Today was day 12 of the People vs. Conrad Murray trial in relation to the death of Michael Jackson. Dr Nadar Kamangar, a sleep expert, resumes his testimony. Today’s session was very short and adjourned early.
Dr Nadar Kamangar
Dr Kamangar continued his testimony today under cross-examination. Michael Flanagan, one of Murray’s defence lawyers, questioned Dr Kamangar about a doctor’s role and responsibilities. Flanagan asked if it is a physician’s responsibility to find out why their patient is refusing certain treatments and asking for inappropriate treatments. Dr Kamangar stated he would make sure his patient received the right care and would not undertake treatments that are not in the patient’s best interest, even if they were asking for it. Kamangar stated it was an “extreme violation of care” that Murray did this with Jackson.
Flanagan then pointed out that doctors could perform a treatment, even thought it would be considered bad medicine, and it doesn’t mean that a bad outcome would occur. Kamangar said that this does not make it acceptable; it is still grossly negligent if a doctor were to work like this. Dr Kamangar also pointed out that Murray was administering very potent drugs without appropriate monitoring equipment. This was a recipe for disaster. Administering a cocktail of drugs in an inappropriate setting was a perfect storm for Michael’s demise. Dr Kamangar was also critical of Murray not having written any notes about the drugs he was administering or Jackson’s vital signs. Kamangar stated that this was a contributing factor in Michael’s death.
The defence then questioned Dr Kamangar about insomnia. Kamangar stated it was obvious MJ was suffering from insomnia. He also stated that Jackson’s dependency on other drugs and anxiety could have caused his insomnia. Flanagan put forward that if used in a clinical setting Propofol is an acceptable treatment for insomnia. Dr Kamangar stated he did not have enough information to answer but it is still incomprehensible to use Propofol in a home setting. The defence then mentioned a study conducted in Taiwan in 2010 where patients suffering from insomnia were successfully treated with Propofol. Dr Kamangar pointed out this study took place a year after Michael Jackson’s death and was conducted in a hospital.
Dr Kamangar then testified that Lorazepam has no role in treating insomnia. He takes this stand point as patients can become dependent on it therefore making an inappropriate treatment for sleep problems. Kamangar stated he would only prescribe oral Lorazepam for patients with anxiety, and only for short term use.
Dr Kamangar then went on to discuss Jackson’s drug dependency. He was critical about Murray not addressing Jackson’s addiction. As Murray mentioned in his police interview Michael would visit Dr Arnold Klein three times a week and would come back ‘wasted’ and had slurred speech. Kamangar states if your patient was in this state you should discuss this with them. Kamangar also states that if people had mentioned a change in Jackson’s behaviour or concern about Michael, Murray should have looked into it. From previous testimonies we know that Frank DiLeo had asked Murray to get blood tests as he was concerned about if Jackson was taking drugs. Kenny Ortega also had voiced concern to Murray about Jackson’s wellbeing. Murray then told Ortega to mind his own business, Michael was fine. And in his own police interview Murray stated that MJ’s production team worried about Michael after he returned from visits to Dr Klein.
Dr Steven Schafer
The last person to testify was Dr. Steven Shafer, an anaesthesiologist and a leading Propofol expert. Dr Shafer had only just taken to the stand when the court was adjourned due to scheduling conflicts. Court was also postponed until Monday morning. Dr Shafer’s testimony will continue then.
News reports
In the press this week there have been some interesting stories about the case. One report suggests that Conrad Murray would not be on trial now if he had not himself requested to speak with police. We heard earlier this week from Detective Scott Smith that the first time the police heard about Propofol was from Murray himself. Prosecutors were not going to push for a case as they believed there was no way they could prove Murray administered Propofol to Jackson. But Murray himself admitted this and also that he had been doing it for two months solid. This went on to prove that up until the 25th June 2009 Murray had administered 5 gallons of Propofol to Jackson.
Detective Smith had testified that the police had no idea Murray had put a bag with Propofol bottles in MJ’s closet. When police informed Murray of this Smith stated Murray looked ‘shocked’. It seems Murray realised at that point the police didn’t know as much as he thought and he had now incriminated himself.
The police were also alerted when they realised parts of Murray’s interview were lies. This caused suspicion and lead to charges being filed.
The prosecution's argument is Murray acted recklessly and was negligent. By his own account to police Murray incriminated himself. Administering Propofol in a home setting is reckless.
Reduced sentence?
At this stage of the trial it is almost certain Conrad Murray will be found guilty. But media reports are suggesting that Murray may not spend much time in prison, if he spends any time at all. A new law was brought into effect in California on the 1st October which states if someone commits a non-violent felony crime they cannot be sent to a State prison due to overcrowding. Instead they will be sent to a county jail. If found guilty Murray would be sent to a county jail because of this.
Currently Murray could face up to 4 years in prison. An LA County Sherriff told the media that Murray would probably only serve half of this sentence. This would make his sentence 2 years. But as there is a problem with overcrowding in county jail non-violent prisoners with no previous criminal history will be eligible for house arrest. As Murray fits into this category he may end up spending whatever sentence he is given wearing an electronic tag but living at home. The Sherriff did state that Murray would serve some time in prison as they would not allow him to be living under house arrest straight away.
I think it is very easy to get caught up in the verdict and forget the sentencing. It seems inevitable that Conrad Murray will be found guilty but his sentence is still something that is unsure. A possible four year sentence could be drastically reduced to an electronic ankle tag. It will be interesting to see what the outcome is.
Summery
I had previously mentioned in my post about the opening statements that I thought the jury may be hung due to what their stand point is regarding doctors giving unnecessary treatments to patients even though the patient has requested it. I found it interesting today that Michael Flanagan brought this point up. I am happy that Dr Kamangar stated that it does not matter what the patient requests, it is unethical for a doctor to perform treatments that are unnecessary and risky. Particularly when they are not in an appropriate environment. It does very much seem in the US there are two ways of thinking when you are a doctor. The doctors who are there to cure sick people, and the doctors who are there to make money. In this case it shows that Murray is in no way unique by performing unneeded procedures on patients. As we have heard with Jackson alone he had multiple doctors throughout the years prescribe him many different drugs and administer Propofol. Lest we forget this will be happening with many patients and doctors across the US. But it does bring hope that the whole of the medical care system is not corrupt when many of the doctors who have testified so far have condemned Murray’s actions and ethics.
I do find the defence’s arguments to be a bit scattered. First they suggest that other people were to blame for not reacting quick enough, then they suggest Michael administered the dose himself and now they talk about the liability of who is responsible if a patient has asked for a treatment. Instead of having one argument and sticking to it the defence seem to be flimsy and whenever the evidence stacks against them they change their argument. It does seem as if they know Murray is guilty of negligence and reckless behaviour but need to try to persuade the jury in any way that maybe he is less accountable due to other circumstances. As I mentioned before it does seem now that the trial is merely a formality. The defence know Murray will be found guilty but his sentence may be reduced if they can try and make other people or circumstances accountable.
The trial enters week four and resumes on Monday.
Sophie Dewing (@sophiedewing)
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