Let’s be clear..we’ve all seen the video by now. Its obvious that these police officers killed George Floyd. The Hennepin County Medical Examiner, and the independent medical examiner hired by the family of George Floyd, Dr. Michael Baden, have concluded that his death was a homicide….but their opinion differs on the cause of death. But if both of them declared that his death was a homicide, does the cause of death really matter? (YES). I want justice for George Floyd, and that is why I’m making this video, because the medical explanation for his cause of death, is not a simple explanation. As a lung doctor, part of my job is to figure out why people can’t breathe. As an intensive care doctor, part of my job is to care for people who are on the brink of death. Like when someone can’t breathe. So when someone dies of asphyxia, as is the case of George Floyd, the determination of cause of death is dependent on information elicited based on the investigation, which includes, the deceased personal medical history namely, autopsy, and crime scene investigation, which of course includes video evidence. Asphyxia is a Greek term that translates to “loss of pulse.”
Mechanical asphyxia involves some physical force or physical abnormality that interferes with the uptake and/or delivery of oxygen. With asphyxia, the brain doesn’t get enough oxygen, and when the pons and the medulla aren’t getting enough oxygen, they can no longer function. Which means they can no longer tell the diaphragm to contract, and breathing then stops. While this happens, the heart is also not getting enough oxygen, and typically the heart pumps slower and slower, until it stops. Prolonged continuous application of extreme pressure on the thorax, such as with the body weight of several officers, is capable of causing death. This is important, because this contributed to the death of George Floyd, in addition to the knee to the neck. The neck contains our airway, the trachea, and it also contains carotid and vertebral arteries, and jugular veins. The arteries here deliver oxygenated blood to the brain, while the jugular veins allow the deoxygenated blood to flow back to the heart. So what happens when pressure is placed on the neck? Well, it depends, on a lot of different factors (amount and duration of pressure, etc). And looking at the George Floyd video, he was unconscious for more than 2 minutes with the knee still on his neck. There’s no doubt, that during this time, he took his last breath, and right around the same time, lost his pulse. By the time the EMS guy checks his pulse, I highly doubt he actually felt a pulse, because it was more than two minutes after George lost consciousness. It was obvious that when they moved George onto the stretcher, he was completely limp, because he was dead. And it wasn’t until much later, did they start CPR, in the ambulance. Now let’s get to what the medical examiners had to say about this case.
Dr. Michael Baden, who did the independent autopsy says Floyd died of “asphyxiation from sustained pressure when his back and neck were compressed, with the neck pressure cutting off blood flow to his brain.” I agree with that assessment. I would also add that partial compression of the trachea, causing airway compromise, was also possible. The weight on George’s back made the work of breathing much harder for his diaphragm, and the neck pressure at the very least, meant less blood (and thus oxygen) was being delivered to his brain, and less carbon dioxide could be removed from his brain. After a while, the diaphragm becomes fatigued, and no longer has the strength to contract, which means the lungs can’t get oxygen into the blood, and can’t get carbon dioxide out of the blood. And all of this caused him to lose consciousness. And probably within seconds, he lost a pulse. And despite losing consciousness, and despite losing a pulse, they continued to apply pressure on the neck, and put their weight on his back. The Hennepin County medical examiner’s office, said that the cause of death is “cardiopulmonary arrest complicating law enforcement subdual, restraint, and neck compression.” This statement doesn’t really make sense to me. But the Hennepin County release also says heart disease was an issue; the independent examiner didn’t find that. The county said that fentanyl and methamphetamine use were among “significant conditions,” but its report didn’t say how much of either drug was in Floyd’s system or how that may have contributed. But Dr. Michael Baden got it right.