Updated April 14, 2021 at 4:01 PM ET

Former Minneapolis police officer Derek Chauvin's defense attorney continued to present his case on Wednesday, including calling a medical witness who disputed the conclusions of many experts who testified for the prosecution.

Chauvin is charged with murder and manslaughter in the killing of George Floyd, who died after Chauvin held his knee on Floyd's neck for nine minutes and 29 seconds on Memorial Day last year.

Dr. David Fowler, a retired forensic pathologist who was chief medical examiner for the state of Maryland, testified that in his opinion, the manner of Floyd's death should be classified as "undetermined" rather than "homicide."

The Hennepin County medical examiner, who testified earlier in the trial, had concluded that Floyd's death was a homicide.

Medical experts called by the prosecution have said that low oxygen levels, caused by the restraint, were the cause of Floyd's death. Chauvin's defense has suggested that Floyd's heart condition and drugs in his system were primary factors.

"In my opinion, Mr. Floyd had a sudden cardiac arrhythmia ... due to his atherosclerotic and hypertensive heart disease ... during his restraint and subdual by the police," Fowler said.

In Fowler's determination, "fentanyl and methamphetamine" contributed to Floyd's death. He also said that "there is exposure to vehicle exhaust, so potentially carbon monoxide poisoning or at least an effect from increased carbon monoxide in his bloodstream."

The witness stated that he did not believe carbon monoxide from the squad car's exhaust did not cause Floyd's death, but said it was potentially a contributing factor.

Questions about Chauvin's restraint

According to testimony, Chauvin's weight was about 140 pounds. Chauvin used a "single-knee technique" in his restraint of Floyd, which Fowler testified would mean that he applied less than 23% of his body weight onto Floyd.

Nelson asked whether Chauvin's knee in any way "impacted the structures of Mr. Floyd's neck."

Fowler replied: "No, it did not. None of the vital structures were in the area where the knee appeared to be from the videos."

Other medical experts in the trial, such as Dr. Jonathan Rich, have stated that the restraint and "positional asphyxiation" caused Floyd's oxygen levels to plummet, ultimately resulting in cardiopulmonary arrest.

Regarding Floyd's injuries, Fowler said "all of his injuries were in areas where the knee was not": the front of his body, his face, places where he was restrained, but not in the back or neck, Fowler said. He said there were not bruises or abrasions on his neck or back, which he said suggests that the amount of force applied to Floyd was less than the amount that causes bruising.

Testimony on cause and manner of death

Fowler concluded that Floyd suffered a sudden cardiac event as a primary cause of death.

He explained the factors that led to his conclusion, including Floyd's enlarged heart, methamphetamine and fentanyl in his system, possible carbon monoxide exposure, and narrowed blood vessels.

"There are multiple entities all acting together and adding to each other, and taking away from a different part, of the ability to get oxygen to his heart," Fowler testified. "And so at some point the heart exhausted its reserves of metabolic supply and went into an arrythmia and then stopped pumping blood effectively."

Fowler contradicted the conclusion made by Dr. Andrew Baker, the Hennepin County medical examiner, that "homicide" was the manner of Floyd's death.

As Baker told the court last week, "In my opinion, the law enforcement subdual, restraint and the neck compression was just more than Mr. Floyd could take, by virtue of those heart conditions." He said he did not believe the drugs in Floyd's system were a direct cause of death.

In Fowler's opinion, the manner of his death should be classified as "undetermined," arguing that there were too many factors at play to decide which is most accurate.

Fowler faces lawsuit in a Baltimore death-in-custody case

Fowler is one of several parties being sued by the family of Anton Black, a Black 19-year-old who died in police custody in 2018. The Maryland medical examiner's office, which Fowler then led, ruled the death an accident and said there were no signs police did anything wrong, The Baltimore Sun reported.

No officers were charged in Black's death.

"Two years before George Floyd died after being restrained and pinned down by police, 19-year-old Anton Black ... was killed by three white law enforcement officials and a white civilian in a chillingly similar manner on Maryland's Eastern Shore," says the lawsuit filed by Black's family. "This lawsuit arises from the wrongful death of Anton Black at the hands of officers from three different police departments on September 15, 2018, and the ensuing efforts by public officials to protect the officers involved from the consequences of their excessive use of force against a Black teenager."

Chauvin's attorney began laying out the defense's case on Tuesday, including showing police body camera footage of Floyd from a 2019 traffic stop. The jury also heard from witnesses including a woman who was seated in Floyd's car when police approached him last May.

A major component of the prosecution's case has been testimony from other officers and experts who have said that Chauvin's restraint of Floyd was not justified and ran counter to police training.

On Tuesday, the defense attorney called upon Barry Brodd, a former officer and use-of-force expert, who said Chauvin "was justified, was acting with objective reasonableness, following Minneapolis Police Department policy and current standards of law enforcement."

Judge Peter Cahill has said closing arguments in the case will likely begin on Monday.

NPR's Merrit Kennedy contributed to this report.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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