People vs. Conrad Murray - Sentencing

Sentencing hearing

After serving 24 days in prison since his conviction, today was the day Conrad Murray was to discover what his sentence would be.

Before presenting their statements both the defence and the prosecution highlighted issues to the judge.

Firstly the defence asked Judge Pastor to not allow any cameras in the hearing today. They stated this was to protect Conrad Murray’s privacy. Judge Pastor pointed out that seeing as Conrad Murray participated in a documentary about the trial he doesn’t seem that worried about privacy.

The prosecution then wanted to highlight two case laws to the judge about making involuntary manslaughter a serious felony. This is because on the 1^st October, during the trial, a new law was passed in California in regards to overcrowding in prisons. This law, called the Realignment Statute, states that unless involuntary manslaughter is treated as a serious felony then Conrad Murray would be sent to county jail instead of state prison. Judge Pastor stated he did not believe the cases the People presented had any impact the Realignment Statute. Therefore if Conrad Murray receives a prison sentence this would be served in a county jail.

Jackson family statement

Brian Panish, a Jackson family representative, then read a statement on behalf of Michael Jackson’s family. It read there is “no way to adequately describe the loss of a beloved father, son, brother and friend”. Michael Jackson’s children stated ‘we will grow up “without a father, our best friend, our playmate and friend”’. The family hope that this will be a reminder to physicians that they cannot sell their services to the highest bidder. They stated that the Bible states that “man cannot do justice. Man can only seek justice”. Justice is what they seek.

The People

David Walgren then addressed Judge Pastor with the People’s statement. Walgren stated that in April 2009 Conrad Murray ordered large quantities of drugs, including Propofol. For two months Conrad Murray administered Propofol every night to Michael Jackson before he killed him. On the 25^th June 2009 Michael Jackson was left alone and abandoned by the person to whom he entrusted his life: Dr Murray.

It is not just the actions that lead to Jackson dying that need to be considered, it is Murray’s actions afterwards. Murray cleaned up the scene, he lied to paramedics and ER doctors and he didn’t tell the truth in his police statement.

Conrad Murray looked out for himself and not Michael Jackson. Conrad Murray looked out for himself and not the family of Michael Jackson. This continued past Michael Jackson’s death at UCLA hospital. Conrad Murray then lied to Mrs Jackson about not knowing what had happened to her son.

Walgren stated the defence want a probation sentence. Walgren askes there be a denial of this. After the verdict was read Your Honour stated that this is a crime that involves homicide. This needs to be taken into account when sentencing.

Another factor that needs to be considered is the vulnerability of victim. Michael Jackson was vulnerable. This vulnerability was created by Conrad Murray. Michael Jackson expected Conrad Murray to be at his side monitoring him. Michael Jackson had put his life in hands of Conrad Murray. Michael Jackson was not just vulnerable at the moment he was under the influence of the drugs. The vulnerability was exacerbated over the two months that Murray treated him. Jackson was most vulnerable when Conrad Murray left him alone to die. Conrad Murray was conducting a pharmaceutical experiment on Michael Jackson.

Infliction of physical injury is another consideration. Propofol was in the home due to Conrad Murray. The lack of monitoring and lifesaving equipment was due to Conrad Murray. The abandonment of Michael Jackson was directly due to Conrad Murray.

The planning and sophistication of the act is another factor. Although Jackson’s death was not deliberate there is gross negligence in the planning. Conrad Murray had kept medical records before for Jackson but when it came to the two months of Propofol treatments Murray didn’t keep any records because he knew what he doing was wrong and could risk the life of Michael Jackson.

Walgren asked Judge Pastor to consider trust. During the trial we had heard about the special relationship between a doctor and a patient based on trust. This relationship was corrupted by Conrad Murray. This was destroyed by Conrad Murray. Michael Jackson trusted he would be cared for and monitored by Conrad Murray so he could wake to see another day and be with

his children for another day.

The People argue strongly against probation. Prison is warranted. The People ask Conrad Murray be sentenced to 4 years in state prison.

Walgren went on to say the defendant was playing Russian roulette with Michael Jackson’s life every single night. It is needed to look at all the evidence leading up to the crime. Murray ordered shipments of Propofol as soon as he got the job. Murray stated he only discovered that Jackson was addicted to Propofol after he started. These large shipments prove contrary.

Walgren then highlighted once more Conrad Murray's behaviour after he had discovered Jackson not breathing. He didn't react like any other doctor would,  he didn't call for help. There was a 20 minute delay and then Murray told lies thereafter. It was not until two days after Jackson had died that Dr Murray ever mentioned Propofol.

Walgren told the court that the threat of great bodily harm was clear from the evidence. Murray repeatedly administered Propofol without appropriate equipment. Instead of being focused on Michael Jackson, Conrad Murray was focused on social calls. Michael Jackson was abandoned by Conrad Murray. Whilst Jackson was under the influence of Propofol Murray thought it was appropriate to phone his girlfriend.

Restitution

The People then requested monetary amounts to cover the costs for the burial and funeral of Michael Jackson. Remuneration is also sought for the loss of earnings. This is an enormous sum because it was Michael Jackson and a huge comeback tour. Michael Jackson would have earned $100,000,000 from the ‘This Is It’ residency and this money would have benefitted his children.

The People are under no illusion that Conrad Murray can pay this but the family are entitled to this restitution. This is a conservative amount. The sum is based purely on a 10 month, 50 date show.  Jackson may have gone on to do more tours and other such things.

The documentary

Walgren then asks Judge Pastor to take into account how Conrad Murray acted after the crime.

The judge needs to consider lack of remorse and responsibility from Conrad Murray. Walgren asks Judge Pastor not to look at the words the defence use but instead look at Conrad Murray’s words from the documentary. 9 days before verdict was read Conrad Murray was asked if he bears any guilty or responsibility. Conrad Murray said ‘I don’t feel guilty because I did not do anything wrong’. Conrad Murray chose not to testify but he chose to make this statement.

Weeks into the trial and years into the case Conrad Murray believes he is not guilty. This deserves a prison sentence.

Mrs Jackson’s statement

Walgren then referred to a statement by Mrs Jackson, Michael’s mother. In her statement she says all the family feel angry and betrayed by Conrad Murray. All the family think about Michael daily. Every morning he is the first thing she thinks about.

Michael Jackson was his children’s world and their world collapsed when he left. When at the hospital after Michael was pronounced dead Paris, Michael’s daughter,  was crying and stated ”I want to go with you” (referring to her father).

Mrs Jackson is angry that on the first anniversary of Michael’s death Conrad Murray got a camera crew to accompany him to Michael’s grave to show himself in a favourable light to the public.

Conrad Murray failed Michael Jackson and her family. Mrs Jackson wants him to receive the maximum sentence.

The People then concluded their statement.

Realignment statute

Judge Pastor then stated that the People have asked for 4 years in state prison. The judge then asked if under the new law they can send Murray to prison. Walgren says Murray would not be held in a state prison but in a county prison or however the court decides.

Judge Pastor then told the People that the court has no discretion in this sentence.

Judge Pastor then asked the People for itemisation of the funeral costs. The People did not have this information at this time.

Defence’s statement

The defence were then able to present their statement. Judge Pastor reminded the defence that Conrad Murray had the right to speak. Chernoff stated he spoke to Conrad Murray for two hours the day before and Conrad Murray did not wish to speak.

The defence stated they would be brief. They had given a detailed report and lots of personal statements to the judge prior for him to read.

Chernoff started by saying he believes the loss of Michael Jackson deserves a punishment. No one is denying that Conrad Murray shouldn’t have done what he did.

Chernoff stated when discussing vulnerability we need to remember that Michael Jackson was a drug seeker. He sought drugs from Conrad Murray, who was wrong to give them to him. He also sought it out from other doctors. He was a powerful, famous, wealthy individual. He had many security personnel and advisors. But he may have still been vulnerable.

Chernoff stated that the defence assume the judge wants to give a jail sentence, going from what the judge said when discussing probation after the verdict. Chernoff highlighted that Conrad Murray now resides in 5 foot by 8 foot cell and is shackled everywhere he goes. Conrad Murray is not a danger to the community. In the 56 years before working with Jackson, Conrad Murray never committed a crime. Instead he raised a family. Chernoff states he understands the tragedy of Michael Jackson’s kids, but what about Conrad Murray’s kids?

But to what extent does the court look at a book of someone’s life rather than a chapter?  Chernoff then told the court Murray life story. He grew up in a poor family in Grenada. He never knew his father. His community did not have electricity until he was 10 years old. But against all the odds he came to America to study. He put himself through medical school

Conrad Murray’s life was as a doctor but that is all gone now. It is his fault but it is a punishment. No matter what he does he is now forever known as the man who killed Michael Jackson.

What about Conrad Murray’s life before the 2 months he worked with Jackson? During the trial you heard from five of Dr Murray’s patients. He helped poor people. He took medicine to the Caribbean. This should all matter and be taken into account when sentencing.

Putting Conrad Murray in prison is a measure of vengeance but when this has faded he is someone else’s problem. On probation he can do things for the community that he can’t do in prison. Probation is best for the community.

Chernoff then concluded his statement.

Restitution

Judge Pastor then asked the defence about the restitution. Chernoff told Judge Pastor that the figure is so high he doesn’t know what to say. Even if Conrad Murray finds work after he has served his sentence he will never be able to pay $100,000,000.

Chernoff also stated the defence need to see receipts to know about amounts.

Judge Pastor

Judge Pastor then addressed the court. He stated the most difficult thing about being a judge is giving a just sentence. It is more difficult when it comes down to the judge’s digression. This is a significant responsibility.

Neither party says Conrad Murray acted intentionally. So the court has to use sense of fairness, decency and experience to give an appropriate sentence. Some people think Conrad Murray is a saint. Some people think he is the devil. He is neither. He is a human being. He is convicted of the death of another human being. He was convicted of criminal negligence. The court needs to take this into account. 12 jurors unanimously voted Conrad Murray was guilty. Some people may feel this was medical malpractice. But in fact this was a homicide case.

Criminal negligence involves more than ordinary carelessness or a mistake in judgement. A person acts with criminal negligence when they perform in a reckless way which creates a high risk of death or injury. A reasonable person would know this would create a risk.

A person acts with criminal negligence when the way they act is so different to the way an ordinary, careful person would act in that situation that their actions leads to a result of indifference to human life or the consequences of the act.

It is important not be to caviller and state that if it wasn’t Conrad Murray doing this then someone else would. Judge Pastor disassociates himself from those types of statements. This is not a question about what might have happened or what if someone else was involved. This was an insult to the medical profession. Michael Jackson died because of the actions of, and failures to perform legal duties of, Conrad Murray.

Judge Pastor accepted Chernoff’s invitation to read the book he gave about Conrad Murray and Judge Pastor had read it. He was impressed by the submissions from family, friends and associates. He had also read the book of Michael Jackson’s life. Regrettably the most significant chapter for Conrad Murray is his treatment, or lack of, of Michael Jackson.

This wasn’t a one off occurrence. This was a totality of circumstances that are attributed to Conrad Murray. This was not a mistake or an accident but because of a series of decisions Conrad Murray made that jeopardised his patient and violated his obligations to his patient. Those violations overcome the treatment of other patients.

Conrad Murray created a set of circumstances and became involved in a cycle of horrible medicine. The practise of “money for medicine madness” violated Murray’s sworn obligation for money, fame and prestige. It is important to not look to one isolated incident in terms of misdeeds or deeds of Conrad Murray. In this case Murray engaged in a recurring pattern of deceit, lies and regrettably that pattern was to assist Conrad Murray.

It is almost inconceivable that Conrad Murray would have persisted in this pattern over an extensive period of time. His lies and deceit were heard over the six weeks of testimonies. He lied from the inception of ordering Propofol in staggering quantities. He lied to the pharmacy. He lied and deceived those associated with MJ: his members of staff and production team, AEG. He continued lying to Jackson’s security personnel and staff at a critical point in time. He told unconscionable lies to health care providers, life savers - paramedics and ER doctors. This was not designed to help the patient. This was designed to give Conrad Murray a way out. Murray also tried to subvert the process by trying to destroy evidence. He deceived and lied to law enforcement in his police interview.

If you look to involuntary manslaughter in a vacuum you can think it is something that went wrong and is tragic. It is important not to have a gut reaction to what happened and look at the totality of the case. This was a failure of character of Conrad Murray to serve his patient. When you look at this you can’t help but be offended by the circumstances in this case.

Audio recording

Of everything Judge Pastor heard and saw in trial one aspect stood out; the surreptitious recording of Michael Jackson by his trusted doctor. Judge Pastor has asked himself why did this happen and for what reason? You could try to surmise there might have been some justifiable reason, a benefit to Jackson. This would be an unreasonable conclusion. Judge Pastor stated that recording was Conrad Murray’s insurance policy. He deliberately recorded his patient at his most vulnerable point. We can’t imagine this happening to any of us because it is a violation of trust.

Judge Pastor wonders that if there were to be a conflict between Michael Jackson and Conrad Murray at a later point in time what value would be placed on that tape recording if the choice were to release the recording to a media outlet to use against Jackson?

Regrettably that failure of character was compounded by later actions by Conrad Murray, each of which was a betrayal of trust and a violation of the doctor / patient relationship. These actions undermine the role that health care personnel perform. We revere doctors and we should. Dr Murray may have been a good doctor but at some point things went wrong for Conrad Murray. When he had an opportunity to decline this treatment he didn’t get out. He got deeper and deeper in and betrayed his oath.

Judge Pastor looked at the totality of Conrad Murray’s life but was disturbed by the chapter he had been discussing. He is disturbed when Conrad Murray says he doesn’t feel guilty. Chernoff acknowledges there is fault in Murray’s actions, but you are not hearing this from Conrad Murray. You didn’t hear this when he talked to paramedics, or the police or in the documentary. In fact Conrad Murray says he was betrayed and entrapped by Michael Jackson. Judge Pastor stated “yikes! Talk about blaming the victim!”

Pastor continued by saying Conrad Murray showed no indication of any involvement in this case. He says he was a bystander and was put in this situation by everyone else’s actions.  These factors cause Judge Pastor tremendous concern. If there is recognition of responsibility and remorse you may consider probation. But why give probation to someone who is offended at why they are even before the court. There cannot be probation if there is no hope of rehabilitation.

Judge Pastor told the court that he had looked for efforts to see if Dr Murray was suitable for probation as he is eligible for probation. Judge Pastor couldn’t find any. The court declines probation in this case.

Judge Pastor acknowledged that Conrad Murray had provided services to the community and helped many people. But he also violated the trust of Michael Jackson on a nightly basis. Michael Jackson as a patient was vulnerable because Conrad Murray put him a situation where Conrad Murray was responsible for Michael’s life.

Conrad Murray obtained Propofol through insidious means. He lied to the pharmacist. He didn’t keep medical records. He allowed his personal life to interfere with his professional responsibilities. He lied to AEG, Kenny Ortega and the insurance carrier. He engaged in a personal matter when he should be paying attention to his patient.

An objective view is that Dr Murray abandoned his patient. This was not a one off occurrence. This was an egregious violation of standard of care. He is a disgrace to the profession. We are not talking about a mistake. His actions were a gross continuing deviation. For those factors the court determines Conrad Murray is not going to have probation

Sentencing

Judge Pastor continued by saying the court has many options of what the sentence could be. This court does not have the authority to send him to state prison. Judge Pastor will follow the law in that regard. The Realignment Act states certain sentences, although felonies do not need to be completed in a state prison.

Judge Pastor stated he can give Conrad Murray a sentence of 2, 3, or 4 years for the charge of involuntary manslaughter. The court has determined a sentence of 4 years imprisonment. Conrad Murray showed negligence to his patient, he repeatedly lied, he tried to cover up his actions, he violated the trust of his patient and the medical community and he has no sense of remorse. He is and remains dangerous.

Judge Pastor cannot decide what happens to Dr Murray’s medical licence but he would like it to be known that he believes Conrad Murray is a danger to the community.

Judge Pastor then told the court there is a fundamental aspect of this punishment. It should be made clear that experimental medicine will not be tolerated. Michael Jackson was an experiment. Although he agreed to it, it makes no difference. Conrad Murray should have walked away as others did. Conrad Murray was intrigued by it and went for “money for medicine madness” which is not tolerated by Judge Pastor.

Technicalities

Judge Pastor then went on to discuss some technicalities. Due to Realignment act Conrad Murray will serve his 4 year sentence in an LA county jail. Murray is to pay an $800 restitution fine, a $30 court security fee and $40 for criminal conviction assessment. Conrad Murray has to give blood, saliva, finger and palm prints for DNA data bank. If he refuses this it is a criminal act and he will be taken to court.

                    

Restitution

Judge Pastor then addressed the People and the defence over the restitution. Pastor stated he is concerned about the restitution in this case. Not often do you get such a large amount, especially as it is based on a three line statement in an email.

Conrad Murray will have to pay Michael Jackson’s children and family plus his funeral costs. As there is not enough information at the current time a later restitution hearing will be arranged. Judge Pastor needs a lot more details before he can comment on the amount of restitution to be paid.

This matter needs to be addressed within 120 days. Judge Pastor asked if the People or the defence have a date they would like to set. The People ask for mid January. The defence then stated they would like the matter resolved as quickly as possible. Judge Pastor stated if that was the case they could just agree on paying the $100.1 million now. The defence stated they would like the hearing in two weeks time. Judge Pastor stated this is not realistic. Judge Pastor set a restitution hearing date for 23^rd January 2012.

Conrad Murray has declined to attend this.

Appeal

Judge Pastor then noted that Dr Murray has already served 23 days in custody and also has 23 days of good behaviour. This means that Conrad Murray has 46 days worth of credits to be taken off of his 4 year sentence.

Judge Pastor then informed Murray that he has the right to appeal. If he wishes to do so he must start the process within 60 days of this date.

Conrad Murray was then taken back into police custody. As he left the courtroom he blow kisses to his family.

Summery

After being convicted of involuntary manslaughter the final chapter in this case was the sentencing. I feel from what Judge Pastor had said in his comments when denying Conrad Murray probation after the verdict was published that it was obvious Judge Pastor was going to go for the maximum 4 year sentence.

Although many people feel that this is not a long enough sentence it must be remembered that for Murray his life will be very different once he leaves prison. Although Judge Pastor has no say over whether Murray gets to keep his licence he wanted it to be known that he believes Murray to be a danger to society.

Even Murray own lawyer, Ed Chernoff, stated today that once Murray completes his sentence he may go to find work maybe as a barista in a coffee shop. It seems even Murray’s own legal team do not have much hope for his future.

But most significantly, and most damaging, is that forever Conrad Murray will always be known as the man who killed Michael Jackson.

Realignment Statute

There was a lot of talk about the Realignment Statute in the sentencing hearing. This was because this act directly impacts on Conrad Murray’s sentence.

The Realignment Act was introduced into law in the state of California on October 1^st, during the trial. This act states that any non-serious felony sentences are served in a county jail rather than a state prison to reduce overcrowding. The irony is county jails are also overcrowded. This means that Murray sentence has instantly been reduced to 2 years by the LA county sheriff.

There had also been speculation that Murray would spend most of his sentence on house arrest (on electronic tag) as a further measure to reduce overcrowding. The LA county sheriff has stated that currently Conrad Murray is not eligible for this.

Too light a sentence?

There has been a lot of discussion over whether four year is a long enough sentence for the crime that Conrad Murray committed. In fact even Judge Pastor seemed to imply that this was too lenient a sentence for what Murray had done.

I think this is a very difficult and ambiguous topic as this crime is unlike any other, and therefore does not really sit in any current category of charge specifically.

When breaking down an involuntary manslaughter charge there is no need to prove that the defendant was directly responsibly for the death of the victim, only that their actions, or lack thereof, would lead to a foreseeable or probably cause of serious injury or death. The very act of administering Propofol in a home environment without proper equipment to me is enough to be found guilty of involuntary manslaughter. By all intents and purposes it does seem that mostly accidental incidents are ones that fit this charge.

So to me if Murray had instantly called 911 and got help and even if Jackson still had not lived (although during the trial numerous medical experts claimed that if Murray had acted instantly Jackson would be alive today) just the act of anesthetising someone in their home would be reason enough to charge Murray with involuntary manslaughter.

What concerns me are the actions that Murray took after he found Jackson not breathing. By delaying getting medical assistance, trying to cover up evidence, to lie to lifesavers, to not tell the truth in his police interview (we know this to be the case as Murray’s account in the documentary he took part in opposes the story that he told police), these actions take the charge to a degree higher than involuntary manslaughter.

Judge Pastor also pointed out in the hearing that Murray had been trying to cover his tracks even before Michael had died. Murray had lied to the pharmacist and deliberately not kept any medical records about these treatments as he knew he was in the wrong.

But the actual actions that caused Jackson to die were not premeditated and I do believe that it was an accident (even though it was reckless and dangerous) so therefore a murder charge is not appropriate.

I believe it really is a unique case and because of this there is no real charge that gives a just sentence for Michael Jackson, or for Conrad Murray.

Accountability

In my first blog I wrote that it was my belief that people’s opinion of the trial would be influenced by whether they believed that a doctors must abide by the Hippocratic oath and medical ethics no matter what, or if whether a patient knows the risks and still asks for a treatment then they take on the accountability if anything were to go wrong. It was interesting to me that this turned out to be the crux of both legal teams’ arguments. I am happy to see that the jury and Judge Pastor both came down on the side of ethics and morality.

What I find interesting is that all of this happened due to Conrad Murray. Obviously he was in the wrong, and accountable, for ever administering Propofol in a home without monitoring or life saving equipment. But there was not enough evidence to prove Murray was in the wrong. It was Murray himself who then lay the fault in his own hands. Two days after Michael had died Conrad Murray asked to speak to police to give his account of that night. The prosecution had previously said that without this interview Conrad Murray would not have been on trial.

And Murray yet again had himself to blame when it came to his sentence. Judge Pastor directly stated that what Murray had said in the documentary he took part in surrounding the trial was a significant factor in him receiving the maximum sentence. In the documentary Murray stated ‘‘I don’t feel guilty because I did not do anything wrong’. Judge Pastor believes that if someone has no remorse and no acceptance of wrongdoing then there is no hope for rehabilitation. Therefore Murray must serve the maximum sentence.

At every stage, from when Murray first started working for Michael Jackson until to sentencing, Murray had continually tried to look out only for himself and in doing so did nothing but make himself more accountable. The saying ‘if you give them enough rope they will hang themselves’ springs to mind.

Medical ethics

Something that has always sat uncomfortably with me was the profit over people approach to medicine in the US. It is incomprehensible to me that in the developed world people with money can hire doctors as essentially legalised drug dealers, whilst on the other hand people die because they cannot afford basic medical care. This is such a backwards system and to me is totally against everything medicine stands for.

We must remember that the reason this came to court was because the victim was Michael Jackson, but we must not forget that it is a milestone in law that a doctor be held accountable for these sorts of actions. Michael Jackson was not the first, and certainly won’t be the last, celebrity to have been prescribed unnecessary drugs by a doctor. And lest we forget that the celebrity world will be a microcosm of the real world. How many other wealthy people are being exploited and enabled by doctors for a fee?

I was very glad that Judge Pastor directly addressed what he called the “money for medicine madness” and firmly stated that in his court this sort of conduct would never be tolerated.

Hopefully some good will come out of such a high profile case as this and will make corrupt doctors realise that they can be held accountable if they decide to take part in this unsightly practice.

All in all this is a very tragic tale of a desperately sad man that was exploited by all, but most unexpectedly by a trusted doctor.


Sophie Dewing

http://exploredreamdiscoverblog.blogspot.com/

The People vs. Conrad Murray - Verdict

The verdict

After 6 weeks, 49 witnesses, over 300 exhibits and 9 hours of deliberation the jury finally reached their verdict.

Juror number 3 passed the envelope with the verdict to the judge who read it, acknowledged an amendment and then passed it to be read and published by the court clerk.

The jury unanimously voted a verdict of GUILTY.

Conrad Murray’s face remained emotionless, much like we have seen throughout the trial. The only person to express emotion was Ed Chernoff, who hung his head and looked defeated.

As the verdict was read out someone in the court room shouted ‘yes!’ and cheers from the crowd outside the court could be heard.

Judge Pastor then thanked the jury for their service and read them their rights now that they are no longer under court rule. He also asked to meet them in the juror’s room to personally thank them for their “sacrifice”.

He then told them they must wait 90 days before they can agree to give any details about the trial in exchange for money.

Further proceedings

Judge Pastor then told the defence that sentencing must commence on, or before, the 8^th December 2011. Ed Chernoff then requested a date – 29^th November 2011. The prosecution agreed with this date.

Conrad Murray will now be sentenced at 8.30AM on Tuesday 29^th November 2011.

The prosecution then asked Judge Pastor to keep Conrad Murray in remand with no bail until his sentencing.  Walgren stated that Murray has had 2 years to prepare for this trial and is now a convicted felon.

The defence then stated that remand doesn’t apply as Murray has been on remand for the past 18 months with no problems whatsoever.

Judge Pastor then told the court that Conrad Murray was presumed innocent but has been found guilty on a unanimous vote and is now a convicted felon.

He stated the things he needed when considering remand were:

1)      Protection of the public.

Judge Pastor stated that this was not an error of judgement. This was a homicide. The result of his actions was the death of a human being. This should lead to him being held in remand without bail

2)      The seriousness of the charge

3)      Previous criminal record

 Conrad Murray has no previous charges or convictions

4)      Probability of not coming to court

Judge Pastor stated that although Murray had always attended every court hearing now he is a convicted felon. Judge Pastor therefore cannot trust that Conrad Murray would turn up to his sentencing, especially as he has many connections outside the state of California.

5)      Public safety

Judge Pastor stated that due to the nature of the charge and the subsequent guilty verdict he believes that Conrad Murray is a threat to the public.

Taking all of these into consideration Judge Pastor deemed it appropriate to place Conrad Murray into remand without bail until his sentencing on the 29^th November.

As the details were read out Murray was handcuffed. It did seem to catch him unawares and was a very striking moment to watch.

Summary

For many today feels like the end of over two years of waiting. For Conrad Murray this is just the beginning. He is yet to be sentenced and to find out whether his medical licence will be revoked. The start of Conrad Murray’s life as a convicted felon is just about to commence.

The remunerations of this will be vast and far reaching. For the rest of his life Conrad Murray will be known as the man who killed Michael Jackson.

This is a huge burden to bear but if anything hopefully it will make doctors aware of their actions and to remember that it is always a doctor’s prerogative to refuse treatment of a patient if it is not in their best interest. I really hope that as this case has put a spotlight on the US health care system and the culture of profit over people will be assessed and changes made. Michael Jackson is not the first, and won’t be the last, person to die from a drugs overdose at doctor’s hands.

This verdict is the final chapter and verse in Michael Jackson’s life. It is sad to think that instead of bowing out on a high the final curtain is draw on yet another court case. It is also tragic to think that the verdict shows that Michael Jackson would be alive today had Dr Murray monitored Jackson correctly.

The biggest tragedy of course is that three children will mark every milestone in their life minus their father.

My personal views

For me personally the trial has been fascinating but trying. I have experienced a whole range of emotions and have swung back and forth with indecision about the verdict.

I had always never really known before the trial what to believe and tried to enter with no bias. Throughout the past 6 weeks I have come to believe that Conrad Murray did not intend to kill Michael Jackson. I believe Conrad Murray was swayed by prestige and money and that this compromised his judgement and medical ethics.

The thing I have battled with most throughout the trial was my ability to dehumanise Michael Jackson. From hearing so much evidence it was easy for me to think of Michael Jackson as a commodity rather than a human being. I feel that the closing arguments finally brought the case back to the fact that this was a human’s life that was being discussed.

I must say that throughout the case David Walgren and Deborah Brazil have been outstanding.  I, as have many other people, always found Murray’s defence team to be ill-prepared and unimpressive. I do think this had a negative effect for Murray but ultimately no matter what Murray’s actions were always going to lead to a guilty verdict.

Although this might be Michael Jackson’s final act in his life, it is certain that he will never be forgotten. His legacy of music, dance, performance and philanthropy will live on throughout generations to come. The magic of Michael Jackson will continue to excite, inspire and entertain long after we are all gone.

For me I am so happy to have been able to have experienced the excitement of Jackson’s mania. When I was a child in the 80’s everyone wanted to be Michael Jackson. My outstanding Jackson memory is that every year in my primary school disco the DJ would play Billie Jean and after the first ‘boom ka’ a boy named Freedom would be surrounded by the whole school as he mesmerised everyone with his Jackson moves. This may be an insignificant fable but just thinking about those moments evokes a childlike sense of wonderment and the belief that anything is possible.

And that is why I admire Michael Jackson. For giving people the belief to aspire and believe in the impossible. Not only was he a musical and dancing genius but he brought people together. The world was united in their love for Michael Jackson. He broke records but more importantly broke down racial barriers. He overcame adversity many times but always remained graceful. And for me one of the most important legacies Jackson leaves is that of looking outside yourself and caring about the issues that affect the planet and our global neighbours.

Of course his life was not a bed of roses and not without many controversies. But if he can inspire and unite millions and give people the ability to dream big and strive for things no one knew were possible then that is a positive mind set to instil in our children.

And that is what I hope to remember of Michael Jackson. Although the latter years of Michael’s life were filled with contention it is clear from this case that he was a man who was suffering. He lived an isolated and lonely existence, with no one really looking out for him. Yet he still preached love and awareness and I believe that is the proof of a beautiful soul.

For me my lingering memory will not be of a media sensationalist or a superstar with a tarnish reputation. For me it will always be that moment when Billie Jean comes on and the little girl in me believes in the unbelievable once more.

Thank you

After 7 weeks and over 40,000 words it is now time for me to complete my final blog on this case.

I would like to thank anybody that has taken the time to read my blog throughout this trial. I have had some truly wonderful feedback and it has made all the hard work worthwhile.  

And I would like to say a special thanks to Anthony King, for giving my blog and voice a forum to express my opinions on his website.

Sophie Dewing

http://exploredreamdiscoverblog.blogspot.com/

People vs Conrad Murray - Day 21

The Conrad Murray trial has now entered day 21 and week 6 of proceedings.  Dr Paul White, the defence’s star witness, is due for cross-examination today.

Dr Paul White

Dr White is the final witness for the trial (unless Conrad Murray does decide to testify) and his testimony is key. Last week he told the court how he believed that Michael Jackson gave himself the fatal dose of drugs. Dr White dismissed Dr Shafer’s scenarios and showed the court his own scenarios around injecting Propofol and swallowing Lorazepam pills on his own accord.

Standard of care

The prosecution started their cross-examination by discussing standards of care. These are guidelines of how a patient should be medically treated. Dr White did agree that Dr Murray deviated away from standards of care in the 2 months he was hired by Michael Jackson before his death.  When discussing Murray’s care of Jackson Dr White based parts of his testimony on conversations he had with Dr Murray. This is not allowed at all in court. Judge Pastor had words with Dr White about this.

Dr White then spoke about the set up that Murray was using.  Dr White told the court that he had never heard of Propofol being administered in a bedroom before. He stated that if an infusion was to take place and not properly controlled you would need equipment present to monitor and to save the patient’s life if anything were to go wrong. Propofol can cause respiratory depression so Dr White stated he would have at least a bag and a mask present (to help with breathing). He also stated suction apparatus was desirable and that a pulse oximeter was essential. Dr White then told the court that during an infusion the patient needs to be monitored every 5 minutes. If this was minimal sedation in a hospital setting then it would be every 15 minutes.

Dr White told the court that airway obstruction and cardiovascular depression are the two most common risks with using Propofol, although it is very rare for these to occur. Dr White stated that it is very rare for a patient to experience apnoea but if Propofol is combined with an opioid or analgesic the risk is heightened. (Such as in this case.)

The prosecution then asked if Dr White disagreed with Dr Shafer’s testimony that Dr Murray’s treatment was an egregious and unconscionable deviation of standard of care. Dr White was very reluctant to answer this question. Eventually he did agree that is was a deviation of standard of care but it was a minor deviation.

Paid Witness

As previously mentioned during the trial Dr White had confirmed he was a paid witness. This was something the prosecution were keen to pick up on. Dr White told them so far he had been paid around $11,000 by the defence. He usually charges $3,500 a day to appear in court. He has been in the court so far for 12 days but does not believe the defence will have enough money to pay for all of his time.

This highlights two points. One, how objective can a witness be if they are paid by the defence and have regular conversations with the defendant which they then try to submit into court? And secondly, he has pointed out that the defence has very little money. I have previously written about the fact that Conrad Murray is virtually bankrupt so does not have the money to hire a first class team (such as the brilliant lawyers that the Michael Jackson Estate have been able to afford to hire). I think throughout this trial it is apparent that this lack of funds has meant a poor defence team, and in particular Ed Chernoff. I feel Chernoff has been very damaging for Murray’s case and it shows that money has a far bigger influence on the outcome of a trial than almost anything else.

But in saying that it is also a fact that the evidence against Murray has been very condemning. But if Murray had the money to hire excellent lawyers he may have more of a fighting chance. (Take for example the O.J Simpson trial. The world believed in Simpson’s guilty yet he had an incredible lawyer who managed to get a not guilty verdict. A good lawyer can make the case go anyway they want – but you need money to enable this.)

Appropriate medical care

The prosecution then questioned Dr White about the way he would respond if a patient were to stop breathing. Dr White stated that he has been in this situation before and he assisted the patient using a bag and mask and performed a tracheal intubation.

Dr White then told the court that as a doctor he has a solemn obligation to do no harm to a patient and you need to do your best to meet their health care needs. The prosecution asked if Dr White believed Conrad Murray had adhered to this in his treatment of Michael Jackson. Dr White stated that Murray was “providing a service to Michael Jackson that he had requested and insisted on”.  Dr White then told the court that medical care is more appropriate than being of service to a patient. A doctor always has the option to walk away if they are not happy or comfortable with what is being asked of them.

Dr White then stated that he would never administer inappropriate medical care to any patient. If they insisted he would walk away.  He later went on to say that is Michael Jackson had approached him with the same request he would have never accepted the job. No amount of money could persuade him to take it.

Monitoring

The questioning then moved onto monitoring patients. The prosecution asked why it is important to monitor patients. Dr White told them that it is very easy for a patient to move from one level of sedation to another. Dr White then stated that a standard of care would include monitoring the patient but this was an unusual case “as Dr Murray was trying to achieve a sleep state”.

Dr White was then asked if he would leave a patient unmonitored. He told the court that if he had administered a small dose for minimal sedation that last 15 – 30 minutes he would have no problem leaving the patient. The prosecution then highlighted that this would be in a hospital environment. Dr White stated that is the only place he had ever administered Propofol. Dr White also stated that if a patient also had benzodiazepines in their system he would monitor them for 30 minutes.

Dr White stated that having a pulse oximeter on the patient is using monitoring equipment. The prosecution then pushed the point that a pulse oximeter without an alarm is pointless. Dr White was very reluctant to answer this but eventually did agree this was correct.

Vitally Dr White stated he would not leave a patient unmonitored if he knew that the patient liked to push the syringe themselves. This is something that Jackson had requested from Murray and had performed with at least one other doctor before.

Responding to the situation

The questioning then moved onto Murray reaction to Jackson not breathing. Dr White stated he could not defend the fact that Murray did not call 911 right away. He then told the court that he believed that Murray probably did this because it was a “very stressful” situation. He also stated that it occurred in an “isolated part of the house” and that there were no working phones in the house. Walgren then pointed out that Dr Murray had a mobile phone in his hand on which he called Michael Amir Williams before phoning 911. Dr White agreed this was true and it would have been quicker to phone 911 instead.

Dr White then told the court that he does not believe that if Dr Murray had phoned 911 any sooner that it would have made any difference. Once the overdose had occurred there was no way to bring Jackson back to life. It is important to remember that when Murray first found Jackson there was a thready pulse. Therefore in my personal opinion if 911 had been called immediately there may have been an opportunity to try and save Jackson’s life. It is also important to remember that every other medical expert that has been asked about this stated that Jackson would be alive today if Murray had called 911 immediately.

 The prosecution then asked Dr White about Murray decision to withhold information from medical personnel about the drugs he had administered to Jackson. Dr White stated he believed Murray “overlooked” giving details about the Propofol he had administered but this was not done in a devious way.

Demonstration

A brief discussion about last week’s demonstration then took place. There was an issue about the apparatus used and if it had been modified. Dr White agreed that this was the case.

Walgren also asked if the IV equipment was small enough to have been removed from the scene without being obvious. Dr White stated that it did appear to be.

Dr White’s Report

Dr White was asked by the defence to write a report (he wrote a letter) that stated he theory on what happened. Initially Dr White stated that he believed Michael Jackson drank Propofol. Dr White stated he has now rejected this theory. He told the court that this report was prepared at short notice.

Dr White stated how he believed that Jackson had self-administered Propofol, whether it be oral or intravenously. Dr White had tried to research oral Propofol ingestion but found no such reports. He wanted to research the area as he “was just trying to cover all the possibilities”. In his original report Dr White did not mention Jackson taking Lorazepam pills.

Dr White states he never had any other theory than Michael Jackson killing himself. He took everything that Conrad Murray had told him to be the truth.

Dr Ornelis

Dr White then mentioned a model that he used to come up with his theory. As he does not have the maths or computer skills to create such a model he hired an expert, Dr Ornelis. Dr White met Dr Ornelis for the first time last week. Dr Shafer had provided a report in court for calculations using his own software. Dr White then used this report to test whether Dr Shafer’s account was possible.

Dr White asked Dr Ornelis to calculate how much Propofol appears in urine after a three hour infusion.

Walgren asked Dr White who thought of the theory that Michael consumed Lorazepam tablets at 10AM. Dr White states that no specific theory was put forward. He stated that Dr Ornelis had been following the trial and chose the timeframe herself.

Animal testing

Dr White then was asked about an animal study he had conducted. He stated after seeing Dr Shafer’s report in April he contacted a vet to conduct research on Propofol ingestion.  The test was conducted on beagles. No report was written up from this test. There was only an oral report from Michael Flanagan stating that the study produced negative results.

Dr White stated he was unaware of any tests that had been conducted on humans in regard to oral doses of Propofol. He did mention that Dr Ian Glenn, who is referred to as the “father of Propofol” had told him that oral consumption did not have an effect.

Self-administration

As mentioned Dr White believes that Michael Jackson self-administered the doses of drugs which killed him. Dr White told the court he could not be sure of the timeframe when the Lorazepam pills were taken. He stated that when Dr Murray was not paying attention Jackson took Lorazepam tablets. He was not sure of where Murray was at the time this occurred but he believed Murray was “somewhere in the vicinity”.  Dr White based his simulation on this. He believes it occurred around 7AM.

Dr White was then asked about the two minute toilet break that Murray had just before he found Michael not breathing. Dr White believes that Dr Murray had drawn up a syringe of Propofol and left this in the room somewhere. After observing Jackson for 25 minutes Murray felt it was safe to leave the room to make phone calls. Sometime during the 46 minutes that Murray was out of the room Jackson self-administered the fatal dose of Propofol.

Dr White believes that Jackson used a port on the IV tube to take the dose, although he states that Murray did not leave the syringe in the port. Dr White stated that Jackson had the ability to walk around the room and find the syringe. When the prosecution cast doubt on this claim, as Jackson was hooked up to an IV stand and was using a condom catheter, Dr White stated this is not the only theory but it is a possible theory. Dr White also stated he believed Jackson didn’t “realised the potential danger” of administering Propofol to himself.

The prosecution also brought up the point that it has been constantly referenced that the 25 mg dose of Propofol Murray administered would give light sedation. MJ had told Ms Lee that he wanted to be knocked out completely. Would Jackson have hired a doctor just to be slightly sedated? Dr White agreed that he would have wanted a deeper, restful sleep.

MAC Care

MAC care stands for Monitored Anaesthetic Care. Dr White had written an article about the use of Propofol in ambulatory care settings. The prosecution were keen to speak about this article as it is easy to trap an expert witness by their own works.

The prosecutions showed multiple quotes from Dr White’s article. The article discusses how standards for MAC are the same as for general anaesthetics and that the same level of care must be applied to patients no matter what venue they are in. It is stated that “during procedures patients are monitored to ensure safety and comfort”. It is important to note that MAC care does not involve off-label use of drugs.

In this section Dr White was very uncomfortable as his article shows that Dr Murray was not acting inappropriately. Dr White seemed very unhappy to have to answer questions that showed this.

A key part of the article for this trial was that it states “vigilant monitoring is required'. Dr White eventually had to agree with his own work and state this was true. Dr White stated monitoring is important because patients can rapidly progress through different levels of sedation.

Dr White went on to say that he has never practised in an office based setting so is not familiar with the requirements, although he did write about them in his article. All major US anaesthesia bodies give out information on the requirements of office based anaesthetic administrations. Mr White then had to read the guidelines out in court. It was clear Dr Murray did not follow these guidelines.

The prosecution then asked if similar guidelines would need to be followed in a bedroom setting. Dr White was very reluctant to answer. Dr White stated that “many of the requirements would be appropriate” but complex re-wording would be needed. But at the very least when administering Propofol in a home setting the minimum safety requirements must be followed.

The article also stated that every patient should receive care as if they were going to be receiving deep sedation, even if they are getting minimal sedation.

Dr White told the court that he could not say that a second person would need to be present when performing this treatment in a home. If the physician is qualified and paying attention Dr White would say only that physician needs to be present.

Simulation

Dr White then spoke about the simulation he has based his testimony on, created by Dr Ornelis. Dr Ornelis created a graph based on two scenarios, the scenario the defence are pushing and the scenario the prosecution are pushing. The test was to see how much unchanged Propofol is in urine sample after being filtered by the kidneys. Dr White asked Dr Ornelis to give an estimation of the result from two 25 mg doses of Propofol versus a 1000 mg infusion of Propofol.

The two urine samples from Jackson were compared. One was taken from the scene so would have been expelled prior to the Propofol overdose. The second sample was taken from the autopsy urine. Dr White stated that the Propofol levels in the scene urine were very low.

Dr White states that from the results of this modelling it looks more consistent with two 25 mg doses of Propofol rather than an infusion. This was also consistent with Murray’s police interview and the fact that there was no Propofol residue in the top part of the IV tubing.

Dr White was also asked about the heartbeat Dr Murray claims he saw. Dr White states this could mean that Jackson had a pulse or that Dr Murray was feeling his own pulse. Dr White told that court that in stressful situations doctors can be deceived into feeling their own pulse.

Dr White stated he was happy to testify using Dr Ornelis model as he trusts her integrity.

Re-direct by Flanagan

The prosecution then finished their cross-examination and a re-direct by Flanagan took place.

Flanagan started by asking Dr White how one should react when confronted with a patient not breathing. Dr White stated that you should start CPR straight away, in case the arrest had only just suddenly happened. He suggests CPR with an Ambubag be performed. Then 911 should be dial.

Flanagan then put forward the argument that nothing Dr Murray would have done could have saved MJ’s life. He also tried to establish that the Propofol’s effect would have elapsed so even if Murray had told the paramedics or hospital doctors about the Propofol it would have been irrelevant. Dr White agreed with this.

It was then stated that there is no specific antidote to Propofol and the only real treatment is to allow the drug to be redistributed and eliminated by the body.

Summary

Today was always going to be an explosive day as the prosecution were going to be able to grill the defence’s star witness. This certainly was the most confrontational day of the trial. Walgren machine gunned Dr White and left so many holes in his testimony it was unreal. Walgren showed how exceptionally skilled he is in cross-examination. Maybe Chernoff could learn a thing or two!

Walgren would often change topic suddenly to try to throw Dr White. And I thought it was very clever to use Dr White’s own words and works against him. It did very much seem that Dr White went in with an agenda and planned what he was going to say. But once Walgren used Dr White’s previous articles he had no choice but to backtrack on many of the statements he made in his testimony. It came across that Dr White was trying very hard to not incriminate Dr Murray but it was not possible to avoid answering Walgren’s questions. It was a wise choice for the prosecution to question in this manner as Dr White either has to show Conrad Murray made inappropriate choices or show that as a witness he is evasive.

I still find it odd that Dr White was a paid witness and that he was staying with Michael Flanagan during the trial. To me it seems he is too in the defence’s pocket to be objective. He was also scolded by Judge Pastor for constantly trying to use conversations he had had with Conrad Murray as evidence and as part of his testimony. This certainly is in no way acceptable. I read a quote from a lawyer who is covering the case and I think it surmises the relationship between Dr White and the defence team: “experts destroy their credibility when they stop being independent but start acting as advocates for the people who pay them.”

Yesterday it seemed the Dr White’s testimony shook the case up a bit. Today as Dr White had to change many of his statements and admit that Conrad Murray had multiple deviations of standard of care it seems that Dr White’s testimony was not strong enough to totally turn the case around.

Today Conrad Murray told the judge that he has not made a final decision as to whether he will testify or not. Judge Pastor told Murray he would ask him one final time for his decision tomorrow.

                                                                                                                                          

The trial continues on Tuesday.

Sophie Dewing

http://exploredreamdiscoverblog.blogspot.com/