CONDITIONS. IF WE COULD HIGHLIGHT THAT OUTBERAKS.
>> SO DO
>> SO DO
YOU
YOU SEE
YOU SEE WHERE I'M REFERRING TO THE OTHER CONTRIBUTING
CONDITIONS?
CONDITIONS? >> YES, AND ONE OF THOSE IN THIS
CASE, THEY ARE ARTERIOSCLEROTIC
HYPERTENSIVE HEART DISEASE
FENTINYL INTOXICATION AND RECENT
METHAMPHETAMINE USE.
METHAMPHETAMINE USE. >> SO WOULD YOU EXPLAIN FOR THE
JURY WHAT DOES IT MEAN OTHER
CONTRIBUTING CONDITIONS? SO
THE WAY FORENSIC PATHOLOGISTS
AND MEDICAL EXAMINERS USUALLY
USE THIS IS PEOPLE OFTEN THINK
OF THE DEATH CERTIFICATE IS
FOR THAT PERSON, THAT SPECIFIC
PERSON WHO DIED AND THEIR
FAMILY.
FAMILY.
FAMILY. >> AND THAT'S TRUE. IT DOES
SERVE A VERY USEFUL PURPOSE
FOR LIFE INSURANCE, WHATEVER.
BUT FORENSIC PATHOLOGISTS
ARE ALSO USING DEATH CERTIFICATE
FOR PUBLIC HEALTH DATA PURPOSES
AND SO IN ANY GIVEN CASE,
WE AREN'T JUST THINKING ABOUT
THIS PARTICULAR PERSON AND THEIR
CAUSE AND MANNER OF DEATH. WE'RE
ALSO THINKING THE THE STATE AND
THE FEDERAL GOVERNMENT COLLECT
DATA ON WHY DO PEOPLE DIE?
>> WHAT IS THE CAUSE OF DEATH?
>> IT'S HOW WE KNOW AS A COUNTRY
THAT WE HAVE, YOU KNOW, HOW MANY
PEOPLE DIE OF COVID,
FOR EXAMPLE.
FOR EXAMPLE. >> IT'S BECAUSE DEATH
CERTIFICATES LIST THAT . SO ONE
OF THE THINGS THAT WE USE THIS
OTHER CONTRIBUTING CONDITIONS
FOR IS TO LIST DISEASE PROCESSES
OR DRUGS THAT ARE PRESENT AT
THE TIME OF DEATH, BUT THAT
WE DON'T DIRECTLY THAT WE DON'T
BELIEVE DIRECTLY CONTRIBUTED
TO THE CAUSE OF DEATH.
>> BUT IT'S SO THAT SOMEONE
LOOKING AT DATA YEARS FROM NOW
CAN SAY, OK, WE WANT TO DO AN
EVALUATION OF ALL DEATHS DURING
LAW ENFORCEMENT'S ABDOUL.
>> AND HOW MANY OF THOSE DEATHS
INVOLVED SOMEONE WHO ALSO HAD
DRUGS ON BOARD BECAUSE THAT MAY
BE SOMETHING THAT IS RELEVANT
THEN IN TRYING TO PREVENT THESE
SORT OF DEATHS IN THE FUTURE,
FOR EXAMPLE, OR THE CASE WHERE
I USE OTHER CONTRIBUTING
CONDITIONS, PROBABLY THE MOST IS
THE HIP FRACTURE CASE THAT I
TALKED ABOUT BEFORE WHERE
SOMEONE DIES OF A HIP FRACTURE
DUE TO A FALL. BUT THERE ARE 84
YEARS OLD AND THEY ALSO HAVE
HYPERTENSIVE HEART DISEASE,
ARTERIOSCLEROTIC HEART DISEASE,
ASTHMA, DIABETES.
ASTHMA, DIABETES. >> AND SO I WILL LIST THOSE AS
OTHER CONTRIBUTING CONDITIONS.
>> NOW, IN NO WAY DID THOSE
THINGS CAUSE THE FALL IN THE HIP
FRACTURE AND THE RESULTING
WHATEVER PNEUMONIA OR WHATEVER.
>> BUT AGAIN, SOMEONE FROM
THE DATA PERSPECTIVE MIGHT WANT
TO KNOW, YOU KNOW, UWI FOUR YEAR
OLD WOMEN WHO DIE OF HIP
FRACTURES, WHAT PERCENTAGE
OF THEM HAVE UNDERLYING HEART
DISEASE? BECAUSE AGAIN, FROM
A DATA COLLECTION STANDPOINT,
DOES THAT PROVIDE USEFUL PUBLIC
HEALTH INFORMATION THAT CAN BE
USED IN THE FUTURE TO TRY
AND PREVENT THESE DEATHS?
>> SO THAT'S HOW I WOULD VIEW
THIS VERY LONG WINDED SORRY.
>> NO, NO. DR. TOMMASEO,
IN UNDERSTANDING THIS IS FURTHER
SO OTHER CONTRIBUTING CONDITIONS
ARE CONDITIONS THAT MAY HAVE
CONTRIBUTED, BUT WE'RE NOT
THE DIRECT CAUSE.
>> EXACTLY. DID YOU CONSIDER
THESE OTHER CONTRIBUTING
CONDITIONS AND YOUR ASSESSMENT
OF THE CAUSE AND MECHANISM
OF DEATH FOR GEORGE FLOYD?
>> YES. AND WHAT HOW DID YOU
CONSIDER THEM , FIRST OF ALL?
>> WELL , I WANTED TO LOOK AT
EACH ONE AS AN ASK THE QUESTION
IS THIS THE CAUSE OF HIS DEATH
IS ARTERIOSCLEROTIC DISEASE
THE CAUSE OF HIS DEATH?
>> HE HAS A NARROWING OF HIS
CORONARY ARTERIES. IN MANY CASES
THAT IS THE CAUSE OF SOMEONE'S
DEATH.
DEATH.
DEATH. >>
DEATH. >> SO I LOOKED AT THAT .
BUT AGAIN, IT COMES DOWN TO WHAT
WERE THE HISTORY OF THE TERMINAL
EVENTS? DOES THIS LOOK LIKE
THE TYPE OF DEATH WE SEE OR IS
YOU KNOW, I'M NOT A CLINICIAN,
SO I DON'T SEE i A FORENSIC
PATHOLOGIST, I KNOW FROM
HUNDREDS OF FAMILIES DESCRIBING
WHAT HAPPENED AT THE TIME
OF DEATH THAT THIS DEATH DOES
NOT FIT WHAT HAS BEEN DESCRIBED
IN SOMEONE WHO DIES OF A CARDIAC
ARRHYTHMIA FROM ARTERIOSCLEROTIC
HEART DISEASE AND LIKEWISE
HYPERTENSIVE HEART DISEASE.
THOSE TEND TO BE CARDIAC
ARRHYTHMIAS, SUDDEN CARDIAC
DEATHS. THIS IS NOT THAT KIND
OF DEATH. LIKEWISE, FENTANYL
INTOXICATION, AS I DESCRIBED
AND AGAIN, I DON'T TREAT
PATIENTS. I DON'T SEE LIVING
PEOPLE. BUT WHAT I KNOW FROM
FAMILY MEMBERS WHO DESCRIBE
DEATHS THEN LATER TURN OUT TO BE
DUE TO FENTANYL. THE DEATH IS
SLOW, IT'S PEACEFUL. THEY FALL
ASLEEP. THEY MAY HEAR SNORING OR
VERY HEAVY BREATHING. THERE'S NO
STRUGGLE. THEY JUST OFTEN
ARE FOUND, JUST KIND OF SLUMPED
OVER. IT'S A VERY SLOW DEATH. SO
AGAIN, TOTALLY DIFFERENT THAN
WHAT IS SEEN IN MR. FLOYDS DEATH
METHAMPHETAMINE AS A CAUSE
OF DEATH GENERALLY IS AGAIN,
MUCH MORE OF A SUDDEN DEATH. IT
MAY CAUSE A CARDIAC ARRHYTHMIA.
IT MAY CAUSE A SEIZURE. AND BY
THAT I DON'T JUST MEAN THIS SORT
OF TERMINAL ANOXIC TWITCH,
BUT LIKE A FULL BLOWN SEIZURE
AND AGAIN, LOOKING FROM
WHAT
WHAT I
WHAT I KNOW ABOUT MR. FLOYD STUFF BECAUSE IT'S SO
WELL DOCUMENTED THAT DOES NOT
FIT WITH A METHAMPHETAMINE DEATH
.SO YOU REVIEWED
THE TOXICOLOGY? YES. OH, YES.
HOW WOULD YOU CHARACTERIZE
THE AMOUNT OF METH, MR. FLOYD
SYSTEM?
SYSTEM?
SYSTEM? >> WELL , IT WAS THERE IT'S NOT
PARTICULARLY HIGH CERTAINLY
IN DEATHS THAT I HAVE ATTRIBUTED
TO METHAMPHETAMINE. IT'S BEEN
MUCH HIGHER, BUT IT'S NOT LIKE
THERE'S ANY SAFE LEVEL
OF METHAMPHETAMINE.
OF METHAMPHETAMINE. >> BUT THIS WAS A VERY LOW
LEVEL.
LEVEL.
LEVEL. >>
LEVEL. >> SO IT WAS THE METHAMPHETAMINE
SIGNIFICANT IN YOUR ASSESSMENT
OF THE CAUSE OF DEATH? NO, SO
THEN BASED ON YOUR REVIEW OF THE
VIDEO AND APPLICATION OF YOUR
WORK EXPERIENCE AND KNOWLEDGE,
DID YOU RULE OUT DRUG OVERDOSE
AS A CAUSE OF DEATH? YES, THAT'S
AN OPINION. YOU HOLD
A REASONABLE DEGREE OF MEDICAL
CERTAINTY. YES,
CERTAINTY. YES,
NOW,
NOW, I
NOW, I WANT TO CLARIFY THIS EARLIER. I JUST FORGOT TO DOES
THE MEDICAL EXAMINER ALSO
COMPLETE THE DEATH CERTIFICATE?
>> YES, WE DON'T ISSUE IT.
THAT COMES FROM THE COUNTY OR