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https://www.hennepin.us/-/media/hennepinus/residents/public-safety/documents/Autopsy_2020-3700_Floyd.pdf

HENNEPIN COUNTY
MEDICAL EXAMINER’S OFFICE
AUTOPSY REPORT
ME NO.: 20-3700
CASE TITLE: CARDIOPULMONARY ARREST COMPLICATING LAW ENFORCEMENT SUBDUAL, RESTRAINT, AND NECK COMPRESSION
DECEASED: George Floyd aka Floyd Perry SEX: M AGE: 46
DATE AND HOUR OF DEATH: 5-25-20; 9:25 p.m.
DATE AND HOUR OF AUTOPSY: 5-26-20; 9:25 a.m.
PATHOLOGIST: Andrew M. Baker, M.D.
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II. Natural diseases
A. Arteriosclerotic heart disease, multifocal, severe
B. Hypertensive heart disease
1. Cardiomegaly (540 g) with mild biventricular dilatation
2. Clinical history of hypertension
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III. No life-threatening injuries identified
A. No facial, oral mucosal, or conjunctival petechiae
B. No injuries of anterior muscles of neck or laryngeal structures
C. No scalp soft tissue, skull, or brain injuries
D. No chest wall soft tissue injuries, rib fractures (other
than a single rib fracture from CPR), vertebral column injuries, or visceral injuries
E. Incision and subcutaneous dissection of posterior and Lateral neck, shoulders, back, flanks, and buttocks negative for occult trauma
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VI. Toxicology (see attached report for full details; testing performed on antemortem blood specimens collected 5/25/20 at 9:00 p.m. at HHC and on postmortem urine)
A. Blood drug and novel psychoactive substances screens:
1. Fentanyl 11 ng/mL
2. Norfentanyl 5.6 ng/mL
3. 4-ANPP 0.65 ng/mL
4. Methamphetamine 19 ng/mL
5. 11-Hydroxy Delta-9 THC 1.2 ng/mL; Delta-9 Carboxy THC 42 ng/mL; Delta-9 THC 2.9 ng/mL
6. Cotinine positive
7. Caffeine positive
B. Blood volatiles: negative for ethanol, methanol, isopropanol, or acetone
C. Urine drug screen: presumptive positive for cannabinoids, amphetamines, and fentanyl/metabolite
D. Urine drug screen confirmation: morphine (free) 86 ng/mL
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The decedent was known to be positive for 2019-nCoV RNA on 4/3/2020. Since PCR positivity for 2019-nCoV RNA can persist for weeks after the onset and resolution of clinical disease, the autopsy result most likely reflects asymptomatic but persistent PCR positivity from previous infection.

https://ndews.umd.edu/sites/ndews.umd.edu/files/ndews-hotspot-unintentional-fentanyl-overdoses-in-new-hampshire-final-09-11-17.pdf

Unintentional Fentanyl Overdoses in New Hampshire: An NDEWS HotSpot Analysis

Marcella H. Sorg, Ph.D.
Jamie A. Wren, MPH
Margaret Chase Smith
Policy Center
University of Maine

Kathleen Stewart, Ph.D.
Yanjia Cao
Center for Geospatial Information Science
University of Maryland

Toxicology FindingsPolydrug complexity is an important feature of toxicology findings for this population. Within the medical examiner’s toxicology findings (most are blood specimens), there are 114 drugs and metabolites identified. Individual toxicology tests ranged widely from just one substance reported (9.7%) to 19 substances in one decedent. Fentanyl was found in 98.4% and fentanyl 8analogs in 11.7% of cases; these cases overlap. The mean number of parent3 drugs was 6.23. Key co-intoxicant and potentially synergistic drugs present include heroin/morphine (20.6%), non-fentanyl opioids (34.5%), benzodiazepines (27.5%), cocaine (31.1%), and alcohol (32.9%).
Postmortem levels of fentanyl confirmed in our sample range widely from 0.75 to 113.00 ng/mL, with a mean of 9.96. We compared the distributions of fentanyl levels for cases where fentanyl was the only drug found with cases with key co-intoxicants (opioids, benzodiazepines, or alcohol); the distributions were not statistically different. The distribution of fentanyl levels among the subgroup of decedents who reportedly had a “rapid” overdose was not statistically different from other decedents.