dr. rich, when mr. floyd was checked for a pulse when he was in the subdual and the restraint of mr. chauvin? >> yes, yes there was. >> at the time that he was checked for a pulse and he no longer had one, in your opinion as a cardiologist was there anything mr. chauvin could have done at that point in time that would likely have saved mr. floyd's life? >> objection, leading. >> sustained. >> well at the time that mr. floyd is determined to have not had a pulse, what is your opinion to a reasonable degree of medical certainty as to what mr. chauvin may have done that would have potentially saved his life? >> objection, calls for speculation. >> overruled, you can give an opinion. >> well, just prior to that point i heard one of the

officers actually ask -- actually on two occasions, if mr. floyd should be turned on to his side and the response was no, just leave him. and once the officer announced that he did not have a pulse anymore, i think he actually said he does not have one was the exact words, at that point the immediate response would then be to not only relieve him of the restraint, but at that point now you've got to start cpr, you've got to start immediate chest compressions because we know that if you can get to a patient right away, even when they've lost their pulse, even when they've gone into cardiopulmonary arrest there is a significant opportunity to save a life. but for every minute that transpires that you are not performing the basic life support and cpr measures, the

literature would suggest in approximately 10% to 15% less chance of survival. it is why we pour so many resources these days into a community education and training for bystander cpr because it's so effective, and it works if the person can be tended to quickly enough. >> then from your review of the video when you could see mr. floyd and mr. chauvin there on the ground, if mr. chauvin knew cpr, did you see any reason from your observation that he could not have supplied cpr? >> objection calls for speculation. >> not within a medical opinion so that is sustained. >> smi'm sorry, your honor? >> sustained. >> all right. >> it's not a medical opinion,

counsel. >> so at the time then that mr. floyd was actually put into the ambulance from the scene in your opinion as a cardiologist what would have been the prospects of resuscitating him at that point? >> objection, calls for speculation. >> overruled, you may give an opinion if you have one. >> so at that point i think the chance of meaningful survival unfortunately was very low because i count the number of minutes that he was on the ground pulseless without any cpr, and by the time the paramedics rushed in to get him onto the stretcher into the back of the ambulance, at that point a lot of time had passed. i give tremendous credit to the efforts of the paramedics and the doctors and nurses in the emergency room. i mean, they worked on foreign

minister -- him for what seemed -- >> objection, nonresponsive. >> sustained. >> do you have an opinion to a reasonable degree of medical certainty as to whether mr. floyd would have lived if not for the 9:29 of subdual and restraint? objection. >> overruled, if you have an opinion. >> let me finish my question for you, dr. rich. do you have an opinion as to whether george floyd one of lived in not for mr. chauvin's subdual and restraint of him for 9:29 on the ground? >> same objection. >> overruled. you may give an opinion if you have one to a reasonable degree of medical certainty. >> yes, i believe he would have lived. >> last question, dr. rich. do you have an opinion as to whether a completely healthy george floyd, that is any healthy human being would have survived the subdual and

restraint that -- on may 25th of 2020. >> objection, calls for speculation. >> sustained as to irrelevant as to a general person. >> i'm sorry, your honor, i couldn't hear you. >> sustained. >> my question, dr. rich, if any person, a healthy person, had survived the circumstances of conditions that george floyd underwent during the 9:29 on may 25th of last year -- >> same objection. >> sustained. >> no further questions, dr. rich. >> members of the jury, let's take our 20-minute mid-morning recess, come back at 11:25, thank you. hello to our viewers in the united states and around the world, i'm john king in washington, you heard the trial of former police officer derek chauvin charged in the death back in may of george floyd. we're standing by for another law enforcement event, this in a suburb outside of minneapolis

where a young black man was shot and killed yesterday in a police event. we're waiting for the police department to explain that shooting as well. we'll take you there as soon as that event happens. but let me bring in on the important testimony this morning our cnn legal analyst laura coates and former philadelphia police commissioner charles ramsey. laura, it has been dr. jonathan rich testifying for the prosecution this morning, he's a cardiologist, he reviewed the records in the george floyd case, both the medical records and the videos. he's the 36th prosecution witness and they are trying to cement in the jury's mind that george floyd died because of officer chauvin's conduct, not because of anything else. >> absolutely. the headline is his statement he believes that mr. george floyd's death was absolutely preventable and they actually outline the different ways of doing so, the idea of not having the restraint at all. repositioning his body to allow him to be able to breathe. to render cpr once a pulse was

detected as a way of trying to, even when somebody's pulse is not there, that the survival rates can be higher if you administer it, referencing bystanders' ability to render cpr, all of this was the context of building off of witness after witness, going back to the bystander of the off duty minneapolis firefighter wanting to provide aid, the way she articulated all of the things she would have done. the pulmonologist, the cardiopulmonary arrest, where heart and lungs stopped. the forensic pathologist who testified why she would not have concluded a drug overdose, and the medical examiner talking about the enlarged heart. he gave great context to talk about how the enlarged heart didn't make him more vulnerable, it showed an even stronger heart, perhaps, to respond to a higher blood pressure, responded how you'd want it to. and finally going through methodically, john, even the past hospital admissions or e.r. physicals that this person had,

george floyd, to talk about how at no point over the course of his life and interacting with medical professionals that he had some abnormality with his heart, this was so holistic to remind the juror on monday what they heard last week. >> that part, chief, is very important, laura coates as a prosecutor understands the sequencing of events and your jury has been gone a couple of days, some of this testimony is redundant, other experts have testified to these facts but the prosecution starting the final couple days of its presentation of the case and then the defense gets its charge wants to remind this jury from its perspective what this is about. >> well, you know, the prosecution over the past two weeks has really developed a lot of momentum, and he's continuing that this monday so i think having a witness like dr. rich, who is very good, and again my hats off to mr. blackwell, the

way in which he walks the doctor through the testimony in a way in which is very understandable to everyone who is listening, in particular the jury, i think it was the right thing to do to start off this week with a strong witness like dr. rich, to talk about this particular case from the standpoint of whether or not his heart or drugs could have caused his death, which is obviously where the defense is going to go once they begin presenting their case. >> and let's listen to a little bit of dr. rich, laura, you make the important point where we are in the presentation of the case. the jury has just had the weekend off, and so we've heard the defense, mr. nelson, trying to make the argument, well, george floyd was high, he was under the influence of something on the scene, they brought up on occasion that perhaps he had a weakness if his heart, they are trying to stir up, could have been this, could have been that, dr. rich on the stand under prosecution testimony says no, i don't believe so.

listen. >> george floyd died from a cardiopulmonary arrest, it was caused by low oxygen levels, and those low oxygen levels were induced by the prone restraint and positional asphyxiation he was subjected to. after reviewing all of the facts and evidence of the case, i can state with a high degree of medical certainty that george floyd did not die from a primary cardiac event and he did not die from a drug overdose. >> give us more, laura, on the point you were making earlier about the prosecution's strategy here. there was a pre-trial before the jury was in the room about the defense is beginning to argue some of these witnesses are redundant, some of these witnesses are cumulative. why can't we move on? but the prosecution believes it's critical to hammer this home. >> anytime the defense is playing please move on it's an indication the prosecution is scoring extraordinary points and that everything is being underscored. having said that the judge has admonished in the past about the

cumulative discussions with law enforcement about the redundancy of use of force. remember, this is a separate medical expert with a different specialty, you've heard from a pulmonologist, not the same a cardiologist, talked to a forensic pathologist. but remember, what this says to me is this. we can go all the way back to the first week and the testimony of the cup foods employee as we watch that in store surveillance video, john, watching george floyd walking around, watching him do different stretches, leaning his body, having conversations, add to that what we already saw from the video evidence here and what the emt did not relay to the emergency room doctor, and you've got the cardiologist now saying, look, this is not what a fentanyl opioid overdose looks like. he describes what that looks like, and many people across the country may have opioid familiarity of people in their lives who have heard generally about it but you have someone saying you have to have clinical

signs of extraordinary lethargy, the idea of almost being unarousable, not being able to speak or slurred speech. the inability to stand or walk normally and have extraordinary dizziness. we, as the audience and the jury of the court of public opinion, and the jury in that classroom, courtroom, are remembering, none of those things existed while we were watching george floyd in the cup foods. those did not exist while we saw him interact with the officers, and so he brings home the point to essentially round the bases, so to speak, to suggest, look, everything you're learning about from heart conditions, lung conditions, how about the drug aspect of it? this is not what you would expect to see of somebody who had a fentanyl overdose. that's why this witness is not redundant for that reason. >> and chief, there is a -- >> can i -- >> jump in, for sure. >> one point i think he made that i thought was important, he dealt with this whole issue of an enlarged heart. i think that was very important, explaining very clearly what

that really means and that, by itself, would not have caused him to pass away. >> we are, i'll ask you both quickly on this point, moments away from hearing from the police in a little town called brooklyn center, a suburb of minneapolis, ten miles away from where officer derek chauvin is on trial right now. a young man was shot and killed yesterday, he was pulled over by police, he had outstanding warrants, tried to flee the scene. we're going to get more details on that but it came up in the morning meeting between the judge and the attorneys in the derek chauvin case because eric nelson believes given there was civil unrest, some protests and looting he believes the jury should now be sequestered. he believes they might be influenced. listen to the argument he made to the judge this morning. >> this incident, while it is -- i understand it's not this case, i understand that it is not involved -- that it does not involve these same parties, but the problem is, is that the emotional response that that

case creates sets the stage for a jury to say i'm not going to vote not guilty because i'm concerned about the outcome. i think the jury should have been sequestered throughout the pendency of this trial and i think that the jury needs to be cautioned at the beginning of every day and at the end of every day to avoid all media. >> the judge, laura coates, denied that request, said he would keep an eye on the jury and keep track of things but he did not believe it was necessary also he did say once you get into the jury deliberations the jury would be sequestered at that point. number one, your take on that ruling and number two, the prosecutor, the defense attorney or the judge, having to deal with a big event like this, a similar related event, something that could stoke emotions, intentions, because of the sources of the issues at play in the trial here. >> well, i think the judge made the right decision here but the defense attorney is trying to preserve his rights on appeal to suggest if there were convictions that there were

external forces and the judge's inability to rule properly made his client biased and prejudiced in the jury's eyes. but the idea of there being a shooting last night, and i used the word shooting, it is distinctly factually different from what we're seeing with what happened with george floyd, we don't know all the facts right now, whether it's fully analogous or not, but the mechanism of death being different makes this judge's decision correct. unfortunately in this country officer involved shootings are quite frequent. i would suspect there's been other instances of officer involved shootings or officer involved deaths of civilians, even since the trial began. it is the judge to stop and sequester the jury because they might hear about cases as well? you have this issue here, the jury's minds and memory is quite enlarged here because all of last summer it was minneapolis and other cities that also had the protests, they had those who hijacked the protests and began looting and engaged in criminal behavior but you also had

protests that were derived from what actually happened to george floyd. the jurors have had to answer questions about their views, already contemplated this in the voir dire period so the question is not whether they know nothing about officer-involved shootings or deaths in this country, it's about whether they can be impartial here, and this judge, the defense counsel, and the prosecution, all agreed that this jury could. >> we'll continue to watch as that plays out. laura coates and chief ramsey, staying with us, the chauvin trial resumes any minute now. and we're waiting for a live press conference with the police in brooklyn center, minnesota, a suburb of minneapolis, about what we're discussing, the officer involved shooting death of a 20-year-old dante wright yesterday, and the biden covid relief team touting a record pace of vaccinations. the world health organization says it's now concerned about the growing case count worldwide. >> seventh week in a row we've had more than 4.4 million new cases reported in the last week. if you compare that to a year ago we had about 500,000 cases

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we're standing by for a police conference in minnesota. a black man yesterday sparked protests last night, dante wright died after being shot by police after a traffic stop yesterday, ten miles away from minneapolis in the trial where derek chauvin is right now on trial. the minnesota national guard was deployed after hundreds gathered to protest. d dante wright's mother says her son called her as he was being pulled over. >> he said he was getting pulled over by the police. and i said why did you get pulled over. they said he got pulled over because he had air fresheners from the rearview mirror. his girlfriend answered and said

he'd been shot. >> adrian broad des is there. >> reporter: we are at the brooklyn center police department. the press conference scheduled to start at noon. there's a little bit of a delay because they're still waiting on others to arrive here. i did speak with some community activists a short time ago who told me they were in meetings at city hall. it's unclear who they are meeting with and the big question this morning is what led to this incident. there's been a lot of outrage and fraustration here in brookln center. continuing to grow. outside of the police station where i am now there's a small group of protesters, some engaging with officers. but i'll say the officers are just holding their line, not saying anything back. this after that officer-involved shooting left 20-year-old dante

wright dead following a traffic stop on sunday. police have told us so far they were attempting to arrest wright after determining he had outstanding warrants and he got back into his car. i spoke with dante's older brother this morning and his brother told me he believed, his words not mine, but he believes his brother didn't know he had these warrants, or warrant. we will ask police about that in the coming moments once this news conference gets under way. but john, here in brooklyn center it's the part of the twin cities, there's physical damage following the looting overnight. stores have been destroyed. i talked to the owner of the local jimmy john's here and he said here we go again, i dealt with this this summer following the protests of george floyd. at his other location. pair wed that physical damage, there's also emotional damage as

people here are hurting and they are on edge. john? >> adrienne, thank you. a quick break for us as we're waiting for the derek chauvin trial to resume. that will come any minute now. new big headlines in the covid fight. michigan has a surge in cases. it wants the biden administration to send in more vaccines, the white house, though, says that's not smart policy.

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now, dr. jonathan rich on the trial of derek chauvin. >> the vast majority of the patients that you treat are in a clinical setting. correct? >> correct. >> meaning they're alive generally when they see you? >> yes. >> all right. can we agree that it is a pretty common occurrence that people die who have arteries that are 90% blocked? >> no, sir. well, everyone dies eventually, but not from the 90% blockage. >> people die every day who have a 90% blockage. >> people die every day from heart attacks. >> well, there's a difference between a heart attack and heart failure. right? >> heart attack and heart failure, you are correct, are completely different terms. >> so people who have a 90%

blockage may have a cardiac event and may die? >> as a hypothetical? >> yes. >> hypothetically, there are undoubtedly people who have died from coronary events with 90% blockages or without blockages. >> okay. and people may not experience pain as a result of an arrhythmia? >> correct. >> and times people have a 90% blockage of the right coronary artery and a 75% blockage of the left an tieterior descending ar, and they die, right. >> again, this is hypothetical, not this case. >> exactly. >> in a hypothetical, any extent of coronary artery disease could potentially die. >> sure.

and again, they may have no pain associated with a fatal arrhythmia, right? >> fatal arrhythmia is often not associated with pain. >> you would agree mr. floyd had coronary artery disease. >> absolutely. >> how is that normally, in a living person, how is that normally diagnosed? >> so usually the patient has symptoms. so they will have chest pain. or they're exercising, if you're an active person, you shouldn't have chest pain and if you come to the doctor and say something's not right. every time i try to exert myself, boy it feels like the elephant on the chest is the classic description. so that would be one of many possible ways that you would diagnose coronary artery disease in someone who's alive. >> may also do a stress test?

>> sometimes. >> a blocked right coronary artery that can contribute to a fatal arrhythmia? >> anyone can have a fatal arrhythmia with or without coronary artery disease. >> and so if a blood vessel is blocked and blood is not getting through that vessel, what happens? >> well, it depends. but i'd like to answer that for you. so in the case of mr. floyd what has most likely happened, based on our understanding of coronary physiology, is precisely because he had a narrowing of up to 90%, and it had calcium in it. we know that that developed gradually. and the heart is fascinating in what it does. it develops what's called coronary collaterals, which

means the body makes additional blood vessels so that if there's one artery that's narrow it recruits and builds many more blood vessels to supply bachelor's deg the heart. it's why you're more likely to have a heart attack if you started with a lesser narrowed artery if the black ruptured and blocked the vessel than if you started with a more severe narrowing because of all these unbelievable coronary collaterals, and adaptive responses that the heart does when that happens. >> what is a safe dose of methamphetamine? >> prescribed? >> illicit. >> i would never consider any illicit drug to be -- off street that's not prescribed by a physician to be safe. >> and methamphetamine is a vaso constrictor, correct?

>> it often does that. >> it constricts the blood vessels more. >> correct, that's what vaso constriction means, narrows them down more. >> you understand based on medical records that there's prior evidence of methamphetamine use by mr. floyd? >> yes, sir. >> and methamphetamine can cause some changes to the heart in and of itself. correct? >> correct. >> in fact it sort of ages the heart more, right? >> i've never used that terminology. >> how would you -- what does it do to the heart over prolonged use. >> every case is different and it depends what we mean by prolonged use. so one day, one week, 25 years, like most things, if you use something for -- if you smoke cigarettes for 50 years, you're going to have more problems than if you smoked a cigarette or a

pack every once in a while. >> in terms of what does -- what does methamphetamine do to the heart itself? >> so methamphetamine, if used over a long period of time can sometimes contribute to the development of coronary artery disease as we've been discussing. it can constrict blood vessels as you mentioned. it can have kind of a host of different effects on various parts of the body, including the heart. >> and there's lots of things that can make the heart work harder and faster, right? >> sure. >> i mean, methamphetamine being one of them? >> yes. >> vigorous activity being one of them? >> sure. >> adrenaline? >> yeah, i mean, we all right now have a lot of adrenaline flowing through our system, adrenaline is needed for life, for sure. >> increases in adrenaline can

cause the heart to work harder and faster? >> yeah. so adrenaline, which is the lay term for k -- that's the purpose of adrenaline is to pump more blood. when we exercise, that's the purpose is to run and jump and we ask the heart to allow us to do that, correct. >> have you worked with someone who has a -- >> i've had a couple of patients who have had fyocromocytomas. >> in the hip area generally. >> no, generally near the adrenal gland which is sort of near the kidneys. but they can sometimes pop up in different places. >> how are they typically identified? >> it depends. if it was clinically pertinent, that's how i diagnosed the ones that i've had, the classic findings are the person who's

saying i'm always having headaches, what is with these headaches? i'm always sweating. why am i always sweating? you start to say i wonder if something is releasing a hormone that can be contributing to that. other times, like in my opinion the case here with mr. floyd, you'll pick them up incidentally, say at an autopsy. >> they're also often identified because a person contributes to high blood pressure. >> it can, right. >> you have agreed that you've reviewed the medical records of mr. floyd. >> correct. >> he has a significant history of extremely elevated blood pressures. right? >> yes. >> i think the one you referenced, that the top number was over 200. >> yeah, on more than one occasion. >> on more than one occasion and a lower number of the blood pressure was likewise elevated, right? >> yes.

>> did you observe evidence in the medical records that mr. floyd was taking prescribed medications to control his blood pressure? >> i saw in the records during an emergency room visit that he was prescribed high blood pressure medication. what i could not see is whether he was taking them or not. but it did look like at one point there was a precipitation given to him, i think one of them was for a calcium channel blocker and one of them was for, i think -- >> the records you have for mr. floyd were relatively limited, agreed, they weren't his entire life medical records? >> i don't know when he started to see medical professionals, so for all i know the first instance in the records that i

saw was the first time he started to see medical professionals. i'm not sure. >> so how many years of past medical records did you review? >> i believe three or so, beginning of 2018 is when i think they started. >> are paragangliomas ever removed from a person? >> if they're causing the symptoms i mentioned, the headaches, the sweating, et cetera, a surgeon would sometimes remove them. >> would you prescribe an amphetamine for somebody who has a 90% blockage of the right coronary artery and a 75% blockage of the left anterior descending artery? >> first off, i don't typically prescribe amphetamines. i have many patients who have

coronary artery disease that are on stimulants, okay. for a variety of medical conditions. so i just don't prescribe them but i do have many patients with coronary disease who are on stimulants. >> would you recommend to someone that they use methamphetamines with that degree of coronary artery disease? >> i would never recommend that anybody take methamphetamine off the street for any reason. >> are you aware of the research showing that deaths where both methamphetamine and fentanyl are found that occurs at a much higher incidence? >> can you repeat the question? >> are you aware the research has demonstrated that deaths of those who use methamphetamine and fentanyl have been notably higher than meth or fentanyl

alone, a combination. >> objection, your honor, for lack of foundation. assuming facts. >> assuming facts, that is overruled. as assuming -- is it the scope of his foundation? the state did ask him for toxicology opinions. >> reference to medical articles, none of which anybody has seen, is simply counsel's reference, your honor. >> overruled. you may answer if you know. >> okay. i am not familiar with the breadth of the literature looking at all of the different combination of drugs and which combination worsens or improves survival. >> you testified that mr. floyd, based on your review of the video, did start complaining of shortness of breath prior to being placed in the prone position. >> yes, i heard on more than one occasion he'd say the words i

can't breathe. >> and if mr. floyd had simply gotten in the backseat of the squad car do you think he would have survived sh. >> objection, your honor, not calling for medical testimony. >> if you have a medical opinion as to that. overruled to that extent. >> so had he not been restrained in the way in which he was, i think he would have survived that day. i think he would have gone home or wherever he was going to go had he not been subjected to the prone positional restraint that he was. >> so in other words if he had gotten in the squad car he'd be alive? >> i think my answer remains the same. anything other than that scenario he was subjected to i have no reason to think from a medical perspective he would not have survived that day, correct. >> and in terms of the prone

position you would agree that the prone position is not in and of itself inherently dangerous? >> in an ordinary individual, if we were to take away everything else that was going on, and we -- and someone was just simply lying in the prone position, while there are many patients who that would be inherently dangerous, the average individual i would agree with you probably just lying flat in that situation generally wouldn't be dangerous. >> even in the icu there are circumstances where people have serious medical conditions where they're maintained in the prone position. agreed? >> in the icu, when patients are put into the prone position, it is when it is a desperate attempt to save someone's life where their lungs have actually developed what we call acute respiratory distress syndrome or ards, they have a ventilator in

to make sure that the amount of air that they get, no matter their positioning, will always be enough. and so it's a funny thing to think about putting someone in the prone positioning in the icu on a respirator but because of the respiratory physiology sometimes that will actually help open up certain segments of the lungs that are needed for oxygenation but it's really important to keep in mind that they are on a respirator every single time to open up those lung airways and they're usually on sedation as well to keep them comfortable. >> and my last question, doctor, is after someone's heart stops is it possible that they continue to respire? >> it is -- well, i'm not sure i could answer that with certainty other than to say there are these things that are called

agonal breaths. when i'm in the intensive care unit with a patient who is dying and they go into cardiac arrest once in a while you will see them take one or two extra breaths. i'm not sure the exact mechanism or the fphysiologic trigger for that so you could potentially see extra breaths for a short period of time. >> by short period of time, up to a minute? >> in my experience, if the heart has completely stopped, i would not expect to see the breathing continue for up to a minute but i might expect it to be seen for several seconds. >> no further questions, your honor. >> any redirect? >> thank you, your honor. dr. rich, you were asked several

questions that had to do -- or at least had as a premise the blockage of mr. floyd's arteries. is blockage a proper medical term to you as a cardiologist to describe the narrowing in mr. floyd's arteries? >> so when we try to use terminology that's not medical terminology, to explain these phenomenon, the term blockage i tend to use when the blood vessel is completely blocked. there's a blockage. i will usually describe if i have a patient like mr. floyd who has coronary artery disease like this i will usually use the term narrowings. the blood is still getting through. in fact, the blood may be getting through just fine. there is no level of narrowing, in fact, even a totally blocked artery, this is what's fascinating, that develops over

time, the territory of blood that that blood vessel was supposed to supply can still be getting enough blood because of those collateral vessels that develop. so i would use the term with mr. floyd as narrowings. >> you were asked questions again about paragangliomas and i think you told us that those are usually preceded by headaches. >> classically correct. >> one of the symptoms. >> yes. >> did you hear amongst the complaints mr. floyd had about pain, did you hear any of them being a headache? >> no, in fact, when i saw that there was a paraganglioma described as an incidental finding, when i went into the medical records i used the control "f" button to put in

haec to make sure i didn't find that. i didn't find headaches at any point. >> when you referenced this being an incidental finding on the autopsy would you tell the jury what's meant by incidental? >> sure. all of us have things in our bodies that aren't causing any medical problems but if they're discovered let's say someone gets a cat scan for one reason they might find that there's a cyst on the kidney or the liver, sometimes we'll even pick up benign tumors. so we refer to those as incidental findings. in fact, in the case of paraganglioma, the name you would call it is an incidental loma because we don't think it has clinical relevance but it was found and described in the imaging or in this case the autopsy. >> are you familiar with any of the data as to how many people in the united states have ever died as a paraganglioma as the

principle primary reason for death? >> to be honest i don't know the exact numbers. i just know that they are variable. >> now, you were asked questions about high blood pressure, the role or impact of methamphetamine, paraganglioma, narrowing arteries. can any of those things in, of and by themselves cause someone to die without first entering the heart? >> can you repeat the question? >> yes. what i'm trying to get at, whether we talk about high blood pressure, methamphetamine, paraganglioma and the impact on the adrenals, narrowing of the arteries, can any of those things by themselves cause a person to die without first impacting the stoppage of the heart? >> well, the reason i asked you to ask the question again is i want to make sure i'm precise and clear here.

high blood pressure can cause death in manners outside of the heart, for example, it can contribute to a stroke. which we know mr. floyd didn't have. and the other thing that can happen is an aortic dissection, i want to make absolutely clear these conditions can cause death on occasion in areas not involving the heart, but most of the time if death is going to occur by them, it's going to be caused because of their impact on the heart. >> and did mr. floyd have an aortic dissection? >> he absolutely did not based on the review of the autopsy. >> did not have a stroke. >> he did not have a stroke. >> to be clear for the jury with all of the discussion about the narrowing of arteries, meth, et cetera, was there any damage at all observed to mr. floyd's heart muscle?

>> based on my review of all the evidence, the ekgs, the autopsy report, i found absolutely no evidence at all of heart damage in mr. floyd's heart. >> thank you, dr. rich. >> sure. >> any recross? >> no further questions, -- on question. on redirect you were asked about the various high blood pressure, if any of those can cause death independently and you answered relevant to the high blood pressure, right, but you would agree that when you combine -- you would agree that the body is -- a lot of things are happening at the same time. right? >> yeah. >> and in combination, if you have a paraganglioma, an increase in the fight or flight

kind of response, you've got coronary heart disease, you've got high blood pressure, all of those things combined could cause death even if there was not a physical restraint? >> well, there's -- his paraganglioma, the likely hood that that was releasing any hormone is highly unlikely. >> but in terms of the combination, the drugs, every -- the high blood pressure, the -- take the paraganglioma out of it, the increase in adrenaline from a struggle with officers, all of those things combined together, even in the absence of a prone restraint, could have resulted in death, yes or no, sir? >> upon my review of the evidence and the facts of the case, i found no evidence to support that. >> fair enough. thank you. >> thank you, doctor. >> thank you. >> you are excused. >> thank you.

and we have our next witness is at 1:30. >> we have two witnesses for this afternoon. members of the jury. and counsel and i have to finish up some legal issues at 1:00. we're going to break until 1:30. have a good lunch. >> the judge is calling a break in the trial of former police officer derek chauvin, on trial in the death of george floyd. you heard dr. jonathan rich, the cardiologist. there was redirect at the end there. let's bring in laura coates, chief charles ramsey is with us as well. former chief of the d.c. police department. laura, you mentioned this earlier during the one of the breaks the idea that as we start the third week of testimony on this monday, very important for the prosecution not only to continue with this case but in some ways to recap its case. >> it's so important. you want to be building up consistently.

remember the theories of primacy and recentsy. bury the bad facts in the middle. . remember, this witness is meant to build off of the testimony of not just the off duty firefighter, a bystander who wanted to render aid and cpr, it builds off the pulmonologist and the idea of a cardio pulmonary arrest, the heart and lung stops, the forensic pathologist, talking about why she would not have put asphyxia on there. and why the size of george floyd's heart would have impact or not at all because of the restraint rendered by the police officers. there was a key moment here to pay attention to. it was the moment when the defense counsel asked the cardiologist that if -- what was the question? it's like what happened with the forensic pathologist last week, the idea of trying to pose a

hypothetical response that took away all of the facts and made it more generic and not key to this one. this time he asked had george floyd gotten in the squad car, he'd still be alive today? and i had to cock my head at the moment, are you telling the jury that but for the police officer's strestraint and condu, he would be alive? it shifts the focus onto george floyd's purported noncompliance at a time when force was not administered yet. as a defense counsel, you're trying to score points to undermine the testimony that's very, very good. at the same time you end up inviting the jurors to ask the question, well, isn't that why we're here? because there was police encounter, because they actually did the wrong thing. isn't that why we're here? >> it's an interesting point, chief, one of the things we know the defense counsel is trying to do is stir up some doubt here

and mr. nelson tries to do that at every turn. could have been this, could have been that. there was a crowd, george floyd was on drugs. one of the things i know you've been impressed with, you share that in the case of dr. rich, we're dealing with highly technical medical terms in many cases as they go through the autopsy report and talk about how the heart is constructed, the prosecution has done at least up to this point coming into this week, by the account of both of you, a very good job of making it english, if you will, making it presenceable and acceptable and language the jury can understand, are we still on that path? >> yeah, i think so. mr. blackwell has been very good at asking very clear questions that aren't complicated, and eliciting the kind of response that you would need to have. it's very understandable. he's done that throughout the interviews of the various technical witnesses, and i'm very impressed with it because i think it just adds to the strength of the case. this is incredibly powerful and i didn't see anything in

cross-examination that really, you know, damaged any of the testimony that was given by dr. rich. i mean, i don't think the defense was able to poke any holes in it at all. so i really do think that the prosecution at this point is doing a very, very good job of presenting their case in a very understandable way. not only for the jury but for all of us that are watching. >> and it's very important on this monday as laura noted. >> john, if i could say this part, as if -- remember, before we were talking about heart stop, lung stop. as prosecutors we never use a $10 word where a quarter will do. when you have the jury to have to write out things like para ganglioma, you're losing the case. you've got very clear english words, short and to the point. once you launch into paraganglioma and think of that

as an distraction, you are undermining the clarity the jurors need to understand this case. >> appreciate your time. we're standing by for another press conference in a neighboring suburb where there was a police shooting last night. quick break. ana cabrera picks up our coverage in just a moment. professional show you how... this is what an annuity can do.

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these are all great. and when you get a big deal... you feel like a big deal. ♪ priceline. every trip is a big deal. do you have a life insurance policy you no longer need? now you can sell your policy, even a term policy, for an immediate cash payment. we thought we had planned carefully for our hello, i'm ana cabrera, thank you for being with us. we're listening live to a press conference out of minneapolis, minnesota, another person was involved in an officer-involved shooting and car crash that turned deadly. let's listen in to the mayor. >> several blocks before striking another vehicle. the brooklyn center police officers who were present at the scene and who were attempting to apprehend the driver didn't respond with an attempt at

saving the young man's life. however, the young man died at the scene. our brooklyn center officers do wear body cams, and so there is body camera footage of the event. and we do plan on releasing the body camera footage today. in fact, we plan to do so here. but, you know, i want to say that our hearts are aching right now. we are in pain right now. and we recognize that this couldn't have happened at a worse time. we recognize that this is happening at a time when our community, when all of america, indeed all of the world is

watching our community, that we are all collectively devastated. and we have been for over a year now by the killing of george floyd and that we continue to be distressed as we go through the derek chauvin trial. so having a police-involved shooting happen in our community, and killing a young man, is heartbreaking and just unfathomable. so our entire community is filled with grief at yesterday's police-involved shooting that led to the killing of dante wright, a 20-year-old young african-american male. and my heart goes out to dante's family and to all those who were impacted by this tragedy in our comm