Don’t be misled by the headline.  Derek Chauvin had his knee across the neck of George Floyd.  The police did not find George Floyd in an alley with a needle in his arm.

But Derek Chauvin did not cut off George Floyd’s oxygen supply.

Derek Chauvin’s knee caused no trauma to George Floyd’s airway.

Derek Chauvin may have caused George Floyd to lose consciousness.

But the medical cause of George Floyd’s death was cardiopulmonary arrest due to pulmonary edema resulting from acute Fentanyl toxicity.

Dr. Andrew Baker is the Chief Medical Examiner for Hennepin County in Minnesota.

Amy Sweasy is the Managing Assistant County Attorney for Hennepin County.  She led the prosecution of Minneapolis Police Officer Mohammed Noor for the fatal shooting of Justine Ruszczyk while responding to her 911 call in July 2017.  She was awarded Attorney of the Year in 2019 for her performance in that case.

Keith Ellison is a former Democrat member of Congress, now the Attorney General of Minneapolis, another elected office.  Keith Ellison is an idiot lawyer who has never prosecuted a criminal case in his life.

The Memorandum below was drafted by Amy Sweasy after her video conference meeting with Hennepin County Chief Medical Examiner, Dr. Baker.

Floyd died in police custody on May 25.  The Memo is dated June 1.  The Attorney General for the State of Minnesota filed second-degree murder charges on June 3, after Democrat Minnesota Governor Tim Walz asked Ellison to lead the prosecution team.   This document was filed in the District Court of Minnesota on Tuesday, August 25.  It has been hidden from the public for nearly three months.  The calendar tells the tale.

The first thing to note from the Memo is that Ms. Sweasy was joined in the virtual meeting by Assistant Hennepin County Attorney Patrick Lofton.   Sweasy and Lofton had been the trial team together on the Noor case.  So they were the best the Hennepin County Attorney’s Office had for a case involved allegations of unlawful use of force by a police officer.

The most recent court filings in the case that I could find were signed by a member of Keith Ellison’s Attorney General’s Office, and Neal Katyal — former Acting Solicitor General of the United States during the Obama Administration – as “Special Attorney for the State of Minnesota.”  I haven’t seen anything yet with Ms. Sweasy or Mr. Lofton’s names listed in the case.

Dr. Baker told them that he had the final toxicology tests from George Floyd using “hospital blood” for the testing.  Dr. Baker explained that “hospital blood” was the best sample to use because “autopsy” blood is taken longer after the person is deceased and the blood contents have already begun to degrade for testing purposes.

According to the Memo, the blood screen for illicit substances showed the following:

4ANPP — this is a precursor chemical used in the manufacture of Fentanyl and is a residual impurity left over from the manufacturing process.

Methamphetamine — 19 ng/ML.  That is 19 nanograms per milliliter of blood.  That is quite low, likely only trace levels remained in the blood system from earlier use.  But methamphetamine is detectable in blood for only 24 hours, so Floyd had been under the influence of methamphetamine close in time to the incident. Methamphetamine is a central nervous system stimulant that causes elevated heart and respiration rates.

Going out of order, the Memo references the presence of Norfentanyl, a metabolite of Fentanyl.  Norfentanyl is the immediate precursor chemical used in the illicit manufacture of Fentanyl.  Norfentanyl is the drug that is converted into illicit Fentanyl in the manufacturing process. It is also a metabolite — meaning when the body absorbs and breaks down Fentanyl, a residual of it remains in the blood.

The key entry is “Fentanyl — 11.”  That is 11 ng/ML.  As noted in the Memo that is extremely high, and represents a lethal level of toxicity.  The therapeutic range for Fentanyl — what a doctor would prescribe — is  .6 — 3 ng/ML.

Fentanyl, like all opioid narcotics, suppresses respiration and cardiac function — it does the opposite to the body that methamphetamine does.  Drug users often use one after the other in a cycle.  They take methamphetamine to give them that “amped” feeling of having a lot of energy, and the opioids to come down off the stimulant in order to relax and/or sleep.

The key is the sentence on the third page — the Chief Medical Examiner of Hennepin County told the best prosecutors that Hennepin County has for this kind of case:

“If Mr. Floyd had been found dead in his home (or anywhere else), and there were not other contributing factors he would conclude that it was a drug overdose.”

At the time of Mr. Floyd’s death — according to the Medical Examiner — his body was experiencing the effects a drug overdose consisting of a lethal level of Fentanyl toxicity.

George Floyd could not breathe because George Floyd’s lungs were full of fluid.  That was not caused by Derek Chauvin’s knee across George Floyd’s neck.  “Pulmonary edema” is the presence of fluid in the lung tissue that interferes with normal lung functions.  The fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.  Fluid can accumulate for other natural reasons such as pneumonia, or based on exposure to toxins and medications.  It can also be caused by trauma to the chest wall and visiting or exercising at high elevations.

As noted by Ms. Sweasy in her Memo, Dr. Baker advised that Fentanyl is one of the medications that cause pulmonary edema.

George Floyd was complaining that he could not breathe when he was standing outside the patrol vehicle while the officers were attempting to persuade him to get in the back seat.  His difficulty breathing was not connected to Derek Chavin’s knee across his neck — it was the product of fluid in his lungs that was already developing before the officers arrived, as evidenced by the fact he was “foaming” at the mouth.

So, what are we to make of the Medical Examiner’s Report which says that the “Manner of Death” was “homicide”?

If you don’t read the Report in conjunction with the law, the report is meaningless as “evidence” with regard to the charges against the officers.

“Homicide” is a medical term, not a legal term.  In Minnesota, stating a “Manner of Death” is required by statute for purposes of statistical classification.  The statute gives the Medical Examiner specific options for classifying the “Manner of Death”, and the Medical Examiner indicates which option is appropriate.  Another option is “Accidental.”  The report notes this is not a legal determination — it does not assign “blame” to any individual.

The medical definition of “homicide” is the volitional act of a third party that ultimately resulted in the death of the decedent.  It is the “mechanism” that led to death, not the “cause” of death.  And that is why Medical Examiner reports state the two issues separately.

The Medical Examiner’s Report for George Floyd listed the “Cause of Death” as “cardiopulmonary arrest complicating law enforcement subdual, restraint and neck compression.”  If you do not know how to read that phrase in relation to the law, you do a disservice in offering opinions on what it means.

Cardiopulmonary arrest means his heart and lungs quit functioning, depriving his brain of oxygenated blood.

That FACT, “complicated” what the officers were engaged in doing.  That DOES NOT mean the officers’ actions caused the cardiopulmonary arrest.  If that is what it meant, the Report would have said so.

Physical findings from the autopsy stated it “revealed no physical findings that support a diagnosis of traumatic asphyxia or strangulation.”

Asphyxia is a denial of oxygen to the body causing unconsciousness/death.

Strangulation is a denial of blood flow to the brain by constriction.

Neither happened to George Floyd as a result of “trauma” — meaning the officers’ actions did not produce an injury to Floyd that led to asphyxia or strangulation.

George Floyd suffered a heart attack combined with pulmonary arrest while handcuffed in a prone position face down.  The pulmonary arrest was the result of edema in his lungs which interfered with the transfer of oxygen from his lungs to his blood.  The edema was so severe that his lungs weight 2-3x their normal weight from the build-up of fluid in them.  This made the expansion of his lungs to take in oxygen more difficult.  That condition resulted from a lethal level of Fentanyl in his blood — a drug that suppresses respiration in a healthy person with no pulmonary edema.

None of the actions taken by the officers were, by their nature, “life-threatening”.  The defense will line up “use of force” experts to testify that every effort at subdual or restraint was consistent with standard law enforcement training.

Any prosecutor with significant experience recognizes the problem here.  The Medical Examiner will not be able to say the actions of the officers caused the cardiopulmonary arrest which resulted in George Floyd’s death — not given the level of Fentanyl toxicity in this blood.  George Floyd’s respiratory system, under the influence of Fentanyl as it was, suffered from pulmonary edema which resulted in cardiopulmonary arrest during the application by the officers of standard techniques of restraint and control.  Based on the Report, the Medical Examiner will not be able to testify that, beyond a reasonable doubt, those techniques caused the pulmonary edema that resulted in the cardiopulmonary arrest that killed George Floyd.    Nothing about the techniques leads to pulmonary edema.  Without that medical testimony, this case never makes it to the jury.

“Manner of death” is meaningless to assigning legal responsibility for George Floyd’s death to the officers.  The key is what will the Medical Examiner be able to testify to in response to the prosecution’s questions.

Minnesota Attorney General Keith Ellison, the activist/politician who has never prosecuted a criminal case in his life, filed the second-degree murder charge after Democrat Minnesota Gov. Tim Walz asked Ellison to lead the prosecution.  Why would you do that rather than allow it to be handled by the experienced Hennepin County Attorney team that had just last year successfully prosecuted another high profile death case that was caused by police use of force?