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Tragic Mistakes in Minneapolis
I am a retired paramedic who worked 36 years for the EMS agency that responded to the George Floyd call. While still involved with that agency doing occasional quality assurance work, I have purposely not used my access to review this case. All information I have comes from training, experience, and public news reports.
This is my take.
1. Found behind the wheel of a minivan, Mr. Floyd was intoxicated with alcohol, fentanyl, and meth on board. He was a smoker and the autopsy reveals he had underlying medical issues that he may not have been aware of. He was also a very big guy – not obese, but tall and muscular. Police had reason to be wary.
2. He was properly arrested and handcuffed. The problems started when they attempted to place him in the squad car. Stating that he was claustrophobic and couldn’t breathe, Mr. Floyd dropped to the pavement and actively resisted for some minutes. After officers finally got him in the back seat, they inexplicably dragged him out the other side and dropped him to the pavement.
3. Here is where the police made a series of errors that may have resulted in Mr. Floyd’s death. When officers handcuff someone it is their responsibility to protect that person from harm. George Floyd stated 16 times (actual count) that he could not breathe. At what point should the police have taken those pleas seriously? Police did call for an ambulance but only due to Mr. Floyd’s bleeding from the mouth.
4. All four officers forgot their training. Positional asphyxia and excited delirium are real dangers. Minneapolis police have been trained to recognize the potential danger of this phenomenon and how to react in a manner to lessen the risk of cardiac arrest. In fact, during the time they had him pinned to the pavement, excited delirium was mentioned at least twice by officers on the scene. Despite that, they did not place the patient in a position that would allow him to adequately ventilate.
5. Excited delirium is a syndrome which is a group of symptoms that consistently occur together, or a condition characterized by a set of associated symptoms. George Floyd demonstrated several signs and symptoms as seen on multiple videos. Due to the struggle with police, his underlying health issues, and the intoxicants in his system, Mr. Floyd was certainly a candidate for this malady.
Specifically what happens is that the blood becomes acidotic. This is a common response to exertion. The body’s mechanism to correct this is a largely respiratory effort. Mr. Floyd had his hands cuffed behind his back which, in and of itself, restricts ventilation to a certain degree.
6. Again, Minneapolis police have been trained for years to recognize this danger. The patient needs to be rolled to his side and no pressure applied to the thorax. Even if the patient continues to struggle, this gives the cuffed patient the best chance to breathe and hopefully limit blood acidosis. Police had George Floyd face down on his stomach.
7. Did the knee to the neck hinder respirations? Yes, but not the way most think. In my opinion, the patient’s airway was not occluded it was the positioning that was the problem. What many are missing is this: Where were the other two officers? While the video most have seen does not show it, I’m willing to bet that one of them was compressing the patient’s back.
8. In my 49 years of EMS experience, I’ve seen a lot of people die in front of me. I believe that George Floyd died on the pavement. Again, the police forgot their training. They did not recognize the patient had gone unconscious and likely suffered cardiac arrest in front of their very eyes. Once a person is cuffed it is the responsibility of law enforcement to protect the patient the best they can and be mindful of the person’s well-being. It appears to me that they failed miserably.
Published in General
Was Floyd pulled over for erratic driving?
No, he purchased a pack of smokes with a fake $20 bill. Police were called and they found him parked behind the wheel of a minivan.
Thank you for the very clear explanation of the situation. Unfortunately, even clear understanding will not help resolve the social crisis we are enduring now with the nationwide riots.
But I think clear understanding does help in the long run if not in the immediate situation.
This is a key point. Perhaps the most important point.
Good job @ambulancedriver. It still amazes me that so many people have no idea how Mr. Floyd died.
@DukePowell, thank you for the first expert, non-biased statement I’ve read on what likely happened in that death.
That was very helpful. Thank you.
So they were trained about this? That lets the police administration off the hook a little bit. But just a little bit.
What’s not been remarked on much is that two of the officers involved were newly minted rookies. This implies that the other two were training officers.
For a perspective from 1000 miles away, see my post It’s Always Easier. . .
These posts need to bookend each other on the main feed.
Yes, this is one the best things I have read on the incident. Thanks for the insights,
As an ER physician I have to concur with the vast majority of this.
The knee on the neck did not asphyxiate him. The fact that he keep saying “ I can’t breathe” proves he was moving air. But people who are acidotic frequently feel short of breath. Being in a prone position while agitated and under the influence of multiple drugs is also associated with hypoxia. We always try to avoid having anyone prone for a prolonged length of time in the ER if we can avoid it. ideally he should have been positioned on his side as quickly as possible before either being placed in the squad or turned over to EMS.
Why do we keep overlooking that Floyd made a serious of mistakes that put him in this situation? Is he a child? an idiot? I see a series of bad decision that Floyd did that contributed to his death before the cops even showed up. But NNNNOOOOOO it is the cops fault because he tried to arrest this idiot. instead of the idiots fault for doing what he did that led to the arrest and his resistance that force the police to restrain him.
That’s maybe kinda sort of relevant, up to the point that he’s cuffed. Once he’s in restraints, his agency ends and the cops have responsibility.
That’s true, of course.
But that doesn’t change the fact that the cop’s behavior was inexcusable.
If he would have just cooperated like almost any other person he would be alive today. He contributed to this himself.
I agree. Passing a fake $20 bill is not punishable by death. I wonder how anyone who has watched the entire video and read the county autopsy cannot find fault with the officers.
Actually to a point it does.
Passing a fake $20 wasn’t punishable by death. Doing so while drunk and on multiple dangerous drugs is certainly in the high risk behavior category, though.
I’m amazed at the number of people who can’t comprehend the idea that both Floyd AND the officers made some awful mistakes, even though I think the officers made more of them – and less-forgivable ones.
People keep treating this like it’s a binary decision set – “If the officers screwed up royally, it forgives Floyd’s mistakes.” That’s not how it works.
Of course it is. Everything is. Punishable by death is all the government has. If you resist the government on anything they will lock you up and take your stuff. If you resist that then the government will continue to ratchet up the violence until you back down, submit or are killed. That is it.
Best explanation by far that I have heard.
People resist arrest all the time. That is not a capital offense, and I imagine there are many, many more difficult situations that are handled without incident all the time. Yes, police work is difficult but that is what the officers are trained for.
Once he was handcuffed he was in the officer’s care. No ifs, ands or buts. It doesn’t really matter what happened before at that point. That is the law and these three officers grossly violated the law in their actions. There are no really good excuses for what they did.
Sure the officers were trained for this situation but something is very wrong here- all three officers somehow forgot their training, while people were filming them? Anyone with a brain should know that if something at all happened to George Floyd that this situation could easily blow up into a huge media event with a huge backlash against police. But to let him die with an officer’s knee on his back – you have got to be kidding. This situation just reeks.
Agree. End of story.
Two points.
It seems that the officers were aware of the situation. From a reported recording one officer asks what position they should put Floyd in to keep him alive and another answers to keep him on his stomach. As I understand one of fentanyl’s side effects is to stop breathing.
One thing that puzzles me is that it was found that positioning Covid patients on their stomachs increased their ability to breath and recover.
Cigarettes kill? /sorry, couldn’t resist
But, I think you have a point about the widespread assumption, perhaps unintentionally promoted by well-meaning white liberals, that American blacks lack moral agency, the result of which we’re seeing in the streets. That and the America-privileged white leftists who just want to burn it all down.
Great post from that rarest of things — a reliable source. Thanks.
Not really. A guy in cuffs can still put up a significant struggle and still be a threat to officers if he continues to resist. From the video, he was still resisting in cuffs when in the police vehicle. He still has some agency here. Yeah the cops didn’t do this well and contributed to his death. I don’t think it was murder however.
Watch a couple of episodes of Live PD and watch how many people being arrested fight like crazy with the police trying to arrest them all the time yelling ” I’m not resisting”, “or “you can’t touch me”.
I haven’t watched the video and won’t, but is it possible he was “resisting” because he was already having trouble breathing? He had COVID (if the Daily Mail headline is correct), he was on fentanyl, he was a smoker, and he had underlying conditions which all may have compromised his ability to breathe even before he was placed in a compromising position. Most people get pretty desperate when they’re having trouble breathing and might attempt to flail and “fight” for breath.
I am amazed how far people want to twist things to forgive the criminal for being a criminal and convict a cop for being a cop. I suspect if he started with he was having a problem breathing instead of resisting thing would have ended differently.