Conrad Murray's trial/ Day 10-13-2011

Propofol Expert Testifies Next in Trial of Conrad Murray

(CNN) – An anesthesiologist will testify Thursday that Dr. Conrad Murray’s treatment of Michael Jackson was so grossly negligent that it was criminal, an opinion that echoes two other medical experts called to testify by prosecutors Wednesday.

Dr. Steven Shafer, who may be the last witness called before the prosecution rests its case in Murray’s involuntary manslaughter trial, is expected to echo the testimony of a cardiologist and a sleep expert who took the stand Wednesday.
Murray’s delay in calling 911 for help as soon as he realized Jackson was not breathing may have cost the pop icon his life, according to cardiologist Dr. Alon Steinberg.

Steinberg and Dr. Nader Kamangar, a UCLA sleep expert, both presented a long list of what they said were instances of Murray’s extreme deviation from the standards of medical care, including his failure to immediately call for paramedics.

“If these deviations would not have happened, Mr. Jackson would be alive,” Steinberg testified.
The Los Angeles County coroner ruled that Jackson’s June 25, 2009, death was from “acute propofol intoxication” in combination with several sedatives, including lorazepam.

Murray’s lawyers contend that Jackson used a syringe to inject the fatal overdose through a catheter on his left leg while Murray was away from his bedside. They dropped the theory pushed earlier that Jackson may have orally ingested propofol that the coroner says killed him.
Murray’s defense also contends that Jackson swallowed eight tablets of lorazepam, a sedative, in a desperate search for sleep the day he died.
Murray should be found guilty even if jurors accept the theory that Jackson self-administered the fatal dose because the doctor was reckless for leaving propofol and lorazepam near his patient when he was not around, Steinberg testified.

“It’s like leaving a baby that’s sleeping on your kitchen countertop,” Steinberg said. “There’s a very small chance the baby could fall over, or wake up and grab a knife or something.”
Steinberg said he based his conclusions on Murray’s own words to detectives in an interview two days after Jackson’s death. That interview was played for jurors in the previous two days of the trial.

Jackson would be alive today if Murray had called 911 for help within two minutes of realizing Jackson was not breathing, instead of waiting about 20 minutes before asking a security guard to call, Steinberg said.
Earlier testimony revealed Murray did ask Jackson’s chef to send a security guard upstairs to help him about five minutes after the time prosecutors suggest he realized there was a problem with Jackson. The chef, however, testified that she sent Jackson’s 12-year-old son upstairs instead of security.

Steinberg said the use of propofol to treat Jackson’s insomnia was another extreme deviation from standards that contributed to Jackson’s death. He later acknowledged a recent report from China that the anesthetic had been successfully used to treat chronic insomnia, but he suggested it needed more study to be accepted.

Kamangar, the sleep expert, testified later Wednesday that propofol has no therapeutic value in treating insomnia, and to use it is unethical and an extreme deviation from the standards of care.
“It is beyond comprehension,” Kamangar said. “It is frankly disturbing,”
Steinberg said he based his conclusions on his belief that Murray had connected Jackson to an IV drip of propofol after he gave him an injection of propofol. That assumption, he said, was made because Murray told police he had used such a drip on most previous nights.

When Flanagan challenged him to show where in Murray’s police interview he said he used a drip the day Jackson died, he eventually said “I will agree with you, it’s not completely clear.”
Steinberg also said it was gross negligence that Murray was not prepared for an emergency, such as having a generator in case there was a power failure.
Murray told detectives he gave Jackson a series of three sedatives — Valium, lorazepam and midazolam — over a 10-hour period before finally giving in to Jackson’s plea for propofol.

“I’ve got to sleep, Dr. Conrad,” Murray said Jackson pleaded to him. “I have these rehearsals to perform. I must be ready for the show in England. Tomorrow I will have to cancel my performance, because you know I cannot function if I don’t get to sleep.”
Murray said he injected a small dose of propofol using a syringe, but the prosecution contends he also used a makeshift IV setup to keep Jackson medicated and asleep. That drip may have malfunctioned while the doctor was not monitoring his patient, they contend.

The prosecution has been unable to produce the tubing that would be a critical piece of an IV system, although they did show jurors an opened saline bag into which they contend Murray placed an opened propofol bottle.
On the recording, Murray insisted he kept a close watch on Jackson after he finally fell asleep. The physician never mentioned the long list of e-mails and calls that cell phone records later revealed.

Murray was hired as Jackson’s personal physician while the singer prepared for his “This Is It” comeback concerts in London, planned to start in July 2009.
If convicted of involuntary manslaughter, Murray could spend four years in a California prison and lose his medical license.

[You must be registered and logged in to see this link.]

Dr. Conrad Murray's Lawyers Ordered Study That Gave Propofol To Beagle Dogs

By Jen Heger
Radar Legal Editor

Dr. Conrad Murray's defense team commissioned a study on Beagle dogs to determine how much Propofol would have to be ingested to cause Michael Jackson's death, RadarOnline.com is exclusively reporting.

At Murray's preliminary hearing earlier this year, his lawyers asserted that the King of Pop swallowed Propofol, and this is what caused his death.

However, in a dramatic turnaround, attorney Michael Flanagan told Los Angeles Judge Michael Pastor on Wednesday outside the presence of the jury, that they wouldn't be pursuing the theory that Jackson had ingested Propofol.

PHOTOS: Key Players In The Trial Of Dr. Conrad Murray

"We are not going to assert at any point in this trial that Michael Jackson at any time orally ingested Propofol," Flanagan revealed. Flanagan said in open court that he had commissioned his own study about the oral ingestion of Propofol, and that findings from the study revealed that taking Propofol orally would not cause death.

"A study was done on Beagle dogs to determine how much Propofol would have to be orally consumed to cause death. The only other study that had been done on the the oral ingestion of Propofol was on pigs rectums. The study definitely involved more than two dogs. It's unknown if the dogs died, or suffered any harm," a source close to Dr. Murray tells RadarOnline.com.

Dr. Murray's lawyers aren't completely abandoning the Propofol defense however. "Dr. Murray's lawyers will likely put expert witnesses on the stand that will tell jurors Michael Jackson administered a dose of Propofol," a source close to the situation says.

PHOTOS: The Jackson Family Arrives To Dr. Conrad Murray’s Trial

The prosecution is expected to rest its case on Thursday or Friday; then Dr. Murray's defense will formally present their case to the jury.

If convicted of the involuntary manslaughter charge, Dr. Murray could face up to four years in state prison.

[You must be registered and logged in to see this link.]

Conrad Murray didn't comfort Jackson's kids in ER, family says
By Alan Duke, CNN
October 13, 2011 --

Los Angeles (CNN) -- Michael Jackson's oldest son disputed Dr. Conrad Murray's claim, given in his police interview, that the doctor comforted him and his siblings in the emergency room after they learned their father was dead, according to a Jackson family member who was with the children that day.
Prince Jackson told his family that Murray's account played in his involuntary manslaughter trial this week was not true, Trent Jackson, the nephew of Katherine and Joe Jackson, said Thursday.

"Perfect storm" of drugs killed Jackson, sleep expert says
Jackson family members were upset that jurors may sympathize with Murray because of perceived compassion for the children that day, Jackson told CNN.
"I hugged them all, gave comfort to Paris, comfort to Prince, comfort to Blanket, which is the last little guy, because whenever they were sick, they would always ask for Dr. Conrad," Murray told detectives two days after Jackson's death in 2009.

Anesthesiologist on propofol dosing
Trent Jackson, who drove Katherine Jackson to Ronald Reagan UCLA Medical Center, where doctors were trying to revive her son, said Murray did not have a conversation with Paris Jackson, the 12-year-old daughter, as he told police.
"She asked me, 'Dr. Murray, you said you save a lot of patients. You know, you save people with heart attacks, and you couldn't save my dad," Murray told detectives. "I said, 'I tried my best.' And she said, 'I know that, Dr. Murray. At least I know. I know you tried your best. I know you tried your best, but I'm really sad. You know, I will wake up in the morning, and I won't be able to see my daddy.'"
Prince, Paris and Blanket Jackson were initially kept in an SUV outside of the emergency room after they followed the ambulance carrying their father to the hospital, Trent Jackson said. Frank Dileo, who was Michael Jackson's manager, later escorted them inside after their grandmother arrived, according to Trent Jackson.

Murray never spoke to Michael Jackson's mother at the emergency room, contrary to his statement to police, Trent Jackson said.
While the truthfulness of Murray's interview is a major issue in the trial, it is not expected that Michael Jackson's 14-year-old son Prince will be called to testify, the relative said. Katherine Jackson, who has custody of the children, is opposed to any of them being called as witnesses, he said.
Prosecutors are near a conclusion to their direct presentation in Murray's trial, but rebuttal witnesses could be called next week after the defense rests its case.

[You must be registered and logged in to see this link.]

Experts in Jackson doctor trial tell of surgical anesthetic's dangers

As prosecutors wrap up their case against Michael Jackson's physician, one expert tells jurors that Dr. Conrad Murray's decision to administer propofol on top of other sedatives without proper monitoring was a 'recipe for disaster.'




By Victoria Kim, Los Angeles Times
October 14, 2011
As their case against Michael Jackson's physician neared its end, prosecutors called to the stand medical experts who told jurors of the dangers of the potent surgical anesthetic used by Dr. Conrad Murray to get his famous patient to sleep.

Jurors on Thursday heard from the prosecution's final witness in Murray's involuntary manslaughter trial, Dr. Steven Shafer, a leading expert on the anesthetic propofol who devised the dosing guidelines for the drug when it was first introduced. Shafer said that although patients can wake up from the drug in minutes even after being sedated for up to 10 days, things can go wrong just as easily.

"Look how flat this curve is," the doctor said, showing jurors a graph charting his analysis on the effects of the drug. "If you're off a little bit and you're giving too much drug, it can actually extend to hours" before a person awakes from the sedation, he said.

FULL COVERAGE: The trial of Conrad Murray

Another doctor, a specialist in sleep medicine, testified Thursday that Murray's decision to administer propofol on top of other sedatives without proper monitoring was a "recipe for disaster."

Dr. Nader Kamangar, a UCLA associate professor who reviewed the case for the California Medical Board, said Murray's dispensing of the anesthetic in a home setting without proper monitoring or documentation, then later delaying calling 911 and making subpar attempts at resuscitation, had directly led to Jackson's death.

"This was the perfect storm I described that culminated in his demise," he told jurors.

In cross-examination, an attorney for Murray asked Kamangar about his review of Dr. Arnold Klein, another physician who treated Jackson and regularly provided him with large amounts of a narcotic. Flanagan asked if the expert was aware that Klein had given Jackson 6,500 milligrams of the narcotic Demerol in the three months leading up to the singer's death, suggesting Murray had no way of knowing another doctor was giving Jackson other drugs.

Kamangar said he reviewed Klein's records but could not determine from the documents whether Jackson had a "Demerol problem." But the drug could have been a factor in Jackson's insomnia, Kamangar said.

Under further questioning by a prosecutor, Kamangar said "knowing when to say no" when a patient asks for something that could be harmful is one of the fundamental elements of a physician-patient relationship.

"No matter how much the patient may complain, no matter how much the patient may beg, you as the doctor should say no?" Deputy Dist. Atty. David Walgren asked.

"That's correct," Kamangar replied.

The prosecution is expected to rest its case sometime early next week once Shafer, who testified for about half an hour Thursday, concludes his testimony. An attorney for Murray told the judge the defense plans on calling 22 witnesses but that the bulk of its case will come from two medical experts.


[You must be registered and logged in to see this link.]

DR. CONRAD MURRAY
If Convicted ...
He May End Up On House Arrest


If Dr. Conrad Murray is convicted of felony involuntary manslaughter and sentenced to the maximum -- 4 years in state prison -- he will not spend a single day in prison ... and he could end up on house arrest.

A new law went into effect in California on October 1, which says, because of overcrowding, people convicted of non-violent felonies cannot be sent to State prison. Instead, non-violent felons serve their time in county jail.

Law enforcement tells TMZ ... involuntary manslaughter is a non-violent felony, which means if Murray is convicted he'd go to L.A. County Jail.

As for how much time Murray would serve ... L.A. County Sheriff's officials tell TMZ ... Murray would be jailed for half the actual sentence. So if he gets the max -- 4 years -- he would only serve 2.

But there's a twist ... Murray could actually serve way less than 2 years. Because of severe overcrowding, inmates are eligible for house arrest, based on 2 factors -- their prior criminal history, and risk to the community. Murray has a clean record and, as one law enforcement official put it, he poses no risk ... it's not like he's going to go out with a bottle of Propofol and kill people.

So if the jail is filled to the gills, the Sheriff could put him on house arrest with an electronic monitoring bracelet. But one official from the Sheriff's Department told us ... Murray wouldn't be placed on house arrest right out of the box. He would almost certainly do some time before the jailhouse doors would open.


[You must be registered and logged in to see this link.]

Conrad Murray trial may be delayed due to death in witness's family
By Alan Duke, CNN
October 14, 2011

Los Angeles (CNN) -- The trial of Michael Jackson's doctor may not resume until Tuesday because the father of the prosecution's last witness died, it was revealed at a hearing Friday.
Testimony in Dr. Conrad Murray's involuntary manslaughter trial was recessed Thursday afternoon so anesthesiology expert Dr. Steven Shafer could attend a medical conference in Chicago, but Deputy District Attorney David Walgren said Friday that Shafer never made it there because of the death in his family.

Prosecutors allege Murray was criminally responsible for Jackson's death because of his gross negligence in his use of the surgical anesthetic propofol and other drugs in Jackson's home to help him sleep.
The Los Angeles County coroner ruled that Jackson's June 25, 2009, death was from "acute propofol intoxication" in combination with several sedatives, including lorazepam.
Los Angeles County Superior Court Judge Michael Pastor, who is known for keeping tight control on his courtroom, scolded and fined prosecutor Walgren and his co-counsel, Deputy District Attorney Deborah Brazil, for being a few minutes late to Friday morning's hearing.
"People, you were late this morning by six minutes," Pastor said. "What is the reason for this, please?"

"We were just running late, your honor," Walgren said. "We apologize."
"Well, this has happened before," Pastor said, before ordering Walgren and Brazil to pay a $60 fine, $10 for each minute they were tardy to court.
Walgren blamed slow courthouse elevators when he and Brazil were 15 minutes late for a hearing last month.
Shafer, who is expected to give a detailed scientific explanation of how the surgical anesthetic propofol is metabolized in the human body, will be on the witness stand for at least a day once he returns from his father's funeral, according to Walgren.
The defense presentation would follow, lasting until next Friday or the following Monday, according to defense lawyer Nareg Gourjian.
Along with two or three medical experts, the defense has lined up about a dozen patients of Murray to testify about how he's helped them.

On Thursday, a sleep expert testifying for the prosecution said Jackson "clearly" suffered from insomnia that could have been caused by Demerol, a narcotic he was getting frequently from a doctor other than Murray.
Murray's defense team contends Dr. Arnold Klein injected Jackson with 6,500 milligrams of Demerol during visits to his Beverly Hills, California, dermatology clinic in the last three months of his life, and that Murray did not know about it.
Jackson desperately sought sleep the day he died, worried that without rest he could not rehearse that night, which could force the cancellation of his "This Is It" comeback concerts, according to Murray's interview with police.

Dr. Nader Kamangar, a UCLA sleep expert testifying for the prosecution, testified that the combination of drugs Murray gave Jackson "was the perfect storm" that killed him.
"Mr. Jackson was receiving very inappropriate therapy, in the home setting, receiving very potent sedatives, including propofol, lorazepam and midazolam, without monitoring by Murray, and ultimately this cocktail was a recipe for disaster," Kamangar said.


[You must be registered and logged in to see this link.]