Conrad Murray's trial/ Day 10-31-2011

Dr. Conrad Murray must decide by Tuesday if he'll testify

Los Angeles (CNN) -- Dr. Conrad Murray has until the start of court Tuesday morning to decide if he will take the stand to defend himself against the charge that he is criminally responsible for Michael Jackson's death, the judge told him at the end of Monday's court session.
Murray told Los Angeles County Superior Court Judge Michael Pastor that he had not decided yet if he will testify in his involuntary manslaughter trial, but he will make a decision overnight after consulting with his lawyers.
The defense anesthesiology expert who concluded Jackson probably died from drugs he gave himself underwent a tough cross-examination from the prosecution Monday and will return to finish his testimony Tuesday.

Los Angeles County Deputy District Attorney David Walgren got Dr. Paul White to concede that Murray deviated from the standards of care in his use of the surgical anesthetic propofol in Michael Jackson's bedroom to help him sleep.
Those deviations, including not having proper safety precautions and failing to quickly call 911 for help when Jackson stopped breathing, are so "egregious and extreme" that they make Murray criminally responsible for Jackson's death, the prosecution contends.

Dr. White characterized Murray's deviations as "perhaps between minor and serious, but it's not extreme."
Prosecutor Walgren also was successful in getting White to agree that he would not have done what Murray did -- take the job of sedating Jackson nearly every night at home with propofol.
"No amount of money" could get him to take the job, White said. "Absolutely not," he testified. "That would be a job I would never consider accepting."
White's determination to dig in and resist Walgren's efforts to shake his earlier testimony may have earned the expert a $1,000 contempt-of-court citation from Judge Pastor.
Pastor said he may fine White after the witness ignored several warnings to avoid references to his personal conversations with Murray, which could have been a way for the defense to introduce statements from the defendant without him having to testify.
The prosecution contends that Murray's reckless use of propofol to put Jackson to sleep caused Jackson's death, but the defense blames Jackson for self-administering the fatal overdose while Murray was not watching.
The Los Angeles County coroner ruled that Jackson's June 25, 2009, death was caused by "acute propofol intoxication" in combination with two sedatives.
Jurors must choose between two competing theories offered by White and Dr. Steven Shafer, the prosecution's anesthesiologist, of how and when the fatal overdose entered Jackson's body.

Both doctors, longtime friends and colleagues, are among the top experts in the world concerning propofol.
White, in his testimony for the defense Friday, said the level of drugs found in Jackson's stomach, blood and urine, convinced him that the pop icon died after he rapidly injected himself with propofol on top of a large dose of lorazepam he swallowed when Murray was away.

Shafer, who testified over an 11-day span for the prosecution, concluded the "only scenario" that fits the scientific evidence is that Jackson was on a constant IV drip of propofol for three hours before his death.
Shafer testified that Murray must have also injected Jackson with a series of large doses of lorazepam, a sedative, hours before his death.
The prosecution theory requires "an incredible coincidence of circumstances" using a "befuddling" IV drip configuration and an "irrational" assumption about how Murray injected sedatives, White testified.
White testified Friday that it is his opinion Jackson died after he injected himself with a 25-milligram dose of propofol between 11:30 a.m. and noon. Testimony and phone records indicated it was about noon that Murray realized Jackson was not breathing.

White theorized that Jackson could have "pushed" the drug into an catheter in his leg using a syringe over a 15- to 30-second period, much faster than a doctor would have done.
"I believe it could potentially have lethal consequences," White testified.
Under cross-examination Monday, White theorized that Jackson used a syringe used by Murray when he gave Jackson a 25-milligram injection an hour earlier. Murray filled it with 50-milligrams initially, leaving it half-filled in Jackson's bedroom, under White's theory.

White said he ruled out the possibility that Murray would have injected the fatal dose unless "he wanted to potentially harm Mr. Jackson."
Walgren asked White if he thought Jackson intended to harm himself.
"I don't think he realized the potential danger," White replied.
Walgren pressed for White's opinion about Murray's decision to leave Jackson alone with a syringe of propofol, who he should have known was desperate for sleep and had "pushed" a syringe of propofol before.
"No, I would not leave the room," he said.
However, White defended Murray's decision to leave Jackson alone 30 minutes after he injected him with propofol because the danger of side effects would have passed.

"If you've observed the patient for 15 or 30 minutes you can certainly move away from the bedside," White said.
Dr. Shafer conceded last week that it was possible, under his theory, that Jackson, not Murray, could have been the one to open the IV drip to a fatal pace under his death theory.

Prosecutors contend Murray is responsible for Jackson's death, even if he did not give him the final and fatal dose, because he was criminally reckless in using the surgical anesthetic to help Jackson sleep without proper precautions.
While Jackson was hooked up to an IV drip, it only delivered a saline solution to keep him hydrated, the defense contends.

Shafer demonstrated in court how he believed the IV system was set up by Murray, but investigators never found a critical piece of tubing that would have been needed to infuse a propofol drip into the catheter in Jackson's left leg.
Prosecutor Walgren got White to agree Monday that the missing tubing was small enough for someone to put in their pocket, suggesting Murray may have taken it from the scene as paramedics were loading Jackson into an ambulance.
White, under re-direct questioning by the defense, said if Murray had put the tubing in his pocket it would have leaked propofol onto his pants.
The 100-milliliter propofol bottle prosecutors believe Murray used was empty when investigators found it, leading Shafer to conclude that the last drops entered Jackson's body just as his heart stopped beating.
White called it "an incredible coincidence of circumstances" that the bottle would empty exactly when Jackson died.


White also said such a flow of propofol would have made Jackson "sleepy but arousable and breathing spontaneously," but it would not have killed him.
But Murray's own words, spoken to police two days after Jackson's death, led the jury toward Shafer's drip theory and away from White's self-injection theory.
Murray told detectives that the pulse oxymeter monitor on Jackson's finger showed his heart was beating at 122 beats per minute after Murray realized his patient was not breathing. This would indicate Jackson suffered respiratory arrest first, followed about 10 minutes later by cardiac arrest, a cardiologist and Shafer both testified.

The difference is key to interpreting what the high level of propofol in Jackson's blood means, since a beating heart would circulate the drug through the liver, which would break it down into a metabolite.
White's theory that Jackson died quickly from a rapid injection requires the assumption that his heart almost immediately stopped beating, before Murray would have seen the monitor on his finger.

Jackson family matriarch Katherine Jackson canceled plans to fly to London this week for the premiere of a documentary about her late son so that she would not miss a verdict, her assistant told CNN. She will return to court Tuesday, he said.

Closing arguments could come Friday or next Monday, depending on how much time prosecutors take for their rebuttal case and how much time lawyers are given to prepare, according to sources close to the defense.
Michael Jackson's father Joe Jackson and sister La Toya Jackson were joined by Kathy Hilton -- a longtime friend of Michael Jackson and Paris Hilton's mother -- in the seats set aside for Jackson family Monday.

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Last Witness in Conrad Murray's Defense Takes Stand Again Today


Dr. Conrad Murray, singer Michael Jackson’s personal physician, appears in Los Angeles Superior Court where Murray pleaded not guilty to a charge of involuntary manslaughter in the pop star’s 2009 death. (AP Photo/Irfan Khan, File) The last witness in the defense's case on behalf of Conrad Murray, who is on trial for involuntary manslaughter in the death of Michael Jackson, is expected to wrap up his testimony today.
Dr. Paul White is described by KTLA as "one of the world's foremost experts on the surgical anesthetic propofol," which was determined to be the drug that killed the King of Pop. White was expected to counter the prosecution's accusations that Murray gave Jackson a fatal dose of propofol at the singer's request then left Jackson alone, after Jackson allegedly said he needed the drug order to sleep.
Multiple experts for the prosecution have testified that Murray was out of line if he did indeed provide the singer with the drug, and especially if he then left Jackson by his lonesome.
Yesterday, White spent the majority of his time on the stand spelling out his credentials. At the last minute, ABC News reports that the defense revealed that White had created a computer presentation detailing how, exactly, Jackson died.
White's statements haven't formed a clear picture just yet of what the defense hopes he'll be able to accomplish on the stand. According to L.A. Now, White said yesterday that if Murray did leave Jackson alone with a propofol drip, that wouldn't be justifiable.
"Conrad Murray has been accused of infusing a dose of propofol and leaving his patient," said defense attorney J. Michael Flanagan. "Can you justify that?"
"Absolutely not," said White.
But KTLA notes that White said he was confused as to how the accusations had been made that Murray had given Jackson a propofol drip. "I was somewhat perplexed at how a determination has been made that Dr. Murray was infusing propofol," he said. "It wasn't obvious to me, I thought there were questions."

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Prosecutor to Grill Key Defense Expert in Conrad Murray Trial

Closing arguments, followed by the start of jury deliberations, are likely to come this week in Murray’s involuntary manslaughter trial.
Los Angeles County Deputy District Attorney David Walgren was given the weekend to consult with his anesthesiology expert on how to attack the testimony of Dr. Paul White, who is the last and most important defense witness.

The prosecution contends that Murray’s reckless use of the surgical anesthetic propofol to put Jackson to sleep caused Jackson’s death, but the defense blames Jackson for self-administering the fatal overdose while Murray was not watching.
The defense contends Jackson’s insomnia, unknown to Murray, was a side effect of withdrawal from a Demerol addiction, which they blame on another doctor.
The Los Angeles County coroner ruled that Jackson’s June 25, 2009, death was caused by “acute propofol intoxication” in combination with two sedatives.
Jurors must choose between two competing theories offered by White and Dr. Steven Shafer, the prosecution’s anesthesiologist, of how and when the fatal overdose entered Jackson’s body.

Both doctors, longtime friends and colleagues, are among the top experts in the world concerning propofol.
White, in his testimony for the defense Friday, said the level of drugs found in Jackson’s stomach, blood and urine, convinced him that the pop icon died after he rapidly injected himself with propofol on top of a large dose of lorazepam he swallowed when Murray was away.

Shafer, who testified over an 11-day span for the prosecution, concluded the “only scenario” that fits the scientific evidence is that Jackson was on a constant IV drip of propofol for three hours before his death.
Shafer testified that Murray must have also injected Jackson with a series of large doses of lorazepam, a sedative, hours before his death.
The prosecution theory requires “an incredible coincidence of circumstances” using a “befuddling” IV drip configuration and an “irrational” assumption about how Murray injected sedatives, White testified.

White testified Friday that it is his opinion Jackson died after he injected himself with a 25-milligram dose of propofol between 11:30 a.m. and noon. Testimony and phone records indicated it was about noon that Murray realized Jackson was not breathing.
White theorized that Jackson could have “pushed” the drug into an catheter in his leg using a syringe over a 15- to 30-second period, much faster than a doctor would have done.

“I believe it could potentially have lethal consequences,” White testified.
Shafer conceded last week that it was possible that Jackson, not Murray, could have been the one to open the IV drip to a fatal pace, but prosecutors contend that it would make no difference in Murray’s guilt.
Murray is responsible for Jackson’s death, even if he did not give him the final and fatal dose, because he was criminally reckless in using the surgical anesthetic to help Jackson sleep without proper precautions, the prosecution contends.

While Jackson was hooked up to an IV drip, it only delivered a saline solution to keep him hydrated, the defense contends.
Shafer demonstrated in court how he believed the IV system was set up by Murray, but investigators never found a critical piece of tubing that would have been needed to infuse a propofol drip into the catheter in Jackson’s left leg.
The 100-milliliter propofol bottle prosecutors believe Murray used was empty when investigators found it, leading Shafer to conclude that the last drops entered Jackson’s body just as his heart stopped beating.

White called it “an incredible coincidence of circumstances” that the bottle would empty exactly when Jackson died.
White also said such a flow of propofol would have made Jackson “sleepy but arousable and breathing spontaneously,” but it would not have killed him.
But Murray’s own words, spoken to police two days after Jackson’s death, led the jury toward Shafer’s drip theory and away from White’s self-injection theory.
Murray told detectives that the pulse oxymeter monitor on Jackson’s finger showed his heart was beating at 122 beats per minute after he realized his patient was not breathing. This would indicate Jackson suffered respiratory arrest first, followed about 10 minutes later by cardiac arrest, a cardiologist and Shafer both testified.

The difference is key to interpreting what the high level of propofol in Jackson’s blood means, since a beating heart would circulate the drug through the liver, which would break it down into a metabolite.
White’s theory that Jackson died quickly from a rapid injection requires the assumption that his heart almost immediately stopped beating, before Murray would have seen the monitor on his finger.
The defense expert also questioned the prosecution’s contention that Murray placed the propofol bottle into an empty saline bag with an opening cut into it to suspend it from the IV stand next to Jackson’s bed.

It would have been more logical for Murray to use a plastic suspension tab built onto the bottle, a routine practice.
“It’s befuddling to me, because anyone picking up the bottle would naturally gravitate for pulling up the little hanger,” White said. “Why would you go to all the hassle?”
Hanging the bottle inside a bag also would not work because if Jackson “rolled over and moved his leg, it would easily come out of the bag,” White said.
The suspension tab on the propofol bottle had not been activated, both sides agreed.

Investigators who recovered the bottle and an opened bag testified they found them together, but they did not photograph it.
White also questioned Shafer’s computer model conclusion that Murray gave Jackson at least nine four-milligram injections of the lorazepam at regular intervals from 1:30 to 5 a.m. the day he died.
Those “enormous” sedative doses alone would have put anyone to sleep and possibly killed them, White said.

He said it would be “irrational” for a doctor to sit at Jackson’s bedside and repeatedly inject the sedatives to a patient in very deep sedation, as Shafer’s theory implies.
White concluded that Jackson swallowed a large dose of lorazepam several hours earlier, which would have left “a very high concentration” of the sedative in his body.
“So you’ve got drugs that have additive or even synergistic effects, and I think the combination effect would be very profound,” White said.

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