Day 12 of the Trial: The Drug Combination Was Lethal

Yesterday’s session was shorter than the previous days. On this day, the prosecution called a specialist in the drug propofol to the stand. Professor Steven Shaffer, an anesthesiology specialist and a professor at Columbia University, told the court that when propofol was first introduced to the medical community in the early 1990s, he personally carried out tests, and his findings still hold true in the world of medicine. He said that, based on his own review, this drug must be used with caution. For example, if even a tiny amount is overused, a patient who should wake up within minutes would remain unconscious for hours. During his testimony, Professor Shaffer corrected the mistake made by Murray’s defense attorney, who had said that Shaffer was a student of Dr. Paul White. Shaffer said that although they are long-time friends and colleagues, he has never been his student. Apparently, Paul White is one of the witnesses for the defense attorneys. Shaffer’s testimony was postponed to the next session because he had to go to Chicago to attend a scientific conference. Shaffer is scheduled to present a review on propofol at this conference. He will not return until Friday, so there will be no court session on that day. It is said that the prosecution will summarize the case in the coming week and hand it over to the defense attorneys. Apparently, Shaffer is the only remaining prosecution witness. Before Shaffer yesterday, Dr. Nader Kamangar returned to the stand to continue his testimony from the previous day. Michael Flanagan, Murray’s defense attorney, asked Kamangar: if Michael Jackson had administered the drug himself, would Conrad Murray still be at fault? Kamangar: "Absolutely." Flanagan asked: if a doctor prescribes a pack of 30 pills for his patient to treat him, and the patient takes all 30 pills in one dose, is the doctor still responsible for the patient’s death? This question was met with objections from the prosecution, and the judge also prohibited the witness from answering. Kamangar said that the combination of drugs created a storm inside Michael Jackson’s body and ultimately brought him down. Murray has admitted that over 10 hours he had injected various drugs into Michael. "Mr. Jackson was receiving very improper treatment. At home, he was treated with drugs such as propofol, lorazepam, and midazolam—drugs that require caution and intense monitoring. Murray did not provide that care, and in the end, the combination of these drugs caused a catastrophe." In another move, Flanagan referred to a study in China. In that study, it was said that propofol is effective for treating severe insomnia. Kamangar responded that this was only an experimental study and does not show that the drug is effective in a hospital setting, let alone for use at home. He continued: "Even the researchers themselves in this study point out that much more research is needed." Flanagan then referred to another study from 2010 in Taiwan, in which 64 insomnia patients were treated with propofol. Kamangar said first that this study did not exist in 2009 and that they had come up with it after Michael Jackson’s death. In addition, the study mentioned was conducted in a safe hospital environment. Among other mistakes by Murray, Dr. Kamangar pointed to the lack of recorded details and prescribed medications. He said that a doctor cannot rely on memory and must accurately record the details of the treatments he performs and information about his patient’s health. Kamangar described the failure to record details as one of the factors that contributed to Michael Jackson’s death. During questioning by prosecutor David Walgren, Kamangar said that the fact that Michael requested the medication was not a reasonable reason for Murray to carry out the injection. He had said on Wednesday that Conrad Murray was not looking for the cause of Michael Jackson’s insomnia. But yesterday he said the cause of the insomnia could have been the use of drugs such as Demerol or anxiety and excitement caused by concerts. The defense claims that Michael used Demerol according to Dr. Klein’s prescription. After Michael’s death, no trace of this drug was found in his body. Kamangar continued that Dr. Murray should have first reviewed his patient’s medical history, found out why he was suffering from severe insomnia, and in doing so should have sought help from other doctors: "The most important thing he could have done was to ask for help." "A doctor should know how to say no to his patient when the patient requests a medication that could harm his health." He added: "The ability to say no to a patient is one of the essential needs in the relationship between doctor and patient." The prosecutor asked Kamangar for his opinion on this statement: "It doesn’t matter how much the patient complains and files complaints. No matter how much he wants you to beg. It’s this doctor who has to say no." Kamangar confirmed: "That’s correct." The prosecutor then asked him whether Murray’s actions directly led to Michael Jackson’s death. "In this case, did Conrad Murray commit many serious errors that directly led to Michael Jackson’s death?" Kamangar: "That’s right." Source: eMJey.com / LA Times / MSN