We have now entered the second week of the trial and are continuing with prosecution witness testimonies.
Day 5
Day 5 started with no real developments or news. The first two testimonies came from two representatives from mobile phone service providers testifying about the call records from Murray's phone.
I did not view these testimonies so am unable to comment fully on these.
Dr Thao Nguyen
The third testimony was from Dr Thao Nguyen, a cardiologist from UCLA hospital where Michael Jackson was taken. Dr Nguyen stated that when she arrived in the trauma room she was directed to Conrad Murray to be briefed as to the situation with Michael Jackson. Murray was the primary source, not Dr Cooper, the ER doctor (who testified on Friday). Hence why Dr Nguyen was directed to him. Dr Nguyen asked Murray if any sedative had been administered to Jackson. Murray only mentioned Lorazepam. He did not mention Propofol. This is what Murray also told paramedic Senneff but is at odds with what Murray told paramedic Blount and Dr Richelle Cooper. Murray only told these witnesses that he had given MJ saline to treat dehydration.
Dr Nguyen also stated that 'it didn't look like time was on Mr Jackson's side' and she believed he was already dead. The only reason the team continued resuscitation attempts was because Conrad Murray told the hospital team he had felt a pulse earlier. Dr Nguyen stated Murray sounded 'desperate' and 'looked devastated'. Murray asked them to 'not give up easily and try to save his [Michael Jackson's] life.’ After an hour of trying to save Michael's life Dr Nguyen said the team tried to use a balloon to resuscitate Michael, even though they believed that it was not going to be successful. The team then had to convince and prepare Murray that they were not going to continue any more attempts and pronounce Michael Jackson as dead.
Dr Nguyen was then asked a lot of detailed questions about certain drugs and the effects they have. This was a very interesting section. Dr Nguyen talked about orally and intravenously (IV) administered drugs. Dr Nguyen stated to treat insomnia she would use orally administered Lorazepam. She would not use an IV (as was the method the Murray told her he had used). She states 2- 4mg of Lorazepam would be needed for insomnia. Murray claimed he gave an IV of 4mg of Lorazepam to get Jackson to sleep. An IV has a much quicker effect and the result lasts longer.
Dr Nguyen explained an IV dose of Lorazepam takes 5 - 7 minutes to put that patient to sleep. It has a half-life of 14 hours - plus or minus 5 hours. From this they can then try to judge when Michael was given the Lorazepam (although this is nothing something Dr Nguyen would be able to testify about as she would not have conducted this test).
When questioned about insomnia treatments Dr Nguyen stated a 1 or 2mg pill of Lorazepam would make someone sleep all night without waking up. Of course this depends on the host and their tolerance to drugs. A benzodiazepine addict (alleged as someone like Michael) would probably need to take more than 4mg to sleep. Dr Nguyen states if someone is not sleeping and need a higher dosage then they need to be closely monitored and the higher the level the higher the risk of side effects.
The defence than asked about a 20mg doze. Dr Nguyen seemed shocked they were asking about such a large amount. Dr Nguyen said 20mg is a large dose that she had never used. The defence asked if this amount could kill someone. Dr Nguyen said it could but went on to explain how Lorazepam works. Dr Nguyen states Lorazepam affects the brain. It makes the host very sleepy. One danger is if the brain becomes so sleepy that it tells the diaphragm not to work so the patient would stop breathing. Dr Nguyen confirmed that 20mg would depress consciousness very quickly and stop the patient breathing. Dr Nguyen added it would not cause respiratory or cardiac collapse.
Dr Nguyen was then questioned about Propofol. She stated as a cardiologist she is licensed to use Propofol. Although Dr Nguyen is licensed to administer Propofol she would only ever do it with a crash cart present and with the correct personnel in the correct areas of a hospital. She has never used Propofol without an anaesthesiologist.
Dr Nguyen then repeatedly and strongly stated that Propofol must only been administered in a hospital but always only in the ICU or the procedure room, a 'designated place with designated personnel'. A crash cart must always be available.
Dr Nguyen states that she does not use Propofol outside of a hospital and had never heard of Propofol being used in a bedroom of a home. She explicitly expressed once more that when Propofol is used in a hospital it is only ever used in certain rooms with certain personnel.
Dr Nguyen also stated that unlike Lorazepam Propofol will cause respiratory and cardiac arrest. Lorazepam can stop breathing but will not cause respiratory or cardiac collapse.
Dr Nguyen asked if Conrad Murray used anything to reverse effects of Lorazepam in Michael. Murray stated no. The defence then asked what would have been needed to reverse the effects. Dr Nguyen explained that an IV of 0.2mg of the drug Flumazenil would be the antidote to an overdose of Propofol. But the Flumazenil needs to be used in seconds. The result will be a delay the depression of the brain and respiratory collapse and possibly stop the need for intubation, or at least give time for intubation to take place. This highlighted the need for a crash cart and lifesaving medical equipment to be near when using Propofol. Something Murray did not have access to.
The final section with Dr Nguyen discussed the effect Propofol has on people. Dr Nguyen states that an IV of Propofol would make someone sleep very quickly. The defence then stated that Propofol would not make someone's speech slurred. Instead they would sleep. It seems this was a tactic to pass blame. In the opening statements the defence claimed that Dr Arnold Klein, Michael Jackson's dermatologist, was responsible for getting Michael addicted to drugs.
Dr Nguyen's testimony was very interesting and gave a very clear insight into the way the two drugs that are key in this case work. It also reiterated the need for Propofol to only be administered by a qualified anaesthesiologist, in a clinical setting and with the correct lifesaving equipment present.
Dr Joanne Praschard
The fourth testimony was from Dr Joanne Praschard, a physician based in Texas. Dr Praschard treated a patient of Conrad Murray. The patient was taking medicine that was a concern to the anaesthesiologist. Dr Praschard needed to speak to Murray to see if she could take the patient off the drug to have the operation. Dr Prashard had some difficulty contacting Murray but eventually spoke on 25th June. Murray stated the patient needed to continue with the drug. Dr Praschard did note that Murray knew exactly what patient she was discussing and recalled the treatment even without notes in front of him. Dr Praschard was impressed with this as she states doctors see so many patients it is often difficult to remember details from memory.
Dr Prashard's testimony seemed to play more into the defence’s hands which is unusual for a prosecution witness. But Dr Prashard did also state that it is vital a doctor write all treatments and drugs on a patient’s medical charts so that others afterwards can then give correct treatments. This was to highlight that Murray did not ever write any medical notes for the treatments he gave Jackson over the duration of time that he worked with Jackson or give vital information to paramedics or the UCLA trauma doctors.
Phonecalls
The prosecution then called two women that Murray spoke to on the morning of the 25th June 2009. The first woman to testify was from Antoinette Gille, a volunteer at one of Murray's medical practices. The second was Bridgette Morgan, a woman Murray met in a nightclub in Las Vegas. Although neither of these phone calls took place during the time that Michael Jackson got into trouble it shows that Murray was distracted in his duties during that day. As has been stated by Dr Nguyen and Bob Johnson, from the pulse oximeter company, the procedure Murray was performing on Jackson needed constant monitoring. Leaving the room repeatedly to make phone calls shows his lack of focus and plays into the prosecutions argument that Murray neglected Michael, which then led to his death.
Tomorrow the girlfriend of Murray, who was apparently on the phone when Michael got into medical difficulty, is set to testify.
Sophie Dewing (@sophiedewing)
http://exploredreamdiscoverblog.blogspot.com/
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