it seems like we always have a long way to go. but also today we are taking steps to confront not just the gun crisis but what is actually a public health crisis. nothing i am about to recommend in any way impinges on the second amendment. these are phony arguments suggesting these are second amendment rights at stake. no amendment to the constitution is absolute. you can't yell fire in a crowded movie theater and call it freedom of speech. from the very beginning certain people weren't allowed to have weapons. the idea is just bizarre to suggest that some of the things we are recommending are contrary to the constitution. gun violence in this country is an epidemic. gun violence in this country is an epidemic and an international

embarrassment. we saw it again last night as i was coming to the oval office. i got the word that in south carolina a physician with his wife, two grandchildren, and a person working at his house was gunned down, all five. so many people, so many of the people sitting here today know that well, unfortunately. they know what it's like when the seconds change your life forever. i have had the pleasure of getting to meet in awful circumstances many of you who have lost your children, husbands, wives. they know what it's like to bury a piece of their soul deep in the earth. we understand that.

mark and jackie, i want to tell you, it's always good to see you, but not under these circumstances. i want to say before i introduce the rest of the folks, you know what a lot of people have not been through what they have been through don't understand it takes a lot of courage to come to an event like this. they are absolutely determined to make change. but mark and jackie whose son daniel was a first grader at sandy hook elementary, daniel loved sports, loved being outdoors getting muddy. my friend, his daughter was a freshman who was an accomplished dancer. i see brandon wolf at the impulse nightclub.

he survived but his two best friends died. greg jackson who was just walking down the street when he was caught in the crossfire of a gun fight. and i see a close friend of jill's and mine, congresswoman gabby gifford who was speaking with her constituents in front of a grocery store in her state when she was shot and a member of her staff was killed. they are here and their pain is immense. you know what a lot of you -- hopefully many of you don't know, you have gone through a trauma, no matter how much you work to make sure others don't go through it, every time you show up at an event like this, it brings back the phone call, the immediacy of what happened at that moment. i genuinely mean it, thank you for having the courage, the

courage to be here, the courage to continue this fight. senator blumenthal understands it. a lot of folks understand it. it takes real courage, so thank you. to turn pain into purpose and demand we take action that gives meaning to the word enough. enough, enough, enough. because what they want you to know, what they want you to do is not just listen. every day in this country 316 people are shot every single day. 106 of them die every day. our flag was still flying at half-staff for the victims of a horrific murder of eight primarily asian americans in georgia when ten more lives were taken in a mass murder in colorado. you probably didn't hear, but

between those two incidents less than one week apart, there were more than 850 additional shootings. 850 that took the lives of more than 250 people. and left 500 injured. this is an epidemic and it has to stop. so i am here to talk about two things. first, the steps we are going to take immediately. and second, the action that needs to be taken going forward to curb the epidemic of gun violence. i asked the attorney general and his team to identify for me immediate concrete actions i could take now without having to go through the congress. and today i'm announcing several initial steps my administration is taking to curb this epidemic of gun violence. much more needs to be done. but first we want to rein the

proliferation of ghost guns. these are homemade, built from a kit and include directions how to finish a firearm. you can go buy the kit. they have no serial numbers so when they show up at a crime scene they can't be traced. and buyers aren't required to pass background checks to buy the kits to make the gun. anyone from a criminal to a terrorist can buy this kit and in as little as 30 minutes put together a weapon. i want to see thinks kits treated as firearms under the gun control act which will require that sellers and manufacturers make the key parts with serial numbers and run background checks on the buyers when they walk in to buy that package. the second action, back in the year 2000, the atf released

its report on firearms trafficking in america. it was of pivotal value, an important tool for policymakers when i was in the senate and beyond at all levels to stop firearms from being diverted into dangerous hands. today with online sales and ghost guns, times have changed and we have to adjust. we also have to ask the justice department to release a new annual report. this report will better help policymakers address firearms trafficking as of today, not what it was yesterday. the third change. we want to treat pistols modified with stabilizing braces with the seriousness they deserve. that essentially makes it a hell

of a lot more accurate than a minirifle. it is more lethal effectively turning it into a rifle. that's what the shooter in boulder appears to have done. these firearms that make them more lethal should be subject to the national firearms act. it requires that an owner pay $200 fee and submit their name to a justice department just as if they purchased a sciencer for a gun. fourthly, during my campaign as president i wanted to make it easier for states to adopt red flag laws, which every one here knows, but many do not. these laws allow police or family member to petition a court in their jurisdiction and

say i want you to temporarily remove from the following people any firearm they may possess because they are a danger in a crisis. they are presenting a danger to themselves and others. the court makes a ruling. to put this in perspective, more than half of all suicides involve the use of a firearm. but when a gun is not available, an attempt at suicide, the death rate drops precipitously. states that have red flag laws have seen a reduction in suicide in their states. every single month an average of 53 women are shot and killed by a partner. i wrote the violence against women act. it has been a constant struggle to keep it moving. we know red flag laws can help

for women against domestic violence. i'm proud, excuse the point of personal privilege as we used to say in senate, i'm glad that the law is named after our son bo biden. i want states to enact their own red flag laws. today i ask the justice department to publish a model red flag legislation so states can start cracking their own laws right now just like with background checks, most americans support these laws. it's time to put the laws on the

books and protect more people. the attorney general will have more to say about this. additionally, across the country there are historic highs in homicides. homicide is the leading cause of death of black boys and men ages 15 to 34, the leading cause of death. there are proven strategies that reduce gun violence in urban communities and programs that have demonstrated they can reduce homicides up to 60% in urban communities. but many of these have been badly underfunded or not funded at all. gun violence in america, from an economic standpoint, is estimated to cost the nation $280 billion a year. you say how could that be, joe?

>> hospital bills, physical therapy, trauma counseling, legal fees, prison costs and the loss of productivity. not to mention the psychological damage done to the children who live in these skis, watching it happen and knowing someone is happened it to. gun violence in our neighborhood has had a profound impact on our children, even if they are never involved in pulling the trigger or being a victim on the other side. for a fraction of the cost of gun violence we can save lives, save communities and build economies that work for all of us and save billions of american dollars. in the meantime much of it is taxpayer money.

finally, the bureau of alcohol, tobacco and firearms, hasn't had a permanent director since 2015. today i'm proud to nominate david chipman to serve as director of atf. he is the right person we believe for this agency. my job is to protect the american people. whether congress acts or not, i am going to use all of the resources of the president to keep american people safe from gun violence. but there is much more that congress can do to help that effort. and they can do it right now.

they have offered plenty of thoughts and prayers, members of congress, but they have passed not a single new law to reduce gun violence. enough prayers. time for some action. i believe the senate should immediately pass three house passed bills to close loopholes that allow gun purchasers to bypass the background checks. the vast majority of american people believe there should be background checks before you purchase a gun. as was noted earlier, hundreds of thousands of people have been denied guns because of background checks. what more would have happened? these bills, one, require background checks for anyone purchasing a gun at a gun show or an online sale. most people don't know when you

walk into a store and buy a gun, you have a background check. you go to a gun show you can buy whatever you want and no background check. second thing, close what is known as the charles loophole. i spent time down at that church in charleston. what happened is someone was allowed to get the gun used to kill the innocent people at the church service if the fbi doesn't complete the background check in three days. there is a process. if it isn't completed in three days, according to the charleston loophole, you get to buy the gun. he bought the gun and killed a lot of innocent people that invited him to pray with them.

three, close the boyfriend and stalking loopholes to keep guns out of the hands of people found by a court to be an abuser and continuing threat. i held over 1,000 hours of hearings, one thing came through. if in fact a stay away order, an order preventing the abuser from coming in a certain distance of the person he has abused or she has abused, and now the idea that they can own a weapon when they have a court order saying they are an abuser. these are some of the best tools we have right now to prevent gun violence and save lives.

all of these bills have had support of both democrats and republicans in the house. universal background checks are supported by the vast majority of people and i might add by the vast majority of responsible gun owners. this is not a partisan issue among the american people. this is the view by the american people as an american issue. i am willing to work with anyone to get these done. it's long pastime we act. this has been a hobby horse of mine for a long time. we should also ban assault weapons and high capacity weapons in this country. for that ten years we had it done, the number of mass shootings actually went down. even law enforcement officials have told me and other champions

of this legislation they sometimes feel outgunned by assault weapons with large capacity magazines. there is no reason someone needs a weapon with 100 rounds, 100 bullets, that can be fired from that weapon. nobody needs that. nobody needs that. we got that done when i was a united states senator. it wasn't easy going up against the gun lobbying, but it saved lives. we should also remove gun manufacturers from the i am -- immunity they received from congress. people here are knowledgeable in the rose garden. but most people don't realize that the only industry in america, a billion dollar industry, that is exempt from

being sued for gun manufacturers. imagine how different that would be had that same exemption been available to tobacco company who knew and lied about the danger they were causing, cancer causing to life. imagine where we would be. this is the only outfit exempt from being pursued. if i only get one thing on my list, the lord came down and said give me that one. i tell you what, there would be a come to the lord moment these folks would have real quickly. but they are not, they are not. they are exempt. i know that the conversation about guns in this country can be a difficult one. but even here there is much more common ground that anyone would believe. there is much more common ground. everything that's being proposed

today is totally consistent with the second amendment. and there is a wide consensus behind the need to take action. i know that when overwhelming majority of americans want to see something change and it still doesn't change, it can be demoralizing to our fellow citizens. it can feel like our entire political process is broken. i know it's painful and frustrating that we haven't made the progress we hoped for, but it took five years to get the brady bill passed and took more years to get the assault weapons ban. it saved lives. no matter how long it takes, we are going to get these passed. we are not going to give up. we have an opportunity to fulfill the first responsibility of government to keep people safe. and we can show the world and ourselves that democracy works. we can come together and get big

things done. when i look around and see such brave survivors sitting out here in the rose garden, public servants who devoted their lives to dealing with this, advocates who are pushing every day to make rational changes and courageous family members, i know it is possible. so, folks, this is just the start. we have a lot of work to do, but i know almost every one of you sitting in the garden here, none of you have ever given up. we are not going to give up now. the idea we have so many people dying every day from gun violence in america is a blemish on our nation. god bless you, but most importantly, the memory of all

who have been lost by senseless gun violence. now i would like to turn it over to the attorney general. i hope i get a chance to see some of you after it is over. thank you, thank you. [ applause ] >> thank you, mr. president and madam vice president. we stand here today not at a moment of tragedy but in the midst of an enduring tragedy. so far this year guns have taken the lives of an estimated 11,000 of our neighbors, friends and fellow americans. as the president explained, gun deaths in our country are occurring at a staggering pace, on the order of about 100

americans killed every day and hundreds more wounded. i am under no illusions about how hard it is to solve the problem of gun violence and i know that the department of justice alone cannot solve the problem. it is a problem that we must all work on together in a collective effort to keep guns out of the hands of criminals and saves lives, but there is work for the department to do, and we intend to do it. today the department of justice is announcing several steps that we will take to keep guns out of the hands of criminals and reduce the risk of gun violence. first, we will ensure that we understand and measure the problem of criminal gun trafficking in a data driven way. over 20 years ago atf undertook a gun trafficking study. it then issued a report that provided information necessary to better understand and to

combat criminal trafficking networks. no such study has been conducted since that time. accordingly, i have directed atf to begin work on an updated study of criminal trafficking that modern gusts are not just cast or forged, but can be made of plastic, printed on a 3-d printer or sold in assembly kits. we will use the ballistics network and tracing center in keeping up with the times. we will analyze what they can show us about modern gun trafficking patterns. we expect that the lessons from this study will help agents, prosecutors and policymakers

tackle modern criminal gun trafficking enterprises. second, we will close a regulatory loophole that has contributed to the proliferation of so-called ghost guns. manufacturers are required to mark all guns with serial numbers so they can be traced in crimes. it also requires background checks to ensure those who are not to purchase firearms cannot do so. currently individuals can buy kits that contain all or almost all of the parts they need to assemble a gun. they can put a working weapon together in as little as 30 minutes. the kits are aptly called

buy-build-shoot kits. yes because of a gap in the regulations, these kits may not be considered firearms. they are being made and sold without serial numbers and without background checks. within 30 days atf will issue a proposed rule to plug that gap and to enable law enforcement to keep guns from being sold to those who cannot possess them. third, we will make clear that statutory restrictions on short barreled rifles apply when certain stabilizing items are applied to pistols. it does so because these weapons are powerful yet easily concealable. currently some manufacturers

market and purchase certain stabilizing braces that when attached to a pistol effectively convert it into a short barrel rifle. a weapon that is in the words of the statute intended to be fired from the shoulder much such braces make them more stable and accurate while still concealable. within 60 days atf will issue a proposed rule that will make clear when a stabilizing device is added to a pistol to a barrel, it becomes subject of the statute. we will offer red flag. they are petitions for court

orderers that prevent people have having firearms if they are a danger to themselves or others. 19 states already have this. . >> /* it will be easier for states to do that in communities that wish to do so. fifth, we will combat gun violence. gun violence is not a problem that law enforcement alone can solve. [ applause ] communities are an essential partner, an asset and a source of resources and ideas. those who are closest to the

problem are a critical part of solving the problem. to that end, the justice department will make available over $1 billion in funding through over a dozen grant programs that can be used to support evidence based intervention strategies for reducing gun violence. [ applause ] >> such strategies include street outreach, hospital based violence intervention services. i have directed all of our grant make components to make community violence intervention and prevention a priority. finally, none of these measures or any of the other critical law enforcement work the department does with respect

to illegal guns can be done without strong leadership. that is why the president has nominated david chipman to be the next atf director. he has come up through the ranks fighting criminal gun trafficking and criminal enterprises. his extensive experience with the atf make him invaluable and i look forward to working with him. looking out at you is not only a reminder of the tragic toll gun violence takes on our community, but also of the resilience and determination that it will take to make our communities safer. the department of justice shares your commitment, that of the president and vice president to

stopping the plague of gun violence and saving the life of those we love. thank you. [ applause ] >> i wasn't supposed to do that. i like to see all of you. thank you, thank you, thank you. let's get to work. >> and good day. this is andrea mitchell reports in washington where president biden has just rolled out new executive actions on gun violence. the president while on the campaign trail promised legislation on gun safety on his first day in office, not the third month.

it is regulations on bracing used on the gun in the boulder shooting. joining me is monica alba, shannon watts, and former u.s. attorney and senior fbi official chuck rosenburg. >> how concerned is the white house about the stalemate in the senate over gun legislation? >> they are worried because they know, as the president himself said, it is priorities. although you can have them on parallel tracks, the president admits you have to do them in a broad sweeping way one at a time. even though he will be taking the executive actions within the context of his own executive

authority, i urges congress to act and do more, but he is keenly aware that is not likely to happen anytime soon. so his remarks in the rose garden were trying to convey to the american people that this was just a start on guns within what he can do and what the justice department can do. he would like congress to come together and do something, but he doesn't believe that is something that will take center stage as compared to, say, his infrastructure plan. the president spoke to this in personal terms, loss. many people hearing the speech have lost their own family members to gun violence. he spoke to that and his frustration that over the years they weren't able to get done.

it is notable he had the attorney general merrick garland there. he said this won't eradicate gun shootings. he said people need to come together and do an assault weapons ban and should pass these two house bills that would close the loophole and expand background checks to prevent gun violence that he called an epidemic politically and an international embarrassment. >> we saw briefly a picture of gabby gifford. others were there, but significantly was gabby gifford who was previously injured in that shooting in a supermarket. do you think this should have

happened sooner? sooner than day one. we are approaching the first 100 days and legislation is not sent to the hill. >> we are thrilled about what happened today. we applaud president biden for his strong leadership. grassroots volunteers have fought with lawmakers in washington for years and years and they ignored the fact that over 100 people are dying every single day in this country from gun violence. hundreds more are wounded. president biden made it clear those days are over. these executive actions will save lives. and as he said this is just the beginning of his plan to address gun violence. these beings as were needed and will save lives. we have to build on this momentum and pass other gun safety items through the senate.

>> gun violence reform was more popular than before. we saw nothing after sandy hook and year after year for president obama and vice president biden in tears literally after sandy hook. if you can't get meaningful action out of this congress after you have 20 children killed in their elementary school, what will it take? >> that is the central question when it comes to gun reform. i remember being a reporter and going to sandy hook, going to some of the funerals of some of those children, small, small caskets. it felt like the nation was going to change everything, that it was going to shift after 6-year-olds murdered by assault weapons. congress was not ever able to have a deal.

if there was no change after sandy hook, what can be done? you saw the vice president, president, attorney general, when talking about the need for gun reform, they were clear about the fact this is not an easy problem to fix. the president talked about the urgency of this. he said it is an international embarrassment, an epidemic. he said enough prayers, time to act, talked about the fact this is costing our country not just mental anguish, but also costing our nation actual dollars when it comes to prison fees. he gave congress a long list of things he would want them to do. we knew what the president would be doing today. legislatively i was asked the white house what does he want done. he wants the assault weapon

ban -- banned. he gave congress the ball. if republicans have any interest in gun reform, maybe things will change, but from my reporting, republicans are very wary about gun reform changes. >> you have a director of atf, but there hasn't been any one there in 2015. this isn't just a trump problem. he is a 25-year veteran, but has been pushed alongside gabby gifford with gun reform. >> he has a very good

reputation. these announcements tonight won't solve the problem. trying to close background loopholes on background checks. these are steps in the right direction, but it will not come solely from the federal government or atf. remember what shannon watts just said. more than 100 a day. that equates to 35 or 40,000 per year. that vast live understates the destruction and damage because of people who are injured and families who was lives are torn apart. this is an epidemic, public health issue, not just law enforcement. it's good to see the department of justice doing something from an executive action standpoint. we need congress. i doubt that we will see that. they haven't had the guts in the past and i doubt they will have

it now. >> shannon, i guess in your line of work you don't give up hope. i remember when the brady bill was signed by bill clinton and had the support of ronald reagan because of the attempt on his life. >> i want to go back to how much things have changed since 2013. i started and we fought for the background checks. we fell a few votes short. but we didn't give up. we pivoted to city halls and passed good laws in red states and blue states. we knew by creating a grass root movement, we would point congress in the right direction. that's what we are seeing today. those champions are leading the white house, senate, house.

i think what we learned is gun safety doesn't start in washington. it ends there. i'm truly hopeful that with the announcements today we are seeing real national change on this issue of gun safety. >> i think of the kids from parkland and the parents of so many. we are going to go back to the trial after a break. he has been testifying about how deadly the force was in choking. the key finding is when you

see his leg going up. keep in mind he's prone. this is his leg coming up backwards. that's what we call as clinicians an extension of the movement leg. that's when somebody suffers major brain lack of oxygen. it tells us what are sometimes called myoclonic seize yours or hypoxic seize yours. -- seizures. there are a lot of different words used, but it comes down to the same thing. that at that point the brain is responding to the drastically low level of oxygen that's

present. >> does the fact of an anoxic seizure indicate damage to the brain? >> severe damage to the brain. >> are the legs coming up an involuntary reaction? >> it's an involuntary action. the bottom line is that the leg jumps up like that as a result of a fatally level of oxygen going to the brain. >> doctor, we talked about the brain injury and you told us about low levels of oxygen potentially causing pulseless electrical activity? >> yes. >> is that also evidence of low oxygen? >> when you have a low level of oxygen, that's going to show up in the brain and also going to

show up in the heart. when it shows up in the heart, it's going to cause the heart to beat abnormally. and the particular way that it happened in mr. floyd was he developed a particular arrhythmia called pea which is pulses electrical activity, where we are seeing electricity in the heart, but it's not resulting in any mechanical force. that's why it has that name. so it's the low level of oxygen is producing both. we don't see the pea, the pulses of electrical activity arrhythmia showing up. here we are seeing huge evidence in terms of the leg. the leg is crucial here. this is the time that -- the

first time you are seeing there is major league oxygen damage. >> so we reach a point where mr. floyd couldn't speak due to low oxygen, was there any correlation to a narrowing of his airways that preventing him from speaking? >> yes, as well. >> i want to show you what is marked as exhibit 934, 936 and 933. just tell us what are these images in general? >> we are seeing again the same mri, but a different view of it than we looked at before. >> your honor, i offer exhibits 934,936 and 933. >> 934, 936 and 933 are received.

>> so doctor, tell us what we see here. >> this is the same mri that you saw before. but what your attention is drawn to by the yellow arrow is the vocal cords. that is simply how you speak. to speak you must inhale, take air into your lungs and when you let the air out you are going to vibrate those little vocal cords there and that's what makes the sound of speech. so here we see the size of the wind pipe, the trachea, and this becomes important in terms of speech. because of our knowledge about the influence of the size of the trachea, the wind pipe for speech is from patients to have an endotracheal tube in place

and develop scarring. as a result of the scarring we know what is the point, how much scarring in your wind pipe will prevent you from speaking. these are just the dimensions so you know the norm of size of the trachea. it's between a quarter and dime as you can see here, in terms of diameters. >> and the next slide. >> here is when those coins have been shrunk to 15%. even when the trachea has narrowed all of the way down to 15%, you are still able to speak. even when the hole through your windpipe is just this size as i have shown here where i have shown the size of the coins. you are still able to speak. that shows you how dangerous it is when you think if he can speak he is doing okay.

at this point you will be able to speak, but, again, if there is a small increase in the amount of narrowing here, not only will you not be able to speak, but you won't be able to breathe, won't be able to live. so it's a very dangerous thing to think that because you are able to speak that you are doing okay. >> doctor, you are not able to speak, breathe or live once the airway narrows to below 15%. >> correct. you go from 15% you will still be able to speak. then as it gets lower from that initially you will be struggling and then at some stage you won't be able to do anything. >> if we could show exhibit 940 that's already admitted. >> again, this is exactly -- this is the same experiment i showed you before. it just so happens this is pure

coincidence. it is at 85%. you are looking at the top curve. it is the same number we showed you on the mri. it's pure coincidence, but once you areup a at 85%, it is at 7.5% increase. as the narrowing gets further and further, it would become unbearable. it emphasizes at the point you can't speak and you are in deep trouble. >> doctor, i would like to transition from talking about the physiology of breathing to talk about your work as a clinician, taking care of patients with respiratory troubles. does that experience factor into your opinions today also? >> yes. >> did you do anything to try to

understand mr. floyd's actual rate of breathing? >> yes, i did. >> why was that important to do? >> because a major part of my work as a lung specialist is looking at people's breathing. you get an awful lot of one of the simplest thing, especially informative, is simply to count as many breaths somebody takes in. it's one of the vital signs like blood pressure, pulse rate, is the respiratory rate. it gives us a lot of clues as to what is happening inside the body. >> is this something you have done before. >> i have done it millions of times. >> and you trained -- >> i trained doctors and nurses

how to do it. >> when you count the breaths, to you account for the muscles? >> you account for the breath, you look at the different muscles they're using, what type of bucket action handle they have, pump action. you're looking at all of this in a glance, with somebody as old as me, i can see all of this very rapidly. >> so did you take this clinical experience and apply it to your observations of mr. floyd's breathing, in this case on the videos? >> yes, i did. >> was there video evidence of which you could take measurements? >> yes, there is. >> i want to show you exhibit 43, which is already in evidence.

i want to play this, doctor, and afterwards tell us what we are seeing. in a moment when we start. >> so if you focus down here where the happened cuff is and where his arm is close to his black shirt is the best place to see and you can count out his respiratory rate. you see he's making a respiratory rate here, and then another and so we can play it back. so i need to tell you where to focus, if you focus down there, you will be able to count out the rates. >> we will play it once more so you can count the rates and the jury can see what you're referring to. >> okay. >> one, two, three, four, five,

six, seven, eight. >> so that was the reference for a 17-second clip. >> right. >> you counted seven or eight reps. >> between seven and eight. >> did you use this to calculate a rate of respiration? >> yes, because it's simple once you have 19 seconds and you count out the number of breaths you have here and if it, say, you count out seven breaths, that would come out as a respiratory rate of 22. >> is that number, the respiratory rate of 22, significant to this case? >> it's extremely significant. >> why is that? >> because one of the things in this case is the question of fentanyl. and if fentanyl is having an effect and calling depression of the respiratory centers, the centers that control breathing, that is going to result in a decrease in the respiratory rate

and it's showing with fentanyl, you expect a 40% reduction in the respiratory rate. so with fentanyl, his respiratory rate should be down at around 10, instead that is right in the middle of normal at 22. >> so you didn't see a depressed rate of respiration or breathing rate in mr. floyd? >> no, it's normal. >> what does that tell you bottom line with respect to fentanyl as relates to mr. floyd? >> exactly, in terms of fentanyl, one of the major changes you see in fentanyl is a slowing of the respiratory rate. again, we will be expecting a 40% reduction in the respiratory rate with fentanyl. the normal respiratory rate is 17 breaths per minute, plus or minus five. 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 would expect a respiratory rate of 10. instead of that, you count it here yourself, and you can see when you count it yourself that the respiratory rate is 22. basically it tells you there isn't fentanyl on board. and that's affecting his respiratory sensors. it's not having an effect on his respiratory sensors. >> so mr. floyd's respiratory rate was normal at 22 just before he lost consciousness? >> correct. >> so the jury may have heard some other information in the case about the fentanyl related to an elevated carbon dioxide level in mr. floyd's body in the emergency. was that significant to you? >> yes, that's very significant as well. >> how so?

>> because he's reported to have a pco -- i'm sorry, i take that back. he's reported to have a carbon dioxide level in the emergency room of 89. that's a very high level of carbon dioxide. you have to take into account what are the factors that might have led to that and there's particularly important factors in mr. floyd to explain why his carbon dioxide was found at 89 in the emergency room. >> so, doctor, would you first tell us, what would normal have been for carbon dioxide levels? >> the normal carbon dioxide level in you or me is 35 to 45 millions of mercury, that is normal. you don't need the mercury stuff but those are the units in the hospital chart. >> you say there are significant factors in the case of mr.

floyd. would you help the jury understand what those were? >> yes, the important factors are we know he made his own last spontaneous effort to breathe at 20, 25:16. you look after that, and he makes no effort. the last breath he took was at 20, 25, 16. and then after that we know he was placed in the ambulance and we know in the ambulance they attempted to put in an airway, an i-gel and you can see that on the officer's cam, you see all of that happening. then you can see at the time they successfully inserted the airway and when they gave him the first breath and that is a gap of 9:50 from when he last

took a breath. >> why is that significant? >> that's very significant because we can calculate what is the rate of increase in the carbon dioxide in somebody who doesn't breathe. if somebody doesn't take a breath, carbon dioxide increases at a predictable rate. and that rate is up to 4.9 millimeters of mercury per minute that it increases. so he has not taken a breath for 9:50, so you would expect just on that basis that his carbon dioxide level will go up by 49. so you add 49 to the normal values of 35 to 45, and then you add that and you're going to get a value of between 89 -- so it

comes out virtually identical to the value that they found in the emergency room of 89. >> so, doctor, what's the punch line with respect to that? what does it tell us? >> the significance of all of that is it's a second reason why you know fentanyl is not the cause of the depression of his respiration. what you're seeing is the increase in his carbon dioxide found in the emergency room is solely explained by what you expect to somebody who doesn't have any ventilation given to him for 9:50. it is completely explained by that. >> when a person then is not breathing, carbon dioxide would naturally continue to build up in the body? >> yes. >> that's what matches what was seen in the o.r. for mr. floyd? >> precisely.

>> you said there were other things that were significant that were related to the rate of respiration and we talked about fentanyl. was there anything else? >> yes. the other thing, there are two other things that are very important to the respiratory rate, because you saw it with your own eyes, exactly his respiratory rate. the first thing is if you have somebody who has underlying heart disease and the heart disease is so severe, that it's been said it's causing shortness of breath, that it's causing difficulty of breathing. when somebody has 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 can give you shortness of breath, instead of as we find his respiratory rate is normal