The People vs. Conrad Murray trial has now entered day 22. Yesterday’s cross-examination of Dr White was a very long and complicated day, as many technical medical references were discussed. The judge is keen for today to be shorter and more concise as the jury were losing interest.
Today Conrad Murray’s final decision as to whether to testify will also be revealed.
Dr Paul White
The cross-examination of Dr White continued today.
Lorazepam
The prosecution wanted to talk about the levels of Lorazepam in Jackson’s stomach. Dr White stated that there really is no way to tell how many tablets Jackson took. (If this was the case as the defence are trying to push).
What we can tell is that the levels of Lorazepam were a lot higher than what Murray told the police.
Dr White’s testimony stated the tablets were taken around 8AM (this would be needed to give the levels of Lorazepam that were found MJ’s blood from the toxicology report). Jackson would have needed to have taken around 6 -7 tablets. Dr White also stated it was possible that the same levels could have been achieved if pills had been taken at around 4, 6 and 8AM.
If Jackson were to have taken tablets in the timeframe that Dr White suggested then Conrad Murray would have been in the room (according to his police interview). Dr Murray told police he only left the room for a two minute toilet break just before noon.
Dr White also stated there were bottles of Lorazepam so it was a possibility that the Lorazepam had been administered via an IV.
Propofol infusion
Dr White told the court that he does not believe Dr Shafer’s scenario of a three hour Propofol infusion is possible as the levels of the drug found in the urine sample were too low. He also reiterated that the 25 mg that Murray told police he gave MJ would only give a minimal amount of sedation, which would induce a light sleepiness. It would last around 5 – 10 minutes.
Importantly Dr White stated that by the time Conrad Murray found Michael there is no possible way that Jackson could have been saved. This will help the defence as they can then state that any actions Murray took afterwards were irrelevant as the outcome would have still been the same.
Standards of care
When discussing standards of care Dr White was keen to differentiate between this and standards of practice. He stated that it is more important to follow standards of care than standards of practice. Dr White stated that in circumstances other than the usual it is not always possible to follow the guidelines.
Dr Conrad Murray
Once Dr White’s testimony was complete Judge Pastor asked Conrad Murray for his final decision to whether he would take the stand. Dr Murray told the court he had decided to not testify.
There was debate between Murray’s team as to whether he should tell the jury his version of events. Michael Flanagan was keen to have Murray tell his side of the story as he believed that otherwise the jury may believe this was a sign of guilt or that Murray is trying to hide something.
Ed Chernoff was keen for Murray to not take the stand as he believed Murray would not have been able to hold up against the prosecution’s questioning.
A big problem Murray would have had is that the evidence by the defence’s star witness, Dr White, was contradictory to what Murray had told police.
Dr Steven Shafer
Dr Shafer was then recalled to the stand on rebuttal. This means that the prosecution want to challenge some of the statements made by Dr White. They would use Dr Shafer’s expertise to do this.
Lorazepam
The prosecution wanted to ask Dr Shafer about Lorazepam. Dr White had testified that if Lorazepam had been taken intravenously then no traces at all would have been found in Jackson’s stomach. This means he must have orally digested some tablets of Lorazepam at some time. Dr Shafer told the court this was wrong. Drugs that are administered via an IV go into all tissues in the body, including the stomach. He also pointed out this has nothing to do with post mortem redistribution.
Shafer also told the court that Lorazepam pills that had been given by Dr Murray or that had been taken by Jackson himself look the same so there is no way to separate the two.
Lidocaine
Dr Shafer told the court that he had included Lidocaine in his scenarios because Lidocaine was present in the toxicology report.
Propofol infusion
Dr Shafer then discussed the key drug in the case; Propofol. He told the court that the main complication with Propofol is a failure to breathe. This is what caused Jackson to die. Shafer did state that Michael could have died at any time, not precisely at noon.
Dr Shafer stated it is fairly usual to administer Propofol using two IV lines but he would use an infusion pump. It had been discussed that Murray had used roller clamps but with these there is less control over the speed that the infusion that occurring.
Roller clamps are usually used for non-critical treatments using drugs such as antibiotics.
Simulations
Both Dr Shafer and Dr White had previously shown the court simulations of the scenarios they believe were possible, or impossible, to have killed Michael Jackson. Most of Dr White’s testimony was disproving the scenarios that Dr Shafer had put forward. Now was Dr Shafer’s chance to comment on Dr White’s scenario. Dr White’s scenario was based on a model completed last week by a doctor he had consulted. His expert’s model used two scenarios – two 25 ml doses of Propofol (the second administered by MJ, the defence’s argument) versus a 1000ml infusion (as Dr Shafer claimed).
The research and findings for this model were based on Simon’s 1988 article. From what I can understand this article discussed how the kidneys filter Propofol and how this can then be measured in urine samples. The results found that 0.3% of unchanged Propofol would be found in urine sample.
The issue Dr Shafer had with this is that it was unknown if the findings in this paper considered metabolites as well as the Propofol in its results. A comment on the article in 2002 stated that metabolites were included in the results. Due to advancements in technology the results could now be more precise. In the 2002 article they found 0.004% unchanged Propofol in eliminated urine. From the 550ml urine sample that was collected from Michael Jackson the reading showed 0.15 ug/ml of Propofol. When calculated a results of 82.5 ug/ml is reached.
This becomes relevant when Dr Shafer then spoke about the 2002 study which was a comment on the Simon’s article. The study used 5 patients undergoing major surgery who received a constant infusion of Propofol (as Shafer believes Murray used). Different levels of Propofol were administered to the patients from 1300 mg to 3300 mg. The focus of the study was to see the amount of unchanged Propofol was excreted in the urine of these patients. The results showed that 70.71 ug/ml of Propofol was excreted with a patient who received a 2000 mg dose of Propofol. This was close to the result that Jackson had. This also shows that it is more likely Jackson was given close to 2000 mg of Propofol.
Dr Shafer then stated that this completely rules out Dr White’s simulation.
Standards of care
Dr Shafer then spoke about standards of care. If a procedure is carried out in a home far greater precautions and vigilance would be needed. In a “remote location” you have no backups so you cannot afford to take any short cuts.
Cross-examination
Dr Shafer was then cross-examined by Flanagan. Flanagan questioned Dr Shafer about his report into Lidocaine. Flanagan stated that Shafer’s report was wrong. Dr Shafer then told Flanagan that this was not the case, telling Flanagan “you’ve misread my report.”
Flanagan then asked if Dr Shafer had rejected the Simon’s report findings. Dr Shafer replied that he had rejected the defence’s interpretation of it.
Judge Pastor
As Dr Shafer’s rebuttal ended the trial’s evidence section was finally complete. Judge Pastor told the jury “you've seen and heard all of the evidence in this case.” The jury will now be given the exhibit list ready for their deliberation.
The court is now in recess until Thursday. On Thursday the prosecution and defence will give their closing statements. This will be a summary of all the evidence they have produced and what they believe this proves.
Once this is complete the jury will then deliberate the verdict. This could be a very quick or a slow process depending on how split the jury is on the verdict.
Dr Murray could learn his fate at the end of this week or early next week.
Summary
After six weeks of evidence both the prosecution and defence have rested their cases. We have heard many weeks of a very strong case presented from the prosecution, so it was always going to be difficult for the defence to put forward a plausible theory that could disprove the prosecutions argument, especially with the evidence that was stacked against them. With the defence having very few witness testimonies and a sparse amount of expert witnesses this task was made even harder. The defence’s case was not helped when many of their witnesses were either seemingly pointless or their evidence supported the prosecution’s argument more.
I think from all the evidence that had been presented that it is certain that Conrad Murray is guilty of the charge of involuntary manslaughter. The only theory that the defence were holding onto was that Michael Jackson administered the fatal dose himself. Even if this was the case I still feel Murray would be guilty as he should not have left a patient unmonitored and with the ability to do this. It is also impossible to try to explain away Murray actions after he found Jackson not breathing. Every single expert witness that spoke about the delays in calling 911 and not informing medical staff of all the drugs he had administer said they could never justify Murray’s actions.
I also believe that Murray deciding to not take to the stand was the best decision for him. Although this does show to the jury that there must be something that is stopping Murray from testifying there is no way Murray could have taken the stand without proving he was guilty. I strongly believe the prosecution would have machine-gunned so many holes into his account that there would have been no way Murray defended himself in cross-examination. Also by testifying he would have had to admit that he lied to the police during his interview (if Murray stated that Jackson had killed himself as Dr White had testified). This then begs the question why lie to the police? Especially as Murray and his lawyers had called for the meeting and had two days to remember exactly what happened to the best of Murray’s abilities.
Dr White
Dr White’s testimony was very interesting, and certainly did shake up the trial. But during cross-examination he had to backtrack on many of his statements and seemed to not have all his facts or research totally straight. His main argument was that Dr Shafer’s three hour infusion scenario was wrong, but this had been the method that Murray been using in the 80 days up until three days before Jackson’s death. It is not as an implausible theory as Dr White might state.
Dr White’s theory that Jackson gave himself the fatal dose of Propofol is also a theory that is not based on the evidence that has been presented in court, rather on medical facts, models or articles. For example Dr White repeatedly commented on how Murray had given two 25 mg injections of Propofol. This was evidently not the case as the toxicology report states otherwise. Dr White also never addressed the fact that Murray did not leave the room for a two minute toilet break, in fact he was out of the room for 46 minutes. You cannot base your testimony without addressing and including the evidence in your findings.
Dr White also proved to not be an objective witness as he based part of his testimony on what he and Conrad Murray had discussed. This is admissible evidence and the judge did not allow this.
The closing statements will take place this Thursday. This is sure to be a day to watch.
Sophie Dewing
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