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Prince Philip Dead at Age 99; European Regulators Probe Possible Link Between Blood Clots and Johnson & Johnson Vaccine; Tenth Day of Testimony in Derek Chauvin Murder Trial. Aired 10-10:30a ET

Aired April 09, 2021 - 10:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

JIM SCIUTTO, CNN NEWSROOM: A very good Friday morning to you. I'm Jim Sciutto.

POPPY HARLOW, CNN NEWSROOM: And I'm Poppy Harlow.

Minutes from now, a pivotal moment taking shape in the Derek Chauvin murder trial, a crucial witness that is the medical examiner who performed George Floyd's autopsy and ruled his death a homicide, is expected to take the stand. But his initial report did not mention asphyxiation, that is a key point made yesterday by the prosecution's medical expert.

SCIUTTO: We're also following major breaking news this morning. Prince Philip, the Duke Edinburg, and husband to Queen Elizabeth has died at the age of 99. And we begin there this morning. CNN's Anna Stewart is in London with more. A remarkable life riddled with history, with history of this monarchy and this country but also a remarkable personality in Prince Philip.

ANNA STEWART, CNN REPORTER: Well, exactly. Good morning, Jim. Good morning, Poppy. It's a somber mood here outside Buckingham Palace. The news came through around three hours ago. And already you can see people are coming to the gates of Buckingham Palace. We've seen people leaving flowers and the flag is at half-mast. This is a nation going into mourning.

Now, the legacy of Prince Philip, as you say, is something that is really quite extraordinary, a really life well lived, I would say. He was married to the queen for 73 years, the longest serving British consul in history. And that is, of course, what he'll be most well known for.

But this was a man, of course, of many passions. He was very much the head of the family. Here's how Boris Johnson, the prime minister, described his legacy.

(BEGIN VIDEO CLIP)

BORIS JOHNSON, BRITISH PRIME MINISTER: Like the expert carriage driver that he was, he helped to steer the royal family and the monarchy so that it remains an institution indisputably vital to the balance and happiness of our national life. Speaking on their golden wedding anniversary, her majesty said that our country owed her husband a greater debt than he would ever claim or we shall ever know. And I'm sure that estimate is correct.

(END VIDEO CLIP)

STEWART: Her majesty also said on that golden wedding anniversary that Philip was quite simply my strength and stay all these years. And while it's important to recognize a live well lived and, my goodness, we're going to celebrate the incredible legacy of the man, it's a very sad day not least for her majesty, the queen, for his four children, eight grandchildren, ten great grandchildren he leaves behind. Poppy, Jim?

HARLOW: Truly the love of her life in every way. Anna Stewart, thank you, at Buckingham Palace for us.

SCIUTTO: Well, just minutes from now, day ten of the Derek Chauvin murder trial will get under way today. We expect to hear from one of the most crucial witnesses, the medical examiner who performed George Floyd's autopsy and ruled his death a homicide.

HARLOW: One big question, will he concur with what the medical expert, the key medical expert, Dr. Tobin, said yesterday?

(BEGIN VIDEO CLIP)

DR. WILLIAM SMOCK, EMERGENCY MEDICINE PHYSICIAN: Mr. Floyd died from positional asphyxia, which is a fancy way of saying he died because he had no oxygen left in his body.

When the body is deprived of oxygen, and in this case, from his chest, pressure on his chest and back, he gradually succumbed to lower, lower levels of oxygen until it was gone and he died.

(END VIDEO CLIP)

HARLOW: Let's bring in our Senior Legal Analyst Laura Coates and CNN Law Enforcement Analyst Charles Ramsey. Good morning to you both.

And I was remised, Laura, because I thought we were going to play sound of Dr. Tobin. That's my mistake. That was another medical expert just adding on to what Dr. Tobin said. So can you talk about what the prosecutors do today when it comes to Dr. Andrew Baker, the Hennepin County Medical Examiner, who performed the autopsy, that does not say the word asphyxiation in it? How do they, I assume, attempt to get him there?

LAURA COATES, CNN SENIOR LEGAL ANALYST: Well, they laid the foundation through other medical witnesses, as you played and, of course, with Dr. Tobin as well and others, who talked about the lack of oxygen, the deprivation of oxygen, as the cause of death, the substantial causal factor in death here. Now, they have to move to the medical examiner.

Although the report did not use the word asphyxia, it does speak about cardiac arrest. And, of course, we've learned from prior witnesses that that is not synonymous or only inclusive of a heart attack as it is often colloquially referred to.

People think cardiac arrest, they assume heart attack, but they have gone to great lengths to say that these medical terms are essentially the cessation of the human heart. That's how everybody dies, the cessation of the human heart, it stops beating.

So now, they'll be unpacking what this report that usually is written not for juries, per se, but written in medical terms, to unpack what that means. And it might ultimately not end up being all that different from what we've already learned so far.

SCIUTTO: Yes. It was like a class almost, a teacher explaining to students in terms that they could understand, the science, the medicine of this.

[10:05:01]

To Poppy's point, Dr. Martin Tobin, this pulmonologist, pulmonary expert, did this explaining. But, Charles Ramsey, I want to talk about a moment where he explained how Chauvin's interaction with Floyd was key and how he demonstrated that. Have a listen. It's about the body position of Chauvin on Floyd. Here it is.

(BEGIN VIDEO CLIP)

DR. MARTIN TOBIN, PULMONOGY EXPERT: Mr. Floyd died from a low level of oxygen.

The toe of his boot is no longer touching the ground.

That's 91.5 pounds is coming down directly on Mr. Floyd's neck.

(END VIDEO CLIP)

SCIUTTO: Talking, of course, about the toe of Chauvin's boot, not touching the ground, therefore, all the weight weighing down on Floyd, in effect, impacting his airway.

And I wonder, as a police officer, given the number of minutes that Chauvin was doing that, what was your reaction to hearing that description?

CHARLES RAMSEY, CNN LAW ENFORCEMENT ANALYST: Well, first of all, I was amazed throughout his testimony just how precise he was and how detailed he was in his review of the video and other evidence. I mean, clearly, I think it's been established that Chauvin acted outside of policy and outside of his training. But I think this has implications for the police departments across the country in terms of their training of police officers because Dr. Tobin also talked about just the manipulation of handcuffs, for example, and how that added to pressure and so forth.

And so whereas the police departments has already trained officers on the issues surrounding positional asphyxia, it's not as detailed, not nearly as detailed as what we've heard yesterday. And I think it's going to have an impact. The defense has a very steep hill to climb. And unless the medical examiner today contradicts what Dr. Tobin said, I think they've got a serious problem here.

HARLOW: How do you fix that serious problem if you're a defense counsel, Laura Coates? I mean how do you cross-examine this medical examiner today?

COATES: Well, the only real hope that you have, I'm going to put my defense counsel hat on, which I'm a prosecutor by trade, but you're going to have to attack for -- you have to attack the notion here that, look, there are alternate explanations for the cause of death. And, remember, just as this idea of how the government has to prove beyond a reasonable doubt that this was a substantial causal factor in their death, they're going to have to say and muddy the waters were there other things that may have trumped that.

Certainly this idea of an intervening cause, they tried to push through, through jury instructions request, the defense has said, look, if there is a superseding event or an intervening cause that essentially says, even though Chauvin did this, that really was not what caused the death. They're going to try to hone in and say, when you wrote this report, did you contemplate the toxicology? Did you contemplate whatever drugs were in his system? Did you contemplate underlying health conditions? Now, try to give us a sense proportionally of which was more substantial than the other.

Now, if this medical examiner provides a proportional analysis that says that the other cumulative aspects outweighed whatever happened with Derek Chauvin's use of force, then they're going to try to have a fighting chance at that point in time. But, again, it is an uphill battle but that's the way they have to go.

SCIUTTO: Charles, you mentioned there that this has impact outside the courtroom on police forces, use of force. Are they already reassessing in the wake of this? Have changes already happened in some places as a result?

RAMSEY: Actually, I spoke with a couple chiefs yesterday after Tobin's testimony and they agreed that they have to take a second look at the training. But I think it's important to note even though that is the case, the training that Chauvin received from MPD was sufficient for him not to have done what he did, and to cause the death of Mr. Floyd.

So it's not as if he got bad training. It's just that you have to have continuous improvement and ways in which you present so that officers better understand. But that doesn't get him off the hook by saying well, he had insufficient training. That's not true. The training he got was enough for him to know that what he did was wrong.

HARLOW: Charles Ramsey, thank you. Laura Coates, as always, again, we're going to take you to the courtroom as soon as the first witness today takes the stand.

SCIUTTO: That's just minutes away. Plus, an associate of Republican Congressman Matt Gaetz is expected to strike a plea deal in a federal sex trafficking investigation. Now, at least one Republican lawmaker is calling on Gaetz, who is also facing sex trafficking allegations to resign.

(COMMERCIAL BREAK)

[10:10:00]

HARLOW: New this morning, European drug regulators say they're reviewing a possible link between Johnson & Johnson's COVID-19 vaccine and blood clots. Officials there say that there were reports of four serious cases of people who developed blood clots after receiving the vaccine.

SCIUTTO: And the news comes as U.S. federal vaccine advisers tell CNN that they don't see the AstraZeneca vaccine being used in this country.

Joining us now, as you could see there, Dr. Sanjay Gupta. Sanjay, what is the significance of this for the U.S.?

[10:15:01]

Of course, we don't depend on it. We've got Pfizer, we've got Moderna, you've got the Johnson & Johnson shots, but it's important in many countries. What is the impact and do you share the concerns of these doctors?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, you know, I -- this is going to have significant impact no matter how you look at it, even though we are talking about something that is very rare. If you go back and look at the AstraZeneca in Europe, there was 25 million doses that were given out. And I think around 64 people who developed these blood clots in the blood vessels around their brain. 18 people died. It's not to be minimized by any means but these are small numbers.

And the question for regulators for some time is how likely would these blood clots spontaneously occurred even outside of the vaccine rollout, and it does happen from time to time. So that's still the back and forth.

But, Jim, you know, the information has just, over and over again, been concerning. There was the vaccine trial pause. There were these concerns about blood clots. There was a question about how the data was originally ruled out. So it's going to have an impact.

The World Health Organization has also said, look, this is plausible, not confirmed, but plausible, and they're going to be an important voice in how this vaccine goes out around the world.

HARLOW: I worry about this in terms of folks who are sort of already on the edge, Sanjay. For overall, for almost everyone, it is been very, very safe. People should just know that. But, look, these polls show about a third of Americans are still hesitant or downright unwilling to get a COVID vaccine.

You took an in-depth look into the proven science, so I want everyone to watch this.

(BEGIN VIDEOTAPE)

GUPTA: People have often described this as a very insular community. Was there, you think, a deliberate targeting of this community because of this insular?

UNIDENTIFIED FEMALE: What I do know is that over the course of this outbreak, they were targeted by robo calls.

UNIDENTIFIED MALE: These people anonymously started producing en masse to the tune of like 40,000 brochures would go out door to door, synagogue to synagogue, booklets of pseudoscience that they collected.

GUPTA: The PEACH document --

UNIDENTIFIED MALE: Yes.

GUPTA: -- which is all about advocating for children's health right? How do you combat that?

UNIDENTIFIED MALE: No. It's a beautiful document that's completely full of lies.

GUPTA: This magazine was locally distributed by PEACH, formally known as Parents Educating and Advocating for Children's Health.

CNN was unable to contact the anonymously-led group.

UNIDENTIFIED MALE: They use seemingly innocuous or noble language. But, in fact, their message is actually one that's depriving kids of safe and effective vaccines.

UNIDENTIFIED MALE: They use this image of a gun with a vaccine needle at the end. Like, no, that's not what the vaccine is like. Vaccine is not a deadly weapon.

(END VIDEOTAPE)

HARLOW: And that, Sanjay, a lot of it was from pre-COVID because that was just about vaccine lies even before COVID and now. COVID has made it so much worse.

GUPTA: Right. I mean, we actually had been filming that in 2019 or earlier. We're going to release that before the pandemic hit. It was focused on the measles outbreak in Brooklyn and Minnesota and Disneyland and things like that. But it was really trying to figure out the origins of the anti-vaccine movement.

It is significant. You know, right now, as you know, you showed the numbers, that may be our ceiling in terms of whether or not we get to herd immunity, and maybe vaccine hesitancy, that limits that from happening. SCIUTTO: We are standing by for the start of the Derek Chauvin trial but we will bring it to you the moment it does start.

But, Sanjay, the upper Midwest of this country, some in the northeast too, show some troubling signs of new infections, the chair of the University of Michigan raising the alarm here. I wonder in this battle between vaccinating and new infections, which of those trend lines is winning out right now?

GUPTA: Well, it's a close race but it depends on who specifically is the demographic that we're talking about. I'm going to show this graphic here of how things have changed. You just mentioned Michigan. It showed how things are changing in terms of who is getting hospitalized. We basically compared at the end of the week back in December of last year to a week that's more recent here in this year.

If we have that graphic, we can put it up. But, basically, what it shows -- there is another one that comes after this graphic that basically shows how the people who are elderly, who are clearly most vulnerable, how -- there you go, that percentage was much larger if you look on the left. That is in red.

So what happened has now? Overall, you see numbers are down a bit compared to that week in December. But look how the demographic have changed. That green is 40 to 69-year-olds. They are now the biggest demographic in terms of people who are likely to be hospitalized. Anybody who is between those ages, 40 to 70 years old, essentially, they need to pay attention to this graph. That's what's happening.

[10:20:00]

So the race is still, I guess, Jim, technically, being won, because, overall, the numbers are down but it's changing a lot. And I think that's going to be a really important point going forward.

HARLOW: You've got more than a quarter, Sanjay, of adults in the United States fully vaccinated. That's great. I mean, I just -- I remember what the past year has been like covering this alongside you. But if cases are rising in some places, shouldn't we be seeing the impact of vaccines? Like, I keep wondering is what is happening in Michigan just soon going to happen in the surrounding states? And my mom calls me from Minnesota worried for folks.

GUPTA: No, I can imagine. I mean, so in part, you know, this change in demographic, becoming younger, people who are younger more likely to end up in the hospital now, that I think we are seeing in places besides Michigan as well.

I think the big question -- and this is the part where I think I'm more optimistic about -- is the impact of vaccines overall on deaths. People are still becoming infected, that is clear. As has been said, it's unacceptably high rate that we're still plateauing at right now. And there are these variants out there that are more transmissible. So things that you -- you've been good, you generally wear your mask, but if you took some chances, this variant is going to be less forgiving. You're not going to get away with it. So the numbers may go up. But what I hope and I think won't happen is that you won't see the corresponding proportional deaths that we saw in the past. And we hope the vaccine is effective against that, as well as having previously infected, your antibodies should be pretty protected against that variant. But we'll see. That's why they've got to keep monitoring this.

SCIUTTO: To your point, I mean, the drop in deaths in nursing homes, for instance, after people have been vaccinated, precipitous, right, more than 90 percent. And that we should take as one of the bits of good news. Dr. Sanjay Gupta, thanks so much, as always.

GUPTA: You got it. Thank you.

SCIUTTO: And you can join Sanjay on his journey to learn why some people are afraid of vaccines. His new CNN special report, The Truth about Vaccines, begins tomorrow night at 9:00.

And we're standing by for the start of the Chauvin trial any minute now. We're going to bring it to you when it starts.

(COMMERCIAL BREAK)

HARLOW: Let's take you inside the courtroom, the first witness, Dr. Lindsey Thomas, being called today in the Derek Chauvin murder trial. She'll take off her mask, she was just sworn in and she will begin to testify as we wait for the medical examiner, Dr. Baker, to testify after her. Let's listen.

JUDGE PETER CAHILL, HENNEPIN COUNTY, MINNESOTA: And let's begin by having you state your full name, spelling each of your names.

LINDSEY CAROL THOMAS, FORENSIC PATHOLOGIST: Lindsey. L-I-N-D-S-E-Y, Carol, C-A-R-O-L, Thomas, T-H-O-M-A-S.

CAHILL: Mr. Blackwell?

JERRY BLACKWELL, PROSECUTING ATTORNEY: Thank you, your honor.

Good morning, Dr. Thomas.

THOMAS: Good morning.

BLACKWELL: Would you please tell us what kind of a doctor you are?

THOMAS: I'm a forensic pathology it.

BLACKWELL: And what is a forensic pathologist?

THOMAS: Forensic pathology is that branch of pathology, which is a branch of medicine where medicine and law overlap. So it could be anything with a medical and legal component, could be toxicology, in some cases, it may involve living patients. But as I practice in this most forensic pathologist practice, it involves what is called medical legal death investigation.

BLACKWELL: Now does it involve taking care of patients in the clinical sense?

THOMAS: Not living patients, no. A forensic pathologist may be consulted to help with the evaluation and interpretation of injuries in a living patient but not in a treatment or clinical sense.

BLACKWELL: So most of your work then is done on deceased people?

THOMAS: Correct.

BLACKWELL: Any specific types of deaths?

THOMAS: Yes.

[10:25:00]

The state statutes lists the types of deaths that have to be reported to the medical examiner. And, briefly, they tend to be unnatural deaths, so accidents, suicides, homicides, unexpected deaths, potentially suspicious deaths, that type of category of death.

BLACKWELL: Do you get special training in how to determine the cause and manner of death?

THOMAS: Yes.

BLACKWELL: Tell us something about the special training you received.

THOMAS: Well, should I start back in medical school or just the end part?

BLACKWELL: Just the end part.

THOMAS: Okay. I did a fellowship in forensic pathology, which is a specified training program for doctors who want to be forensic pathologists to learn how to do medical, legal death investigations and certify cause and manner of death.

BLACKWELL: So would you tell us what pathology is as a field of medicine?

THOMAS: Sure. Pathologists are sometimes considered the doctor's doctor because we don't directly treat patients but we provide information to doctors who then do treat patients. So, for example, if you ever been to a lab and had blood drawn, that goes to a laboratory that is run by a pathologist, a clinical pathologist. So, you know, blood count, chemistries, things like that. Or if you've ever known someone that had a biopsy and was diagnosed with cancer, that is the type of pathology that is done by an anatomic pathologists. So you look at tissue under the microscope and make diagnoses.

BLACKWELL: Is a medical examiner a forensic pathologist?

THOMAS: In Minnesota, a medical examiner is a forensic pathologist who is appointed by the County Board of Commissioners to be that county's medical examiner.

BLACKWELL: So it's a public official?

THOMAS: Yes.

BLACKWELL: So when talk about the medical legal investigations, is that sort of a fancy way of describing what forensic pathologists do?

THOMAS: Yes, it's what the medical examiner's office does. It's death investigations, again, where there is a medical component and there may be a legal component.

BLACKWELL: Is it different from, say, a death in a hospital?

THOMAS: Yes. So if someone dies in a hospital, those are usually deaths due to natural causes. And they may have medical death investigation in the sense that a hospital pathologist might do an autopsy. But they wouldn't do the full scope of the medical legal death investigation because those are mostly due to natural diseases.

BLACKWELL: What does death investigation entail?

THOMAS: Well, the way a medical examiner's office performs a death investigation, I think a lot of people assume it's all about the autopsy, the physical examination of the body. And that's really just a tiny part of the death investigation. The death investigation really starts at the very beginning when a death is found, a person is found deceased or the office is notified of a death.

We, as medical examiners, want to know all about that person. What's their past medical history, social history, family history? So we will do whatever we need to do to get that kind of history.

Then we want to know, well, what happened? What were their terminal events? What happened around the time of their death? Were they complaining of something? Were they interacting with someone? Were they driving? Were they using, you know, machinery, something like that?

And then we'll look at the physical examination and that part of the exam might include X-rays. It could include getting specimens for toxicology, for cultures, for all kinds of other laboratory tests, including looking at things under the microscope, little sections of each organ under the microscope. So that is the physical exam part.

Then we'll look at the laboratory results. So that would be usually toxicology. But as I say, it could be blood cultures or more recently as probably been a lot of COVID-19 testing, that kind of thing. And then look at the microscopic slides and then put all of that together with the history, the terminal events, the physical findings, the laboratory findings and then that's how the medical examiner reaches a conclusion about the cause and manner of death.

BLACKWELL: So all of that goes into a death investigation?

[10:30:00]

THOMAS: Yes. BLACKWELL: Do you sometimes interview people also as part of it?

THOMAS: Yes. The investigators who go to the scene may talk to family members.