Embarrassment. You know, we saw it again last night as i was coming to the oval office, i got the word that 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. You know, they know what its like when the seconds change your life forever. Ive had the pleasure of getting to meet in awful circumstances many of you, many of you whove lost your children, your husbands, your wives. You know, they know what its like to bury a piece of their soul deep in the earth. We understand that. Mark and jackie, i want to tell you, its always good to see you but not under these circumstances. I want to say before i introduce the rest of the folks is, you know, what a lot of people have not been through what theyve been through dont understand it takes a lot of courage to come to an event like this. Theyre absolutely, absolutely determined to make change, but mark and jackie, whose son daniel was a first grader at sandy hook elementary school. Daniel loved sports, loved outdoor sports, getting muddy. I see my friend, fred guttenberg, his daughter jamie was a freshman at Marjory Stoneman douglas high school. She was an accomplished dancer. I see brandon wolf, who the shooting at the impulse at the pulse nightclub. He survived, but his two best friends died. Greg jackson, who is just walking down the street when he was caught in the cross fire of a gunfight. And of course, i see a close friend of jills and mine, congresswoman gabbie gifford who is here, 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. You know, theyre here and their pain is immense. And you know, what a lot of you hopefully many of you dont know, is if youve gone through a trauma, no matter how much you work to make sure others dont go through it, every time you show up at an event like this, it brings back when you got that phone call. It brings back the immediacy of what happened at that moment. So i genuinely mean it, thank you. Thank you for having the courage, the courage to be here, the courage to continue this fight. Senator blumenthal understands it. A lot of the folks out here understand it. But it takes real courage. So thank you. To turn pain into purpose and demand that we take the 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. Everyday in this country 316 people are shot, every single day. 106 of them die every day. Our flag was still flying at halfstaffed for the victims of the horrific murder of eight primarily asianAmerican People in georgia when ten more lives were taken in a mass murder in colorado. You probably didnt hear it, 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, 500 injured. This is an this is an epidemic, for god sake, and it has to stop. Im here to talk about two things, first, the steps were going to take immediately and second the action Going Forward to curb the epidemic of gun violence. I asked the attorney general and his team to identify for me immediate convcrete actions i could take now without having to go through the congress and today im announcing several initial steps my administration is taking to curb this epidemic of gun violence. Much more need be done but the first, first, want to reign in the proliferation of socalled ghost guns. These are guns that are homemade. Built from a kit that include directions on how to finish the firearm. You can go buy the kit. They have no serial numbers. So when they show up at a crime scene they cant be traced. And the buyers arent required to pass the background check to buy the kit. To make the gun. Consequently, anyone from a criminal to a terrorist can buy this kit for as little as 30 minutes, put together a weapon. You know, i want to see these kits treated as fire arms under the gun control act. Which is going to require that the seller 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 were going to take, back in the year 2000 the bureau of alcohol, tobacco and fire arms released a report on its investigation into fire arms trafficking in america. The report was a pivotal value. It was an important tool for policymakers when i was in the senate and beyond, at all levels, to stop fire arms from being illegally diverted into dangerous hands. Today, with online sales, and ghost guns, times and trafficking messages have changed. Now, 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 fire arms trafficking as it is today, not what it was yesterday. The third change, we want to treat pistols, modified with stabilizing braces, with the seriousness they deserve. A stabilizing brace, essentially makes that pistol a hell of a lot more accurate than a mini rifle. It turns it into a short bellied rifle. I want to be clear that these modifications to firearms that make them more lethal should be subject to the National Fire arms act. The National Firearms act requires that a potential owner pay 200 fee and submit their name and other identifying information to the Justice Department. Just as they would if they went out and purchased a silencer for a gun. Fourthly. During my campaign for president , i wanted to make it easier for states to adopt extreme Risk Protection order laws. Theyre also called red flag laws, which everybody in this law knows, but many people listening do not know, these laws allow police or family members 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 theyre danger in a crisis. Theyre presenting a danger to themselves and to others. And the court makes a ruling. To put this in perspective, more than half of all suicides, for example, 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, and see the reduction in the number of suicides in their states. Every single month, by the way, an average of 53 women are shot and killed by an intimate partner. I wrote the violence against women act. Its been a constant struggle to keep it moving. We know red flag laws can have significant effect in protecting women from Domestic Violence and we know red flag laws can stop mass shooters before they can act out their violent plans. Im proud excuse a point of personal privilege we used to say in the senate, im proud that the red flag law in my home state of delaware was named after my son, attorney general beau biden, excuse me, our son, National Red Flag law and legislation to incentivize 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 crafting their own laws right now, just like with background checks the vast majority of americans support these extreme Risk Protection order laws. And its time to put these laws on the books and protect even more people. The attorney general will have more to say about this in a moment. Additionally, recognize that cities across the country are experiencing historic spikes in homicides as the Law Enforcement can tell you. The violence in black and brown communities is the highest. Homicide is the leading cause of death of black boys and men ages 15 to 34, the leading cause of death. With our proven strategies, that reduce gun violence in urban communities, and there are programs that have demonstrated they can reduce homicides of up to 60 in urban communities, but many of these have been badly underfunded or not funded at all of late. Gun violence in america, for those you think of this from an economic standpoint listening to me, estimated to cost the nation 280 billion let me say it again, 280 billion a year. How could that be, joe . Hospital bills. Physical therapy. Trauma counseling. Legal fees. Prison costs. And the loss of productivity. Not to mention a psychological damage done to the children who live in these cities, watching this happen, knowing someone it happened to. This gun violence in our neighborhood. Its had a profound impact on our children. Even if theyre never involved in pulling the trigger, or being the victim of someone on the other side of a trigger. For a fraction of the cost of gun violence, we can save lives, create safe and healthy communities, and build economies that work for all of us. And save billions of american dollars in the meantime. Much of it as senator cicilline knows is taxpayer money. Finally, the bureau of alcohol and tobacco and fire arms, the key agency enforcing gun laws hasnt had a permanent director since 2015. Today im proud to nominate David Chipman to serve as the director of the aft. David knows the aft well. He served there for 25 years. And Vice President harris and i believe hes the right person at this moment for this important agency. Ive said before, my job, the job of any president is to protect the American People, whether Congress Acts or not, im going to use all the resources at my disposal as president to keep the American People safe from gun violence. But theres much more that congress can do to help that effort, and they can do it right now. Theyve offered plenty of thoughts and prayers, members of congress, but theyve passed not a single new federal 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 purchases, purchasers to by pass the background checks. The vast majority of the American People, including gun owners 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 the background checks. What more would have happened . These bills, one, require a background check for anyone purchasing a gun at a gun show, or an online sale. Most people dont know it, you walk into a store and you buy a gun, you have a background check. But you go to a gun show, you can buy whatever you want and no background check. Second thing is, to close the whats known as the charleston loophole. Like people here, i spent time down in that church in charleston, what happened is someone was allowed to get the gun used to kill those innocent people at a church service. If the fbi hasnt didnt complete the background check within three days. Theres a process. If it wasnt done in three days according to the charleston loophole, you get to buy the gun. They bought the gun and killed a hell of a lot of innocent people who invited him to pray with them. And three, reauthorize the violence against women act. Which is so called closed 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 a thousand hours of hearings to pass the violence against women act. And one thing came through. If, in fact, a stay away order, an order preventing the abuser from coming in at 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. But all these bills, they had support of both democrats and republicans in the house. And universal background checks are supported by the vast majority of the American People. And i might add, the vast majority of responsible gun owners. So let me be clear. This is not a partisan issue among the American People. This is a view by the American People as an american issue. And im willing to work with anyone to get these done. And its long past time that we act. Now, i know this has been a hobby horse of mine for a long time. Got it done once. We should also ban assault weapons and high capacity magazines 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 told other champions of this legislation, they sometimes feel outgunned by assault weapons of large capacity magazines. Theres no reason someone needs a weapon of war 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. Wasnt easy. Going up against the gun lobby but it saved lives. And we should also eliminate gun manufacturers from the immunity they receive from the congress. You realize, again, the people here, because theyre so knowledgeable, down there in the rose garden, but what people dont realize, the only industry in america, a billion dollar industry, that cant be sued, as exempt from being sued, are gun manufacturers. Imagine how different it would be had that same exemption been available to Tobacco Companies who knew and lied about the danger they were causing, the cancer cause and the like. Imagine where wed be. But this is the only outfit that is exempt from being sued. If i get one thing on my list, the lord came down and said, joe, you get one of these, give me that one. Because i tell you what, there would be a come to the lord moment, these folks would have, real quickly. But theyre not, theyre not, theyre exempt. I know that the conversation about guns in this country can be a difficult one. But even here, theres much more Common Ground than anyone would believe. Theres much more Common Ground. Everything thats being proposed today is totally consistent with the second amendment. And theres a wide consensus behind the need to take action. I know that when overwhelming majorities of americans want to see something changed and it will affect their live and it still doesnt change it can be demoralizing to our fellow citizens. It can feel like our entire political process is broken. I know its painful and frustrating that we havent made the progress that wed hoped for. But it took five years to get brady bill passed and it took even more years to work to pass the assault weapons ban and it saved lives, no matter how long it takes, were going to get these passed. Were not going to give up. We have an opportunity to fulfill the first responsibility of gunmen to keep our people safe. And in the process we can show the world and show ourselves that democracy works. And 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 feel strongly and are pushing every day to make the rational changes, and courageous parents and family members, i know the progress, even in this most difficult of issues, is possible. So folks, this is just a start. Weve got 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. Were not going to give up now. The idea that we have so many people dying every single day from gun violence in america. Its a blemish on our character as a nation. Let me say to all of you, god bless you but most importantly the memory of all the many of you have lost in the senseless gun violence, and now id like to hand it over to the attorney general for him to speak and make some comments. And i hope i get a chance to see some of you after this is over. Thank you, 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, with 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 the collective effort to keep guns out of the hands of criminals and save 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 gun trafficking, one that will take into account the fact that modern guns are not simply cast or forged anymore, but can also be made of plastic, printed on a 3d printer, or sold in selfassembly kits. We will evaluate how some of our best tools, including the National Integrated ballistics Information Network and the National Tracing Center are keeping up with the times. And we will analyze our criminal cases and investigations to determine 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 socalled ghost guns. Federal law requires that manufacturers mark all firearms with serial numbers so they can be traced if it also requires licensed firearms dealers to run background checks, to ensure that individuals who are barred by law from purchasing firearms cannot do so. The emergence of ghost guns threatens both of these important Law Enforcement objectives. 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. Yet, because of a gap in the atf regulations these kits may not be considered firearms. As a result they are being made and sold without serial numbers and sold without background checks. Within 30 days atf will issue a proposed rule to plug that gap. And to enable Law Enforcement to trace crime guns and to keep guns from being sold to those who cannot lawfully possess them. Third, we will make clear that statutory restrictions on short barrelled rifles apply when certain stabilizing braces are added to highpowered pistols. Federal law requires the taxation and registration of all short barrelled rifles. It does so because these weapons are powerful yet easily concealable. Currently, however, some manufacturers market and some individuals purchase certain kinds of stabilizing braces that when attached to a pistol effectively convert it into a short barrelled rifle. A weapon that is in the words of the statute, quote, intended to be fired from the shoulder. Such braces make high powered pistols more stable and accurate, while still concealable. Within 60 days atf will issue a proposed rule that will make clear that when a device marketed as a stabilizing device effectively turns a pistol into a short barrelled rifle, it is subject to the requirements of the statute. Fourth, we will publish model red flag legislation for states. Red flag laws, as the president has explained, allow family members or Law Enforcement to petition for court orders that temporarily bar people in crisis from accessing fire arms, if they present a danger to themselves, or to others. 19 states and the District Of Columbia have already made this important step. Within 60 days the Justice Department will publish model legislation that will make it easier for states that want to craft laws permitting such emergency risk orders to do so. Fifth, we will empower our communities to combat and prevent gun violence. We all recognize that although Law Enforcement plays an important role, gun violence is not a problem that Law Enforcement alone can solve. 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 evidencebased intervention strategies for reducing gun violence. Such strategies include but are not limited to street outreach, violence interrupt ers, and hospital based violence interruption services. I have directed all of our grant making 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 effectively carried out without strong leadership. That is why the president has nominated David Shipman to be the next atf director. Mr. Chipman has come up through the ranks, spending 25 years in the trenches fighting illegal gun trafficking, and criminal enterprises. His extensive experience as an atf agent will prove invaluable, and i look forward to working with him. Looking out at many of you is not only a reminder of the tragic toll that gun violence takes on our communities, but also of the resilience and determination that it will take to make our community safer. The department of justice shares your commitment, and that of the president and of the Vice President , to stopping the plague of gun violence, and saving the lives of those we love. Thank you. [ applause ] hello to our viewers in the United States and around the world. Im jong king in washington, youre watching here the rose garden at the white house. Lets listen to President Biden. Thank you, thank you, thank you, lets get to work. [ applause ] the president heading back into the oval office with the Vice President and the attorney general of the United States, you saw him run off the stage and elbow bump there the former congresswoman Gabby Giffords gunned down in tucson, her district when she served in Congress Several years ago. This one, one big important of many big important events today, also dramatic testimony in the Derek Chauvin trial, back to that momentarily. But lets discuss what we just heard, new gun control measures and new promises from the United States. Joining us kaitlan collins, dana bash and justice correspondent evan perez. Kaitlan, at the white house, proof that elections, they do have consequences, this day 78 of the biden presidency, the new president promising several executive actions on rolling executive actions to sign to sake some guns off the market within 30 or 90 days. They want new regulations and also this is more aspirational because at the beginning of his remarks i thought it was interesting, he acknowledged the tough Political Climate but he said i will do what i can with executive power, and i Wish Congress would finally act on several other measures. Yeah, hes still calling on congress to act but what we recognize and what he publicly conceded this that First Press Conference he had a few weeks ago is that its going to be really tough to get any kind of legislation passed and there is no appetite right now to get those house passed bills on capitol hill through the senate. And so what he is calling for there, you know, isnt really going to its not likely to happen any time in the near future. So instead he is focusing on these executive actions, but of course the problem with executive actions is theyre pretty limited. This is something that President Biden actually even argued about with Vice President harris, of course, when they were both candidates on the stage about what you could do as president when it came to guns. And so what he is doing here is he is proposing these new rules that are going to go through the Justice Department, before they actually become rules but, one is he said, something that we did not actually hear from officials yesterday, which is that those ghost guns, those kits where you can essentially build a gun from scratch, and they dont have serial numbers, you dont have to go through background checks for them. He wants them classified as firearms and he wants this rule proposed where they could curtail the proliferation of those and the other rule is they want to have a regulation for stabilizing braces. This is something we saw happen in the recent shooting in colorado. Basically, you can put it on a pistol and it makes your shot more accurate. And so he wants those to be regulated, more often than they are right now. And, of course, the other steps are more symbolic, presenting these model red flag laws for other states to follow, and so these are really modest compared to what the actions that President Biden promised on the campaign trail and so where that goes from here, that remains to be seen because he did acknowledge theres a lot more work to be done. But these are the steps that he was taking after he was facing pressure to do something, to do anything on guns after those shootings we saw happen in georgia and colorado. Evan perez, kaitlan is absolutely right, only so much the federal government can do through executive action but it does matter if you have a president who wants to talk about this issue, President Trump back in his days met several times with victims of gun violence and promised them quite a bit. In the end the administration only changed the regulations about bump stocks, one of them used in the vegas shooting. When you have a president , a Vice President , an attorney general, and now a new director of the bureau of alcohol and tobacco and firearms, confirmed, a gun control advocate. How much of a difference does that make . Well, yeah, look, if you have a president who says he wants to do it, and will not yield to the pressure from groups like the nra, then you can have certain things done, certainly you can do the exec futive actions, but john, a couple things that come to mind. Dave chipman, the president s nominee to run the but reof alcohol and tobacco fire arms and explosives, hes not going to have an easy time going through nominations. We expect people like joe manchin, some senators, perhaps, from progun states are going to think twice before voting for someone who is out there calling for strict restrictions on guns. Thats going to be a tough fight for the administration. And clearly theyre ready to make that fight. So well see how that unfolds. One of the things that the president is talking about is one of those arm braces, regulation for that, which as kaitlan pointed out, the shooter in boulder was using to make his pistol shoot more accurately. What that was a regulation that actually the Justice Department tried to put into place just in the last few months, of the obama im sorry, of the Trump Administration, and they face tremendous pushback from the gun lobby, from gun rights groups, and they withdrew it. So the idea that theyre going to try to do that now, i suspect, that youre going to get this similar pushback and well see how they can how they can bring that about. As you said, if you have leadership, here the Justice Department at the white house, that wants to do something, you can get something done. And thats the question, dana bash, youve been through this many times, your times covering the white house and capitol hill, do you have sustained focus on the issue . Lets just look, we have a map here, this is just in the two weeks, the two weeks, the last two weeks of march, 21 Mass Shootings across the United States, two weeks in march, two weeks in march, the president of the United States himself noting 850 people were shot in the United States of america, victims of gun violence in the one week between georgia and boulder, colorado, and we can put up this polling, this is from abc news, and ipsos, back in a late march. Protecting the right of gun owners, its a 66 issue out in the country right now. So out in america, there is support for much, maybe not everything, but much of what the president just talked about, the question is, in this town, it always gets stuck in the weeds, and, you know, kaitlan made the argument, evan again, you look at a fivevote democratic majority in the house, 50 50 senate, midterm elections coming up and you would expect the preponderate thats the moment to be bold. Thats exactly right and that polling you showed is similar to the polling the white house used to push along party lines this is a different issue, they cant do this, the covid bill. The approach inside the white house has been regardless of the fact that things are stuck in partisan in washington, look at how real people in the real country feel about it. The issue is, you mentioned it, and our friends at capitol hill and justice mentioned it, the nra and gun rights groups. President trump, when he was in the white house meeting with families after so many of these horrible tragedies, he came pretty close, and we all know what stopped him. It was the nra, it was a conversation with the nra, it is this is a prime example of groups that exist and raise money off of the idea that they are going to stop something in this case and that is from their from the perspective of 60 of americans, common sense gun control. So unless there is real leadership from the biden administration, and even with that it is going to be incredibly hard. He was part of the obama administration, im listening to former president obamas memoir, he talks about how impossible it was, even given Gabby Giffords, one of their colleagues being shot, what happened in newtown, and so on and so forth, and not much has changed even with that polling. Even with that polling, not much has changed in this town. The question is, youre right about the Trump Administration days, but the nra was able to show up in the gates and get into the oval the next day. It wont happen now. We will see, as this plays out, dana bash, kaitlan collins. Well take you back live to minneapolis, the prosecution still questioning a very important today. Dr. Martin tobin, lets listen in. So you might recall mr. Floyds last words, you know, i cant breathe. Right. Are those words significant to you apulmonologist. Very important, complaining to you of difficulty with breathing but theyre also telling me that at that time, when hes saying please, i cant breathe, hes we know at that point he has oxygen in his brain. But and again, its a perfect example of how it gives you a huge false sense of security because very shortly after that were going to see that he has a major loss of oxygen in the way that he moves his leg. And so it tells you how dangerous is the concept of, if he can breathe or if he can speak, he can breathe. Yes, that is true on the surface. But highly misleading. Very, very dangerous mantra to have out there. So if im hearing you correctly when he says i cant breathe, that shows his brain is alert. Yes. But then immediately thereafter his brain wasnt. Correct. And did you see or is there anything in the video that you can show the jurors that they can see also that would point to the fact that his brain was no longer alert . Yes. Let me pull up exhibit 47, already in evidence. And 2024. So im going to play a clip for you, dr. Tobin and then tell the jurors what they see afterward. Yes. Youre enjoying it. So theres a key finding that youre seeing here, and that is when you see his leg going up, and you have to keep in mind hes prone. So hes facing down, this is his leg coming up backwards. And so thats what we call as clinicians, thats an Extension Movement of the leg. And that is something we see when somebody suffers major brain lack of oxygen. And it tells us at that point hes having what are sometimes called myclonic seizure or hypoxic seizure. But amounts to saying youre seeing fateful injury to the brain from a lack of oxygen. Sometimes also called an anoxic seizure. All of these different words, a lot of different words used but they all come down to the same thing. That it is that at that point the brain is responding to the drastically low level of oxygen thats present. And does the fact of an anoxic seizure reflect damage to the brain . It indicates Severe Damage to the brain. And the reflex that we saw with the legs coming up, is that an involuntary reaction . Its an involuntary reaction. I mean, theres a lot of different medical terms that we apply to it. But the bottom line is, that youre seeing that the the leg jumps up like that, as a result of a fatally low level of oxygen going to the brain. So doctor, we talked about the brain injury. We also told us earlier about low levels of oxygen, potentially causing pulseless electrical activity. Yes. And is that also, then, evidence of low oxygen . Right. So, i mean, when you have a low level of oxygen, thats going to show up in the brain, and its also going to show up in the heart. When it shows up in the heart, its 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 a p. E. A. Pulseless electrical activity. Electricity is in the heart but its not resulting in any mechanical force. Thats why it has that name. And so its the low level of oxygen is producing both. We dont see the p. E. A. , the pulseless electrical activity arrhythmia until thats shown up on the ekg in the ambulance. Its much later that we see the evidence of it in terms of display. But here were seeing huge evidence in terms of the leg. The leg is crucial here because this is this is the time that youre the first time youre seeing there is major oxygen damage. You reach a point where mr. Floyd couldnt speak due to low oxygen, was there a correlation to the narrowing of the airways that prevented him from speaking . Yes, as well. I want to show you whats marked as exhibit 934, 936 and 933, and just tell us what are these images in general . So were seeing again the same mri, but at a different view of it that we looked at before. Your honor, ill offer exhibits 934, 936 and 933. Any objection . No, your honor. 934, 936 and 933 are received. So doctor, tell us what we see here, starting with the first all right, so this is the same mri that you saw before. But whats full what youre being your attention is drawn to by the yellow arrow is the vocal cords. And the vocal cords is simply how you speak. So to speak you must inhale, you must take air into your lungs. When you let the air out youre going to vibrate those little vocal cords there and thats what makes the sound of speech. And so here we see the size of the windpipe, the trachea, and this becomes important in terms of speech because our knowledge about the influence of the size of the trachea, of the windpipe for speech is from patients who have had an endotracheal tube in place and it causes scarring after that. We know what at the point how much scarring in your windpipe will prevent you from speaking. These are just the dimensions. You know the size of the normal trachea, its between a quarter to a dime as you can see here in terms of the diameters. Next slide. And here is when the those coins have been shrunk to 15 . And even when the trachea has narrowed all the way down to 15 , you are still able to speak. Even when the hole through your windpipe is just this size as ive shown here where ive shrunk the size of the coins you are still able to speak. So it tells you how dangerous it is to think, well, if he can speak, hes doing okay because at this point you will be able to speak, but again if there is a small increase in the amount of narrowing, not only will you not be able to speak, you wont be able to breathe, you wont be able to live. So its a very dangerous thing to think that because youre able to speak youre doing okay. And so, doctor, youre not able to speak, breathe or live once the airway narrows to below 15 . Correct. Once you go from the 15 , youre still able to speak and then as it gets lower from that initially youll be struggling and then at some stage you just wont be able to do anything. If we could show exhibit 940. Its already admitted. So again, this is exactly because this is the same experiment i showed you before. And it just so happens, this is pure coincidence. Its at 85 here, looking at the top curve and thats the same number that we showed you on the mri. This is pure coincidence. But you can see here, once youre up at 85 , the work of breathing is enormous. Its 7 1 2 fold increase. And then as that and that narrowing would get further and further, and then the work will become unbearable. So again, it just emphasizes at the point where you cant speak, and you are indeed troubled. Doctor, id like to transition now 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. Floyds 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 peoples breathing. You get an awful lot of information by looking at how they breathe, by looking at how they use their chest wall, all of this is extremely informative. And at the lowest level, one of the simplest things to do that is especially informative is simply to count how many breaths somebody takes in. Its one of the vital signs, like with blood pressure, pulse rate, temperature, is the respiratory rate. It gives us a lot of clues as to what is happening inside the body. Is this something youve done before . Ive done it millions of times. Do you train others how to do it . Ive trained nurses, respiratory therapists, medical students and doctors how to do it. So youre accounting the breaths. Do you observe the muscles and things also . Separately from count it is breaths, youre going to look at the different muscles theyre using, what type of bucket handle they have, pump handle, youre looking at all of this in a glance, i mean 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. Floyds breathing in this case on the videos . Yes, i did. Was there Video Evidence from which you could take measurements . Yes, there is. Want to show exhibit 43 thats already in evidence. So i want to play this, doctor, and afterward tell us what were seeing. In a moment it will start. So if you focus down here on where he is, the handcuff 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, hes making a respiratory rate here and then another, and so we need to play it back. Because i needed to tell you first where to focus. If you focus down there you will be able to count out the rates. We will play it once more so that you can count the rates and we can see what youre referring to. One, two, three, four, five, six, seven, eight. So that was roughly a 17 second clip. Right. And you counted seven of eight breaths. Between seven and eight. Did you use this to calculate a rate of respiration . Yes, because i mean, its simple, once you have 19 seconds, and you count out the number of breaths, you have here, and if you say you count out seven breaths, that will come out at a respiratory rate of 22. Is that number, the respiratory rate of 22 significant to this case. Its 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 is causing depression of the respiratory centers, the centers that control breathing, thats going to result in a decrease in the respiratory rate. And its shown that with fentanyl you expect a 40 reduction in the respiratory rate. So with fentanyl his respiratory rate should be down at around 10. Instead of that its right in the middle of normal, at 22. So you didnt see a depressed rate of respiration for breathing rate in mr. Floyd. No, its normal. And so what does it tell you, bottom line, with respect to fentanyl, as relates to mr. Floyd . Exactly in terms of fentanyl the major one of the major changes you see in fentanyl is a slowing of the respiratory rate. So and again, we would be expecting a 40 reduction in the respiratory rate with fentanyl. The normal respiratory rate is 17 breaths per minute, plus or minus 5. So that would mean a normal respiratory rate of between 12 and 22. Thats the normal range of respiratory rate. And so if it was with fentanyl, youd expect a respiratory rate of about ten, its data you counted here yourself. You can see when you counted yourself the respiratory rate is 22. Basically you can tell there isnt fentanyl on board thats affecting his respiratory centers, its not having an effect on his respiratory centers. Mr. Floyds respiratory rate was normal at 22 just before he lost consciousness . Correct. So the jury smamay have hear some other information in the case about the fentanyl related to an elevated Carbon Dioxide level in mr. Floyds body in the emergency room. Was that significant to you . Yes, thats very significant as well. How so . Because hes reported to have a pc 02, sorry, i take it back, hes reported to have a Carbon Dioxide level in the ar terial blood in the emergency room of 89. Thats a very high level of Carbon Dioxide. You have to take into account what are the factors that might have led to that. Theres 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 millimeters thats the normal. You dont need the millimeters of mercury stuff, but theyre the units that are given in the hospital chart. So you said that there were significant factors in the case of mr. Floyd. Would you help the jury understand what those were . Yes, the important factors are that we know that me made his own last spontaneous effort to breathe at 20 25 16. After that, you can look at the videos, and you see he makes no effort to breathe. He makes no breath. The last breath he took was at 20 25 16. Then we know after that hes stayed on the street for another three minutes or so. Then hes placed into the ambulance, and we know that in the ambulance they attempted to put in an airway. An igel and you can see that on officer lanes body cam. You can see all of that happening. And then you can see the time at which they actually 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. And why is that significant . Thats very significant because we can calculate what is the rate of increase in the Carbon Dioxide in somebody who doesnt breathe. If somebody doesnt 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. And 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 youre going to get a value of between 89 and above so it comes out virtually identical to the value that they found in the emergency of 89. So doctor, whats the punch line with respect to that . What does it tell us . The significant of all of that is its a second reason why you know fentanyl is not causing the depression of his respiration. What youre seeing is that the increase in his Carbon Dioxide, that is found in the emergency room, is solely explained by what you expect to happen in somebody who doesnt have any ventilation given to them for 9 50. Its completely explained by that. When a person, then, is not breathing, then Carbon Dioxide would naturally continue to build up in the body . Yes. And thats what matches what was seen in the o. R. For mr. Floyd . Precisely. Now, youve said that there were other things that were significant that were related to the rate of respiration and we talked about fentanyl. Right. Was there anything else . Yes. The other things theres two other things that are very important to the respiratory rate. You saw it with your own eyes, exactly his respiratory rate and the first thing is that if you have somebody who has underlying Heart Disease, and the Heart Disease is so severe that its been said that its causing shortness of breath, that its causing you difficulty with breathing. If somebody has Heart Disease thats causing shortness of breath, virtually all of those parishes are going to have very high respiratory rates, theyre going to have respiratory rates of over 30, even over 40 when you have Heart Disease that will give you shortness of breath. Instead we find that his respiratory rate is normal at 22. The second thing thats important about the respirator