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Pulmonology Expert Says, Floyd Died from a Low Level of Oxygen; Rep. Matt Gaetz (R-FL) Associate Likely to Strike Cooperation Deal with Government. Aired 1-1:30p ET

Aired April 8, 2021 - 13:00   ET




DR. MARTIN TOBIN, PULMONOLOGIST: Yes. The other things -- there's two other things that are very important to the respiratory rate, because you saw it with your own eyes exactly his respiratory rate. And the first thing is that if you have somebody who has underlying heart disease, and the heart disease is so severe that it's been said that it's causing shortness of breath, that it's causing you difficulty with breathing, if somebody has a heart disease that's causing shortness of breath, virtually, all of those patients are going to have very high respiratory rates.

They're going to have respiratory rates of over 30, even over 40 when you have heart disease that will give you shortness of breath, instead that we find that his respiratory rate is normal at 22.

The second thing that's important about the respiratory rate of 22 is, if you have somebody where the primary problem in the body is airway narrowing, where you have somebody where there is, that the airways are being compressed, there's narrowing in the neck or there's narrowing like in somebody in the chest, what the response -- the physiological response to airway narrowing is a normal respiratory rate. And that is what he has. So it's the respiratory rate that you see that's normal is the expected physiological response in somebody who has airway narrowing.

BLACKWELL: So, Doctor, we've covered the mechanisms of how low oxygen occurs. As a clinician, did you observe results of low oxygen in the video showing the last minutes of George Floyd's life?


BLACKWELL: What did you observe?

TOBIN: I mean, in terms of what we're seeing is the changes in his facial appearance, this becomes crucially important, again, in seeing the effects of the low oxygen.

BLACKWELL: And have you seen this effect in other patients as a clinician?

TOBIN: Yes, because I work in an ICU where 40 percent of our patients die. So I'm extremely familiar with seeing people who die, unfortunately. And so when you see these changes, you see the changes in the face. That is the key way of noticing something happening is by looking at the effects on the face.

BLACKWELL: And, Doctor, I want to show you Exhibit 15, already admitted into evidence, at 404. And I want to play a clip and have you tell us what it shows.

TOBIN: At the beginning, you can see he's conscious. You can see slight flickering. And then it disappears. So one second he's alive and one second he's no longer.

BLACKWELL: Could we just (INAUDIBLE) that went pretty fast, so the jurors can see it.

Just one second. It is 20:24:53 in the composite. Yes, and the speed is slowed down by a third, just so we can see it.

Is that the flickering?

TOBIN: You can see his eyes, he's conscious, and then you see that he isn't. That's the moment the life goes out of his body.

BLACKWELL: I want to also show you a clip from another body-worn camera, Exhibit 43. And for Mr. Nelson, that's the K one (ph). 20:22:22 is where it starts.

And I want to play this for you also, Dr. Tobin, and you could tell the ladies and gentlemen of the jury what this informs us.


TOBIN: So now he's rocking his right side. You can see how he's moving his hip to try and rock the right side of his body to try and get air. You can see him again pushing down on the street to get air in. And there is movements of his hip. You may miss, but he's having to use all his internal spine to just try and get air into that right side of the body.

Keep in mind, the left side is nonfunctional from the way they have manipulated him and pushed him into the street. So he's constantly -- he's cranking up his right side of his body, you can see it right, there to try and get some air into his -- right side of his chest.

He's making repeated struggling movements. He's moving again the hips because he's using his spine to try and get them -- those muscles to move air into the right side of his chest. And he's, again, trying to use his right arm and he's unable because of the chain, the small chain linking it over to the left side. He's trying to have pushed down on that right arm into the street to try and help him but he's unable to do it because of the chain on the handcuffs.

BLACKWELL: And at some point, Mr. Floyd stops speaking, and what does that tell us about his oxygen supply?

TOBIN: That tells us at that point -- where he's not speaking, it tells us that the airway narrowing in his upper airways is more than 85 percent and then it's separate from the -- in terms of the oxygen level. That we're seeing by the face. But they're all happening together. And so once -- once -- seeing how much narrowing there is in the airway but they're all coming in together.

BLACKWELL: And then did the restraint stop at the time of the brain injury and the PEA arrhythmia?


BLACKWELL: The restraint stopped at that time?

TOBIN: No, the restraints continued after that -- he has the cessation of respiratory efforts. When you last take a breath, the knee remains on the neck for another three minutes and 27 seconds after he takes his last breath. There's the knee remains. After there's no pulse, the knee remains on the neck for another two minutes and 44 seconds after the officers have found themselves, there's no pulse, the knee remains on the neck another two minutes, 44 seconds.

BLACKWELL: Thank you, Dr. Tobin, no further questions.



ERICA HILL, CNN ANCHOR (voice over): So a short sidebar here. We have been listening this morning to testimony from Dr. Martin Tobin, who is a pulmonary expert, who is a pulmonologist there. And if you're just joining us, he has walked through with great detail this morning the last moments and the last breathes that George Floyd took and how difficult it was for Mr. Floyd to take those breathes.

With us, of course, CNN Legal Analyst Laura Coates and CNN Law Enforcement Analyst and former Philadelphia Police Commissioner Charles Ramsey.

Just a moment before -- I just want to get to the judge has to say quickly.

CAHILL: -- we're going to take until 1:30.

HILL: So the judge announcing a lunch break there, to be expected. The attorney for the prosecution, Mr. Blackwell, just saying he had no further questions. I -- this is a moment, I have to say, for anyone who is just joining us, if you see even a small moment of this testimony, the calm demeanor of this gentleman as he is presenting this evidence, Laura, in many ways, almost makes it even harder to listen to.

LAURA COATES, CNN SENIOR LEGAL ANALYST: Oh, this is incredibly, compelling testimony. Just think about the way in which he's delivering the information, the entrancing tone that he has, the idea of how he's disinterested in the sense that although this is his expertise, this is his field, he is not a player, he has no agenda particularly in this particular ball game, so to speak.

And so he's calm, he's volunteered his testimony, and what testimony it is, walking us through the last moments of desperation, the way in which a human being was reduced, trying to lift one's chest up just to respirate, using his knuckles, his finger, eventually his shoulder to no avail, talking about the ways in which he was desperate to be able to do this.

And not just through the eyes of the laymen watching the nine-minute and 29-second video, Erica, over time, but through the eyes of an expert who introduces us four different areas of why he wasn't able to breathe. It wasn't just the knee to the neck or the knee to the back and side, it was also the idea of having him handcuffed, and in sandwiched against the sidewalk and prone.


I mean, this has been devastating testimony from a defense perspective.

But it has been overwhelmingly tragic for everyone to hear about the final seconds of this man's life to know, as he said, there was not an ounce of oxygen left in his entire body, and still Derek Chauvin's knee remained on his neck for an additional three minutes and two seconds.

HILL: I just want to play some of these moments so that people at home can hear exactly what you're referring to. If we could play stop one (ph), first of all, just this idea of how George Floyd was trying to breathe, in any way possible.


TOBIN: Over on the right image, you see his knuckle against the tire. And to most people, this doesn't look terribly significant, but to a physiologist this is extraordinarily significant. Because this tells you that he has used up his resources and he is now literally trying to breathe with his fingers and knuckles. Because when you begin to breathe, you begin to breathe with your rib cage and your diaphragm. The next thing you recruit after that is your sternum mastoid muscle, which is the big muscle in your neck.

And then when those are wasted up, then you're relying on these types of muscles, like your fingers, to try and stabilize your whole right side because he's totally dependent on getting air into the right side. So he's using his fingers and his knuckles against the street to try and crank up the right side of his chest. This is his only way to try and get air to get into the right lung.


HILL: I mean, as he lays that out, you know, Commissioner, I heard you say earlier, his testimony could also be used in further training for officers to better understand the literal impact of what is happening in all of these moments.

CHARLES RAMSEY, CNN LAW ENFORCEMENT ANALYST: And I think that's incredibly important. I mean, we're watching this tragedy unfold to the point where you're actually now seeing the last flicker of life that George Floyd had as you're watching, you know, the video. It is incredibly compelling.

And the only word I can think of when I think about the testimony of Tobin is masterful. I mean, it is just -- and I would also say the same thing for the prosecutor, the way in which he's walking him through his testimony, in a very deliberate fashion, to not confuse the jury but to feed them the information they need at a pace where they cannot get overwhelmed by it. And I think that's very important as well.

As far as looking at the video and what we've heard so far from the doctor, I mean, there are so many points there that could be used in training beyond just, you know, positional asphyxia, don't keep a person in this position for too long because, you know, they can't really breathe, get them up and so forth. Why is that? What is it that's going on with that individual when you keep them in that position, when you apply pressure?

Laura and I spoke during one of the breaks, and she asked whether or not -- you know, about the whole handcuff manipulation part, that's pain compliance is what it is. The problem is, you do that to try to get a person to comply but Floyd couldn't have complied if he wanted to. I mean, you're sitting on him. How is he going to do anything? You can't.

And there's another segment there that I just noticed, I think it's 20:23:05 or something. Anyway, and this is Chauvin, because he's got the gloves on. He's actually got his hands wrapped around his fingers and knuckles, and, again, he's applying pressure. And anyone who's ever shaken hands with someone who is very strong, that gets that real strong grip, and you feel the pressure and the pain when your knuckles are pressed together, that's exactly what's going on.

Again, that's a pain compliance technique. We used to call it the come along a while back that if you've got a person you're trying to either handcuff or trying to get them to walk with you, that is one way of applying pressure and pain in order to get him to comply. None of that was necessary. That added to the torture that the man was going through at the time.

HILL: I mean, the torture is exactly what it is, as you listened to the way, again, that it is laid out, so methodically and literally second by second from what we've seen this morning.

What I found was interesting is just a few moments ago, toward the end of his testimony and his questioning by the prosecution, what was brought up was whether -- if there was Fentanyl in his system, how that could impact his breathing and also his CO2 levels ultimately and what the impact could have been there.

[13:15:05] And I just want to play some of those moments.


TOBIN: So we see here that he reaches a level of zero of oxygen at 20:25:41. And so at that point, there's not an ounce of oxygen left in his body, in his entire body at 20:25:41.

BLACKWELL: So was the knee then lifted off of his neck at the point there was no more oxygen in his body?

TOBIN: No, the knee remained on the neck for another three minutes and two seconds after we reached the point where there was not an ounce of oxygen left in the body.

One of the major changes you see in fentanyl is a slowing of the respiratory rate. So -- and, again, we would be expecting a 40 percent reduction in the respiratory rate with fentanyl. The normal respiratory rate is 17 breaths per minute, plus or minus five. So that would mean a normal respiratory rate of between 12 and 22. That's the normal range of respiratory rate.

And so if it was with fentanyl, you'd be expecting a respiratory rate of 10. Instead, it actually counted here yourself, and you can see when you count it yourself that the respiratory rate is 22. So, basically, it tells you that is -- there isn't Fentanyl on board.


HILL: Laura, on more than one occasion that we heard him say, you can figure this out with precise science. He's pointing to that science there. He also pointed to the CO2 levels, noting he had taken his last breath, and it was nearly 10 minutes before they got a tube into the back of the ambulance to try to get more oxygen in. And if you add those numbers up, based on what would happen to your body without breathing for nine minutes and 50 seconds, you would get that exact CO2 rate.

This goes to the heart of some of what the defense is trying to say may have been the real contributing factor to George Floyd's death, Laura?

COATES: I mean, this pulmonologist is a textbook author but he has just written the book on preemptive strike when it comes to expert analysis. I mean, the idea of the prosecution having to anticipate and resolve even before the defense is able to raise the issue about this and other aspects, this was a preemptive strike to say, whatever you think you're going to hear on cross or any statements that may be made from their own experts, look how compelling this testimony has been to have the jurors understand this with such precision that they are now better informed and guarded against being influenced.

I mean, he talks about -- just as you think it can't get worse, this trial began, Erica, with the entire world believing that the rallying cry of eight minutes and 46 seconds was bad enough. Then we learn it's nine minutes and 29 seconds. Then we learn through the course of the trial they're talking about a brain injury after five minutes, somebody who's lost every ounce of oxygen out of their body and still the knee stays on the neck. All of these things, the frame by frame, down to the moment of his eye expression when life leaves his body and he is no longer conscious.

I mean, the jurors are having to absorb every detail and it just gets worse. It should not shock anyone that the defense has essentially raised more objections during this testimony or asked for more sidebars than we've seen in recent testimony and they were saved by the bell of a lunch break because they're trying to figure out, how do we undermine this testimony of somebody who doesn't seem to be trying to predict a verdict or put his thumb on the scale, but instead is trying to demonstrate how, with scientific certainty, he was able to undermine any discussion about heart disease or underlying conditions. In fact, he was asked about the underlying conditions, Erica, as you know. He says even a healthy person Subjected to what George Floyd was subjected to would have died.

Where do you come back from that as a defense? They're probably right now trying to figure that out.

HILL: We were earlier on, as he was explaining things for people who weren't with us during that point in the trial, we couldn't see the jury at that point, but he was encouraging members to put their hands on their neck so they could understand what he was trying to explain in terms of where the pressure may be coming from, what would be happening to George Floyd in that moment. That was a concern raised by the defense. The judge said, listen, you don't have to do this to the jurors.

What we know from the poll reporters inside is that many of the jurors, even after that direction from the judge, continued to touch their own neck, their own body part, to try to better understand what this witness was saying. We're also told from pool reports that there was -- they've been very attentive throughout the morning, taking a lot of notes.

One other thing that came that really struck me is we've heard, if you can speak, you can breathe. Commissioner Ramsey, in response to George Floyd saying, I can't breathe, and the defense has said, well, you know, if he can say he can't breathe, he actually can breathe.


And Dr. Tobin addressed that too, saying, basically, this is sort of -- this gives you a false sense of security. If you can speak, you can breathe, is not correct, we learned.

RAMSEY: Yes. I mean, you know, I've not seen that as an official part of training but it certainly is a myth that exists. And as he said, you know, there's some truth to it but it doesn't mean that you can breathe five seconds later. And so it gives you a false sense of security that the person is okay. They're not okay.

And so, you know, this is testimony that cannot be forgotten, and a jury will not be able to forget this testimony. It is just that powerful. And I think, you know, I know they're on a lunch break but I think they -- I think the defense just got handed their lunch because when you think about the power of this testimony and the way in which they actually dealt with all those issues that they know are going to come, you know, fentanyl, bad heart, all that sort of thing, if it was not for the actions of Derek Chauvin and the other officers, he would not have died on May 25th at that time because it's a substantial part of his cause of death. And that's all you have to prove.

So he's got all these other things going on but how can you possibly deny this didn't play a role? And that's all you have to do, is prove that, and I think they just did.

HILL: Laura, as you pointed initially, Dr. Tobin said there were four reasons that led to this low level of oxygen. The handcuffs and street, the way he's positioned acted as a vise on his body, Chauvin's knee on the George Floyd's neck, the prone position, and then Chauvin's right knee on his back or on his side.

The weight too is something that Dr. Tobin got into. And I just want to play a bit of that. I think this may be stop two (ph).


TOBIN: What you're seeing is the orientation of Officer Chauvin. His body build is quite erect. 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.

Because in many of the calculations, I excluded the effect of his leg and his shoe because some of it was touching the ground, but here you can see none of it is touching the ground. So we're taking half his body weight, plus the weight of his -- half the gear and all of that is coming directly down on Mr. Floyd's neck.


HILL: And the amount of weight, Laura, that's coming directly down, we learned yesterday there was 30 to 40 pounds of equipment on Officer Chauvin. So we're talking about probably 90 pounds coming down on George Floyd's neck at that point, Laura.

COATES: I mean, that number, it's all in the numbers here, eight minutes, 46, nine minutes, 29, 91 pounds of weight, brain injury after five minutes, the idea of all the oxygen leaving the body and three minutes still remained for this person to have the knee removed and only when the EMTs request that to happen. I mean, these numbers here are so powerful.

And I know we talk a lot about statistics, I'm sure, in everyone's life but certain numbers tell a story even better than others. This is probably the first day that I'm sure the defense is asking for themselves, can we just play the video through the eyes of the laymen?

Because when you now have to guard against viewing this video through all the different vantage points, not of a cell phone video, not through the testimony of a 911 dispatcher, but instead through the eyes of an expert who has trained, who is an expert in all things related to the respiratory system, to view it through his eyes, he's adding additional layers, the manipulation of handcuffs, the idea of his body being trapped between virtually the rock and the hard place, the manipulated handcuffs and hard pavement and the discussion about his underlying health. I mean, it's so truly damning here to think about this.

But there's one point that Mr. Ramsey spoke about, and that was the idea of if you're breathing, you can talk, you can still breathe. I'm wondering if now the straw that the defense will have to grasp at will be this idea of, well, hold on, he believed that, Derek Chauvin believed. So perhaps he was just misinformed. He's not a murderer under the charges, he's a misinformed police officer who thought that perhaps the suspect was lying or that there was a use of force he had to use, or now maybe that if he was breathing, he's not a pulmonologist.


I can see them going that direction. But, again, you still have the idea of the crowd who was shouting, just check his pulse, just do something.

And so even the common sense sort of defense that he might have, those knee jerk reactions of the defense, it can't undermine what has been done in the video.

HILL: Well, and to your point, Laura, we've already heard some of that, right? And we've heard that over the last couple of days the defense say, you can't necessarily trust what a suspect is saying in this moment, but, boy, there is a whole lot of science that we can look at today.

Laura Coates, Charles Ramsey, as always, I appreciate your insight and your expertise.

Stay with us. We'll be resuming coverage of the trial obviously in a bit but I do want to get you updated on this breaking news at this hour out of Florida. Joel Greenberg, who is a key figure in the investigation surrounding Congressman Matt Gaetz, we're learning, is likely to strike a plea deal with federal prosecutors. That is according to his attorney.

CNN's Paula Reid joining me now. So, Paula, what more do we know about this?

PAULA REID, CNN SENIOR LEGAL AFFAIRS CORRESPONDENT: Erica, this is potentially bad news for Congressman Matt Gaetz and his ongoing sex crimes investigation. As you just noted in court just moments ago, the Justice Department and defense attorneys for one of Gaetz's closest friends and political allies signaled that that close friend and political ally, Joel Greenberg, is likely to strike a plea deal to resolve the dozens of federal criminal counts he is currently facing. That is significant for Congressman Gaetz because it means that his friend and ally would likely have to provide any evidence of criminal wrongdoing that he's aware of against his friend.

Now, what was interesting, they said, the government said that they thought that this could all be resolved in a month but the defense attorney for Mr. Greenberg said, nope, not so fast. And both sides, Erica, acknowledged it's possible they may not be able to come to a plea deal. It's possible they won't be able to come to any kind of agreement. But right now, Congressman Gaetz is likely concerned, one of his closest friends and allies will now likely have to cooperate with the government.

And it's interesting, the investigation into Congressman Gaetz actually began with a larger sex trafficking investigation, where his close ally, Joel Greenberg, has been implicated. And, again, he's facing dozens of criminal counts, so a lot of incentive for him to provide anything he knows to the Justice Department.

HILL: Yes, absolutely. Paula, stay with me for just a minute. I also want to bring back in Laura Coates now.

So, Laura, I know you were just hearing and getting some of these developments as well. As Paula laid out, this may not happen, but the fact that this is being considered, that this is being discussed, this is a big moment here.

COATES: It's a huge moment, the idea of federal investigations. Part of what happens is that you're trying to get your bearings as the investigator, as the prosecution, you're seeing what allies you may have, how you're going to get testimony and evidence in and who are going to be your cooperators.

And the second you're able to identify that cooperator, you're able to apply some pressure in order to have them have potentially reduced charges they must plead to, but there is always a hook. And the hook is, you scratch our back, we'll scratch yours.

The scratching the back here seems to be providing information about the colleague, Congressman Matt Gaetz. And so the idea of us now learning about this demonstrates that the cooperation may be an issue here, what type of evidence, to what extent he'll provide it, the timeliness of that provision of evidence is always going to be part of it, but remember, the plea is separate oftentimes from the sentencing, which means that a cooperator may still have a prolonged period of time under which they are required to still cooperate with the prosecution.

They may be able to move the needle but remember cases involving, say, Michael Flynn, you know, the infamous elongated period of time when he was a cooperator with the government, the time in which, of course, he was to be sentenced, et cetera, they oftentimes will use that window in order to get all the information they can.

So taking a plea, deciding to change one's plea, until sentencing happens, that person might be on the hook, and the net might be cast even wider.

HILL: Wow, what a day, Laura, always happy when you're here to help us walk through all of this.

Stay with us, everyone, we're going to get you caught up on a few other headlines we're following today. We'll get you back to the courtroom as well when testimony resumes.

Meantime, just a short time ago, President Biden signing a series of orders aimed at reducing gun violence in America. This as critics say, the efforts fall short of candidate Biden's promises, back on the campaign trail.

Plus, millions of Americans are now vaccinated and many COVID long- haulers say the vaccines are finally starting to relieve symptoms that some worried may never go away.