Dr. Conrad Murray’s preliminary hearings CONCLUDED

On Tuesday 11.01.11 Superior Court Judge Michael Pastor judge ruled that Dr. Conrad Murray should stand trial.

There is so much to say in this connection that I don’t know where to start with. No, I do know – only I don’t know whether you see it the same way. The number one thing for me is how the media reported the preliminary hearings and will report the future trial.

Why I regard this as the most important factor?  Because we all know what Dr. Murray did and how negligent and non-professional he was, so the focus will be not on him – he will surely answer for what he did and is already answering by losing his practice and means to existence.

No, the man to be in the focus of attention will be Michael Jackson again as well as everything concerning his taking propofol and drugs in general. And it is  being decided now – on the basis of people’s comments and replies – whether he will be shrugged off as an ordinary drug addict or a heavy case of an insomniac who desperately needed qualified help but never received it.

The media will form public opinion on this issue and the way they report it  will bring about the ultimate verdict in the court of public opinion.

Public opinion is everything when it comes to Michael Jackson – it accused Michael of unspeakable crimes when the court proclaimed him innocent and it can now fully accept him and find him the victim of inhumane treatment even if Dr. Murray and Co. go free out of the courtroom.

I will risk saying here that it is not even important how many years of imprisonment Dr. Murray will get – four or only one, but it is only the matter of interpreting various issues which is top important for Michael’s image now.

• Will the media trash MJ as the earth scum who deserved this end or will they treat him with respect and sympathy as a heavy case of insomnia the responsibility for which is fully (or at least partially) on their shoulders?

• Will they explain to the public the difference between a drug addict who just wants to get high and a person who is desperate to get some sleep which is essential for his concerts and even survival?

• Will they admit that his anxiety and stress could have been eased if the media had stopped harassing him?

• Will they portray Dr. Murray as an “enabler” willing to answer each of Michael’s whims or will they show that the doctor actually listened only to his bosses – his AEG employers?

• Will they point out that if AEG had supplied the monitoring and life saving equipment Michael Jackson could be alive now?

• Will they make a probe into the activities of the people who drove him to such desperation, pressurized him without any specific need and who are the ultimate reason for his death?

These are only some of the questions the future of Michael and his image will depend on and it is answers to these questions that I am looking for when browsing the Internet.

On Day 6 of the hearings, January 11, 2011 one of the greatest testimonies was that by coroner Dr. Christopher Rogers who said that Michael was in excellent health considering his age, did not have any cardiac disease and that it was a homicide case even in the unlikely case Michael administered the drug himself. Dr. Murray should have provided the necessary life-saving and monitoring equipment and his general level of care for Michael was substandard.

Despite this testimony being the crucial one very few newspapers reported the coroner’s statement in detail that day:

Michael Jackson hearing: Coroner says drug dose amounted to ‘homicide’

January 11, 2011 | 11:16 am

The medical examiner who ruled Michael Jackson’s death a homicide testified Tuesday he would stand by the classification even if it turned out the pop star gave himself the fatal dose of anesthetic.

Dr. Christopher Rogers made the statement as a lawyer for Jackson’s personal physician questioned him about the possibility the singer administered the anesthetic propofol when Dr. Conrad Murray wasn’t looking.

“Based on the quality of the medical care, I would still call this a homicide even if the doctor did not administer the propofol to Mr. Jackson,” said Rogers, chief of forensic medication at the Los Angeles County Coroner’s office.

He said Murray had endangered Jackson by using the drug in a home setting without proper monitoring, regardless of who gave the final dose. The testimony was a blow to the defense.

Over the course of the six-day hearing to determine whether there is enough evidence to try Murray for involuntary manslaughter, his lawyers have hinted they may argue for acquittal at trial by blaming Jackson for the fatal dose.

Rogers testified the pop star was in “excellent” health for a middle-aged man and died because of “substandard” medical care. The pathologist said Murray violated treatment norms with his use of propofol.

The drug, he said, is not indicated for insomnia and requires constant patient monitoring, which Murray did not provide.

“The information we received indicates that the doctor left Mr. Jackson while he was anesthetized and this is something you would not do,” Roger said.

Despite testimony from a paramedic that the singer was so underweight as to resemble a hospice patient, Rogers said Jackson was “normal weight” at 5 feet 9 and 136 pounds.

http://news.yahoo.com/s/afp/20110103/en_afp/entertainmentusmusicjacksontrial

While the coroner’s crucial testimony was being reported scantily the majority of media outlets were busy publishing an old but slightly renovated article carrying a catchy headline “Did Jackson kill himself? Pre-trial hearing due in LA”.

The article was initially reported by the Agence France-Presse (on January 3, 2011 judging by the date), but was slightly corrected to become the big news of the Jan.11 Tuesday hearing. It is repeated almost word for word by a number of papers as the Yahoo search brought me at least 6 identical headlines in the first two pages of the items found. Here they are:

Did Jackson kill himself? Pre-trial hearing due in LA

Agence France-Presse
First Posted 08:19:00 01/04/2011
http://showbizandstyle.inquirer.net/breakingnews/breakingnews/view/20110104-312469/Did-Jackson-kill-himself-Pre-trial-hearing-due-in-LA

Did Jackson kill himself? Pre-trial hearing due in LA

Posted: 04 January 2011 0705 hrs http://www.channelnewsasia.com/stories/afp_world/view/1102558/1/.html

Did Jackson kill himself? Pre-trial hearing due in LA

By Agence France-Presse, Updated: 1/4/2011 http://news.malaysia.msn.com/top-stories/article.aspx?cp-documentid=4556777

Did Jackson kill himself? Pre-trial hearing due in LA

http://news.yahoo.com/s/afp/20110103/en_afp/entertainmentusmusicjacksontrial

Did Jackson kill himself? Pre-trial hearing due in LA First Posted

04:47:00 01/04/2011 http://showbizandstyle.inquirer.net/entertainment/entertainment/view/20110104-312425/Did-Michael-Jackson-kill-himself-Pre-trial-hearing-due-in-LA

Why I am paying so much attention to these copies is because the original article was most probably written before the pretrial hearings but its numerous replicas miraculously reappeared on January 11, 2011 which was exactly the day when Murray’s defence attorney Edward Chernoff talked of a possibility of Michael self-administering propofol –  the idea which none of the witnesses actually supported.

To make the article look fresh –  as if reflecting the January 11 situation –  it was updated with a statement that Deputy District Attorney David Walgren discussed the “killing himself” possibility at a preliminary hearing last week.

Considering that the hearing only started on January 4  – while the article was written on Jan.3 and reproduced on Jan.4 – and no hearings were held before that date, it can only mean that the article was prepared in advance and was to be showered on its readers with sensational headlines on the very same day when the “killing-oneself” issue was to be handled.

So what? you will say. Nothing, is my reply – only it shows that when it comes to Michael Jackson the media is capable of reporting the news even before the news actually takes place. I regard it as an interesting phenomenon –  of a somewhat supernatural character unless some human beings meddled with it. If similar supernatural occurrences took place while Michael was alive and was battling with the press,  I can imagine how difficult it was for him to deal with these inexplicable things.

We’ve encountered a couple of such inexplicable incidents ourselves.  In December last year some ghosts attached false lyrics to Michael’s new Monster song and persistently kept them on several key sites for a month making Michael look as if he were confessing crimes after his death.

Only recently other dedicated haters busied themselves with e-mails sent in Charles Thomson’s name creating a good deal of confusion within the community of unsuspecting fans.

Now we see the catchy “news” about Michael killing himself made in advance and spread to various media outlets for throwing it in a single shot just in time for the matter to be raised during the pretrial hearings…

Okay, okay – I agree that it would be utterly ridiculous to ever think that there might be any connection between these random facts, so let us get back to the articles instead.

What did that renovated article say about the possibility of Michael killing himself? Nothing serious – just a catchy headline with no substance to support their supposition. The idea behind such tricks is to impress the readers who are browsing the Internet with a sensational title and fix their attention onto it and it doesn’t matter whether you read it or not – after seeing some 6 or more headlines the idea will settle firmly in your mind on its own:

Did Jackson kill himself? Pre-trial hearing due in LA

Mon Jan 3, 3:33 pm ET

LOS ANGELES: Lawyers for Michael Jackson’s personal doctor will argue that he killed himself, prosecutors claimed ahead of a pre-trial hearing Tuesday into the pop icon’s death.

The case centers on the role of Dr. Conrad Murray, a cardiologist who faces charges of involuntary manslaughter over the June 25, 2009 death of the “King of Pop.” Jackson died at age 50 from drug-induced respiratory arrest.

At the preliminary hearing, Los Angeles Superior Court Judge Michael Pastor will decide whether there is enough evidence to try Murray, 57, on charges of involuntary manslaughter — essentially, a killing done without malice.

A prosecutor claims defense lawyers will say Jackson woke up that fateful night at his Beverly Hills mansion and injected himself with an overdose while Murray was out of the room.

“I do think it’s clear the defense is operating under the theory that the victim, Michael Jackson, killed himself,” said Deputy District Attorney David Walgren at a preliminary hearing last week.

“They don’t want to say it but that’s the direction in which they are going,” he added. A defense lawyer declined to comment on any theories outside the court.

There is likely to be strong emphasis in the hearing on Murray’s use of propofol, an anesthetic used in surgery, to treat Jackson’s insomnia. The powerful drug is not approved for home use or to treat sleep disorders.
Full story here and in all the other links quoted above: http://news.yahoo.com/s/afp/20110103/ts_alt_afp/entertainmentusmusicjacksontrial

What I notice is that the Yahoo news service doesn’t favor Michael at all. No information on the hearings was placed on the Yahoo home page (the last time I checked it they ran “Why blankets are better than comforters” as their key story).

However if you search for news about Michael Jackson you will naturally find a lot. For example the article below which has already drawn 3794 replies seems to be correct and unbiased.

Since it is conducting a kind of a public opinion poll in the form of collecting comments please remember to press the like/dislike button for every comment you find there – remember you are doing it for Michael, not me:

Testimony ends at hearing for Jackson doctor

By LINDA DEUTSCH, AP Special Correspondent Linda Deutsch, Ap Special Correspondent – Tue Jan 11, 5:40 pm ET

LOS ANGELES (AP) — A coroner who performed the autopsy on Michael Jackson testified Tuesday that the pop star’s death would have been classified a homicide even if the singer gave himself the final dose of the anesthetic propofol.

Dr. Christopher Rogers, chief of forensic medicine for the Los Angeles County coroner, was questioned by a lawyer for Dr. Conrad Murray, who is charged with causing Jackson’s death by administering a lethal dose of propofol and other sedatives and failing to provide proper care.

Attorney J. Michael Flanagan suggested Jackson could have swallowed the drug, which is meant to be administered intravenously. While Rogers said that seemed unlikely, he said it would not have made a difference in his finding of homicide because of inadequate care by Murray.

Flanagan’s inquiry was the first disclosure of how the defense plans to counter the involuntary manslaughter charge against Murray. The lawyer has suggested Jackson could have injected himself intravenously while Murray was out of the room.

In court, Flanagan displayed a chart showing the drug levels in Jackson’s blood at the time of the autopsy.

Flanagan asked Rogers, “If the ingestion (of propofol) is by the decedent (and) led to these blood levels, it would not be a homicide?”

“I believe it would still be a homicide,” Rogers replied.

Asked why, the witness said, “Based on the quality of the medical care, I would still call this a homicide even if the doctor didn’t administer the propofol to Mr. Jackson.”

Rogers said propofol should not have been present in the bedroom because it is meant only for hospital settings and, “If there was propofol there, the doctor should have been prepared for the effects.”

Rogers said Jackson had a strong heart and was mostly healthy.

“The care was substandard,” Rogers said. “There were several actions that should have been taken.”

Rogers also testified that Murray was improperly using the powerful anesthetic propofol to treat the musician for insomnia, and that Murray was wrong to leave Jackson’s side while he was under anesthesia before he died.

Under Flanagan’s questioning, Rogers said he consulted with an anesthesiologist about the possibility that Jackson could have injected propofol into his intravenous line while Murray left the room.

“She concluded that the propofol could not have been self-administered, given the configuration of the IV setup,” he said.

He said she also noted that Jackson’s IV tube was connected to his left leg below the knee and it would have been “extremely awkward” for the singer to reach it,especially if he had been sedated.

“The question is whether all those things can happen in such a short time that the doctor was in the bathroom,” Rogers said.

On Monday, a detective testified that Murray spent nearly three hours telling police about his final hours with the superstar, who was so desperate for sleep that he was getting the anesthetic in his bedroom six nights a week.

Murray’s interview two days after Jackson’s death on June 25, 2009, led police back to the singer’s mansion, where they found 12 vials of propofol — a fraction of the 255 vials a Las Vegas pharmacist said he shipped to Murray in the three months before Jackson died.

Detective Orlando Martinez said Murray told police he left the room for only two minutes after giving Jackson a 25 milligram dose of propofol at 10:40 a.m. He said he returned to find him not breathing.

Another witness. Dr. Richard Ruffalo, was called to the stand by Deputy District Attorney David Walgren.

Ruffalo, an anesthesiologist and clinical pharmacologist, gave the judge an exhaustive rundown on the sophisticated medical equipment that should have been present when Murray administered propofol in Jackson’s bedroom.

Among the devices were monitoring equipment for heart and lungs and resuscitation equipment.

“You need to know what you’re doing with the expectation your patient will wake up quickly,” Ruffalo said. “Even if you’re using propofol for a short time, it can do a lot of unfortunate things, especially if mixed with other drugs.”

He also said Murray should have been keeping written charts while monitoring Jackson’s vital signs every five minutes while he was under sedation.

Police have said they never obtained written charts from Murray, who could face up to four years in prison if tried and convicted. http://news.yahoo.com/s/ap/20110111/ap_on_en_mu/us_michael_jackson_doctor_49

Reuters elaborates on the story and emphasizes that even if Michael Jackson did take some propofol in desperation for sleep the case would be nevertheless regarded as homicide:

Michael Jackson giving self drugs still a homicide: official

By Alex Dobuzinskis – Tue Jan 11, 6:04 pm ET

LOS ANGELES (Reuters) – A coroner in the Michael Jackson death case on Tuesday testified that even if the pop-star self-administered the drug that killed him, the doctor caring for the singer still would have committed a homicide.

The testimony of Dr. Christopher Rogers, chief of forensic medicine for the Los Angeles County Coroner, could damage a possible plan by defense lawyers to claim it was the singer who caused his own death, not their client, Dr. Conrad Murray.

In questioning on the stand, Rogers said the simple fact that Murray gave Jackson the powerful anesthetic propofol without proper precautions constituted homicide.

Roger’s testimony came on the sixth day of a preliminary hearing into whether Murray should be tried for involuntary manslaughter in Jackson’s June 2009 drug overdose death.

Involuntary manslaughter is defined as an unintentional killing without malice. It is a lesser charge than murder.

Homicide refers to the killing of another person and encompasses everything from premeditated murder to involuntary manslaughter.

The doctor has pleaded not guilty, and defense attorneys have raised a question of whether Jackson killed himself.

On Tuesday, defense lawyer J. Michael Flanagan asked Rogers about injections of the drug, which typically is used in hospitals but which Jackson used at home to sleep.

“If the doctor didn’t put the propofol in Mr. Jackson, it’s not a homicide is it?” Flanagan asked.

“Based on the quality of the medical care, I would still call this a homicide even if the doctor did not administer the propofol to Mr. Jackson,” Rogers said. “The fact that there was propofol there in the first place — in other words, this is not a usual setting to administer propofol — and if there was propofol there, it was there to be administered to Mr. Jackson and so the doctor should be prepared for adverse effects.”

Flanagan asked if Murray should have been prepared for Mr. Jackson self-administering propofol?

“If that’s a possibility, yes,” Rogers replied.

Rogers said in his testimony that medical examiners believed, based on the evidence, that Murray was the one who administered the propofol to Jackson.

In past court sessions, prosecutors have established that Murray ordered large quantities of the anesthetic along with other drugs including the sedative lorazepam that was also found in Jackson’s body.

Using testimony of Jackson’s security team and telephone records, prosecutors also have tried to paint a picture of Murray being neglectful of Jackson while he was on the drug and hiding evidence of propofol’s use between the time Murray found the singer not breathing and when paramedics were called. http://news.yahoo.com/s/nm/20110111/en_nm/us_michaeljackson_7

CNN provides some important details but calls Michael an addict though they could have chosen to call the word insomniac which is reflecting Michael’s situation much more precisely.

I am strongly against the word drug addict used in connection with Michael. When someone is in constant need of some medication it does not mean the person is a drug addict. We don’t call patients with high blood pressure drug addicts though they are also dependent on drugs and take them on a regular basis – so why should we give this name to an insomniac who is also treated by doctors, though in a somewhat strange way?

Focusing all attention on a person’s addiction to some medication is actually a way to distort the subject as it hides from the public eye the reason for taking the medicine and is diminishing the health problem the patient had.

Dr. Murray said that Michael didn’t take any recreational drugs when someone of the paramedic team asked him this question and this is the news which not a single media outlet has yet reported:

Blount:

• “I did not ask him if the patient took recreational drugs. One of my team did. The answer from Dr. Murray was “NO”.

http://sprocket-trials.blogspot.com/2011/01/dr-conrad-murray-prelim-day-3-part-i.html

Dr. Richard Ruffalo, the anesthesiologist who testified during the hearings, unfortunately drew a parallel between a person heavily deprived of sleep with a heroine addict who reaches for a syringe when nobody sees him. The comparison is incorrect as insomniacs don’t take medicine to get themselves high – they need medication to fall asleep, and they need sleep for sustaining their lives!

Even absolutely healthy people deprived of sleep for several days running are risking their lives – so we should never compare insomniacs with addicts who take hard drugs for recreation purposes and undulging themselves!

The anesthesiologist speaks of Dr. Murray leaving a dangerous drug in the presence of his patient:

• “That would be then another extreme departure, because the patient is a known addict, and the doctor then allowed that much like a known heroin addict, and leaving a syringe of drugs available. It’s an extreme departure. And making sure the patient can’t have self access to drugs. That’s an extreme departure. 

Dr. Ruffalo also admitted he had made a mistake when calculating the amount of propofol in Michael’s stomach but said Dr. Murray’s  guilt was still there as “either way, it doesn’t matter,” he testified. “He abandoned his patient and didn’t resuscitate appropriately.”

• I made an interpretation mistake. I thought it was micrograms and it’s really milligrams.
  So, we’re back to it being orally? Well, we’ll have to talk to the coroner. 

  It’s a big difference isnt’ it? I totally agree.

   

• 45x what it is in the hospital blood.

• Yes, I made a mistake
  

http://sprocket-trials.blogspot.com/2011/01/dr-conrad-murray-prelim-day-6-part-ii.html

The anesthesiologist could of course have done better if he had explained why insomniacs are so desperate to get anything to send them to sleep. Some thirty years ago I also suffered from a year-long horrible insomnia and still remember what it’s like when you are so weak that are unable to stand upright in the daytime but despite the immense fatigue cannot sleep at night either – and you feel like you can take anything – I mean anything –  to get some precious fractions of sleep. It is a matter of survival, this is what it is…

Here is some more information sleeplessness and how insomniacs feel:

• Question: How long can the human body go without sleep?
• The record for the longest period without sleep is 18 days, 21 hours, 40 minutes during a rocking chair marathon. The record holder reported hallucinations, paranoia, blurred vision, slurred speech and memory and concentration lapses.

Source: http://wiki.answers.com/Q/How_long_can_the_human_body_go_without_sleep#ixzz1AqA3l1og

• Hi, Yes it is fully possible for a person to go without sleep for this amount of time. I too am a suffering insomniac, and have gone 5 days with zero sleep. However I went to an insomnia specialist who was recovered from insomnia herself and she once went 8 weeks without sleep. She said it was like feeling close to death, but she made it through and now helps others. http://www.sleepnet.com/insomnia12/messages/667.html
• You can get seriously sick from lack of sleep starting around 5 days and the record was 8 days done on a radio program (He did have the help of drugs to keep him awake, too) but the Guinness book of world records won’t accept it because they say it is too dangerous. Scientists say that at around 10-11 days you would be dead. Even not getting enough sleep each night is enough to make you ill later in your life by lowering your immunity.
• I suffer from insomnia and let me tell you, there are nights where I dont even recognize my own apt. During the day sometimes even the simplest things require repeat explanations. Sleep is wonderful when you can sleep, my brioan wont shut up long enough for me to sleep more than two hours. A body needs at least eight to function properly in the work place or at home. The immune system is the first to take the hit, it drops nad it is much harder to get over being sick. Next the memory goes, it gets harder to remember what happened yesterday much less a week ago.
• There was a study done where someone was deprived of sleep for 11 days, but at that extreme, the word death seems to crop up in the conversation quite a lot. Apparently, among the many things that go haywire in your body the longer you stay awake, your immune system fails and relatively simple pathogens can become deadly. I have personally gone about 4-5 days with no sleep, and at the end I was hallucinating and developed a strange rash on my skin. ( It went away after I slept) I don’t recommend staying awake for long periods of time (more than 48 hours) as it really does knock you around.
• I have gone almost 8 days without sleep. I had been through a very traumatic experience & it affected me for about 1.2 weeks. Towards the end I was getting sleep but very little. If I tried to sleep, my mind would automatically wake me after about 90 minutes (I know a little about sleep cycles & I believe my brain could not initiate REM for some reason, but that’s just my opinion) After a period I was hallucinating and my vision was fogged. When I looked at people they said it was as though I was “staring right through them” only because my eyes were wide & unmoving. I was incredibly nervous & reverting back to childlike behavior. Even the simplest things needed to be explained to me. Conversations with others would go in a circle because I would question everything with “why?”. I became stubborn, scared, paranoid, delusional, confused & bleak.. but mostly scared. I thought I was going to die.

Source: How long can the human body go without sleep? | Answerbag http://www.answerbag.com/q_view/60182#ixzz1AqBk2bpr

At the pretrial hearings Los Angeles Police Detective Orlando Martinez testified about the crucial fact mentioned to him by Dr. Murray during the 2,5 hours interview with him. He said that Murray told him:

• “Mr. Jackson began to complain that he couldn’t sleep and that he would have to cancel his rehearsal and cancel his shows if he couldn’t get any sleep since he couldn’t perform” .

This is top important as at the meeting the next day after Kenny Ortega noticed Michael too weak for the rehearsal and sent him home (June 19, 2009)  Randy Phillips of AEG  demanded Michael should attend all rehearsals and “if Jackson missed any further rehearsals, they were going to ‘pull the plug’ on the show”. This fact is stated in Katherine Jackson’s suit against AEG which she filed in September 2010.

Let me remind you that the number and schedule of the rehearsals Michael attended was none of their business as his obligation was to ensure first class performance in concert and it was only if he failed to do so there that the promoters could claim anything at all.

Their claims only added to his anxiety which prevented him from sleep and this is one of the MAIN factors that drove him to death!

Los Angeles (CNN) –

Los Angeles Police Detective Orlando Martinez testified at the preliminary hearing about what the doctor told him two days after Jackson’s death.

Several doses of two sedatives Murray used in place of propofol still hadn’t put Jackson to sleep after several hours on the morning of June 25, 2009, Murray said, according to Martinez.

“Mr. Jackson began to complain that he couldn’t sleep and that he would have to cancel his rehearsal and cancel his shows if he couldn’t get any sleep since he couldn’t perform,” Martinez quoted Murray as saying.

Jackson had depended on propofol to put him to sleep almost every night in the previous weeks as he was preparing for his “This Is It” comeback concerts, but Murray began to wean him off the surgical anesthetic two nights earlier, Murray told police.

A civil lawsuit filed last year by Jackson’s mother against the company producing the concerts alleged that he had been warned a week earlier “that if Jackson missed any further rehearsals, they were going to ‘pull the plug’ on the show.”

Murray said he eventually gave in to the pressure from his patient and administered a dose of propofol about 10 a.m., the detective testified.  Jackson finally fell asleep, according to Murray’s account.

While his patient slept, Murray sent an e-mail to a British insurance agent assuring him that Jackson was in good health, according to another witness Monday.

… “Michael is not with us today because of an utterly inept, incompetent, reckless doctor, the defendant Conrad Murray,” Los Angeles County Deputy District Attorney David Walgren said in his final arguments.

Earlier Tuesday, the prosecution’s expert witness in the case admitted he made a math mistake and that the recalculation supports the defense theory that Michael Jackson may have given himself the fatal dose of propofol.

Dr. Richard Ruffalo, an anesthesiologist hired by the prosecution, was the last witness to take the stand.

“I actually made a mistake on that,” Ruffalo said during cross-examination, referring to his calculation of the levels of propofol in Jackson’s stomach fluid.

The admission drew an audible gasp from Jackson family members sitting in court.

Murray’s lawyers suggest a frustrated and sleepless Jackson may have poured the surgical anesthetic propofol into his juice bottle while the doctor was out of his bedroom.

“Now it doesn’t make sense unless he ingested it orally in a huge amount,” Ruffalo testified.

But he said Murray would still be at fault, because he left dangerous drugs near a patient who was addicted.

“Either way, it doesn’t matter,” he testified. “He abandoned his patient and didn’t resuscitate appropriately.”

Murray should have anticipated that Jackson, who had previously asked to inject himself, might do this, Ruffalo said.

“He gets upset if he doesn’t get his milk,” he said, referring to Jackson’s habit of referring to propofol as his “milk.”

The pop star’s sister La Toya Jackson was clearly upset by hearing a prosecution witness vilify her brother as an addict.

The pathologist who conducted Jackson’s autopsy acknowledged earlier Tuesday it was possible, although improbable, that Jackson gave himself the fatal dose of the propofol.

The defense planted the seed Monday for its theory that Jackson may have given himself the fatal dose. A doctor said in a police interview two days after the death that a sleepless Jackson begged Murray for propofol the day he died, a police detective testified.

While Murray told police he eventually gave Jackson propofol, the defense lawyer suggested that it could be that a frustrated Jackson poured the fatal dosage into his juice and drank it.

http://edition.cnn.com/2011/CRIME/01/11/california.conrad.murray.hearing/index.html?section=cnn_latest

The next article says the anesthesiologist enumerated a long list of monitoring and life-saving equipment which was to be present in the bedroom and lack of which testified to substandard care and gross negligence on the part of the doctor.

I wish someone also mentioned the fact that the equipment was supposed to be supplied by AEG but was never provided – evidently for the following reasons:

–        AEG had only an oral agreement with Dr. Murray and made no written commitments as regards supplying the equipment, though they did promise both the equipment and services of a nurse

–        They allowed Dr. Murray to work for more than two months without pay and the necessary equipment, evidently supplying him with money for purchasing the medicine (the pharmacist said that Murray paid with a company check and I do hope it is AEG’s check though I doubt they made such a blunder).

–        The reason why they delayed making a contract with Murray was most probably the fact that they didn’t want their name to be involved with the propofol issue. This is actually what they are currently stating as they claim they didn’t know that propofol was used.

–        However if they didn’t know it was used they shouldn’t have promised the equipment either. And vice versa, if they promised the equipment it means they did know about it.

–        The draft of the contract with Dr. Murray was made only after that fateful meeting on June 20, 2009 when,  just a few days before Michael’s death,  AEG demanded that Michael should sign a contract for Murray clearly stating there that 1) it was him who wanted that doctor and 2) that he was going to pay for the doctor’s services – thus fully releasing AEG of any responsibility for hiring him.

–        Michael Jackson did NOT put his signature under Murray’s contract

–        However Dr. Murray signed it thus assuming all the obligations arising from it

–        now AEG wash their hands saying that 1) they don’t owe Dr. Murray any money for the over than two months of his services (as MJ didn’t sign the contract), 2)  they were not supposed to supply any equipment and that 3) they didn’t know that  Dr. Murray was giving Michael propofol!

–        I wonder if one day then will say that they don’t know Dr. Murray either….

All the information stated above has been taken from Katherine Jackson’s suit against AEG: http://tmz.vo.llnwd.net/o28/newsdesk/tmz_documents/0916_jackson_wrongful_death_TMZ_WM.pdf

Some of those statements can be confirmed by the news articles. Here is one of them:

“Chernoff also said the promoter of Jackson’s 50-show London concerts, AEG Live, owes the cardiologist $300,000.

“His contract with the promoters states he would receive an amount of money each month to be his (Jackson’s) personal physician and they have failed to honor that contract,” Chernoff said. “They are two months behind.”

Randy Phillips, president and CEO of AEG Live, acknowledged the contract called for Murray to be paid $150,000 a month, but said the contract required Jackson’s signature.

“Michael never signed the contract,” Phillips said.

He also said the doctor’s claim for payment may be against Jackson’s estate, not AEG which was merely advancing the money to Jackson.

http://www.huffingtonpost.com/2009/06/28/conrad-murray-jackson-doc_n_221972.html

Another thing we will learn from the article below is that Dr. Murray – in spite of being in dire straits – has three top lawyers to defend him: Edward Chernoff, Joseph Low IV and J Michael Flanagan. Somewhere in the media I saw a short piece of news that they were not getting paid for their work, however the link to it has been lost, so let us consider it a play of my imagination only.

However if this news finds confirmation I’ll be truly surprised that when it comes to defending Michael’s adversaries there are a great many top lawyers who volunteer to do unpaid work. The last time I heard of a top-earning professional receive nothing for working for Michael Jackson adversaries was when the glorious Larry Feldman did pro bono work for Janet Arvizo and her parents, trying to hide from the defense that she had put money to her parents’ account…

Jackson doctor ordered to stand trial

Updated: 14:19, Wednesday January 12, 2011

A judge on Tuesday ordered the personal physician of Michael Jackson to stand trial for involuntary manslaughter after hearing testimony that he administered a dose of a powerful anesthetic and other sedatives then left the pop star alone.

Murray’s defence lawyer Ed Chernoff and prosecutors declined comment on the ruling.

During closing arguments at the preliminary hearing, another defence lawyer, Joseph Low IV, argued the case should be dismissed because prosecutors didn’t adequately prove how Murray caused Jackson’s death. He also said Jackson’s health may have been a contributing cause.

‘In contrast to Mr Low’s comment, let me just say, it was not Michael Jackson’s time to go,’ Deputy District Attorney David Walgren said. ‘Because of Dr Murray’s actions, Michael’s children are left without a father.’

One of the final witnesses on Tuesday was Dr Christopher Rogers, chief of forensic medicine for the Los Angeles County coroner. During his cross-examination, defence lawyer J Michael Flanagan suggested Jackson could have swallowed propofol, which is meant to be administered intravenously.

While Rogers said that seemed unlikely, he said it would not have made a difference in his finding of homicide because of inadequate care by Murray.

Flanagan’s inquiry was the first indication of how his lawyers might defend Murray at trial. Flanagan has suggested Jackson could have injected himself intravenously while Murray was out of the room.

Rogers, however, testified that propofol should not have been present in the bedroom because it was meant only for hospital settings and, ‘If there was propofol there, the doctor should have been prepared for the effects.’

Rogers also said Jackson had a strong heart and was mostly healthy.

‘The care was substandard,’ Rogers said. ‘There were several actions that should have been taken.’

Rogers also testified that Murray was improperly using propofol to treat the musician for insomnia, and that Murray was wrong to leave Jackson’s side while he was under anesthesia before he died.

Another witness, Dr Richard Ruffalo, an anesthesiologist and clinical pharmacologist, gave the judge an exhaustive rundown on the sophisticated medical equipment that should have been present when Murray administered propofol in Jackson’s bedroom.

Among the devices were monitoring equipment for heart and lungs and resuscitation equipment.

‘You need to know what you’re doing with the expectation your patient will wake up quickly,’ Ruffalo said. ‘Even if you’re using propofol for a short time, it can do a lot of unfortunate things, especially if mixed with other drugs.’

Jackson had been receiving propofol intravenously six nights a week for the two months before his death, Murray told detectives.

http://www.skynews.com.au/showbiz/article.aspx?id=563474&vId=2092594

The judge suspended Dr. Conrad Murray’s license as his services present a danger to his patients but denied the prosecutors’ request to raise the amount of his bail:

Michael Jackson’s doctor to stand trial in manslaughter

January 12, 2011

The judge’s decision to send the case to trial was widely expected, including by Murray’s attorneys, but the defense had strongly contested the suspension of his license, with one of his lawyers calling it a “nuclear option” that could destroy the 57-year-old doctor’s ability to support his family and mount a criminal defense.

Murray is licensed in California, Texas and Nevada, but does not practice in California, his attorney said. As part of his ruling, Pastor gave the doctor 24 hours to inform medical authorities in the two other states that the court had suspended his California license until the conclusion of the criminal case. The notifications could have repercussions on his practice in the other states, his attorney said.

The judge denied a request by prosecutors to raise Murray’s bail from $75,000 to $300,000. Murray is to return to court for arraignment Jan. 25 and is expected to again plead not guilty.

How lethal levels of propofol got into Jackson’s system was the focus of the final day of testimony in the case. Through the testimony of 20 previous witnesses, including police officers, paramedics and the performer’s household staff, the defense had hinted that Jackson might have given himself the fatal dose.

But with the last two witnesses — both medical experts — the defense delved directly into the issue, with a lawyer suggesting that Jackson either injected himself with propofol or drank it when Murray wasn’t looking.

The medical examiner who ruled the death a homicide said that he would stand by the classification even if it turned out that the pop star gave himself the fatal dose. Dr. Christopher Rogers, chief of forensic medicine for the Los Angeles County coroner’s office, said Murray’s “substandard” treatment in using propofol to treat insomnia in a home setting without proper monitoring remained key to his opinion.

The final witness, Dr. Richard Ruffalo, an anesthesiologist and pharmacologist, said his review of Murray’s treatment suggested numerous deviations from the standard of medical care, from “simple” deviations such as a lack of understanding of the interactions between drugs to “extreme” deviations such as performing “totally useless” CPR with one hand.

He initially said that small amounts of propofol found in Jackson’s stomach were not consistent with ingesting the drug, but under cross-examination, he acknowledged making a math error in his analysis and said ingestion “would seem to make sense.”

http://www.latimes.com/news/local/la-me-conrad-murray-20110112,0,3520547.story?track=rss

To give you a feel of how the hearings were concluded let me reproduce here part of the transcript from Day 6 of the hearings made by the heroic reporters of TRIAL & TRIBULATIONS site. Please note that this is a draft only:

They discuss the usage of propofol. Since the moment propofol is given its level should be maintained in a patient’s blood either by dripping method or through regular syringe infusions. The moment propofol stops dripping the patient wakes up almost immediately. So the amount of 20 ml Dr. Murray claimed he gave to Michael would have kept him asleep only for 5 minutes:

– IF Dr Murray gave a 25 mil of propofol, over a period of three to five minutes, you would expect it to produce sleep. -I would think it would produce sleep.

-And the sleep would be very short lived wouldn’t it? – Yes.

– Now, assuming the 25 ml between 10:40 -10:50. That could keep him asleep short period of time. – Well, six five minutes.

– As of 11 oclock, propofol is no longer keeping him asleep. That’s always possible.

– From Dr. M statement and phone records, Dr. Murray probably was out of the room for 40 minutes.

– You know it’s not going to last more than 5 minutes.

– Dr. Cooper presented, talked about using propofol to use on brain injury patients. But the other beautiful thing is it doesn’t last long and when you come out you’re not drugged out.

– What purpose does it serve, if it’s only going to keep the person asleep for five minutes?….

It doesn’t serve any purpose unless propofol goes on dripping into blood and the doctor continues slowly infusing it by syringe. Propofol is an anesthetic and is meant to work only while being continuously delivered into the blood system. The moment it stops flowing the patient immediately wakes up – this is the whole idea of a well-controlled anesthesia. That is why the doctor has no right to leave his patient’s side while administering it:

– And if this is the hypothetical, of ingestion of propofol by the decedent, and ingestion of lydocaine, this would not be a homicide?

-I would think it would still be a homicide. Based on the quality of the medical of care, I would still consider it a homicide even if the Dr. did not give the propofol.

Just the fact that there was propofol there in the first place. This is not the accepted setting to administer propofol in the first place.

He was not prepared for any adverse effects.

The doctor left Mr. Jackson while he was anethetistized, and that is something that you should not do.

Under anethesia, you have to have someone there quickly, so if there is some bad side effect you can (attend?) to it.

The patient could have been saved. When he stopped breathing his breathing could have been brought back if the doctor’s intervention had been immediate:

He could bring breathing back.

The doctor gives a good explanation as to why if the intervention was immediate, and the right intervention, he could have brought the breathing back.

The Defense asks questions about self-administering propofol:

Questions about how difficult it would have been for someone, not medically trained to start an IV.

In order for Mr J to administer the propofol himself certain things have to happen. The doctor has to stop the drug. Then he has to leave. and Mr. J has to wake up and you have to be sufficiently aware to be in some way to press the propofol (?) into the syringe…

Dr. told us he was in the bathroom for a very short time, and so could have all of those things happen in such a short time.

No one has ever tried to drink propofol but if they did same as with all other drugs it would take more time to absorb than when taken intravenously :

Would you also agree that ingestion of propofol would be less efficient than IV. Yes, it’s going to take time (to absorb).

Assuming self admistration as Mr. F included, would any of your opinions change in your standard of care? No. You don’t walk away from a patient. (explains in detail. Addicts, that is the first tip off, you dont walk away, just like a heroin addict.)

Your opinion doesn’t change whether or not there was a self administer…. No. the standard of care doesn’t change. You don’t walk away from a patient.

The prosecution states their final conclusions:

Failure to use appropriate monitoring equipment.
blood pressure equip, that is electronic. People have them in their home and they set the time.

Failure to inform the paramedics and doctor’s the nature of the drugs given.

Failure to monitor and document all drugs given. Explains the details of what you monitor and what can change (the breathing, the blood pressure, depth of sedation) all those things can be factored in and recorded.

Failure to remain and be present.

What did you mean by that?

1. if you have a patient that is being given drugs like this, with a patient in like anethesia. you have to be vigilant you have to bet there all the time. Someone who is qualified to handle the issue and monitor the equipment.

2. If you walk out and leave the patient, things can happen. If you don’t know what the patient did, if you didn’t nitice it or record it or note it, no matter what, you are responsible 100 percent for the patient.

Failure to provide ACLS care. And you described that as an extreme departure.

Overall, identified several points of extreme deviation of care.

Failure to immediately call 911. If you are a single person by yourself, the first thing you do is to call to get (other’s to help).

Failure to use ambu bag, with oxygen. Dr. explains the use and how it’s used. Long explanation as to how the ambu bag can give you information back.

Airway and breathing, are the first steps.

Failure to apply the ABC’s of ACLS.

And addressed the one handed CPR on the bed. “Totally useless.”

One handed behind the back? It’s totally useless. You can’t get enough pressure to push down on the chest. We use that in neonatal. Describes what you should do with an adult in the bed. Describes how you get them out of the bed easily. Even if you claim you can’t move the person from the bed, the proper training would be to protect the head, slide the individual off the bed, and then bea ble to start chest compression.

Even if they are morbidly obese, you can generally do that. (ans)

If you look at the conduct of Dr. Murray over 3 months time, Dr. M would have the best understanding day after day after day, exactly how MJ would have reacted to the propofol drugs.

All those machines in the hospital tell doctors who have never seen a patient before….but Dr. Murray, who had seen MJ day after day would have seen how this drug (interacted with him).

Your honor, in contrast Mr. Low’s comment, it was not MJ time to go. It was not for the recklessnes of Dr. M. It was not his time to go. MJ children are without a father.

And for him to opine, that it was just frankly time to go, is offensive.

The reason MJ is not here today, is because of the carless, neglegence careless incompetence of Dr. M.

MJ is dead at the hands of Dr M.

Walgren is very angry and passionately in a loud voice, arguing his case.

Every single drug on that report, was provided, by Dr. Murray.

He’s very forceful in his statements.

Goes over the testimony of various witnesses.

At 12:12 receives first phone call MAWilliams receives.

Mr. Alvarez, from when he enters the room.

He’s busy with hiding evidence.
He’s telling him to take these bags.
Take down an IV bag that appeared to have a bottle in it so that it could be placed elsewhere.

We also know Dr. M tells members of the detail, Dr. M is trying to get back to the home to get some cream, I submit it was to get back to the home to dispose of evidence.

Paramedics testimony.
What we do know from paramedics, at no time did Dr. M mention propofol. when the information was needed, he never mentioned it. That goes to consciousness of guilt. But never once mentions propofol, but never mentions the benzodiaz he administered.

He doesn’t mention to UCLA medical doctors. He doesnt mention because he knows what he’s done, he knows that he’s trying to cover up.

Fleak testimony, and what she found at the house.

Also know, cooberating testimony of Alvarez, recovered an IV bag with a bottle of propofol upsidedown in the bag.

Toxicology findings by Jaime Lintemoot.

Testimony of how much propofol was shipped. 90 bottles shipped on June 10 just two weeks before his death.

Coroner testimony.
It’s still a homicide, even if MJ self administered.

Ruffalo testimony. The detail of the gross neglegence and standard of care. That it was an extreme departure from standard of care. ANY doctor, any doctor should know.

We heard from DEA as to the email. We know from the screen shots, that Dr. Murray is reading from the email.

We know that he’s responding with another lengthly email.
We heard in detail about the phone records, and the phone calls to girlfriends and from patients.

Heard from Sade Anding at 11:51, and that Dr. Murray stopped responding and after 5 minutes , Dr. M stopped responding and she heard a commotion.

Now look at Dr. M ‘s own words.

Goes over what he has said that he did to treated MJ in the interview . Goes over his detail time line.

Goes to the bathroom and he’s shocked. Shocked to find MJ not breathing, and that he’s never breathing again.

Why is that significant.

MJ was called at 12:17.. That means Dr. Murray waited almost an hour before he calls 911. (over an hour)

Points out the specific contradiction. Given not the day of the incident, given 2 days after the incident in a hotel, with his attorneys.

Dr. Murray has time to think about the events think about what he’s going to say.

According to Dr. Murray’s own timeline, that he let MJ lie there for over an hour not breathing.

Or he could be lying about his timeline, and Dr. M is not being truthful about his timeline.

Third option, is that Dr. Murray is so utterly so incompetent and reckless, that he has no idea what he gave him or when.

Tragically, it led to the death of MJ, based on the theory of involuntary manslaughter.

He took time to call Michale Amir. Took time to call security guard.

To call 911 would give a quicker response, but would not give him time enough to cover up what he had done.

Walgren is talking so fast I can’t get it all.

Goes over the explanations he gave for not calling 911 when he did and why he didn’t get MJ off the bed so he could do proper CPR.

You are trained to grab them by the shoulder, protect the head and drag them to the floor.

Heard about the failure to keep medical records or to monitor.
Failure to monitor and be present.

Standard was breached over and over and over again.

Because of Dr. M. actions is why MJ is not longer here, and NOT because it was his time to go.

He was motivated by other things. Because of his complete failure and his actions – that is why MJ is no longer with us.

Submitted.

The Defense:

Saying doesn’t make it so. Although Mr. Walgren appears to be angry, saying doesn’t make it so.

Although there appears to be emotion and angry.. need to…. sheesh. I can’t keep up.

Did Mr. Walgren ever prove to you that if they had done something sooner, no that was just benefit without the fact.

(I’m sorry. I just can’t write anymore of this weak, ineffectual argument.)

Instead of getting upset, at least prove. Saying doesn’t make it so.

These points he’s bringing up….Oh. My. Lord. Now the discrepancy as to the LENGTH of the interview of Dr. Murray by the detectives.

The judge: This court has reviewed all the evidence the defense motion to dismiss is denied.

Any issues of bail filed by medical board. do the state want to be heard?

Ms. Saunders Medical board.

We’re appearing on behalf of director of the medical board, to provide justice and that as a condition of bail, that the defendant have restrictions on him – not to be able to practice,

Since the defendant held over, that there are restrictions on his license are in effect we further request that he be prevented from practicing here in California.

delay in calling 911.

did not monitor patient while under heavy sedation.
(goes through her list of reasons to restrict his license.)

I’m not going to list all that she says. Sorry. It’s like a total repeat.

If he’s still allowed to practice, the public is at risk.

Allowing the defendant to continue to practice is too much of a risk to the public.

Chernoff: Murray has always appeared. He has never failed to appear. Don’t know that he’s a flight risk. He’s already under 3 times the amount scheduled.

He did help a woman who has fainted in the air (flight).

Medical license.

Now asking, you’ve found probable cause that something going on, but they have not provided any other information, no complaints, no malpractice, he’s spent 21 years as a Dr… the thing you found probably cause for, was an issue in isolation.

The At G. full well knows, Dr. M hasn’t practiced in California since 2009. Dr. Murray practices have been limited to two other states. there’s no meaningful distinction from practicing, from that. His patients, they do not have a doctor, the effect it will have on his personal life, his defense, is immediate.

It’s not imminent. If it was imminent, we would have heard this already.

The effect on the citizens. they’ve asked you to take away his ability to practice in California. The real effect of that is nothing, since he doesn’t practice here.

The real effect is punishment, because of where he does practice in TX.

If he really doesn’t have any patients here, then not practicing here in California, won’t be a problem.

Prior, we didn’t have all the facts that we have now heard in the last six days.

More…. All of this makes him a danger, but to any patient he sees.

One more comment from Chernoff.
It’s not that Dr. M says he wants to practice in California, it’s the effect.

Talks about what he does currently, sees patients in his office and prescribes heart medication.

Increase the bail, court denies the request. Satisfied that the bail presently set, which is three times the presumptive.

In this case there is a direct nexus and connection between the actions of Dr. Murray, and a homicide. (more) and the fitness and competence to practice medicine.

Conditions of bail is appropriate.

Immediateley cease practicing in the state of californila is now suspended by this court as a condition of bail.

They are to notify the appropriate authorities in other states within the next 24 hours.
Arraignment will be set two weeks from today.
January 25th, at 8L30 am.

Nothing else?

Defense?

Stay this order pending appellate review?

No.

That’s it. Concluded.

http://sprocket-trials.blogspot.com/2011/01/dr-conrad-murray-prelim-day-6-part-ii.html