The trial has now entered day 11 of proceedings and the prosecution are getting towards the end of their witnesses.
Dr Alon Steinberg
The first person to testify today was Dr. Alon Steinberg, one of the leading cardiologists for the California Medical Board. Dr Steinberg made it clear that he was a cardiologist and not an anaesthesiologist. The key point Dr Steinberg made was that he found six separate deviations of standard of care from Conrad Murray in regard to Michael Jackson and each one showed “gross negligence”.
Dr Steinberg testified that he reviewed the case by reading the transcript of Murray’s interview with the LAPD so he could “judge Dr. Murray on his very own words." The main comments Dr Steinberg made were that Propofol should only be used in hospital and using it would require an anaesthesiologist. He said he had never heard of anyone using Propofol to treat insomnia. Steinberg stated it is gross negligence to use Propofol in this way. He also stated it was unethical. He went on to say that using Propofol in a home without proper medical equipment or staff is also gross misconduct. Because Murray did not have the correct essential medical items he was not prepared if complications were to arise. The equipment he did have, like the pulse oximeter, did not have an alarm so unless constantly monitored this device is useless. Dr Steinberg believes Murray should have had an assistant at all times.
Dr Steinberg then went on to discuss the events that took place on the 25th June 2009. Steinberg stated that Murray should have called 911 immediately. Help could have arrived in 4 minutes. Crucially Dr Steinberg testified that if Murray had done this Michael Jackson would be alive today. Steinberg told the jury that "for every minute of delay there's less and less chance the patient will survive." It took Murray 20 minutes to call paramedics. During these 20 minutes Murray tried to save Michael’s life himself. The methods he used were inappropriate according to Dr Steinberg. Steinberg testified that when Murray noticed MJ was not breathing he started chest compressions. This was completely wrong because when people stop breathing their heart is still pumping. They do not need chest compressions. Instead Murray should have used an ambubag straight away and administered Flumazenil to try to reverse the affect of the Propofol and the other sedatives. The priority was to get oxygen into Michael and the fact that Murray performed CPR was 'inexcusable'. Murray also wasted time by calling Michael Amir instead of getting an ambulance. Dr Steinberg said Murray’s reaction and behaviour were “bizarre”. Dr Steinberg also stated that even if Jackson had self-administered the Propofol Murray had still failed to monitor him properly and this negligence still makes Murray accountable.
Dr Steinberg then went on to detail other errors Conrad Murray made. Murray did not make any notes. This is vital so the patient can continue to receive the right care in the future but also important for legal and insurance purposes. Records can also be checked to see if mistakes were made. The defence did try to argue that Murray did not need to write notes as he only had one patient. Dr Steinberg stated that Murray should have still been writing notes because when he arrived at UCLA he couldn’t remember what he had given Jackson so was unable to tell the doctors. This can make the difference between a patient living and dying.
A very interesting point Dr Steinberg made was that Conrad Murray was not board certified on June 25 2009 when MJ died. This is huge. This basically means that in California (at least, I am not sure about other states) Conrad Murray was not registered as a doctor.
Dr Steinberg went on to further criticise Murray for leaving Michael on his own as he states "it's like leaving a baby that's sleeping on your kitchen countertop,". Steinberg also said that according to the transcripts Murray gave Michael a drip of Propofol in addition to the 25mg he had already given him. The drip would have been needed to keep Michael under and to remain asleep.
Steinberg stated Murray's breeches in care "directly contributed to the untimely death of Michael Jackson."
A major development then occurred. Murray’s defence team announced they were no longer contending the Michael Jackson drank Propofol. They still will argue that Jackson gave himself the fatal dose but not orally. This is a crucial point in the trial and it will be interesting to see just how the defence will now alter their argument.
The defence also suggested that the two minute toilet break that Murray told of in his police interview wasn’t accurate. Murray’s statement is improbable and it had previously been testified that it would be difficult for someone who is sedated to suddenly sit up and then have the knowledge, skill and ability to administer Propofol themselves, particularly in a two minute timeframe. Previous phone call records and numerous testimonies from people who spoke to Murray that morning have already proven that in the hour leading up to Jackson’s death Conrad Murray was on the phone for 46 minutes. The police also never believed Murray only left for a two minute break. The admittance that Murray may have been out of the room for longer may play into the defence’s hands as it gives more time for Jackson to have self-administered Propofol. Although with testimonies from medical professionals who state this is still very unlikely it seems implausible that this is a strong enough argument to turn the case in Murray’s favour.
Dr. Nadar Kamangar
The final testimony of the day came from Dr Nadar Kamangar, a pulmonary and critical care doctor who specializes in sleep medicine. Dr Kamangar stated that he uses Propofol on a daily basis but it is a drug that can be extremely unpredictable especially when used with other sedatives. Kamangar testified that patients who have been administered Propofol need to be closely monitored as their condition can change rapidly. Dr Kamangar also stipulated the importance of using an automated pump when administering Propofol so the dosage can be regulated. This is vital as Propofol is so powerful.
Dr Kamangar then went on to discuss Conrad Murray directly. Dr Kamangar testified that he found "multiple extreme deviations" in Murray's standard of care calling his use of Propofol "inconceivable," "unethical," and "disturbing." Murray's use of Propofol outside of a highly monitored facility was "inconceivable." Kamangar stated Murray's treatment of Michael Jackson amounted to "gross negligence."
Dr Kamangar told the jury Murray should have never given Jackson any sedatives at all because he was dehydrated. This means his blood pressure was already low. Kamangar stated Murray’s CPR was poor and in violation of standard of care. Much like Dr Steinberg, Dr Kamangar believes Murray wasted time calling Michael Amir instead of 911 and not calling them right away was an "unconscionable deviation of care".
Kamangar also stated that by withholding information from the doctors at UCLA Murray broke the first rule of medicine – putting your patient first. Kamangar also believed it was unethical for Murray to ignore signs of Michael’s drug dependency.
Summery
Today was a turning point in the trial as the defence have admitted that Jackson did not drink Propofol. They still will argue that Jackson killed himself but the Propofol was not taken orally.
The past few days have also seen Conrad Murray come under very harsh criticism from many medical professionals. Multiple testimonies have stated that Propofol is inappropriate to use in a home setting and that many standards of care were not met. The key phrase seemed to have been ‘gross negligence’. Seeing as the prosecutions argument is that Murray was negligent and abandoned Jackson when he was administering a risky treatment, currently it is almost certain Murray will be found guilty. The witnesses to testify so far have solidified the prosecutions argument.
The trial continues tomorrow with Dr Kamangar finishing his testimony.
Sophie Dewing (@sophiedewing)
http://exploredreamdiscoverblog.blogspot.com/
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