Some say, "He was speaking so he wasn't being choked....he was moving air." In medical terms we use the term 'obstructed or obstruction' to indicate either a complete or partial obstruction. An example might be a carcinoma in the trachea or bronchus with a 50% or 70% occlusion or obstruction. This impedes movement of air to the lungs where gases are exchanged. An intrinsic mass obstructs air flow just as an extrinsic pressure obstructs air flow. The real issue here is not if he was partially or completely obstructed. The issue is whether he could move oxygen adequately to the alveoli and on into the bloodstream to serve O2 to the heart muscle to keep him alive. So.....as he was standing on the street he was not in extremes. There was no exigency until he was taken down by five men. At that time he began to sense the fact that he could not breath, and repeatedly said so. What changed between the time he was trying to sell a singular cigarette and when he died. We saw it all on video.
So what conditions existed at the time he started complaining of breathlessness?
Broadly classified, we speak of obstructive lung disease and restrictive lung disease. Emphysema (COPD), asthma, and airway obstruction are prime causes of obstructive airway disease.We know he is reported to have asthma, which is partial occlusion due to the tiny muscles around the bronchioles going into sustained construction and though the spongy nature of the lung will normally assist in moving air out of the alveoli, when obstructed by this spasm the obstruction will not allowl movement OUT of the lungs. The scar tissue from chronic smoking will likewise prevent the air from moving out of the lungs, but for a different reason. Now may of you have seen asthmatics in crisis. They are speaking, but not with a normal ability. As COPD brings one near the end of life, the old lingers will speak usually until their overall physiological condition and oxygen saturation will no longer sustain life. Often we put these people on positive pressure ventilators to force oxygen into the alveoli and then the bloodstream so it can be delivered to tissues. But, they are not completely obstructed.
Restrictive lung disease results from the chest wall or contents of the abdominal cavity (ie. fat, fluid, tumor) which prevents adequate excursion of the chest to move gas into and out of the lungs. Heavy weights on the chest wall and/or abdomen will likewise restrict movement of those gases.
Often you will see these people sit or sleep in a slightly upright position to diminish the compromised air flow.
As he stood vertically the weight of the contents of the abdomen (large fat content in the abdominal cavity), asthma was not a physiological issue. We are also told he had some degree of heart disease. It has been reported that he did not die of being choked to death, he died of cardiac arrest. Well, OK, don't we all die ultimately of cardiac arrest. The real question in this case is, ''what caused the cardiac arrest?' Most death certificates would read - Cause of death-Cardiac arrest, secondary to hypoxia, secondary to obstructive and restrictive lung disease, secondary to emphysema, asthma,choking, and restrictive lung disease secondary to obesity and heavy weight on the chest wall and abdominal cavity, secondary to men laying on chest and abdomen, secondary to arrest. That would essentially sum up the series of e events.
I think the grand jury either need to wrestle or should have wrestled with the question, "What was the proximate cause of the death of this man?"
I think to see him standing on the sidewalk under his autonomous power and once the assault to obtain custody by the police he rapidly degenerated to death.
One might consider the fragility of this man. A marathon runner will often have a heart rate of 40/minute (or less) and his hemoglobin is slightly raised. (This is what Lance Armstrong did when he was blood doping - taking packed cell infusions so he could acquire more oxygen delivery). Obese people, people who are in poor health will often run an oxygen saturation of 91-92% while normal healthy people will have a 97% oxygen saturation. Once you get to 90% oxygen saturation we put people on ventilators with positive pressure oxygen therapy. That is not a lot of margin for compromising a mans oxygen saturation. i suspect this fellow also had an element of congestive heart failure which compromises the ability of the muscle of the heart to pump adequate volumes of blood out of the heart to the lungs to pick up oxygen. If asthma (bronco spasm) was in play that too was a factor complicating the situation.
So again, while standing on the sidewalk, he was not in extremes. Once the assault began his physiology rapidly decompensated and he died. He would not be dead if he had not been assaulted.
Some say, "The police could not have known he was so compromised." But with 11 prior arrests (9 of which for selling single cigarettes), it is my understanding that the police take a cursory medical history so they will not have trouble while he is locked up. This may or may not be true, but it is reasonable.
But when the responsible party (the police) are needing to exercise good judgement they should have enough 'smarts' to know when a person like this says he cannot breath, they should give that complaint due consideration or be ready to suffer the consequences. Those consequences would be to put your head on a pillow each night knowing you were the cause of death for this mans death.
I have read freezers who have said the man was a POS, fat, obese, didn't take care of himself, and much much worse. But non of those are reasons for the authorities to kill him or rather be the proximate cause of his death.
Sorry for going on so long.
From the video please describe what you think was the lack of consideration during the time that he was saying that he couldn't breathe.
Don’t be sorry. Very worthy explanation of things; much appreciated.
While you give an excellent overview, you miss a couple of key things. First, it was reported by Mr. Garner’s friends that he couldn’t walk a single block without stopping and sitting down. Second, it was alleged he was either in a fight or had stopped a fight, thus in some heightened state of respiration etc. Third, he was not assaulted. When they went to arrest him (and he was on parole), he said “not today,” a verbal indication he was resisting/refusing arrest. Fourth, he pushed the hands of the police away, which may constitute assault on his part. Fifth, due to resistance, he was pulled to the pavement, which is not assault. Sixth, within 3 seconds of first saying “I can’t breathe,” the officer completely removed himself from Mr. Garner. EMS was called immediately after he said “I can’t breathe. Approximately 3 minutes later, EMS arrives, he is breathing, conscious, and speaking. He remained breathing, conscious, and speaking until he entered the ambulance. By this time, it had been approximately 11 minutes since the arrest was effected. Finally, Mr. Garner expired, in the ambulance, while having an heart attack. The total amount of time the officer had any part of his body touching the head or neck area was 17 seconds. Further, no one was sitting on top of him within seconds of him first saying “I can’t breathe.”