin County Medical Examiner Andrew Baker testified Friday that he thinks the stress of Floyd’s arrest overwhelmed his already overburdened heart.

Now, in the context of an altercation with other people, that involves things like physical restraint, that involves things like being held to the ground,” Baker testified. “Those events are going to cause stress hormones to pour out into your body, specifically things like adrenaline. And what that adrenaline is going to do is it’s going to ask your heart to beat faster. It’s going to ask your body for more oxygen so that you can get through that altercation.”

And in my opinion, the law enforcement subdual restraint and the neck compression was just more than Mr. Floyd could take by virtue of those heart conditions,” Baker added.

Floyd’s health conditions meant that his heart was “limited in its ability to step up to provide more oxygen when there’s demand,” Baker testified. His coronary arteries were narrowed, Baker said, indicating “very severe underlying heart disease,” and Floyd also had “hypertensive heart disease, meaning his heart weighed more than it should.”

Baker is a key witness as the defense and prosecution propose different answers to the question at the center of Chauvin’s trial: What killed Floyd? Baker is a former president of the National Association of Medical Examiners.

Baker ruled Floyd’s death last year a homicide and listed the cause as “cardiopulmonary arrest complicating law enforcement subdual, restraint, and neck compression.” Cardiopulmonary arrest, Baker explained Friday, means that Floyd’s heart and lungs stopped.

Chauvin’s defense attorney, Nelson, said in his opening statement that “the state was not satisfied with Dr. Baker’s work” and has enlisted other professionals “to contradict Dr. Baker’s findings.” The prosecution has called experts who said that Floyd died of asphyxia as a result of police officers’ actions.

7:23 p.m.
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No pill or pill fragments found in Floyd’s stomach during autopsy, medical examiner says

Andrew Baker told prosecutors Friday that no pill or pill fragments were found in George Floyd’s stomach during his autopsy.

Baker, the Hennepin County medical examiner, was asked by prosecutor Jerry Blackwell about whether such substances were discovered in his stomach.

“I did not,” he replied.

Eric Nelson, Chauvin’s attorney, has argued that drugs played a contributing role in Floyd’s death. While searching Floyd’s car, investigators recorded that they found white pills and a wrapper for suboxone, a type of opioid that can treat opioid use disorder but also can be abused.

6:53 p.m.
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Medical examiner knew of Floyd video but chose not to watch to avoid bias, he says

Hennepin County Medical Examiner Andrew Baker took the stand Friday and said he “intentionally” chose not to watch any videos of Floyd’s arrest and death before conducting the autopsy, although he was aware that at least one video had gone viral.

“I did not want to bias my exam by going in with any preconceived notions that might lead me down one pathway or another,” he said, adding he did watch one video shortly after his examination.

Before the autopsy, Baker said the only information he had about Floyd was that he had become unconscious while in police custody and that he had been transported to Hennepin Healthcare where he was pronounced dead.

5:32 p.m.
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There was no evidence Floyd suffered heart attack, Thomas testifies

Toward the end of her testimony Friday, Thomas said there was no evidence Floyd suffered a heart attack when he was detained by Chauvin and other officers outside Cup Foods.

Throughout much of Nelson’s cross-examination of the forensic pathologist, Chauvin’s defense focused on Floyd’s heart and the conditions that, they argued, played a contributing factor in the 46-year-old’s death.

But when prosecutors returned to ask Thomas a few more questions, she was clear that Floyd’s heart did not have a role in his passing.

“Is there any evidence that Mr. Floyd suffered from a heart attack?” the prosecution asked.

“No,” she replied.

She confirmed to prosecutors that no injury was found in Floyd’s heart during the autopsy.

5:21 p.m.
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‘Like asking Mrs. Lincoln if we take John Wilkes Booth out of this’

Prosecutor Jerry Blackwell pushed back on the defense attorney’s use of a hypothetical to cast doubt on the police role in Floyd’s death.

“You were asked a number of questions that were to the fact that if we take the police subdual restraint and neck compression out of this, what would you conclude?” Blackwell noted to Thomas, as the forensic pathologist sat at the witness stand. “Aren’t those questions a lot like asking Mrs. Lincoln: ‘If we take John John Wilkes Booth out of this...’"

Defense attorney Eric Nelson interrupted with an objection and Blackwell was forced to reframe his question.

“From your standpoint as a forensic pathologist and your analysis of manner and cause of death, would you ever approach an assessment, a manner and cause of death, by taking out of it the facts that you found relevant and highly pertinent to assessing [it]?” he asked.

“No,” Thomas said.

Blackwell pushed back on other seemingly incomparable scenarios that Nelson had asked Thomas about, including “a question about laying by the pool on my stomach in Florida.”

“George Floyd was not laying by the pool on his stomach in Florida, was he?” Blackwell said.

5:16 p.m.
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Defense pushes heart disease as cause of death, asks pathologist to consider hypothetical scenario with ‘no police involvement, no drugs’

Chauvin’s defense attorney Eric Nelson sought to emphasize the possibility or even likelihood that Floyd’s death could have derived from heart disease, noting a series of indicators of poor heart health — and at one point asking a forensic pathologist to consider a hypothetical scenario in which the only factors under consideration involved Floyd’s preexisting heart conditions.

Floyd’s right coronary artery had a 90 percent blockage, while his left anterior descending artery was 75 percent blocked, Nelson noted in his cross-examination of Thomas, a forensic pathologist. His heart was also significantly larger than the average size for a man of his height, he added. He asked Thomas what causes an enlarged heart.

“Probably the primary cause is high blood pressure,” she replied.

Floyd had high blood pressure, Nelson said. When someone is exerting themselves, does that make the heart work harder?” he asked.

“Yes,” Thomas said.

“Does that mean that more blood, oxygen, it needs more blood to function? The heart needs more blood to function at that time?”

“Yes,” she said.

Nelson asked Thomas to consider a hypothetical situation in which there were “no police involvement, no drugs,” and Floyd was found dead at home. “The only thing you found would be these facts about his heart,” Nelson said. “What would you conclude to be the cause of death?”

“In that very narrow set of circumstances? Uh, I would probably conclude that the cause of death was his heart disease,” Thomas said.

5:14 p.m.
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Arguing that a prone position is not dangerous, Chauvin attorney points to chiropractors, massage therapists

As part of the defense’s argument that the prone position is not inherently dangerous, Chauvin attorney Eric Nelson on Friday made reference to other professions that regularly use the position, specifically chiropractors and massage therapists.

After pointing to doctors and hospital workers who regularly work with patients in the prone position, Nelson turned his attention elsewhere.

I mean, chiropractors put people in the prone position, right?” he asked Lindsey Thomas, a forensic pathologist.

When she agreed, Nelson followed up with, “Massage therapists put people in the prone position, right?” Thomas again agreed.

“So the prone position — I’m just talking generally speaking, no other factors — the prone position in and of itself is not inherently dangerous, right?” Nelson said.

Again, Thomas concurred.

Later, when Nelson asked the pathologist to describe Floyd’s behavior, Thomas described what she saw on the video.

“He couldn’t breathe, and he calls for his mother, and he says he loves people,” she said.

5:03 p.m.
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Pathologist rejects Chauvin defense’s citation of research on prone-position arrests by Canadian police

As Chauvin attorney Eric Nelson during cross-examination pointed to research in Canada regarding the lack of fatalities from police putting people in a prone position, forensic pathologist Thomas wondered aloud Friday why it was different in the United States.

Isn’t that amazing when you consider that virtually every forensic pathologist in the United States has probably had an officer-involved death like this?” she replied. “It utterly baffles me.”

Chauvin’s defense presented research from Canada that found no deaths in about 3,000 prone-position arrests.

Nelson objected to the forensic pathologist’s sarcastic response, and Thomas smiled and said, “Sorry,” before looking down.

4:38 p.m.
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Seat for a Chauvin associate occupied for the first time

For the first time since proceedings began last month, someone filled the seat designated for Chauvin’s family on Friday morning, according to the pool report.

This person was not immediately identified, but their appearance marked a shift in the case so far.

The judge laid out strict limitations on who could be in the courtroom, with attendance limited because of coronavirus concerns. In an order before jury selection began, he said that one member of Floyd’s family and one member of Chauvin’s family could be present at any given moment. Different people could rotate through that spot, he said, but only one at a time.

Floyd’s family seat has regularly been filled, with different people cycling through. Court security on Monday removed the chair designated for a family member or friend of Chauvin because it has sat empty since March 8, when proceedings opened with jury selection.

The seat was returned on Friday morning and a woman sat there shortly after 9:10 a.m., the pool report stated. She was sitting in the corner of the room, possibly to avoid being seen on camera.

4:29 p.m.
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Prone restraint research ‘bears no resemblance’ to what Floyd experienced, Thomas claims

While research finds that the prone restraint is not dangerous for respiration, Thomas said real-life situations are another case — including what happened to Floyd.

“It bears no resemblance to what Mr. Floyd experienced,” the forensic pathologist said.

Thomas testified to prosecutors that the research was fine for laboratory purposes, but that the findings were “irrelevant for purposes of what we’re talking about here.”

She pointed out that these studies normally involve young people who voluntarily agree to be on a surface such as a gymnastics mat during the research.

When asked if any of the research involved a knee on someone’s neck, Thomas said she did not know of any kind of study resembling that situation.

3:43 p.m.
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Thomas: ‘No evidence to suggest he would have died that night except for the interactions with law enforcement’

On April 9, forensic pathologist Lindsey C. Thomas testified at the trial of Derek Chauvin regarding the cause of George Floyd's death. (The Washington Post)

Thomas told the court she saw no evidence to suggest that Floyd would have died, had it not been for the police officers restraining him and restricting his breathing.

“There’s no evidence to suggest he would have died that night except for the interactions with law enforcement,” she said.