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Expert: Lack of oxygen killed George Floyd, not drugs

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MINNEAPOLIS (AP) — George Floyd died of a lack of oxygen from being pinned to the pavement with a knee on his neck, medical experts testified at former Officer Derek Chauvin’s murder trial, emphatically rejecting the defense theory that Floyd’s drug use and underlying health problems killed him.

“A healthy person subjected to what Mr. Floyd was subjected to would have died,” prosecution witness Dr. Martin Tobin, a lung and critical care specialist at the Edward Hines Jr. VA Hospital and Loyola University’s medical school in Illinois, testified Thursday.

Using easy-to-understand language to explain medical concepts and even loosening his necktie to illustrate a point, Tobin told the jury that Floyd’s breathing was severely constricted while Chauvin and two other Minneapolis officers held the 46-year-old Black man down on his stomach last May with his hands cuffed behind him and his face jammed against the ground.

The lack of oxygen resulted in brain damage and caused his heart to stop, the witness said.

Tobin, analyzing images of the three officers restraining Floyd for what prosecutors say was almost 9 1/2 minutes, testified that Chauvin’s knee was “virtually on the neck” more than 90% of the time.

https://www.youtube.com/watch?v=KAR9F-jtKJ8

He said several other factors also made it difficult for Floyd to breathe: officers lifting up on the suspect’s handcuffs, the hard pavement, his prone position, his turned head and a knee on his back.

Chauvin kept his knee on Floyd’s neck for 3 minutes, 2 seconds, after Floyd took his last breath, Tobin said. After that last breath, Floyd’s oxygen levels went down to zero and Floyd “reached the point where there was not one ounce of oxygen left in the body,” he said.

As prosecutors repeatedly played a video clip of Floyd on the ground, Tobin pinpointed what he said was a change in the man’s face that told him Floyd was dead. That moment happened around five minutes after police began holding Floyd down.

“At the beginning, you can see he’s conscious, you can see slight flickering, and then it disappears,” Tobin said. He explained: “That’s the moment the life goes out of his body.”

Chauvin, 45, is charged with murder and manslaughter in Floyd’s death May 25. Floyd was arrested outside a neighborhood market after being accused of trying to pass a counterfeit $20 bill. Bystander video of Floyd crying that he couldn’t breathe as onlookers yelled at the white officer to get off him sparked protests and scattered violence around the U.S.

Tobin also testified that just because Floyd was talking and can be seen moving on video doesn’t mean he was breathing adequately. He said a leg movement seen in the footage was an involuntary sign of a fatal brain injury, and that a person can continue to speak until the airway narrows to 15%, after which “you are in deep trouble.”

Officers can be heard on video telling Floyd that if he can talk, he can breathe.

During cross-examination, Chauvin attorney Eric Nelson pressed Tobin on that common misconception, pointing to earlier testimony that Minneapolis officers are trained that if people can speak, they can breathe.

Nelson has argued that Chauvin did what he was trained to do and that Floyd’s death was caused by illegal drugs and underlying medical problems, including high blood pressure and heart disease. An autopsy found fentanyl and methamphetamine in his system.

Tobin said he analyzed Floyd’s respiration as seen on body-camera video and explained that while fentanyl typically cuts the rate of respiration 40%, Floyd’s breathing was “right around normal” just before he lost consciousness.

Tobin also said the high blood level of carbon dioxide measured in the emergency room can be explained by Floyd not breathing for nearly 10 minutes before paramedics began artificial respiration, as opposed to his breathing being suppressed by fentanyl.

Another prosecution witness, Dr. Bill Smock, an expert on deaths from asphyxia, backed up Tobin’s assessment. Smock said Floyd did not have symptoms of a fentanyl overdose such as constricted pupils and decreased breathing. He said Floyd’s actions were the opposite, because he was pleading for air.

“That is not a fentanyl overdose. That is somebody begging to breathe,” said Smock, the police surgeon for the Louisville, Kentucky, department and a former emergency room doctor. He said Floyd died of “positional asphyxia,” a lack of oxygen because of the position of the body.

On cross-examination, Nelson questioned Smock about Floyd’s history of heart disease, getting Smock to agree that a struggle with police could put stress on the heart and that shortness of breath could be a sign of a heart attack.

But when questioned again by the prosecution, Smock said there was no evidence that Floyd had a heart attack or sudden death from arrhythmia, saying his death was caused by a gradual decrease of oxygen over several minutes “because of the pressure being applied to his back and neck.”

Also Thursday, a forensic toxicologist said that he tested blood drawn from Floyd at the hospital, as well as urine from his autopsy, and found a “very low” amount of methamphetamine. Daniel Isenschmid said fentanyl and a byproduct of its breakdown also were in Floyd’s system.

Isenschmid put the level of fentanyl in Floyd’s blood at 11 nanograms per milliliter. For perspective, he said that testing of more than 2,000 people arrested for driving under the influence of fentanyl revealed an average concentration of 9.59, and dozens of them had levels higher than Floyd’s — and survived.

On cross-examination, Nelson suggested there was no way to know how much fentanyl Floyd had ingested, and Isenschmid agreed. The defense attorney also said it’s impossible to know the concentration of fentanyl in street drugs: “Every single pill you take, it becomes a unique experience for the person, right?” Isenschmid agreed.

In his own turn on the stand, Tobin used simple language, explaining that when the airway narrows, breathing becomes far more difficult, like “breathing through a drinking straw.”

At one point, the doctor loosened his tie and placed his hands on his own neck and the back of his head to demonstrate how the airway works, inviting the jurors to examine their own necks. Most of them did so, though the judge later told them they didn’t have to.

The expert calculated that at times when Chauvin was in a near-vertical position, with his toes off the ground, half of Chauvin’s body weight with his gear included — or 91.5 pounds (41.5 kilograms) — was directly on Floyd’s neck.

He said it appeared that Floyd was getting enough oxygen to keep his brain alive for about the first five minutes, because he was still speaking. Tobin said that where Chauvin had his knee after the five-minute mark was not that important, because at that point Floyd had already suffered brain damage.

Chauvin’s attorney has repeatedly shown the jury still images from the video that he said depicted Chauvin’s knee on Floyd’s shoulder blade, not his neck. But nearly all of those images were captured after the five-minute mark, according to the time stamps.

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Crimes and Courts

Florida Gaming Control Commission Seizes 163 Illegal Slot Machines, $247K in St. Petersburg

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Florida Gaming Control Commission

State gaming agents and partner law enforcement agencies targeted two St. Petersburg businesses, seizing more than $247,000 in cash and issuing notices to appear to three people.

ST. PETERSBURG, Fla. (FNN) — The Florida Gaming Control Commission seized 163 alleged illegal slot machines and $247,285 in cash during searches of two St. Petersburg businesses as part of an enforcement action dubbed “Operation Final Spin,” according to the agency.

The Sept. 10 operation was conducted with the Pinellas County Sheriff’s Office, Florida Highway Patrol and Florida Department of Business and Professional Regulation’s Division of Alcoholic Beverages and Tobacco, according to an FGCC news release.

The searches targeted Action Arcade, 6541 54th Ave. N., and The Zoo Sports Club and Grille, 5111 66th St. N.

FGCC is responsible for regulating authorized gambling and enforcing Florida’s criminal gambling prohibitions. Its stated enforcement priorities include investigating illegal arcades, slot-machine businesses and the distribution of illegal gambling devices.

163 Machines Seized at Two Locations

According to FGCC, agents seized 90 machines and $142,020 from Action Arcade.

Two people were issued notices to appear, with each accused of one count of possession of slot machines and one count of keeping a gambling house, the agency said.

At The Zoo Sports Club and Grille, agents seized another 73 machines and $105,265, according to FGCC. One person was issued a notice to appear on allegations of possession of slot machines and acting as an agent or employee of a gambling house.

The allegations are charges, and the individuals are presumed innocent unless proven guilty.

State Rep. Berny Jacques Joins Enforcement Action

Florida Gaming Control Commission Vice Chair Tina Repp and state Rep. Berny Jacques participated in the enforcement action, according to the commission.

“These machines are designed to take advantage of people, and far too often that means senior citizens living on fixed incomes who can least afford to lose what they have,” Jacques said in the agency’s release.

Jacques thanked FGCC and participating law enforcement agencies and said the operation was intended to protect vulnerable residents.

Repp said the operation was part of a broader statewide enforcement effort.

“Operation Final Spin and the more than 200 illegal arcades we have shut down before this should make it clear that our goal is to disrupt and dismantle illegal gaming across the state of Florida,” Repp said.

The claim that more than 200 illegal arcades have previously been shut down is attributed to Repp and FGCC.

Where Slot Machines Are Legal in Florida

Florida tightly restricts where slot machines can legally operate. FGCC says slot-machine gaming is authorized at eight licensed pari-mutuel facilities in Miami-Dade and Broward counties and at certain tribal gaming facilities. The agency says offering slot-machine gaming at an unlicensed establishment, including bars, restaurants and adult arcades, violates state law.

FGCC also warns that illegal gambling businesses operate outside regulatory safeguards governing licensed slot machines, including requirements related to game integrity and minimum payout percentages.

Florida’s gambling laws and regulations are primarily contained in Chapters 550, 551 and 849 of the Florida Statutes.

Reporting Suspected Illegal Gambling

People who suspect illegal gambling activity can submit information through the Florida Gaming Control Commission’s reporting system or call 850-880-3433.

Additional information about authorized gambling locations is available through the FGCC Gaming Locations directory.

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Crimes and Courts

DOJ: Man Charged With Laundering Conspiracy in $1.3 Billion Medicare, Health Insurance Fraud Scheme

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Federal prosecutors allege Erekle Gugava helped move proceeds from a transnational fraud operation that used stolen identities and submitted at least $1.3 billion in fraudulent medical-equipment claims to Medicare and private insurers.

BOSTON (FNN) — A federal grand jury in Massachusetts has indicted a 33-year-old Georgian national on a money laundering conspiracy charge stemming from an alleged $1.3 billion health care fraud operation, according to the U.S. Department of Justice.

Federal prosecutors allege Erekle Gugava served as a money launderer for a transnational criminal organization accused of orchestrating a multibillion-dollar scheme targeting Medicare and other health insurers.

The Justice Department announced the indictment Friday, Sept. 4.

According to DOJ, the organization, which prosecutors said was based in Russia and elsewhere, was previously identified through Operation Gold Rush, part of what the department has described as the largest health care fraud case it has prosecuted.

DOJ: $1.3 Billion in Allegedly Fraudulent Claims

According to charging documents cited by DOJ, Gugava purportedly owned ND Medical Solutions LLC, a Pennsylvania durable medical equipment company, from February through July 2025.

During that five-month period, prosecutors allege ND Medical submitted at least $1.3 billion in fraudulent durable medical equipment claims to Medicare, private insurers providing Medicare supplemental coverage, employer-sponsored health plans and other insurers.

Those insurers paid ND Medical approximately $6.5 million, according to the Justice Department.

The distinction between the $1.3 billion and $6.5 million figures is significant: DOJ alleges $1.3 billion was billed, while approximately $6.5 million was actually paid to the company.

Prosecutors Allege Money Was Transferred Overseas

Federal prosecutors allege Gugava facilitated the deposit and transfer of proceeds generated by the scheme.

According to DOJ, Gugava opened several bank accounts in ND Medical’s name and was the sole signatory. Checks from Medicare supplemental insurers and other health insurers were allegedly deposited into those accounts.

Prosecutors allege the money was ultimately transferred to overseas bank accounts for the benefit of the transnational organization.

“Fraud networks cannot function without people willing to launder and transmit their proceeds,” Assistant Attorney General Colin M. McDonald of DOJ’s National Fraud Enforcement Division said in the department’s announcement.

McDonald said prosecutors allege Gugava helped move fraud proceeds through domestic and international financial channels.

DOJ: Stolen Identities Used to Support Claims

The alleged scheme also involved stolen identities, according to federal prosecutors.

DOJ said the fraudulent claims relied in part on identities belonging to people in Massachusetts, elsewhere in New England and across the United States.

Some were elderly or disabled Americans who reported receiving insurance explanation-of-benefits forms showing medical equipment they said they never received, according to the Justice Department.

Prosecutors said some records also identified doctors the beneficiaries said they had never visited and listed equipment as coming from ND Medical, a company with which they said they were unfamiliar.

Operation Gold Rush

DOJ said Gugava’s case is connected to Operation Gold Rush, an investigation targeting a transnational organization accused of exploiting Medicare and other insurers.

According to the Justice Department, the organization allegedly used payments originating from legitimate government programs and established insurance companies to facilitate money laundering. Because the payments came from legitimate insurers, prosecutors contend the proceeds initially appeared legitimate.

The department previously identified Operation Gold Rush as part of its broader national effort targeting health care fraud.

Six Federal Agencies Investigating

The investigation involves multiple federal law enforcement and oversight agencies, including:

  • Department of Health and Human Services Office of Inspector General
  • FBI
  • U.S. Postal Inspection Service
  • IRS Criminal Investigation
  • Homeland Security Investigations
  • Department of Labor’s Employee Benefits Security Administration

Prosecutors from DOJ’s National Fraud Enforcement Division’s Health Care Fraud Section and the U.S. Attorney’s Office for the District of Massachusetts are handling the case.

Defendant Faces Up to 20 Years if Convicted

Gugava is charged with one count of conspiracy to commit money laundering.

If convicted, he faces a statutory maximum penalty of 20 years in federal prison, according to DOJ. A maximum statutory penalty does not indicate what sentence would ultimately be imposed if a defendant is convicted.

The Justice Department also described Gugava in its announcement as an “illegal alien from Georgia.” That description reflects DOJ’s characterization of his immigration status in its Sept. 4 press release.

DOJ Expands Federal Fraud Enforcement

The Justice Department said the prosecution is part of its broader federal campaign against fraud involving government benefit programs.

According to DOJ, its Health Care Fraud Strike Force Program has charged more than 6,200 defendants since 2007 in cases involving more than $45 billion in alleged billings to federal health care programs and private insurers.

The department also announced the creation of its National Fraud Enforcement Division earlier this year to coordinate investigations and prosecutions involving fraud against federal programs and the public.

Indictment Contains Allegations

An indictment is a formal accusation and does not establish guilt.

Gugava is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

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Crimes and Courts

DOJ Charges Five in Pennsylvania, New Jersey and Wisconsin in Alleged Illegal Voting, Voter Registration Cases

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WASHINGTON (FNN) — Five people in Pennsylvania, New Jersey and Wisconsin face federal charges in separate cases involving alleged illegal voting, false claims of U.S. citizenship or fraudulent voter registration connected to the 2022 or 2024 elections, according to the U.S. Department of Justice.

The Justice Department announced the charges Friday, Sept. 4, saying the defendants include four non-U.S. citizens accused of illegally voting and one U.S. citizen accused of aiding and abetting election-related offenses.

The cases were brought in the Middle District of Pennsylvania, District of New Jersey and Western District of Wisconsin.

DOJ: Election Fraud Will Be Prosecuted

Attorney General Todd Blanche said in the DOJ announcement that election integrity is fundamental to American democracy and emphasized that voting in federal elections is limited to eligible U.S. citizens.

“Election fraud is a serious crime, and it is the duty of the Department of Justice to treat it as such,” Blanche said.

FBI Director Kash Patel said the bureau considers election integrity a priority and would investigate credible allegations of election fraud and illegal voting.

Federal officials also emphasized that the charges are allegations and have not resulted in findings of guilt.

Pennsylvania: Three People Charged

According to the Justice Department, Thomas Holtzman, 68, and his wife, Marisol Guzman, 50, both of Carlisle, Pennsylvania, were indicted by a federal grand jury in connection with allegations that Guzman illegally voted as a non-U.S. citizen in the 2024 election.

DOJ said Guzman was charged with voting as an alien.

Holtzman, a U.S. citizen, was charged with making a false statement of citizenship in order to vote and aiding and abetting, as well as fraudulent registration and aiding and abetting, according to federal prosecutors.

In a separate Pennsylvania case, Katya Rodriguez, 30, a Mexican national living in Harrisburg, was indicted by a federal grand jury on charges related to alleged illegal voting in the 2024 election.

According to DOJ, Rodriguez was charged with making a false statement of citizenship in order to vote, fraudulent registration and voting as an alien.

If convicted, Holtzman faces a statutory maximum of 10 years in prison, Guzman up to one year and Rodriguez up to 11 years, according to the Justice Department. Any sentence would be determined by a federal judge based on applicable law and federal sentencing guidelines.

Homeland Security Investigations investigated the Pennsylvania cases, DOJ said.

New Jersey: Federal Complaint Alleges Noncitizen Voted in 2024 Primary

In New Jersey, Mercedes Alexandra Cardoso of Union County was charged with voting by an alien in a federal election, according to the Justice Department.

The federal complaint alleges Cardoso was not a U.S. citizen when she registered through the New Jersey Division of Elections’ Online Voter Registration System.

According to prosecutors, Cardoso falsely certified on her voter registration application that she was a U.S. citizen.

DOJ said Cardoso allegedly cast a ballot in the June 2024 primary election, which included candidates seeking federal office.

Federal prosecutors said Cardoso entered the United States from Ecuador on a B-2 visa and was not a U.S. citizen when she allegedly voted.

If convicted, Cardoso faces a statutory maximum of one year in prison. Her initial court appearance was scheduled for Sept. 8, according to DOJ.

The FBI, Homeland Security Investigations and U.S. Citizenship and Immigration Services investigated the case.

Wisconsin: 2022 Election Vote Leads to Federal Charge

In Wisconsin, Jesus Javier Jurado Garcia, 25, a Mexican national living in Beloit, was charged Sept. 2 with illegally voting as an alien in the November 2022 election, according to the Justice Department.

A federal criminal information alleges Jurado Garcia knew he was not a U.S. citizen when he voted on Nov. 8, 2022, in an election that included races for the U.S. Senate and House of Representatives.

If convicted, Jurado Garcia faces a statutory maximum sentence of one year in prison, DOJ said.

Federal Officials Emphasize Election-Law Enforcement

U.S. attorneys in all three jurisdictions used the announcement to emphasize federal enforcement of election laws.

U.S. Attorney Brian Miller for the Middle District of Pennsylvania said his office would prosecute people accused of illegally voting in federal elections as well as those accused of facilitating illegal voting.

U.S. Attorney Robert Frazer for the District of New Jersey said the federal government has a responsibility to safeguard elections and investigate alleged violations of federal election law.

U.S. Attorney Chadwick M. Elgersma for the Western District of Wisconsin similarly said his office is committed to enforcing federal election laws.

Homeland Security Investigations also said its agents worked with federal partners to investigate the alleged conduct and support the prosecutions.

Charges Remain Allegations

The cases are at the charging stage.

A criminal complaint, indictment or information contains allegations and does not establish that a defendant committed a crime. All five defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

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