The doctor, Floriana Persechino, said the officer’s chokehold and the compression of Garner’s chest during his arrest on Staten Island in 2014 “set into motion a lethal sequence.”
Though Garner had high blood pressure and chronic asthma, Persechino, a veteran city medical examiner, stood by her finding that his death was a homicide caused by the officer’s use of force. “The chokehold is a significant initial factor of the cascade,” she said.
Persechino testified at a disciplinary hearing for Officer Daniel Pantaleo, who faces possible dismissal over charges of reckless use of a chokehold and intentional restriction of breathing.
Garner died during a struggle with several police officers in July 2014 near the Staten Island Ferry Terminal. The police had stopped him because they believed he was selling untaxed cigarettes.
His death set off protests and contributed to a national reckoning over how the police treat people in poor and minority neighborhoods, with his last words — “I can’t breathe” — becoming a rallying cry for a national movement against police brutality.
A grand jury on Staten Island declined to indict Pantaleo in 2014 on criminal charges. A federal civil rights inquiry has dragged on for years without charges being filed. The statute of limitations expires July 17, the fifth anniversary of Garner’s death.
Last fall, the police commissioner, James P. O’Neill, decided to move ahead with the disciplinary hearing, giving the first public airing of the evidence against Pantaleo.
Narrating graphic photos of Garner’s body, Persechino said Wednesday that internal bleeding visible in four layers of soft tissue from his neck indicated the use of a chokehold that set off the asthma attack.
While Persechino was being cross-examined, Pantaleo’s lawyers and prosecutors from the Civilian Complaint Review Board exchanged heated words, as one of the officer’s lawyers, Stuart London, suggested that Garner was in poor health and caused his own death by resisting arrest.
Persechino is the third official to testify this week that Pantaleo used a prohibited chokehold on Garner. On Monday, two internal affairs investigators testified that they had recommended in 2015 that Pantaleo face disciplinary charges for using the banned technique.
And on Tuesday morning, the commanding officer of the police academy, Deputy Inspector Richard Dee, said what Pantaleo can be seen doing in a bystander’s video of the arrest — wrapping an arm around Garner’s neck from behind and squeezing — “meets the definition of a chokehold.”
London, the defense lawyer, has argued Pantaleo was trying to use a safe takedown technique taught in the Police Academy, known as a “seatbelt” hold.
But Dee testified that the seatbelt maneuver was not taught or approved by the department in 2006, when Pantaleo went through the academy, nor in 2008, when he received training to become a plainclothes officer.
The autopsy photographs shown in a hearing room at Police Headquarters on Wednesday grimly illustrated the damage caused to Garner’s huge frame by Pantaleo’s left forearm during the struggle.
Using a laser pointer, Persechino methodically explained the physical trauma visible on the layer of the muscle and soft tissue inside of Garner’s neck, pointing out a “band of hemorrhaging” that deepened from dark red to purple.
Gwen Carr, Garner’s mother, left the courtroom before the photos were shown. “I wasn’t going to be able to sit there and look at photos of my child,” Carr said. “It’s not getting any easier. It’s very emotional being here.”
On cross-examination, London attempted to challenge Persechino’s findings. He repeatedly asked her about Garner’s other ailments: He was obese, weighing 395 pounds, had chronic asthma and an enlarged heart almost twice the size of a healthy person.
“Any stress he engaged in would probably be more deadly for him than a normal person,” London suggested to the doctor.
London also cited a report from the Police Department’s chief surgeon that blamed Garner for his own death, because he refused to comply with orders from Pantaleo and his partner.
“He obviously resisted arrest, your honor,” London said at one point during the cross-examination.
Suzanne O’Hare, a prosecutor for the watchdog agency, immediately objected. “Is counsel testifying now?” she asked.
London drew another objection from O’Hare when he said of Garner: “Had he just accepted a summons for untaxed cigarettes, none of this would have happened.”
On Tuesday, Dee said the techniques Pantaleo used on Garner during their fatal struggle violated the department’s decades-old ban on chokeholds.
Both in the academy and during specialized training, officers are repeatedly taught not to use chokeholds or restrict someone’s breathing, he said.
Dee, a former narcotics and gang supervisor, also testified that the officers’ decision to wrestle Garner to the ground instead of continuing to talk to him was questionable.
“Would you have put your hands on Mr. Garner?” asked Jonathan Fogel, one of the prosecutors.
“I would have waited for backup, for uniformed officers to arrive, and I would make one more appeal,” Dee replied.
The disciplinary hearing is being closely watched by many elected officials, who view it as a test of O’Neill’s commitment to improving the often fraught relationship between the police and the city’s poorer residents.
“The public is watching,” Councilman Donovan Richards, a Queens Democrat, told O’Neill at a City Council hearing Wednesday. Richards added that people will “be able to see clearly from this case how serious you are about holding officers who break the law accountable.”
Speaking to reporters after the hearing, O’Neill would not commit to uphold whatever verdict Judge Rosemarie Maldonado, who is overseeing the hearing, reaches, nor the penalty she recommends.
“I’m not going to prejudge it,” he said.
This article originally appeared in The New York Times.