Conrad Murray trial week 5. WILL THE TRUTH WIN?
This is a place to collect everything about week 5 of Conrad Murray’s trial.
* * * * *
We haven’t yet finished with the last two days of week 4, but I still hope to fully transcribe day 14. It is the culmination of Dr. Shafer’s testimony, is central to the case and deserves to be covered in full (so please give me some time for that).
But simultaneously I would like to cut on Chernoff’s cross-examination of Dr. Shafer – simply because there is not much to say there. Let me repeat what I earlier said about his method of defending Murray. It looks more like a bullying spectacle or a bad theatre where each question is pronounced with an intonation implying it has some meaning while actually it does not.
I was a little afraid that the highly gentlemanly Dr. Shafer would not be able to stand up to this bullying technique but was amazed to see that he did. And even realized why.
He is not only a doctor – he is first and foremost a scientist who is used to scientific debate and defending his findings. You could see it from the easy way he could get any paper needed from his computer or from the polite but stern manner in which he was answering Chernoff’s questions. This type of confidence can arise only from hard work in searching for the truth and realization that you have looked into every possibility there was to look into.
What you see in Dr. Shafer is what true science is all about.
Scientists may be different too – some of them think of career only and may not be even above falsifying facts in the field of their studies. By the time their opponents make similar experiments and discover the deceit, time will pass while they have already made a successful career and grabbed a lot of money and awards.
But real Scientists are a totally different breed. Their system of values is nothing you can compare with – they will spare no time and effort to get to the truth of the matter. When others relax and enjoy themselves they will still work. They will not be pompous and full of self-importance but will look childlike in their desire to sacrifice a lot in exchange for a small grain of knowledge they are seeking. In their enthusiasm they will remind you of boys who tirelessly climb trees in order to see what’s there on the horizon.
They have a strict code of ethics which will not allow them to charge fees for the testimony because this may compromise their integrity and unbiased approach. They will even pay their own money for making an experiment to get to the bottom of the matter (Dr. Shafer paid $150 for a specific type of an infusion site to be delivered overnight). And all this because they value the truth more than anyone else and are terribly curious to know it.
Dr. Shafer is that kind of a Scientist.
It is a sort of a miracle that after his death Michael Jackson has started to draw to himself the best kind of people.
How many of them have we seen for the past four weeks? A lot, and surely much more than Michael Jackson saw when he was alive. The paramedics who arrived only four minutes after the 911 call, the emergency room doctors who worked so hard that they would have surely revived him had he not died long ago, the coroner who set the record straight by pronouncing a homicide, Dr. Steinberg who boldly handled Murray’s false interview and proved his guilt on the basis of his own lies. And now Dr. Shafer who is the epitome of science, hard work, selflessness and truth.
The feeling that Michael Jackson has suddenly become a magnet for only the best kind of people is reinforced by prosecutors David Walgren and Deborah Brazil who are doing a fantastic job. Walgren’s clear-cut questions are a treat to listen to and his whole demeanor, professionalism and determination to do justice are a complete opposite to the qualities of other prosecutors in Michael Jackson’s life – Tom Sneddon and his ilk.
In short this trial is a total opposite of the farce they created for Michael in 2005. Over there only Thomas Mesereau was enjoying the same level of excellency, while here there is a whole squadron of the same kind of people. And it is only the reason why all of them have come together which is damping the joy of seeing them by Michael’s side.
* * * * *
Here is an article by Linda Deutsch which was posted as a comment on week 4 but is so good that it deserves to be brought to everyone’s attention as a summary of week 4 at the trial:
After an emotional start, science takes over trial
By LINDA DEUTSCH, AP Special Correspondent
October 23, 2011
LOS ANGELES (AP) — While the defense was on the verge of its counter attack in the trial of Michael Jackson’s doctor, the prosecution dramatically shifted the focus from personalities to science — its most powerful weapon in the courtroom battle..
Its star witness, a scientist with a reassuring witness box manner, had jurors on their feet straining for a better view of his show-and-tell demonstration. It was the closest they would come to seeing a purported re-enactment of how the King of Pop died.
Dr. Conrad Murray, charged with causing Jackson’s death, watched intently as Dr. Steven Shafer closed the case against him holding a bottle of propofol, an IV bag and a tube carrying the milky white liquid downward.
That was how it happened on June 25, 2009, said Shafer. He was certain.
On Monday, a defense attorney will try to shake his testimony and later a fellow scientist billed as “the father of propofol,” will offer another theory. Whether Dr. Paul White can absolve Murray of blame for the singer’s death remains to be seen. But the defense is just beginning.
“He will have to stand firm on the fact that reasonable minds can differ,” said Marcellus McRae, a former federal prosecutor and trial attorney who has been following the case closely. “He will have to change the landscape here and show some reasonable doubt. The question is will this be enough?”
Murray, a Houston based cardiologist, has pleaded not guilty to involuntary manslaughter.
McRae said calling Shafer as the final prosecution witness was a master stroke. “Brick by evidentiary brick, Shafer has built a wall of scientific reasons for the jury to conclude that Dr. Murray was criminally negligent,” he said. “It allows the prosecution to tell the jury that their case is built on science rather than shifting theories.”
In addition to making the science understandable, Shafer offered some colloquial phrases that may resonate with jurors including the words “crazy” and “clueless.”
He called Murray’s unorthodox use of propofol as entering “a pharmacological never-never land “and said the doctor was “clueless” when it came to helping his dying patient.
And he denounced a defense theory that Jackson could have awoken from sedation and given himself the drugs that killed him during a few minutes that he was left alone by Murray.
“People don’t just wake up from anesthesia hell-bent to pick up a syringe and pump it into the IV,” Shafer said, reminding the jury that the procedure was complicated. “It’s a crazy scenario.”
Shafer stood in the well of the courtroom with an IV pole, a bag of saline solution and a bottle of propofol, showing how the drug could have run quickly into Jackson’s veins while his doctor was out of the bedroom.
He drew a scene in which Murray, lacking the proper equipment to measure doses, left Jackson on an IV drip of the powerful anesthetic flowing quickly under the pull of gravity into the sleeping singer. It was the explanation, he said, of how Jackson died of a propofol overdose with no one present to see that he had stopped breathing.
“This fits all of the data in this case and I am not aware of a single piece of data that is inconsistent with this explanation,” Shafer said.
In early cross-examination, defense attorney Ed Chernoff asked Shafer if that wasn’t “a bold statement.”
“It’s an honest statement,” he replied.
Shafer’s mathematical calculations projected on a large screen concluded that Murray had not given his patient the minimal 25 milligrams he claimed, but had started a vastly larger infusion of a 100 milliliter bottle, containing 1,000 milligrams of the drug. No, Shafer said, Jackson had not given himself an additional infusion of propofol.”He can’t give himself an injection if he’s asleep,” he said.
Shafer was the prosecution’s closer. An anesthesiology professor and researcher at Columbia University Medical School, he wrote the package insert instructing doctors how to use propofol.
He listed 17 “egregious” violations of the standard of care by Murray, chief among them leaving his anesthetized patient alone and failing to call 9-1-1 when he found Jackson not breathing.
Deputy District Attorney David Walgren concluded a key day of Shafer’s examination by asking: “Would it be your opinion that Conrad Murray is directly responsible for the death of Michael Jackson for his egregious violations and abandonment of Michael Jackson?”
Shafer replied, “Absolutely.”
Just giving Jackson the anesthetic as a sleep aid in a home setting was unconscionable, Shafer testified. It is intended for surgery in hospitals where resuscitation equipment is available.
“We are in pharmacological never-never land here, something that was done to Michael Jackson and no one else in history to my knowledge,” he told jurors.
Gray haired and amiable, Shafer entranced jurors with his easy manner, speaking directly to them as he made molecules understandable and led them through complicated graphs projected on a courtroom screen.
When Chernoff accused him of trying to send a message to jurors, he responded calmly, “I’m trying to make it easy for the jury. These are complex graphs and I’m trying to explain to the jury a very complex pharmacology. There is no other agenda as you’re suggesting.”
McRae gave Walgren and co-prosecutor Deborah Brazil high marks. “Good trial lawyers know that you have to persuade on the law, persuade on a factual level and then persuade on a moral and common sense level,” he said. “Even though you’re not going to hear an instruction about morality, the jury has to feel they’re making the right decision on a gut level. I think the prosecutors here have done a very effective job of hitting the human element, the moral element and now the factual element.” he said.
A parade of 32 witnesses had testified before Shafer took the stand and stole the show. They included Jackson’s household personnel, security guards, paramedics and a business associate. Jurors heard about the legendary singer’s final day on earth — singing and dancing at a rehearsal for his comeback concert, revelling in the adulation of fans who showered him with gifts. And then a night of horror, chasing the most elusive treasure he craved — sleep.
Most dramatic were two recordings — one of the heavily drugged singer dreaming aloud to his doctor about future triumphs and then the doctor himself being interviewed by police two days after the death that shook the world of pop culture.
All of it told a compelling story structured by prosecutors Walgren and Brazil to prove that Murray, who had been hired by Jackson for $150,000 a month as his personal physician, was responsible for his famous patient’s death.
With the trial winding down, they brought on the experts, a coroner and two doctors who evaluated Murray’s conduct for the California Medical Board.
Dr. Nathan Kamangar, described Murray’s conduct as “unethical, disturbing and beyond comprehension.”
Dr. Alon Steinberg enumerated deviations from the standard of care, and said, “If all of these deviations didn’t happen, Michael Jackson might have been alive.”
Copyright © 2011 The Associated Press. All rights reserved.
Day 16. Monday, October 24
First he asked about rapid boluses of propofol and showed a graph prepared by Dr. Shafer for his opponent (!) Dr. White.
The model is trying to prove that if Murray administered 25mg of propofol slowly there was never a risk of apnea (a stop in breathing).
No, there wasn’t – only Dr. Shafer effectively proved that Michael Jackson was given a much higher dose.
Chernoff tried to compromise Dr. Shafer’s method of work by saying that Murray never said to the police that he had given more than 25 mg (wrong – Murray said that he usually administered 50mg), so all those figures of 50mg or 6 injections were just taken “from thin air”.
But this is exactly what the science of pharmacokinetics does! Since Murray was not keeping any records Dr. Shafer had only one figure to go by – the level of profol in the femoral blood found on autopsy – and all the other figures were introduced into the model for computer to process and see which combination of data would be consistent with the end result.
And what does it matter what Murray said or didn’t say to the police? Most of it was lies anyway. Dr. Shafer was working on a model which would explain the high amount of propofol in Michael Jackson’s blood (though propofol is a drug which leaves the body very quickly).
And the only scenario which was consistent with that concentration in blood upon autopsy was a combination of an IV infusion of 100ml propofol and it still going into the body after the heart stopped beating. Otherwise the propofol level would have fallen within a very short period of time due to continued blood circulation and metabolism.
Then Chernoff raised his favourite theme of Lorazepam. He referred to the number (from Dr. Greenblutt’s findings) which Dr. Shafer used for calculating the half-life of Lorazepam in the stomach. According to these data the amount of the active drug in the body is cut in half every 22 minutes. Other findings show it may be 40 minutes but Dr. Shafer used the most conservative variant of 22 min.
This is an interesting tool for calculating how much active Lorazepam will stay in the body after coming into the stomach. It shows that if the initial dose was – hypothetically – 16 ml, in the first 22 minutes it will turn into 8 ml, 22 minutes later it will be 4 ml, then 2 ml, then 1 ml and so on.
I’ve made some rough calculations myself and found that if 16ml were taken, in 5 hours only 0, 00157ml of it would be left in the stomach. However if a different system of calculation was used – the one based on a 40min half-life of Lorazepam – the same would have been found in the stomach in approx. twice as longer time (around 10 hours!)
This means that Dr. Shafer’s study was really conservative and if 16ml of Lorazepam pills had been taken, say at 02.00 am, some particles of the drug would have still be found at the time of death (supposedly noon time) 10 hours later.
After being tortured by Chernoff’s questions whether Dr. Shafer “could envision Lorazepam pills taken by MJ” the doctor said that before 8 o’clock he could envision it (only it doesn’t change anything in respect of the propofol intoxication Michael really died of).
Then they discussed the time when Lorazepam reaches its peak – it is 2 hours after it comes into the stomach. Dr. Shafer explained it in a fascinating manner. When a drug is swallowed, there are two processes starting to play off against each other – the stomach sends the drug into blood and the liver removes the drug from the blood (for breaking it up into metabolites), so they are more or less competing with each other in the rate at which they are doing it.
The peak concentration in the blood is when the rate of the drug coming in from the stomach is equal to the rate of it being removed by the liver, after which the liver wins and the concentration starts falling.
Dr. Shafer also determined the amount of Lorazepam in the urine and his results were based on the toxicology report. Chernoff asked a crazy question whether he had made an independent analysis of the urine to which Dr. Shafer said had no possibility to do it as he wasn’t running a lab.
Dr. Shafer specifically looked into the urine results to see if they were consistent with either oral or intravenous dosing paradigm of Lorazepam suggested by the two opposing sides at the trial.
Chernoff asked “From where is the oral paradigm coming”? implying that Dr. Shafer believed in that scenario, otherwise he wouldn’t have looked into it.
Dr. Shafer said, “From you” (meaning that otherwise he would not have looked into those insignificant numbers at all).
“Oh”, said Chernoff.
After Lorazepam is metabolized in the liver, its metabolite is excreted by kidneys (93% of it leaves the body that way). And Dr. Shafer checked for Lorazepam metabolite (lorazepam gluconoride) in the urine based on the defense’s theory that 16ml of Lorazepam were taken at 8 and 10 in the morning. The theory was evidently ruled out as Chernoff didn’t venture to ask further questions here.
Instead he switched over to Propofol. Chernoff produced Dr. Shafer’s final model (where Murray is giving a drip of 100ml of propofol) and asked an incredible question trying to impress the jury with its nasty implications,
- “You constructed a simulation where just by chance at the exact time the bottle ran out Michael Jackson also died. Is that sort of a coincidence”?
- Dr. Shafer politely answered,“No, it was my intent”.
It was indeed Dr. Shafer’s intent to work out a model which would be totally consistent with all the data available to him.
The major (and probably the only one) was the level of propofol in Michael Jackson’s blood found on autopsy. There was simply nothings else due to the absence of medical charts and records which Murray failed to make.
To try to disprove Dr. Shafer’s 100 ml simulation of propofol in the blood, Chernoff asked if Dr. Shafer could make a projection of the level of propofol in the urine which would be consistent with his simulation of the level of propofol in the blood.
Chernoff gave Dr. Shafer a research paper showing that the level of propofol metabolite in the urine should be 50% of the administered drug. Dr. Shafer said that the process is a little more complex as at least 25% of propofol goes to the bile, so making the determination on that point would require research.
The toxicology report showed the level and number of propofol in the urine as a drug but didn’t show the number of it as its metabolite (propofol glucoronide). If there is a propofol glucoronide number and the time within which the glucoronide was excreted to urine it will be possible to make a model and determine the consistency of the dose with the gluconoride number, said Dr. Shafer.
And this means we can expect the show to go on. Now the defense will go after the number of propofol in the urine (and there were at least two samples of it – one in the jug, and another taken from the bladder on autopsy) and if they obtain those results they will compare them with Dr. Shafer’s final simulation trying to discredit it.
Given that there are several samples of urine (the one in the room was taken at an unknown time) there might be a multitude of variants, and I am afraid that the defense will try to use them to turn a totally clear picture into something vague.
Chernoff raised another favourite subject, that of Demerol, and confronted Dr. Shafer with another bullying statement:
“You decided to venture an opinion which is outside your area of expertise?”
Dr. Shafer explained that he takes care of patients with various types of addictions on a very regular basis, but doesn’t consider himself a specialist in the field (with all his modesty I bet he is a much better expert in addiction than Murray in his cardiology).
When re-examined by Walgren he developed that point and said that the records kept by Dr. Klein were not sufficient for him to say that Michael Jackson was an addict. Based on those records alone it is not possible to say that. (Indeed the injections a doctor gives to a patient to dull his pain during procedures do not mean that the patient is an addict!)
Dr. Shafer also confirmed that no Demerol or its metabolites were found in Michael Jackson’s blood, urine or wherever, and Demerol didn’t contribute to his death (so all Chernoff’s talk about its usage is the unnecessary thundering of the air).
However it is clear that in the future we can expect Chernoff to claim things like Michael Jackson developing a heart problem due to a “rapid withdrawal from Demerol”. He will also claim that it was not a respiratory arrest but a heart arrest that brought Michael into a coma (which makes a big difference in terms of how it is handled).
Our Lynette has already commented on the so-called “rapid withdrawal” from Demerol:
“There is no such thing as rapid withdrawal! Withdrawal is withdrawal and it has to take a certain time to progress.If there were such a thing as rapid withdrawal there would be no such thing as addiction. If there were rapid withdrawal no one would have a problem with it because it would be over with rapidly. See how stupid that idea is.
Withdrawal takes about 72 hours to reach it’s peak and depending on the drug involved in this case Demerol it would take up to 2 weeks for the person to stop having the symptoms.
I just spent the last 12 hours today with 7 people that are actively in withdrawal from opiates and believe me when I tell you that I would like nothing more than to ease their suffering and have them go through rapid withdrawal however I can’t because there is no such thing.
However since there was no Demerol found in Michael’s system we have every reason to believe that he had no problem with it at all, so any withdrawal from it is again just the usual thundering of the air.
On Friday last week Chernoff had issues with Dr. Shafer’s using an unknown infusion line for his staggering demonstration. Dr. Shafer did indeed have to buy an analog. At redirect examination on day 16 David Walgren explained that Dr. Shafer had to use a different type of a vented infusion set as he did not have access to the original one.
Now they compared the one used at the demonstration with the standard SeaCoast infusion vented set available to Murray and didn’t find any difference between the two, except that the SeaCoast product was a much smaller and less cumbersome one (and so was easier to put into a pocket).
Walgren showed two entries from SeaCoast company’s medical records which supplied Murray with those vented lines and it turned out that under two shipments alone (made on April 14 and May 12, 2009) Murray received 150 infusion lines of this type!
- Let me remind you that a vented line is required for drawing Propofol from a glass bottle – this bottle won’t shrink when the drug is drawn out of it and due to a vacuum created inside it needs air for the liquid to freely flow. A vented infusion line allows to introduce air inside the bottle.
Walgren also spoke about the slit in the saline bag – it struck Dr. Shafer as extraordinary (and therefore suggested to him that the vial of propofol was put inside it). This was an answer to Chernoff’s earlier question about how Dr. Shafer came to the idea that the bottle was inside the bag (the implication was that the idea was suggested to him by the prosecution).
David Walgren referred to Friday’s testimony of Dr. Shafer (the one which I haven’t covered yet) and also said something very important about Lorazepam.
It turns out that Dr. Shafer asked the toxicologist Dan Anderson to differentiate between Lorazapam proper and Lorazepam gluconoride in the stomach and when the differentiation was made he came up to even a smaller number of the drug proper remaining there – it was only 1/330th part of a 2ml tablet (before that differentiation was made the overall result for both Lorazepam and its metabolite had been 1/43d of one tablet).
And since there was almost no Lorazepam as a drug in Michael’s stomach it means that either it was not taken orally at all, or was taken, but very long ago, so that the drug had practically disappeared from the stomach. And Michael could not have taken long ago – at the beginning of the night he didn’t yet know he would not be able to fall asleep.
Since most of Lorazepam was found in the stomach as a metabolite it means it came from its injection into the blood after which it went through the liver and then splashed into the stomach. So finding Lorazepam in the stomach as a metabolite is a sign that it was given intravenously.
Following Chernoff’s criticism last Friday (that Michael could not get Lorazepam by IV at 12.00 am as he was not home yet) Walgren presented a new simulation of Lorazepam given intravenously on June 25.
Dr. Shafer just shifted the administration of the drug to a later time when Michael was already home. The model started later but had shorter intervals between the injections.
The result was the same and was consistent with the level of Lorazepam in Michael’s blood found on autopsy.
Then Walgren returned to Chernoff’s statements that all Dr. Shafer words were “his opinion only”.
Dr. Shafer said that though it was his opinion, it was based on almost 30 years of expertise. And the standards of care heavily violated by Murray were not just taken “from thin air”, but are published by his professional society and are obligatory for all anesthesiologists and physicians giving anesthesia.
David Walgren asked: “Can you rule out the possibility that Michael Jackson manipulated something to cause the propofol to flow?”
“That’s a possibility,” Shafer said. But that is assuming Murray set up the drip and left Jackson’s side, he said.
Would Shafer’s opinion that Murray was responsible for Jackson’s death change if he knew Jackson turned the drip on?
“No, if Michael Jackson had reached up, seen the roller clamp and opened it himself, this is a foreseeable consequence of setting up an essentially dangerous way of giving drugs,” Shafer said. “It doesn’t change things at all. It would still be considered abandonment.”
Walgren asked if there was any other factual scenario – based on the data – which would explain the level of propofol in Michael Jackson’s blood other than the use of 100ml of Propofol by IV?
Dr. Shafer said that he had been unable to create any other model which would be consistent with the femoral blood level on autopsy.
- Let me remind you that according to his model Michael was put on a drip and his death occurred during the infusion. First his breathing stopped, then ten minutes later his heart stopped , but the propofol went on pouring into his body. Since the circulation stopped propofol was no longer metabolized and therefore reached the high level shown in the autopsy report.
David Walgren reminded the jury that Dr. Shafer was making simulations not only for the prosecution but for the defense too. Dr. Shafer said that if they had requested some other models from him he would have of course done it (what a rare witness Dr. Shafer is!).
Walgren is also evidently struck by his witness and asked him questions about his pro bono work. Dr. Shafer said that it was his custom not to charge fees in any kind of consultations. He would provide consultations for both sides – to defend doctors and provide his opinion in a malpractice cases.
He said that he adhered to the same principles in his research work too – he made available the results of his work to his colleagues all over the world on a free basis. He developed numerous computer models concerning the administration of drugs and made this software available to other doctors via the Internet. When Walgren asked him if it could have a great monetary value Dr. Shafer was too modest to say that it could have brought him a fortune and merely said “there would have been some”.
Walgren asked, “Why do you do it?”
“It helps promote science”, said Dr. Shafer.
* * * * *
Donne Norris is employed at the Beverly Hills Police Department. She commented on the 911 call made by Alvarez.
It was registered at 12.20 and then redirected to the Fire Department. The duration was 43 seconds (while the paramedics were already on the way). What drew my attention is that it was a call from a cell phone – so if Alvarez could call 911 from a cell phone, Conrad Murray could too.
* * * * *
Alexander Supall is employed at the Los Angeles Police Deparment and is a police surveillance specialist. He went to N.Carolwood Drive 100 to assist in a possible retrieval of the video footage. He arrived there at 7.30 pm. Detective Martinez was already there. The found the digital video recorder somewhere in the basement and watched it. The defense played two records which didn’t really show anything except that first one car arrived (Murray?), then one more arrived and at 00.58 one car brought Michael Jackson (he wasn’t shown) and the second car followed it. At 1.06 pm one of these cars left.
* * * * *
The Defense asked him questions primarily about his interview with Alberto Alvarez, the bodyguard who testified at this trial that he had seen a vial of Propofol inside a saline bag, that Murray had been collecting things from the floor before he asked him to call 911 and who ultimately made that 911 call (see his testimony here).
The questions were aimed to show that Alvarez had kept silence until August 31, 2009. However we remember that Alvarez was never asked any questions before August 31. Detective Scott Smith briefly spoke to him on June 25 (see his testimony here) and took his contact information and it was only after the coroner had determined that it was a homicide that the police approached Alvarez some two months later.
Detective Mayers had no other possibility but agree with questions like:
- “He never mentioned Dr. Murray putting away any vials?” No.
- “He never mentioned any bottle in the bag?” No.
- “Did Alvarez draw the bottle in the bag two months after Michael Jackson’s death? ” Yes.
- “Was it a few days after the coroner’s office released its report?” Yes.
What else could he say in reply?
* * * * *
Martinez has been a police detective of the Homicide Division for 10,5 years. He arrived at the ULCA hospital at 3 pm to conduct interviews. He did “half of it” with Alvarez and then attended to something different and Detective Smith went on with it.
Let me remind you that during that brief interview the most the detectives did was taking contact information from the body guards.
The same questions and answers ensued: “Did Alvarez mention putting away the vials?” “No”, etc.
At 7.30 he arrived at N.Carolwood Drive. He didn’t observe Alvarez there but saw Faheem Mohammad and Alex Supall who was in charge of the surveillance cameras.
Detective Alvarez was the one who determined that out of all the video footage only the arrival of Conrad Murray and Michael Jackson would be of interest and downloaded. Now he admits that more of it could have been recorded.
At the August 31, 2009 meeting he wasn’t present. But he met Alvarez in April 2011 when the Deputy D.A. Walgren called him and asked to bring some evidence to a meeting with Alvarez. Out of the box of evidence he showed to Alvarez the saline bag, the pulse oxymeter and the propofol bottle.
The Defense showed the detective the drawing made by Alvarez on August 31, 2009.
The Defense: Would you agree that two years after that he made a drawing which is significantly different from the original?
Martinez: Yes, I would.
Prosecutor Walgren: Was there a reason why you asked Mr. Alvarez to make this drawing (in April 2011)?
Detective Martinez explained that when Alvarez saw the saline bag he recalled that when Murray had asked him to put it away into a bag there was an additional chamber to it (that chamber is marked by a white dot in the picture on the right).
The Defense asked the detective whether Alvarez had mentioned that chamber before. Martinez said “No”. (When could he? When Martinez spoke to him in the hospital?)
The way I see it, it could be the spike (or part of it) we earlier spoke of. Before putting the bags in the closet Murray could have disconnected it from the saline bag and put it in his pocket.
Alvarez had no way to know what it was, but noticed that it was missing when he saw the saline bag again.
* * * * *
I have put down this testimony practically in full.
Dr. Allen Metzger is a physician and has been in practice since 1974. He met Michael Jackson 15-20 years ago. He started treating Michael Jackson at about that time. Over the years they became friends. He was mostly one of his primary physicians in Los Angeles. He was his main internal medicine physician while Michael would see on and off other specialists. He knows the dermatologist, Dr. Arnold Klein as one of those specialists.
In February 2009 he received a phone call from Michael Jackson. Prior to that time he had spoken to him on June 12, 2008.
To determine the precise date he referenced with his medical records and in the process of it we learn that though they cover the period of 2002-09 there are only 5 pages in those records! So when you read in newspapers that Dr. Metzger had a “pile of records” in front of him please disregard it as a lie.
The conversation in 2008 was about Michael’s health, sleep issues, nutrition and some skin care issues. Dr.Metzger believed that at that time he was primarily living in Las Vegas.
Prior to that conversation Dr. Metzger had spoken to Michael Jackson many years earlier, in June 2003 when Michael came into his office. Michael said to the doctor that he was taking Xanax for sleep. The conversation also concerned a preoperative examination before some therapy to be undertaken. The conversation is recorded in the medical records as the doctor usually dictates the notes after an office or house call by a patient.
In June 2008 they discussed general health issues. Michael was under stress and was taking Tylenol PM for sleep. The doctor asked Michael when would be the next time he would come to Los Angeles and he was not sure. They talked about some basic skin care and his back strain. He probably said that he was looking forward to seeing him as he always wanted him to know that he was always medically and socially available for him. He asked Michael to see Dr. Klein as they discussed skin issues.
He next heard from Michael Jackson on February 26, 2009. It was a phone call. The doctor was aware that Michael was rehearsing because he mentioned it himself and he saw it in the press.
He was mostly in touch with Michael’s nanny Grace Rwaramba who functioned as a personal assistant and took care of the children. He had been in touch with her frequently – generally over the children’s issues, social issues and about how the children were doing.
Dr. Metzger personally spoke to Michael Jackson on April 18, 2009. He visited him at his home at his request. Michael had called him and asked him to come over to discuss several things.
Answering Chernoff’s question about the time of visit he said he had come definitely in the day time, early afternoon. (Does Chernoff imply propofol at night?) It was Saturday or Sunday. It wasn’t unusual for him to go to Michael’s home as he would want to see the kids and check up on them.
When he came to the house there were the three children there, Michael, some security guards whose names he doesn’t recall. Grace was not there. It started with Michael, himself and the children. Then the children went outside and Michael and the doctor had privacy in the living room.
Michael didn’t say that he was seeing any other doctors. They mostly discussed medical issues and the stress he was going through due to the rehearsals schedule. (So Michael was under stress because of the rehearsal schedule! They should have changed the schedule and there would have been no stress!)
Totally that visit took an hour and a half and the private conversation with Michael lasted 20-25 minutes. His state of mind was lucid. He was excited, he was talking of creative things that he was thinking about, he spoke to the doctor about his excitement and fear about the tour. His fear was that it was a big obligation and he didn’t want not to do the job with 50 shows.
“He realized that it was a huge ordeal to do that”, said Dr. Metzger. (This is why Michael was so much under stress and couldn’t sleep. And you remember who imposed those 50 shows on him. Will these people ever answer for what they did to Michael?)
He believed that he was up to the task but he was also fearful about his nutritional state, staying healthy. They discussed some of the things the doctor had worked with him years ago, for example health food. They talked about hydration and some things to do before and after performing.
They didn’t talk about injuries because he was doing very well with his chronic back issues. It was mostly nutrition and hydration.
Dr. Metzger cited his records which read that they had “discussed physical and emotional strain from the forthcoming concerts rehearsal schedule, his nutritional and hydration state of health and the stress related to his profound sleep disorder”.
Michael Jackson had brought to the doctor’s attention his sleep disorder many years before that. He knows that for 15-20 years sleep was an issue, particularly after performing – he could not calm down.
Chernoff asked, “Was it a problem he was experiencing on tours or on a regular basis?”. Dr. Metzger replied that he was familiar with the problem when he was on tours and when he was with him. And he treated some sleep issues over the years. He said that he had traveled with Michael Jackson. (Frankly, from the look of Dr. Metzger I would not expect him to have given Michael any propofol on those tours).
Chernoff asked if during their April 18, 2009 conversation Michael mentioned any specific medicine that he hoped to obtain for these sleep issues? Dr. Metzger said that he asked him about intravenous sleep medicine.
“Did he happen to mention the name of this medicine?”
Dr. Metzger said that he thinks he used the word “juice” (did Dr. Metzger mix it up with the word he heard during the 2005 trial?). He said that Michael had not used the name of a specific medication. He thought it could be an IV Valium, it could be an anesthetic drug – he was not sure what he was asking. Dr. Metzger said that Michael didn’t believe any oral medicine would be helpful.
He clearly remembered from his personal experience that many medicines just did not work. He had personally tried him on Tylenol PM in the past. They had tried Xanax to help his anxiety and help him go to sleep and on that visit on April 18th he tried other medication – he gave him Clonapam or Trazadone to be used not together.
Michael wanted some form of anesthetic (but did not name Propofol). Dr. Metzger was aware of Propofol but not about all the subtleties of that medication. (By the way Dr. Metzger looks quite convincing while saying all that).
He didn’t recall referring him to any specific anesthesiology clinic whatsoever. Chernoff asked him about Dr. Randy Rozen who is a pain-management physician. Dr. Metzger had worked with him over the years with Michael in terms of pain management. Most of the time it was chronic back sprain, and mostly from overwork practicing, performing and on a couple of occasions he had injuries.
As to Dr. Randy Rozen’s specialty maybe he is an anesthesiologist by training, said Dr. Metzger. They worked together specifically for pain management. Now Dr. Randy Rozen is involved with a group of physicians who, to Dr. Metzger’s knowledge, do outpatient pain procedures in their suite.
“During you conversation on April 18 did Michael Jackson tell you that he was visiting Dr. Arnold Klein?”, asked Chernoff.
“I presume that he was seeing Dr. Klein frequently for dermatological treatment. Most of the time Michael was having mild dermatologic procedures, minor cosmetic issues and his treatment of chronic vitiligo and other skin issues with Dr. Klein.”
“Did he ever mention taking you to London?”
But he did mention the need to have a doctor in London. Dr. Metzger explained why – Michael was concerned about hydration, he was concerned about sleep and he was concerned about injuries. He didn’t ask for any referrals – Dr. Metzger said he didn’t know any practicing physicians in London.
“You didn’t give him any other advice other than Clonapam and Trazadone?”
“I couldn’t give him any other advice”.
“You didn’t provide him with any IV medication?”
“Definitely not. I did not provide any intravenous medication to Michael Jackson”.
“I would say ever”
“In the 15 years you have never provided any intravenous medication of any sort?”
“That is my testimony”.
After the April 18 meeting Dr. Metzger left and didn’t have an occasion to speak with Michael Jackson again. He gave him instructions about the medication prescribed and asked him to get back to him to tell which medication was helpful.
“During the 15 years did you keep medical records?”
“I have 5 pages of medical records since 2002”.
At cross-examination Walgren asked Dr. Metzger if he explained to Michael that intravenous sleep medication was dangerous, life-threatening and should not be done outside the hospital setting. “That’s correct”. He asked the doctor if he had ever given Michael Jackson Propofol. He said “Never”.
“Is there any amount of money that would have convinced you to give him intervenous propofol in his house?”
“Absolutely not,” Metzger answered.
At redirect examination Chernoff asked a logical question, “You said it was dangerous, but you had no idea what medicine he was referring to?” But Dr. Metzger again looked convincing when answering: ” Any intravenous anesthetic should not be given in a home”.
“So Michael Jackson said “Anesthetic”?
Dr. Metzger said, “Or intravenous sleep medication”.
Dr. Metzger put on his spectacles back, looked through his papers and said,”In my records I said, quote, “intravenous sleep medication. My notes say “sleep medication” and anything intravenous was unsafe. I don’t recall getting in any more detail”.
It seemed to me that Chernoff had a hard time with Dr. Metzger.
Here is what papers say about Dr. Matzger’s testimony:
“Focusing on advice he gave Michael Jackson, Dr. Metzger was very clear that he didn’t give any advice for any intravenous sleep medicine to the entertainer either. It was obvious his practice was very strict in making sure the advice he gave didn’t violate any standards of care he assumed were part of his job” http://www.examiner.com/celebrity-headlines-in-national/michael-jackson-s-sleep-issues-dr-alan-metzger-says-no-intravenous-anesthetic#ixzz1bnqhBFJu
The defense called Metzger in an apparent effort to show Jackson was seeking — and getting drugs — from other doctors at the same time Dr. Murray was working as his full-time physician.
The judge stopped the defense from asking Metzger questions about Jackson’s visits to Dr. Arnold Klein, the dermatologist who gave Jackson Demerol injections during frequent visits to his Beverly Hills clinic in the months before his death.
Deputy District Attorney David Walgren used the defense witness to make the prosecution’s point that using propofol outside a clinical setting is unacceptable.
* * * * *
The defense then called Cherilyn Lee, a nurse who practices nutrition and natural remedies, who testified that she worked with Jackson to help his fatigue and insomnia from February through April of 2009.
After two months of using IV infusions of vitamins, “sophisticated” vitamin smoothies and bedtime teas, Jackson began asking for more help, Lee testified.
“His complaint was ‘I have a problem sleeping and all the natural remedies and everything you’re doing is not working,'” she said. “When I need sleep, I need to go to sleep right away.”
The court session ended just before defense lawyer Ed Chernoff could ask Lee to describe what kind of help Jackson was asking for, but the nurse previously told CNN that he requested propofol.
“I told him this medication is not safe,” Lee told CNN on June 30, 2009. “He said, ‘I just want to get some sleep. You don’t understand. I just want to be able to be knocked out and go to sleep.'” http://www.click2houston.com/news/29566931/detail.html
Next up was nurse practitioner Cherilyn Lee, who became a public figure with her press appearances shortly after the singer’s death. With some hesitation, Lee was led laboriously by Chernoff through the history of her involvement with the singer in early 2009, when she was making numerous visits to his home and giving a fatigued Michael natural, IV–delivered therapies such as the mineral-rich health concoction, “Myers’ Cocktail.”
Lee testified that Michael began complaining about having difficulty sleeping, and after she administered a number of all-natural remedies to the singer, Jackson lamented that they were ineffective. “When I need sleep, I need to go to sleep right away,” Lee recalled him telling her. Lee suggested that Michael undergo a sleep study, but “he said he didn’t have time for all that,” Lee testified.
Lee’s testimony ended on something of a cliff-hanger, as she told the court, under Chernoff’s questioning, that Michael mentioned a medication to Lee. However, court adjourned for the day before Lee could state the specific medication that Michael inquired about.
While looking for information about Cherilyn Lee’s testimony I accidentally came upon the following smashing news about Dr. Paul White. This definitely shows us what kind of an expert he is:
The defense is expected to call 16 witnesses in all this week, including an expert in anesthesia, Dr. Paul White, their star witness.
White, however, has already been heard from during the trial, when he was chastised by Judge Michael Pastor for talking to reporters about the trial.
E! online reported that Murray could be heard whispering loudly to the possible witness, Dr. Paul White, “Can you believe that?” in response to the testimony of Dr. Steven Shafer, a witness for the prosecution. In response, White allegedly turned to journalists and said, “What a s***bag.”
It was unclear whether White was referring to Shafer or prosecutor David Walgren.
Pastor scolded White for his remark and set a Nov. 16 hearing date to determine whether White should be held in contempt of court.
* * * * *
Day 17. Tuesday, October 25
At the beginning of her testimony on day 17 family nurse practitioner Cherylin Lee asked to excuse her for a few minutes as it was hard for her to talk. The court waited for her for some time. I noticed that she felt more comfortable when answering Walgren’s questions than Chernoff’s.
She first came to Michael Jackson’s house when the kids had a cold on January 29, 2009. The same day Michael spoke to her about his health and said that he felt tired. On February she returned to the house, did a physical exam and an interview – Michael answered some 200 hundred questions. He noted that he had lupus and vitiligo.
Michael talked to her about concerts and dehydration – during the show he would lose so much liquid that people had to mop the floor from sweating. He would sweat so much that he would lose 3-5 lbs .
(This is 1,5-2,5 kgs! And we never guessed. We thought that for him it was easy! And after concerts like these he gave away all his hard earned money! He gave away all the proceeds for the Dangerous tour to charity).
Her impression of Michael Jackson was that he was very healthy. But he was drinking too much caffienated Red Bull and she advised him against it. He answered, “Whatever you tell me to do I will do. I want to stay healthy”.
She also advised him that his sleep patterns should be remedied – he used to go to sleep with music or movies on. She said he was putting so much energy into what he was doing that it was difficult for him to turn off.
The Dictionary says:
- Amino acids are small molecules that are used as building blocks for all proteins. Some amino acids are also used in the body for the manufacture of hormones. There are about 20 nutritionally important amino acids, including glutamic acid, glycine, methionine, lysine, tryptophan, serine, and glycine.
- Holistic medicine refers to alternative health practices that claim to treat “the whole person.” To holistic practitioners, a person is not just a body with physical parts and systems, but is a spiritual being as well. The mind and the emotions are believed to be connected to this spirit, as well as to the body. Holistic practitioners are trulyalternative in the sense that they often avoid surgery or drugs as treatments, though they are quite fond of meditation, prayer, herbs, vitamins, minerals and exotic diets as treatments for a variety of ailments.
Prior to that and in the process of treatment she meticulously recorded all Michael’s vital signs, his lab tests, her observations of him and plans of treatment.
The meetings were held on February 2, 3, 16, March 9, 13, 16, 20, 24, 26, 31. Michael felt better and was full of energy.
Only on April 12, 2009, which was Easter Sunday, the issue of poor sleep was raised for the first time. This is when she discussed the “sleep hygiene” and told him about every natural remedy for sleep. He said that he had tried everything and it didn’t help.
On April 19 he complained that his energy was great but he could not sleep. That day he mentioned to her Propofol. She didn’t know what it was, went out of the room and called a doctor she knew. He explained to her that it was an anesthetic which was not safe to use at home.
She returned to him and related what the doctor had said, but Michael said doctors had told him it would be safe. He only needed to be monitored while he slept. On the night of April 19 she stayed with him to note his sleep pattern. By 12.15 he was asleep but at 3 in the morning he woke up. He was happy that he could sleep a little longer this time.
He asked her, “Can you find me someone to help me to sleep?”
She looked up propofol in the Physicians’ Desk Reference (PDR) and found a great deal of its side effects – dizziness, agitation, chills, shivering, trembling, memory loss. She told him about those side-effects, especially the memory loss and said he could forget lines. He answered that he would never forget the lines.
He repeated that doctors told him that it was safe – as long as there is a doctor beside him who will monitor him with the equipment. (By the way I agree, if all the equipment is there and the doctor is qualified and has a back-up in case he has to leave the patient – it is indeed safe. All experts say that it is if used under proper setting).
She heard from Michael again two months later – on June 21, when his assistant called and said that Michael wanted to see her. In the background she could hear Michael saying, “Tell her what is going on with me. Half of my body is cold, and the other is hot”. She said that he needed to go to the hospital. It reminded her of the symptoms she had read in the PDR and she thought that they were related to the central nervous system problems.
On July 9 she was interviewed by the police.
My personal opinion is that with that makeshift IV stand for administering propofol and in the absence of a proper dosing propofol infusion pump Murray was heavily overdosing Michael. He could have been sending him into coma every night without Michael not even knowing about it. And if Michael’s breathing stopped every night as it does when the usual sedation level is exceeded and there was no adequate help, it means that he was also dying every night for those two months running.
* * * * *
Amir Rubin is the UCLA hospital Chief Executive Officer. Why he was called by the defense is not clear because he didn’t see much and was mostly speaking about the way they handled Michael’s death from the point of the media, security problems, conference rooms provided to the people present. The only important issue was Murray’s demeanor which Amir Rubin observed “distressed” and the fact that Murray was making a comment on the press-release handed out by the AEG people to him, Jermaine Jackson and some others.
Conrad Murray added to the press-release that the cause of death was not known.
Answering Walgren’s questions Amir Rubin said that the news of the death was broken to Katherine Jackson by Dr. Cooper. He said the anguish of the mom hearing about her son’s death is not a good thing to hear.
* * * * *
However some points are interesting to note.
The first negotiations about the shows took place in 2007 after a call from Michael’s lawyer Peter Lopez. There was no resolution after that meeting as it was “relatively apparent” to Randy Phillips that Michael Jackson was not ready to go on stage.
The next contact was in August 2008 when Tom Barrack of Colony Capital contacted Phil Anschutz of AEG. Colony Capital is a private equity fund who had bought a note (I may have misunderstood the word ) on Neverland from the company called Fortress.
“What does it have to do with the concerts?” asked Chernoff (objection from Walgren, sustained).
The same week of August 2008 the Colony Capital people set up a meeting for Randy Phillips with Dr. Tohme who introduced himself as Michael’s manager. Tohme said Michael wanted to restart his career, part of it being touring live and part of it being putting out new music during the course of the tour.
The follow-up on that meeting were phone conversations, meetings, negotiations – all of them with Dr. Tohme and two attorneys – Dennis Hawk and Peter Lopez.
- Nota bene: Dennis Hawk was Dr. Tohme’s attorney while Peter Lopez represented Michael Jackson. Sometime in January 2008 Peter Lopez was dismissed from the negotiations over AEG, but continued representing Michael in other matters. Dennis Hawk remained the only lawyer in the deal. In May 2010, approximately a year after Michael’s death, Peter Lopez allegedly committed suicide by shooting himself but there was no note or weapon found beside his body.
Randy Phillips personally met Michael Jackson in September 2008. “It was me, Dr. Tohme and Michael”, said Randy Phillips.
The plan was to start in London on O2 arena and do a “residency show”. They called it the “mountain going to Mohammed – instead of the artist touring with 20 trucks and all the expense of that, getting fixed to one venue and then advertising it around the world. Obviously it takes a very special artist to be able to do that”. It could be the first phase of what could have been a multitour plan.
- Nota Bene: AEG’s so-called contract names “the world” as the “territory” of the contract, so travelling around the world was an option. The papers said that all expenses were placed on Michael’s shoulders and Randy Phillips is not telling us everything there is to tell here.
In 2008 it became apparent to Randy Phillips that Michael Jackson was motivated and receptive to the idea of the concerts. After that they had a number of meetings, all held at the Bel Air hotel. Randy Phillips said that they never discussed money with Michael [so they discussed it only with Tohme Tohme!]. “Those negotiations were done separately and the meetings with Michael were more creative”.
In October 2008 in the Bel Air hotel he met Tohme, Michael, his children wearing Halloween costumes and their nanny. When asked where Michael was living at the time he said he didn’t know. At that meeting Michael explained why he wanted to restart his career. The primary reason was that he wanted to finally settle down, and get a really good home for the kids who were living like vagabonds.
When Michael said he was tired of living like that he got emotional, according to Phillips. He says that he cried listening to Michael and Michael cried too.
It was the last meeting before the lawyers ‘got involved with the numbers’. The contract was prepared and signed in mid January.
- Nota Bene: There are huge doubts that the AEG paper can be legitimately called a contract. At the most it is a letter of intent stating the intentions of the parties to make a definitive agreement. And the signatures under that letter do not match each other. For details please go to this or this post.
Phillips said the ‘contract’ was signed in January 2009 in the house Michael Jackson had moved into which was some time prior to that. Michael ‘signed it personally’ and Phillips himself signed it for AEG.
I am finally beginning to see why Walgren objected to some of Chernoff’s questions. Numerous questions about where Michael lived before and when (and why) he moved into the house in Carolwood Drive may have been interpreted in multiple ways. So I am almost ready to forgive Walgren for objecting to the following questions from Chernoff though I would have loved to hear Randy Phillips answer them:
- How was AEG Live going to make money on this contract?
- What was AEG’s stake in the contract?
- Can you estimate what Michael Jackson’s stake was?
- Can you estimate how much Michael Jackson was making assuming successful completion of the shows?
- Did AEG Live pay for that residence?
- What would AEG get if the shows were cancelled?
Randy Phillips would have lied of course but his lies could have been very instrumental in showing what phenomenon Michael Jackson had to deal with in the face of AEG and their Randy Phillips. Despite all his lies we could have learned some truth about the events of June 2009 and the months prior to that.
Chernoff managed to have only one interesting question answered by Randy Phillips. He asked him whether Michael Jackson was to cover all production expenses for the show and Randy Phillips said “Yes”. This fully confirmed my own conclusions from AEG’s so-called contract – Michael Jackson was to cover all the expenses on the show!
The confirmation of this fact gives a new shade to AEG’s public tears that they were spending too much on the show and to Randy Phillips’s alleged worries about Michael not attending every rehearsal.
- Nota Bene: If someone wants to create a show and fully pays for it, will you worry whether he comes to every rehearsal or not? Especially when you know that the money he has borrowed from you has been insured by the debtor (and you are the beneficiary) and all of it is fully covered by all his belongings – his shares, his music catalog and rights to all his current and future earnings? And that you also have the man’s written promise to repay and if he doesn’t pay you at least one small installment you receive his everything and receive it irrevocably? Together with full rights over managing his estate in the future? (Please go to this post for details)
Even the little truth Randy Phillips provided in his testimony can give us some idea about the situation in the spring of 2009:
Randy Phillips said that there was no production on the concert tour from January to March 2009. “In March no production had not started. It didn’t kick into gear until sometime in April”.
- But this was too late a start for the show which was beginning in early July! AEG’s own contract said that the tour was to start on July 26 only, so why push the shows almost a month earlier and start selling the tickets in March when there was still no trace of the preparations done?
Philips said that in March “Michael and Paul Gongaware had a couple of meetings about the show, some production people were brought on board to help do budgets”.
By April Kenny Ortega had been the director of the show (the other director was Michael).
In April Michael Cotton, choreographer Travis Payne and other personnel were hired. Auditioning of the dancers began.
Randy Phillips said that he honestly didn’t remember when the rehearsals had started.
And I honestly cannot believe that with a tight schedule like that and only two months left before the beginning of the tour Randy Phillips was not concerned about the rehearsals and does not have an idea when they began. Each of us would have been a nervous wreck if we knew we were responsible for the show but rehearsals had not even started – though tickets for 50 shows had already been sold!
Now Chernoff and his medical experts are telling us addiction horror stories about why Michael could have had a severe anxiety and insomnia while the reasons are there on the surface for everyone to see – two months before the show the rehearsals had not yet started, the costumes, the stage props and special effects were still only an idea, and nothing was ready!
As far as AEG Live is concerned this type of neglect could be possible only if they didn’t give a damn whether the rehearsals or the tour itself took place at all.
Another aspect of the same problem is – if they themselves delayed the process by so long how could they later demand that Michael should rehearse every day to catch up with their schedule and make up for their mistakes?
It is no wonder that when Michael returned home from a rehearsal on June 24 he said to Murray that he was tired and added, “I AM TREATED LIKE I’M A MACHINE”.
After Randy Phillips’ testimony AEG cannot even blame Michael for anything because even though Michael was visiting Arnold Klein’s office in March and April and could be probably too sedated for rehearsing, it still doesn’t explain why AEG was not hiring the production personnel and not doing anything serious until April or even May!
Later in the testimony Randy Phillips recalled, “I believe the rehearsals may have started in May, but I may not be one hundred per cent sure”.
According to Randy Phillips the conversation with Michael Jackson about a personal doctor also took place in late May. He said he never knew anything about Dr. Murray and had nothing to do with hiring him.
He recalled a meeting at the beginning of June when some “concerns” were expressed about Michael’s diet, etc. This is too mild a way of putting it – at that meeting they decided to play tough love on Michael and put Conrad Murray “into the fold” – his job was to make a strict schedule for Michael Jackson and ensure that he attended every rehearsal.
References to the first June meeting are found in the email Kenny Ortega sent to Randy Phillips early in the morning of June 20th. Here it is in case someone missed it during Ortega’s testimony on week 1 of this trial:
I will do whatever I can to help with this situation. If you need me to come to the house just give me a call in the morning. My concern is, now that we’ve brought the Doctor into the fold and have played the tough love, now or never card is that the Artist may be unable to rise to the occasion due to real, emotional stuff. He appeared quite weak and fatigued this evening. He had a visible case of the chills, was trembling, rambling and obsessing. Everything in me says that he should be psychologically evaluated. If we have any chance at all to get him back in the light, it’s going to take a strong Therapist to help him through this as well as immediate physical nurturing. I was told by our Choreographer that during the Artist’s costume fitting with his Designer tonight they noticed he’s lost more weight. As far as I can tell there is no one taking responsibility (caring for) him on a daily basis. Where was his assistant tonight? Tonight I was feeding him, wrapping him in blankets to warm his chills, massaging his feet to calm him and calling his doctor. There were four security guards outside his door, but no one offering him a cup of hot tea. Finally, it is important for everyone to know, I believe he really wants this. It would shatter him, break his heart if we pulled the plug. He’s terribly frightened it’s all going to go away. He asked me repeatedly tonight if I was going to leave him. He was practically begging for my confidence. It broke my heart. He was like a lost boy. There still may be a chance he can rise to the occasion if we get him the help he needs.
Do you get the impression that Kenny Ortega is using expressions like “tough love” and “pull the plug” for the first time here? No, you don’t?
And our good old Randy Phillips lies in his testimony that he saw those expressions in Ortega’s email for the first time ever.
But Kenny Ortega says that playing tough love was the resolution of the first meeting they had approximately a week prior to June 20. That meeting was actually the moment when they decided to “bring the doctor into the fold” . My notes from Ortega’s testimony on week 1 of the trial explain what it was:
“The first meeting came as a result of Michael missing several rehearsals and the “playing the tough love” phrase refers to the resolution of that very meeting. In between the two meetings there was a series of conversations between Ortega, Randy Phillips and Paul Gangaware. Frank Dileo was not involved”.
But total misrepresentation of the “tough love” issue is not the only lie in Randy Phillips’s testimony. He also lies that:
- He left the second, June 20 meeting with Michael together with Ortega. Ortega does not confirm it – he himself stayed there for 10 minutes only (he was specially summoned to speak about his email) and then left, while Michael, Murray and Phillips remained in the house. This is important as we do not know why Phillips stayed and what further instructions he gave to Murray.
- Randy Phillips’s story about Michael wanting to do 31 shows is a lie. You just need to look up their ‘contract’ to see how AEG is twisting Michael’s hands in order to make him agree to that number. The only definite thing in the clause concerning the number of shows is that “in no event shall the number of shows performed by Artist in the first leg of the tour be less than 18”. The rest of it said that 31 shows were “pre-approved” only, and that it would be “unreasonable to withhold approval for adding shows” with a conclusion that “the parties agree to negotiate the definitive agreement expeditiously and in good faith”. And all this indefiniteness is presented as the agreed number of shows and an allegedly final contract?
- He also says that he first learned about Michael’s willingness to make concerts from his boss Phil Anschutz who told him to set up an appointment with Colony Capital (the ones who suggested a deal with Jackson). Previously Randy Phillips said that it was hard to persuade Phil Anschutz to go into this project as he is a “devout Christian” (implying that he was not willing to enter the project with a man who had been suspected of nasty things?).
- Randy Phillips is distancing himself now from the contract with Michael Jackson and says that he as the CEO of AEG discussed mostly creative work with Michael while Paul Gongaware did production (and probably the rest). And Gongaware as his co-CEO said that he was responsible for ticketing activities only and even did not see the final contract. Moreover Gongaware ‘wasn’t personally involved in contract making and had no personal knowledge of its clauses”. It is incredible, but now we cannot even find the Chief Executive Officer at AEG who discussed those criminal contract terms with Michael !
- Randy Phillips says he did not meet Murray or hear about him until late May. However the first version of the AEG contract with Murray was dated May 1, when Murray officially started attending to Michael. That contract version already incorporated most of the details including the kind of equipment to be provided by AEG. Let me also remind you that Kathy Jorrie, the hired lawyer drafting a contract with Murray, said in her testimony on week 1 that she had received a list of the equipment to be included in the contract from an AEG employee – so AEG was very well aware of their duties and I cannot believe that Randy Phillips as its CEO knew nothing about them.
- And what is your opinion about Randy Phillips’s sudden revelation during his testimony that on June 25 he learned about Michael’s death from Frank Dileo at 10.30-11.00? He says he grabbed his car and 15 minutes later was there seeing the paramedics truck leaving for the hospital, but it looks like Randy Phillips is just playing a “being forgetful” and “it was so much stress” cards to make people believe that he should be excused for such gross inaccuracies in his testimony.
In short Randy Phillips is telling us innumerable lies. And if he can lie like that under oath I am even afraid to think what amount of lies he was capable of telling to Michael Jackson!
Here are some more details about Randy Phillips’s interview from Wiki:
Brandon Keith Phillips is President and CEO of AEG Live, division of AEG, for nine and a half years. Has worked in the entertainment industry for thirty years. AEG are the owners and operators of the Staples Centre in Los Angeles and the O2 arena in London. Phillips is responsible for profit and loss, booking talent for tours, making sure regional offices function properly as well as festival division. Phillips represented Jackson as an agent/consultant as early as 1993. Saw Jackson next in a meeting in 2007.
Contract was drawn up and signed (in mid-Jan 2009) for thirty one shows; Jackson wanted to do ten more than Prince (artist) did. Chernoff asked questions about the finances of the contract. All questions were objected to and the judge sustained them. It was heard that ten shows went on sale first and the demand was “over the top”. “We had never seen that kinds of demand for tickets, it was obviously we would have blown through thirty one shows in the pre-sale and not had any for general sales”. Within twenty minutes Jackson agreed to more shows. Jackson said he wanted to do maximum fifty shows because he didn’t want a passport, didn’t want to live in London. He asked for a country house estate (16+ acres with running streams) so he and the kids wouldn’t be stuck in a hotel in London. He also wanted the Guinness World Records to be there at the fiftieth show. It was heard that Jackson was very firm about having his own (24/7) physician (Murray). It was heard that Phillips met with Murray and Jackson in early June 2009 to discuss Jackson’s health. Murray assured Phillips he was in great health and that Murray would look after Jackson’s diet. It was heard that Kenny [Ortega] told Phillips that he was concerned about Jackson’s focus in performances in a production of this magnitude. Phillips started seeing stress and pressure in Ortega towards the middle of June because of this. There was an issue of Jackson showing up for performances. Ortega said he needed to be there because he was the fulcrum, everything surrounded him in the production. Ortega scheduled a meeting for on June 20 would be about Michael Jackson’s tardiness/focus at rehearsals. It was heard that based on Kenny Ortega’s email, it was clear he felt this was an emergency meeting (over Michael Jackson’s ‘focus’). The meeting was with Murray, Jackson, Ortega and Phillips at Carolwood house. Ortega didn’t understand why Jackson wasn’t engaged like he thought he’d be, maybe there were health concerns. “Michael didn’t respond immediately. Murray spoke for Michael on the situation, guaranteed us that Michael would get into it”. Phillips attended rehearsal on June 23-24 to make sure everything was back on track. On June 25, Phillips went to hospital and stayed there the entire time Jackson was there. “I was there all day into the evening”. Murray was in “severe distress”.
* * * * *
I missed the testimony of the next witness on that day, Michael Henson and will rely on Wiki again:
The next defense witness is toxicologist Michael Henson, a tech operations officer at Pacific Toxicology. Defense attorney Michael Flanagan doing direct examination. Henson has known Flanagan since 2009, his company has worked with Flanagan for quite some time. Henson examined urine samples handed over from LA County Coroners Office he also provided defense testing for stomach content of Lorazepam.
It was heard that Dr. Shafer emailed Henson about what his standard operating procedure (SOP) was for Lorazepam results but he did not email Shafer back and contacted Flanagan instead. During cross examination, Walgren asked Henson why the People and the Defence have 2 different copies of lorazepam results. Henson said he did not know.
* * * * *
Day 18, Wednesday October 26
This was the day for the so-called character witnesses speaking for the defense. The dictionary defines character witness as follows:
- A person who testifies in a trial on behalf of a person (usually a criminal defendant) as to that person’s good ethical qualities and morality both by the personal knowledge of the witness and the person’s reputation in the community.
I clearly remember all five of them being invited by the highly enthusiastic Piers Morgan of CNN who devoted to them more time than any character witnesses who ever spoke for Michael Jackson. That program was repeated again and again until made you totally sick and tired of listening how good, kind, non-greedy and so on Dr. Murray was. Probably to them he was, but it doesn’t change anything as to his gross violations of duties to Michael Jackson!
And what does it matter that he didn’t take anything from his low-income patients? From Michael Jackson he wanted $5 million! And our Lynette has explained how else a doctor can make money if he works in a low-income community:
- There are other ways that a Doctor that serves these patients can benefit that people who work outside the medical community don’t know about.The biggest one is one of the many Student Loan forgiveness programs out there. Take for instance the fact that If I chose to I could submit my student loans to a program that allows me to work in a certain area like one of low income and in a certain field like mental health or geriatrics and in a given amount of time those loans will be forgiven if I just work there.I know it doesn’t sound like a big deal until I tell you that the average medical student leaves school with almost a million dollars in student loans.
Certain employers will cover those too but they can be more arbitrary in who they give this to. They can have some pretty strict criteria like your GPA and other things that so not everyone that goes to med school gets those. What people don’t realize is that a Doctor especially a specialist has ot pay not only for the four years of college, four years of general med school but their residency and fellowship.
That said that might mean that Murray may have taken advantage of one of those programs but I will add that that is not a reflection on him what so ever.
The first witness is Gerry Causey, who lives in Cedar City, Utah. Causey has known Murray for 11 years, they met when he lived in Las Vegas, when Causey had a heart attack. “Murray made me sign some paperwork, some kind of release, then they took me to the operating room for an Angiogram. “During my procedure I didn’t want to be sedated. I saw everything on the screen. He always explained me everything he was doing”. He has been in constant contact with Murray ever since he was in hospital. They have remained friends. It was heard that they have remained friends because of the love Dr. Murray has for his patients. Causey has stated Murray is his “best friend”. Causey said that Murray was not greedy, he has never been, he would treat you regardless whether you had insurance or not. Murray broke down in tears when Causey said Murray would spend all time necessary with him, he would call his wife to explain problems. It was heard that Causey has given two TV interviews regarding Murray. He gave them free of charge “to help my friend”. During cross examination Causey said that Dr. Murray is known for “his compassion, his feelings, you can ask any of his patients, he’s the best doctor in the world”. “I don’t think he did what he’s accused of. From what I know, what I feel right now he didn’t do it”. Walgren asked Causey even if he knew Murray was grossly negligent if he would come and testify on the doc’s behalf – he said yes. Causey was excused and as he walked out he kissed Dr. Murray on the forehead and shook his hand.
Next to the stand was Andrew Guest, also a previous patient of Murray’s from Las Vegas. Guest described how he first met Murray and the procedures he went through for his heart. Guest said “that man sitting there is the best doctor I have ever seen” “I’m alive today because of that man”. It was heard that Guest did an interview, free of charge, with CNN because he believed Murray needed support and wasn’t getting a “fair shake”. Walgren asked “Nothing would change your opinion of that man would it?” “Correct”.
Next to the stand was Lunette Sampson. Another patient of Murray’s. She now lives in San Diego, but lived in Las Vegas for long time. Sampson had 2 heart attacks while in Las Vegas, Dr. Murray treated her. “I have never had a doctor that was more caring and thorough”. When asked if she thought Murray was greedy or was motivated by money she said: “I know Dr. Murray is not greedy or money-hungry. He is taking care of people pro-bono, people without money”. Sampson said Murray never once mentioned he was going to work with Jackson. “He told me he was going to take sabbatical for a year”.
Next called was Dennis Hix. He had heart problems and got stents, the last one around 2004-2005. Murray’s children’s were his neighbours. It was heard that Hix is a 66 and has gone to a lot of doctors and never had one who gave me the care he did. “I had insurance that ‘didn’t hardly pay for nothing’, he said he would help”. “When my brother saw I got the stents, my brother said he wanted some too. He had heart issues but didn’t have money for the procedure” “Dr. Murray told my brother not to worry about the payment that he would treat him for free. And he did.” Walgren asked Hix “When did you learn Dr. Murray was going on tour with Jackson? I didn’t even know it until I saw it on TV.”
Next to the stand was Ruby Mosley. She lives in Houston. She’s the secretary of Acres Home Citizen’s Council, a low income seniors community. Dr Murray’s father was a doctor in the Acres Home district. Dr Murray opened clinic in his father’s memory. “He made a committment to community to open a clinic in memory of his dad” (Dr Murray Senior was there from 1968 until 2003). Upon Chernoff asking if Murray was greedy, Mosley replied “if this man was greedy he would’ve not come to work at Acres Home, where 75% of people are poor, he was making less than in Las Vegas”. Murray treated Mosley for heart problems.
* * * * *
Day 19. Thursday, October 27
An important testimony came from the defense witness Dr. Robert Waldman, which is retold rather decently by Reuters:
10/27/2011 | Bob Mezan, Reuters
The defense called its own addiction specialist to the stand in the Conrad Murray trial Thursday, but there’s a question as to whether he helped or hurt the doctor’s case.
Murray is on trial for the involuntary manslaughter of Michael Jackson.
Addiction expert Dr. Robert Waldman took the stand, but – in what could be a blow to the defense – said Jackson was not necessarily addicted to the painkiller Demerol. The defense is hoping to prove that Jackson was suffering from Demerol withdrawal and could have self-administered a fatal dose of propofol so he could sleep.
But that theory was challenged by their own key witness while he was questioned by the prosecution.
“Would you diagnose Michael Jackson as addicted to Demerol, based strictly on these documents?” prosecutor David Walgren said.
“I would diagnose him as physically dependent and because the initial doses were high for somebody who may or may not have been opioid naive, it raises the specter and question of prior opioid use,” Waldman said.
“Let me try again. Dr. Waldman, would you diagnose Michael Jackson as addicted to Demerol based strictly on these documents in my hand, yes or no,” Walgren said.
“Probably not,” Waldman said.
Wiki summed up the doctor’s testimony as follows:
Dr. Robert Waldman, a physician specialising in Internal medicine, Nephrology and Addiction medicine, has been involved in addiction medicine and treating patients who have addiction diseases for 23 years butis not board certified in it. He described to the court what happens to a patient during addiction and withdrawal, including the tell-tale signs, the symptoms and the drugs that can be involved. Dr Waldman stated that the side effects of withdrawal of drugs are sweating, increase heart rate, nausea, cramp, insomnia, temperature deregulation and tremendous anxiety. It was heard that the addict’s biggest fear is that you’re not going to respect the amount of discomfort they’ll go through during treatment and detoxing process. It was also heard that rapid detox is not a treatment. It uses high levels of sedation intravenously and it is a process that uses general anesthesia to help tolerate the discomfort. It was heard that Dr. Waldman’s opinion is that there is evidence to suggest Jackson was dependent (not addicted) on Demerol (Pethidine) due to the frequent high doses he received in May 2009 indicated by Dr. Klein’s medical records of Omar Arnold (an alias of Jackson’s). It was heard that Dr. Klein’s medical records indicate that in April of 2009 Jackson received 775 mg of Demerol for Botox and Restylane procedures. During 3 days in beginning of May 2009, Jackson received another 900 mg of Demerol for Botox and Restylane procedures. Dr. Waldman said being injected during 6 days with very high doses of Demerol would create opioid dependency in anyone of us.
Our Lynette has shared her opinion about Dr. Waldman’s testimony:
“I watched today with anger that man, a supposed addiction specialist, say that he based his opinion on public information (i.e. gossip and a 17 year old admission of addiction) and what others told him. He admittedly said it was assumption not a medical opinion on outside unconfirmed information. He even speculated that Michael was doing street drugs by insinuating that the records he got were not complete. Jane valez Mitchell went after it like a bulldog and she just wouldn’t let go. It was 2005 and 1993 combined.
It seems like the wonderful Stacy Brown got information yesterday and sent a heartfelt email message to the Jackson Family and the fans stating that we are the ones that are trying to rewrite history when he clearly misstates that Michael had a problem since 1985.
I want to correct him with that. It was not the initial surgery but one that he had in 1991 with a balloon device inserted under his scalp to stretch the skin to enable the scar reduction that caused cranial facial nerve damage and led to severe migraine like headaches known as cluster headaches. These are the kind of headaches that cause people to lay curled up in a ball and scream and eventually they will become nauseated and throw up. They usually last for up to 24 hours without relief and leave the persons head feeling tender and sore to the touch. That would be ample indication for the administration of opiate pain killers nothing else would have worked.
That said once Dave Walgren got hold of the defense’s addiction specialist it was a whole different story. He became rude, insolent and had to be told to answer a question several times by Judge Pastor. Judge Pastor once even told him to tell the truth. Then we found out that once again they had a faulty chart the second time that a piece of evidence presented by the defense that had to be corrected by the prosecution.
He ended his testimony with Dave Walgren asking him if based on the records alone “Was Michael Jackson an addict?” and he said “No”. When Dave Walgren and Ms.Brazil left the courtroom for lunch they were met by a standing ovation. Congratulations Mr Walgren and Ms Brazil on doing your best to defend the reputation of the victim Michael Jackson and continuing to remind people that this trial is about a doctor that overstepped every standard of care and killed his patient.”
The defense made extensive use of Dr. Klein’s medical records and went over them page by page. The idea was to claim that after Arnold Klein started treatment of Michael’s facial scars in April and began administering Demerol as a painkiller, by May Michael had allegedly developed a tolerance as he had to be given a higher dose (300mg) than before (100-200mg). The fact that in June the dosages were dropped again first to 200mg and then to 100mg was explained by a further speculation that small doses were needed “to relieve the symptoms of a physical dependency” which in their opinion must have formed by then.
In short all of it was a huge pile of speculations where one assumption was based on another assumption but all were presented as if they were facts.
The truth is, however, that the amount of Demerol given was in direct correlation with the amount of work done.
Dr. Klein briefly mentioned it in his statement concerning his HIPAA violation complaint regarding the records of his former patient, Mr. Michael Jackson. HIPAA stands for Health Insurance Portability and Accountability Act. The part of the report concerning Demerol injections says:
- First these records are not simply my records but that of three physicians treating Mr. Jackson: Myself, David Rish and Ilya Reyder.
Michael was treated by me to rebuild his face for the “This is It Tour.” Injection sessions to rebuild his face from the consequences of faulty plastic surgery took 3-4 hours and he was given Demerol for pain relief during these procedures.
Please note the entire month of May I was out of the country so injections he received during that time were not mine.
Addiction requires the frequency and dose of medication to increase. As my treatments with Michael became less lengthily the dose of Demerol that was used and the frequency of visits was greatly reduced.
The figures that have been erroneously quoted to the public indicate a grossly increased frequency of visits and size of dose than that actually used.
Please understand what you have experienced and I have suffered is an attempt by the greedy parties responsible for Michael Jackson’s death to use me as a scapegoat. They have defamed my name and attempted to destroy me. My relationship with Mr. Jackson taught me many things one of which was the ability to survive. Now it is my turn to take action against the media and finally reveal the greedy and disgusting people who were truly responsible for Michael Jackson’s death.”
Among many other facts Dr. Klein mentioned that his associates who had embezzled his money and depleted his retirement fund had been contacted by none other but AEG:
- “It should be noted that Jason Pfeiffer, Muhammad Khilji with the assistance of Richard Charnley have embezzled over 12 million dollars from me leaving me in bankruptcy court. The have made illegal loans, stolen my identity, written checks, taken out loans, open and closed bank accounts, and depleted my retirement fund.
These individuals did this without my permission but I have reason to believe the concert promoter’s AEG is involved in that they have been in contact with Charnely”.
In an interview with Harvey Levin of TMZ in November 2010 Dr. Klein said that Demerol was a drug of his choice and that Michael never asked for it.
Klein had to use it because he was doing very painful procedures under Michael’s eyes. The slides of Klein’s records did indeed contain drawings with marks under the eyes. Klein said that he had sedated Michael to keep him from squirming during the procedures. In his interview with Harvey Levin he also spoke about it:
Levin …and you saw that he was a drug addict during periods of his life yet you prescribed Demerol numerous times…
Klein I never prescribed Demerol.
Levin You administered.
Klein I administered Demerol because you have to understand that the procedures I do are painful injections and I would give him…I would say I would take an hour-and-a-half to inject him and I would do somewhere around… oh, well over a hundred facial injections on him and unless I sedated him… He was very, believe it or not, needle-phobic when you got to needles on his face, and I mean, did you ever have injections in your face?
Levin Not really.
Klein Okay. It’s really a painful procedure, so, I mean, you had to stop him from squirming. You had to go to his eyes. The scalp injections were very, very painful, which I had to do because also I had to reduce a great deal of scarring on him. So what I used drugs for, it was not to give him drugs. I mean, I used drugs to relieve the pain when I did a procedure. So we have to make a big difference. If you’re having a surgical procedure, and these are really minor surgical procedures, with my length of time it takes for me to do it, it’s not minor, you have to use some amount of drug but when you look at how much I used, it’s not anything compared to the amount that some other doctors give. I didn’t give him bags of it to take home as some doctors do. …
Levin Did he ever ask you for Demerol?
Levin He never said, “I want Demerol”?
Klein No, because I wouldn’t give him what he wanted. You don’t give a person what they want.
Levin There was a lot of talk that Michael…it was almost the cart before the horse…that Michael would come to you for procedures, not because he necessarily wanted the procedures but he wanted the drugs that would put him under.
Klein No, because I did the procedures frequently with no anesthesia, I mean, no prior anesthesia.
Levin Did he repeatedly come to you and ask for drugs?
Klein No, not at all.
Levin My understanding of Demerol, correct me if I’m wrong here, is that it almost operates like a poison in the body, that over time it literally takes over the…
Klein Okay, I reviewed forty-eight articles on this. If you give me that statement and I reviewed it, I would say, contrary to what you say it’s non-toxic because what it has in the body are active intermediates and these active intermediates are non-toxic to the body if they’re done in a sterile fashion. What they do is they stimulate the body and that’s the good thing about Demerol, is Demerol becomes a stimulant once you give it to them, so they don’t have the narcotizing effect. It’s not like Morphine or Dilaudid or those drugs, and that’s what I like about Demerol. And also it’s active in the body over forty-eight hours, it’s about forty-eight hours it remains in the body so it takes a long time for the body to metabolise it but in all forty-eight articles on Demerol addiction, which I read very specifically, there was not any article about toxicity”.
All of the above means that Demerol was the drug of DR.KLEIN’S CHOICE and not Michael’s.
And he says it himself. ThereforeDr. Klein is taking all responsibility for those injections on his shoulders.
Dr. Klein could have shifted all the blame for Demerol onto Michael (same as Murray is doing it) – however he is not doing it and this is what makes me respect him and his words. It seems that he really wants to get to the bottom of the matter and also find out who was responsible for Michael Jackson’s death.
We can only welcome that.
* * * * *
Wiki summed up his testimony as follows:
Dr. Paul White, with an interest in intravenous anesthesia, started working with propofol in 1983, FDA approved it for general anesthesia in 1989. He has published 435 papers on PubMed. He has written about fifteen books, two are major textbooks. He has written five books on propofol, wrote twenty one chapters on propofol in various textbooks. After initial study showed propofol allowed patients to wake up sooner, went back to company and asked to do follow-up study. Dr. White said “Some people call me the father of Monitored Anesthetic Care (MAC) (Anesthesia awareness) sedation”.
“In January of this year, Mr. Flanagan contacted me and mentioned the name Conrad Murray. I wasn’t sure if I wanted to get involved in a high-profile trial involving death of a celebrity. I was perplexed how experts determined that Murray was infusing propofol. It was not obvious to me.”
Dr. White met the Shafers in 1981, shortly after arrival at Stanford. They approached him about doing research. It was heard that Dr. White performed a study with animals, found that propofol directly into stomach has no clinical effect. Regarding the paper Dr. Shafer testified about a sleep study in China, Dr. White said “My take on the paper was different than Dr. Shafer’s. The study showed that propofol was safe and effective for normalizing disturbed sleep but it’s certainly not a definitive study.”
The above statement by Dr. White is probably the only one which I really liked as it showed that in a proper setting and under due monitoring Michael was right in expecting Propofol to normalize his sleep – it is only that he was born a little bit too early for that practice. The science will probably accept this method of treating chronic, severe and profound insomnia later, however at the time he was suffering from this type of insomnia the propofol treatment was denied to him.
Isn’t it surprising that even here Michael was a pioneer?
Dr. White explained that when Propofol was introduced its main purpose was deep anesthesia, however he tried this drug for minor sedation and found that it was an amazingly controllable drug which allowed a whole range of sedation – from minor hypnotic effect (reducing the patient’s anxiety and just making him comfortable with no sleep) to deep general anesthesia when the patient is no longer responsive to painful stimulus.
At the time he was trying this drug for conscious sedation Propofol had not yet been cleared for it (conscious sedation is when a patient is sleepy but is not fully knocked out), however after he turned over his studies to the producer the insert for the drug was corrected and the drug was approved for sedation.
Such experimental use of the drug is called “off-label” and means that an approved drug may be used for a purpose which is not indicated in the insert.
Flanagan developed this theme and wondered if it would be on-label to use Propofol for sleep in the hospital setting but would be off-label to use it at home? I need to check the video again but my notes do not say a flat “No”, so probably Dr. White agreed to it in some form or anotehr.
Despite the fact that it fully contradicts with the position of the Prosecution I still support the idea that if a proper specialist had administered proper doses of propofol with proper equipment and provided adequate care for Michael, it could have been a solution of Michael’s problem – even if it had the status of only an experiment. Needless it to say that in case of an experiment double monitoring was to have been done.
The defense and Dr. White want to create the impression that he is a pioneer in science while Dr. Shafer and other witnesses for the Prosecution are too conservative and are not keeping up with the latest trends. And though such an idea is unpleasant it is still within the range of the usual scientic debate.
However what is not part of true science is Dr. White’s own admission that he made a “speculation” over the possibility of oral administration of propofol as a cause of Michael Jackson’s death. He says he made this speculative remark because some propofol was found in the stomach – however when he read Dr. Shafer’s report he became aware that Propofol was 100% non-bioavailable (or cannot get into blood if swallowed).
Well, firstly, serious scientists never make any unsubstantiated “speculations” (this is totally non-professional) and secondly, Dr. White admits that a little of Propofol somehow did get into the stomach from blood. This is important, as in connection with Lorazepam he will say that there is absolutely no way Lorazepam could get from the blood into the stomach.
But if Propofol could, why couldn’t Lorazepam? After all both could get there with some blood during the resuscitaiton efforts, couldn’t they?
* * * * *
Day 20. Friday, October 28
All I’ll say about Dr. White’s speculations during that day is that he made a tale-telling slip of the tongue.
When making a very sloppy demonstration of some 50mg (5ml) of Propofol pushed into a tubing from a syringe (he couldn’t take 25mg (2.5ml) as all of it would stay in the tubing and would not even drip out) – so when making that demonstration he suddenly mentioned “THE CRIME SCENE”.
He didn’t notice what he said. There was a little bit of silence after which the judge asked to cross out the word “crime”. Dr. White apologized several times but looked embarassed as he unwittingly said what he really thought about Murray.
Just a few pictures. Please compare and find the differences:
Dr. Shafer uses the standard infusion set. It is not the exact equivalent of the one used by Murray (he couldn’t get it overnight) but is pretty close to it.
He shows that the infusion port is approximately 3 feet away from the catheter (the thing attached to Michael’s body). When you push 25mg through this part of tubing it practically fills the whole of it and hardly drips.
The tubing used by Dr. White was extremely short and he was injecting a syringe filled with 50mg (5ml) of propofol and 50mg (5ml) of lidocaine, so it was no problem for it to drift through that tube.
(sorry for not finishing it yet)