Conrad Murray's trial/ Day 10-12-2011

DR. CONRAD MURRAY'S LAWYER
MJ Had Plenty of Time
To Kill Himself



Dr. Conrad Murray's attorneys are trying to change doctor's story, trying to convince jurors that Michael Jackson had way more than 2 minutes to self-administer the fatal dose of Propofol.

Murray's attorney J. Michael Flanagan suggested in court today -- perhaps the 2-minute window Murray described in his infamous police interview wasn't so accurate. Murray told cops he left to pee, and when he came back Michael wasn't breathing.

The problem with Murray's statement -- it's improbable that during the 2-minute window, MJ woke up, grabbed the Propofol and shot it into the port in his leg.

So ... during his cross-examination of cardiologist Alon Steinberg, Flanagan said ... "Let's assume Dr. Murray was gone for a period of time longer than two minutes ... maybe it was ten ... fifteen ... twenty ... what is it about [MJ] that makes him savable?"

Here's the reality. In the hour before Murray began resuscitating MJ, Murray was on the phone for around 45 minutes. As we've previously reported, cops never believed Murray was out of the room for only 2 minutes. They think he left to make his calls. Apparently, this theory is also palatable to the defense, because it gives MJ time to awaken and inject.

The question -- will the jury buy the new version?


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Conrad Murray trial: Dr. Christopher Rogers says unlikely MJ gave self propofol


The doctor that performed the autopsy on Michael Jackson, Dr. Christopher Rogers testified yesterday, and discussed his findings in court. The prosecution and defense questioned Dr. Rogers, and based on his examination of Michael Jackson, Rogers concluded that Michael Jackson could not have administered that fatal dose of propofol that killed him.

By the line of questioning done by the defense, it was quite obvious that they were looking to obtain a different answer from Dr. Rogers. Lorazepam of course was brought up again, as it seems to always be a major topic for the defense, however, Dr. Rogers maintained his testimony. The official cause of death of Michael Jackson was listed in official reports as "acute propofol intoxication."

Yesterday was a very upsetting day. An autopsy photograph was shown, and it made many people sad to see it being put on display for the world to see. Many maintained that while it is necessary in the trial, it is another to see the photograph published on the websites of media outlets.


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Jackson would be alive if not for Conrad Murray, expert says
October 12, 2011



A cardiologist who reviewed Dr. Conrad Murray’s care of Michael Jackson for the California Medical Board testified Wednesday that the physician’s treatment was riddled with egregious deviations from standard of care that contributed directly to the singer’s death.

Alon Steinberg, a Ventura County cardiologist and medical board reviewer, told jurors at Murray’s involuntary manslaughter trial that even if Jackson had given himself the anesthetic that caused his death, the doctor would be just as guilty of giving substandard care. Murray’s attorneys have contended the singer gave himself the anesthetic propofol and a second sedative while his doctor wasn’t looking, killing himself instantly.

“We don’t give opportunity for a patient to self-administer,” Steinberg said.

“When you monitor a patient, you never leave their side, especially after giving propofol. It’s like leaving a baby that’s sleeping on your kitchen countertop,” he testified.

Live video: Full coverage of Conrad Murray trial

Steinberg rattled off a long list of factors that led him to conclude that Murray’s actions were an extreme departure from standard of care — treating insomnia with a surgical anesthetic, administering propofol without the necessary monitoring equipment, delaying calling 911 and making ineffective resuscitation efforts once Jackson had stopped breathing.

“It’s basic knowledge in America, you don’t have to be a healthcare professional, that when someone is down you need to call 911 for help,” Steinberg told jurors.

The doctor delayed calling for emergency help for at least 20 minutes when paramedics were only four minutes away, he noted.

“Every minute counts?” Deputy Dist. Atty. David Walgren asked.

"Every minute counts,” Steinberg responded.

Steinberg said were it not for the deviations in standard of care, Jackson would have lived.

Murray has been stripped of his license to practice in California.

Also on Wednesday, an attorney representing Murray told the judge that despite indications at earlier hearings, the doctor’s defense had reached the conclusion that propofol would not have an effect if taken orally and would not be making the argument that the singer might have drank the anesthetic.

“We are not going to assert at any point in time in this trial that Michael Jackson orally ingested propofol,” attorney Michael Flanagan said.


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Defense Drops Theory Michael Jackson Drank Propofol

(CNN) – Dr. Conrad Murray’s defense team has dropped its theory that Michael Jackson may have orally ingested the surgical anesthetic propofol that the coroner says killed the pop icon, his lawyers told the court Wednesday.

Lawyers for Murray, who is on trial for involuntary manslaughter, will instead focus on the theory that Jackson used a syringe to inject the fatal overdose through a catheter on his left leg while Murray was away from his bedside.
Murray’s defense also contends that Jackson swallowed eight tablets of lorazepam, a sedative, in a desperate search for sleep the day he died.
Also Wednesday, Dr. Alon Steinberg, a cardiologist called as an expert witness by the prosecution, listed six examples of gross negligence by Murray that he testified contributed to Jackson’s death.
“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.
Prosecutors argue that Murray is criminally responsible for Jackson’s death because his use of propofol to treat the singer’s insomnia was grossly negligent and an extreme deviation from the standard of care required of physicians.
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 the drugs near his patient when he was not around, Steinberg testified Wednesday.
The possibility that Jackson drank propofol arose during Murray’s preliminary hearing in January, when a prosecution expert agreed with the defense that a higher level of propofol in his stomach compared to his blood suggested it could have happened.

Both prosecution and defense experts conducted tests on animals since January’s preliminary hearing on the “bio-availabity” of propofol if consumed orally. Defense attorney Michael Flanagan agreed Wednesday that the studies showed “propofol, when orally ingested, is not bio-available.”
Another study, conducted over the summer on university students in Chile, concluded “if you drink propofol, it will have trivial effects on the person,” Deputy District Attorney David Walgren said.

“Oral propofol did not kill Michael Jackson,” Walgren said.
The defense, in a rare moment in the trial, agreed.
“We are not going to assert at any point in time that Michael Jackson orally ingested propofol,” Flanagan said.

Steinberg is the first of three experts who will wrap up the prosecution’s case.
With about three days of defense testimony expected, closing arguments could be just a week away in Murray’s involuntary manslaughter trial.
The pathologist who conducted the autopsy on Jackson testified Tuesday that while it was physically possible that Jackson could have given himself the overdose that killed him, Murray is still guilty of causing his death because he gave him access to the dangerous drugs.

If convicted of involuntary manslaughter, Murray could spend four years in a California prison and lose his medical license.
The closing days of the prosecution case will be filled with science, a contrast to previous testimony from Murray’s girlfriends, dramatic audio recordings and shocking death photos that highlighted the first 10 days of the trial.
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.
A stark photo of Jackson’s naked corpse lying on the autopsy table a day after he died was displayed on a large screen in front of the jury Tuesday.
A Jackson fan who won a lottery for a seat in court became so upset she fled, while other fans quietly wept and hugged each other.

The singer’s mother, Katherine Jackson, was forewarned by the prosecutor about the photograph and chose to leave the courtroom during the mid-morning break, before the pathologist who autopsied her son took the witness stand.
The photograph was shown during the testimony of Dr. Christopher Rogers, the Los Angeles County deputy medical examiner who conducted the autopsy and ruled Jackson’s death a homicide.
Rogers said Murray’s admission in a police interview that he used propofol to treat Jackson’s insomnia was a factor in his conclusion that it was a homicide, not an accidental death.

He said Murray’s use of propofol in Jackson’s home without proper monitoring and resuscitation equipment or a “precision dosing device” contributed to the singer’s propofol overdose and subsequent death.
“Essentially, the doctor would be estimating how much propofol he would be giving,” Rogers testified. “I think it would be easy under those circumstances for the doctor to estimate wrong and give too much propofol.”
Murray, in the interview played for the jury over the past two days of testimony, 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 propofol bottle that prosecutors say Murray used for the IV drip had a slit in the rubber top, which Rogers said is evidence it was part of the drip system.
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.

Rogers testified it was unlikely that Jackson self-administered the deadly dose of propofol in the two minutes Murray said he was away from him, but he conceded under defense questioning that it was physically possible.
Jackson could have reached the IV port near his left knee to self-inject propofol, he said. If Jackson pushed the drug in quickly, it could have made his heart stop immediately, Rogers said.

Rogers later added, under questioning by the prosecutor, that he would still consider it a homicide even if Jackson administered the fatal overdose to himself since the doctor would have been negligent in leaving the drugs nearby.
His testimony also gave some support to the defense theory that Jackson orally ingested an overdose of lorazepam from a pill bottle next to his bed.
A toxicology study of Jackson’s stomach contents, conducted in recent months, showed a level of lorazepam four times higher in the stomach that in his blood.
“There would have to be some oral lorazepam taken somewhere along the line,” Rogers testified, after taking a moment to do some quick math while on the witness stand.


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Defense drops claim Jackson swallowed fatal dose

LOS ANGELES -- An attorney for the doctor charged in Michael Jackson's death surprised prosecutors and a judge by dropping a key defense claim that the pop superstar swallowed a fatal dose of the anesthetic propofol while the physician wasn't looking.

Attorneys for Dr. Conrad Murray for months have suggested that Jackson could have swallowed a fatal dose of propofol, which is normally administered through an IV drip in hospital-settings. They told jurors in opening statements that they would present a theory that Jackson swallowed several pills of the sedative lorazepam and somehow self-administered the dose of propofol - killing the singer before he had a chance to close his eyes.

Attorney J. Michael Flanagan told the judge on Wednesday that he had commissioned a study about the effects of propofol if swallowed, mainly to counter a study performed by a key prosecution expert who would have testified about the negligible effects of propofol if it is swallowed.

Flanagan said the study he commissioned confirmed that the effect of swallowing propofol would be "trivial."

"We are not going to assert at any point in this trial that Michael Jackson orally ingested propofol," Flanagan said.

It was unclear if the defense planned to argue if Jackson might have injected himself with the fatal dose.


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Conrad Murray's care of Jackson unethical, expert testifies
October 12, 2011


Dr. Conrad Murray’s care for Michael Jackson leading up to his death was so inadequate that it violated the Hippocratic oath and fundamental ethics all doctors swear by, an expert reviewer for the Medical Board of California told jurors Wednesday.

Nader Kamangar, a physician specializing in pulmonary critical care and sleep medicine, said at Murray's involuntary manslaughter trial that administering the potent anesthetic propofol outside a hospital setting was “inconceivable.”

Kamangar concluded in a report for the medical board that Murray’s conduct involved several extreme deviations from the appropriate standard of care.

“It’s imperative for the physician to be observing the patient at all times; this is just the basics of medicine,” said Kamangar, an associate professor and a physician for UCLA. “In this case it was clear there was a period of time when Mr. Jackson was basically left alone and was not being monitored. That in somebody that is receiving sedation is really not acceptable.”

Kamangar echoed the opinions of a cardiologist who testified earlier in the day that Murray’s delay in calling 911 and ineffective CPR were egregious violations that harmed his patient.

He also said the first thing the doctor should have done was not chest compressions -- given that Jackson still had a pulse -- but trying to help Jackson breath.

“When a patient is found out of the hospital in cardiopulmonary arrest ... the first rule of thumb in basic life support is to call for help,” he said.

Kamangar said the CPR that Murray performed -- on a soft surface with one hand -- could have been a “disservice” to his patient.

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