February 08, 2011
Less than a week after Michael Jackson died,
after allegedly suffering cardiac arrest, CNNs
Drew Griffin interviewed Nurse Practitioner Cherilyn Lee. The
world was still reeling and Michaels family and investigators
in LA were still sleeping when, at 7:15 a.m., the public first
heard the word Propofol. Nurse Lee identified Propofol and speculated
it may have caused Michaels death. Michael met Nurse Lee
and had her recommend vitamins and nutritional supplements.
She was familiar with his insomnia and had once assessed his
bedroom for levels of stimuli and sleep patterns. But in
April 2009, Michael asked her to help him find an anesthesiologist
to monitor him. He then told her about Propofol,
which he claimed was the only thing that ever worked to provide
instantaneous sleep. He described the drug as being administered
intravenously and said that he would fall asleep as soon as
he received the first drop. When she asked him who administered
the drug, he said that a doctor gave it to him a long
time ago. After consulting with her Physicians Desk
Reference a comprehensive volume that provides a detailed
description of drugs, their side effects, and contraindications
she warned Michael that the drug was dangerous and that
she feared if he took it he would not wake up. Michaels
response, after she voiced her concerns, demonstrates why Dr.
Conrad Murrays conduct in monitoring his patient was reckless
and, at the least, constitutes manslaughter.
Michael told Lee, I need to have somebody here to just
monitor me. If somebody stay (sic) here and monitor me with
this IV then I would be okay. I would be okay because theyre
gonna be here twenty-four hours or twelve hours to monitor me
so I could sleep eight hours. Drew Griffin aptly predicted,
Half the people watching this are not going to believe
you. They are going to think this woman is just seeking fame.
When asked why she was speaking out now, she responded, Im
coming forward because the more I watch the news and the more
they kept saying drugs and Im thinking, This is
not drugs. It wasnt the drugs theyre saying;
the Demerol, it wasnt that. He kept saying he wanted to
have somebody there that could watch him and medically supervise
him. Thats what [Michael] said.
Nurse Lees reiteration of Michaels words show (1)
he had not taken Propofol in many years and (2) he understood
that when given the drug, he needed to be monitored. With that
as a background, Murrays defense that Michael was a drug
addict who, in the absence of his physician, self-administered
the fatal dose, is quite thin.
On June 27, 2009, robbery-homicide police officers Orlando Martinez
and Scott Smith interviewed Dr. Conrad Murray in the presence
of his attorneys, Michael Peña and Ed Chernoff. Since
Dr. Murray failed to keep any records of his treatment of Mr.
Jackson, unless he testifies at trial, his statement to these
police officers may be the only evidence giving insight into
that treatment.
According to the recorded conversation, Murray first met Mr.
Jackson in 2006 through a patients son. He was referred
not as a cardiologist, but merely because Jackson needed a physician.
Murray subsequently treated Jacksons children for flu
while they lived in Las Vegas. Dr. Murray told Martinez that
he received a phone call from Michaels personal assistant,
Michael Amir Williams, requesting that he treat Mr. Jackson
for the upcoming concerts in London. Mr. Jackson then personally
called Murray and asked that he join the tour. Murray was elated.
Dr. Murray said that for a little over two months before June
2009, he had been treating Mr. Jackson, assisting him to sleep
by administering Propofol every night. Murray would first give
an injection to get Mr. Jackson to sleep and, with an IV drip
of 50 milligrams of Propofol, keep him under. According to Murray,
fifty milligrams per night was the maximum dosage Murray administered.
At various points throughout the interview, Dr. Murray told
Martinez that Mr. Jackson had developed a dependency on Propofol.
As a result, Murray decided to try to wean him off, and introduce
other agents. Beginning three days before Mr. Jackson died,
Murray administered Lorazepam and Midazolam instead of Propofol.
A common side effect of Midazolam is a change in respiration.
On autopsy, doctors discovered that Michael Jackson had an undiagnosed
reduced lung capacity. Before changing Michaels medical
regimen, Dr. Murray should have, at the very least, conducted
a physical to determine if the medications he was first prescribing
were appropriate for his patient.
On June 25th, Murray arrived at the Carolwood residence around
12:50 a.m. and went to Mr. Jacksons bedroom. Mr. Jackson
arrived around 1:00 a.m. They had a brief discussion as to how
rehearsals went that night. Mr. Jackson then took a shower.
Dr. Murray then began using an IV for hydration. He administered
Valium orally. Using a syringe through the IV port, at 2:00
am he administered two milligrams of Lorazepam, diluted with
saline, over the course of two to three minutes.
Mr. Jackson remained awake for another hour, so at 3:00 a.m.,
Dr. Murray introduced two mgs. of Diazepam in the same manner
he administered the Midazolam.
Around 3:20 a.m., Mr. Jackson fell asleep for according
to Murrays watch 10 to 12 minutes. Dr. Murray turned
down the lights, turned on the music, and suggested that Mr.
Jackson meditate. Mr. Jackson said he would have to cancel his
rehearsal because he could not sleep. Dr. Murray then administered
Midazolam; it did not work.
At 5:00 a.m. Murray administered two milligrams of Lorazepam.
Still unable to sleep, Mr. Jackson again complained that he
would have to cancel rehearsal. Mr. Jackson confided that he
was under a great deal of pressure about cancellations. Dr.
Murray administered two milligrams of diazepam at 7:30 a.m.,
but Mr. Jackson remained awake.
Still awake at 10:00 a.m., Mr. Jackson began asking for milk,
allegedly his name for Propofol. Doctors have nicknamed the
drug, Milk of Amnesia. According to Dr. Murray,
he relented and administered Propofol at 10:40 or 10:50 a.m.
Murray gave half the normal dose, saying he administered only
25 milligrams over 25 minutes. It was simply an injection to
put Mr. Jackson to sleep, and then a slow drip to keep him asleep.
According to Murray, he was looking at his watch and Mr. Jackson
fell asleep around 11:00 am. Murray said that he monitored Mr.
Jackson for a while, until he felt comfortable with Mr. Jacksons
condition; he then left the patient.
According to Murray, he went to relieve himself in the restroom
in Mr. Jacksons bedroom. Dr. Murray said he was gone approximately
two minutes. After Dr. Murray returned from his two-minute absence,
he was stunned to see that Mr. Jackson was not breathing.
Once he noticed that Mr. Jackson was not breathing, Murray started
chest compressions and performed mouth-to-mouth resuscitation.
Mr. Jackson was still on the bed. The 6-foot 5-inch, 220-pound
Murray was unable to move Jackson who, according to the
autopsy report, weighed 136 pounds to the floor by himself.
Murray described that he had one hand under Mr. Jacksons
back supporting his back and the other hand on
top of his chest. At this point in time, Dr. Murray explained
that he did not call 911 because he was caring for his patient
and did not want to interrupt it. Had he made that call, the
911 operator would have asked what this was all about; responding
to the operators questions would have interfered with
Murrays care.
The irony about Murrays concern with the 911 operators
interference is self-evident when one considers that Murrays
timeline has been totally undermined by his phone records.
On June 25, 2009, Dr. Murray had two cellular phones
one with AT&T service and the other with Sprint/Nextel service.
Therefore, prosecutors had two phone company witnesses detail
Murrays extensive telephone use while Mr. Jackson lay
dying.
Harry Dhaliwal, an AT&T employee, discussed Murrays
cell phone activity on June 25th, 2009. Beginning at 12:04 am
and continuing every hour, on the hour until 6:04 am, Murray
received data. In addition, at 6:25 a.m., 9:00 a.m., 9:11 a.m.,
10:26 a.m., 12:03 p.m., 12:04 p.m., 12:53 p.m. and 1:23 p.m.,
Murray received or sent a text message. He received data at
7:03 a.m., 7:20 a.m., 8:14 a.m., 8:35 a.m., 8:54 a.m., 10:04
a.m., 10:15 a.m., 10:24 a.m., 12:13 p.m., 12:18 p.m. and 2:19
p.m.
In addition, he had several phone calls on June 25th, 2009:
9:23 a.m. incoming call lasts 22 minutes (Bioni)
·10:29 a.m. incoming call lasts 22 minutes[1]
·11:07 a.m. incoming call lasts 1 minute (Ruggles)
·11:18 a.m. incoming call lasts 32 minutes (Global Cardiovascular)[2]
·11:26 a.m. incoming call lasts 24 minutes (Russell)
·11:49 a.m. outgoing call lasts 3 minutes
·11:51 a.m. outgoing call lasts 11 minutes (Anding)
·12:12 p.m. outgoing call lasts 1 minute
·12:15 p.m. outgoing call lasts 1 minute
Jeff Strohm is a custodian of records for Sprint/Nextel. He
detailed the phone calls Murray made from that phone:
·7:01 a.m. outgoing call lasts 25 seconds (Butler)
·8:49 a.m. incoming call lasts 53 seconds (Guild)
·10:22 a.m. incoming call lasts 111 seconds (Dr. Prechad)
·10:34 a.m. outgoing call lasts 8 ½ minutes (Ruggles)
·11:26 a.m. incoming call lasts seven seconds (Morgan)
·1:08 p.m. outgoing call lasts 2 minutes (Alvarez)
Further undermining Dr. Murrays timeline was testimony
by Stephen Marx, a computer forensic examiner. He conducted
an examination of Dr. Murrays iPhone, which was recovered
on July 28, 2009, to track when Dr. Murray reviewed incoming
or created outgoing data.
Mr. Marx recovered a 5:54 a.m. incoming e-mail, with the greeting
of Hi Conrad, with signature, Bob Taylor, of Bob
Taylors Insurance of London. The e-mail specifically inquired
about Mr. Jacksons health. Mr. Taylor also needed to confirm
that Dr. Murray was the only physician consulted during that
period, and that his records dated back to 2006 when he first
met Mr. Jackson. Conrad Murray responded to Mr. Taylors
e-mail at 11:17 a.m. In a lengthy e-mail, Dr. Murray denied
Taylor access to Michaels medical records. Murray wrote,
however, that press reports about Michaels health were
false to say the least.
The most fateful call was one made to Sade Anding. Anding
was a cocktail waitress that Murray met in Texas. He had begun
referring to her as his girlfriend. Murray called her at 11:51
a.m. and began telling her how things were going. According
to Anding, Then I cut him off and I started talking. I
said, Well, let me tell you about my day.
At some point, she realized, He wasnt on the phone
no more. There was commotion I heard noise
as though the phone was in his pocket. I heard coughing and
mumbling. It went on about five minutes. She said, hello,
hello, hello. Are you there? Are you there? She received
no response. I called and called and texted him and never
heard back. She did not believe the mumbling she heard
came from Murray.
In a February 3, 2011, interview, responding to how she felt
when she heard that Mr. Jackson had died, Ms. Anding said,
It made me sad. I felt like it was my fault. But I really
felt like, if [Murray] wouldnt have called me, then maybe
all that stuff that happened wouldnt have happened.
The most astonishing aspect of Andings testimony is that
she heard mumbling that did not come from Murray. This suggests
that Mr. Jackson may indeed have been alive at 11:56 a.m., yet
Murray did not request that anyone summon help from medical
professionals until 12:21 p.m., twenty-five minutes later. Once
called, paramedics were on scene within four minutes. Considering
responding paramedic Richard Senneffs testimony that his
team had successfully revived patients who had been down
for fifteen minutes, Murrays delay was lethal.
The testimony of Strohm and Dhaliwal is relevant for several
reasons, the most important of which was the fact that Murray
was taking phone calls, communicating with his office, his girlfriends
and former patients when he was being paid to watch Michael
Jackson sleep. In the period between 1:30 a.m., when he began
treatment, and approximately 12:00 p.m., when he discovered
his patient was not breathing, Murray spent three hours on phone
calls, with the heaviest call activity beginning at 10:29 a.m.
Considering Senneffs testimony that Mr. Jackson may have
been dead for up to one hour before his 12:26 p.m. arrival,
Murrays phone records, which show three overlapping phone
calls at 11:26 a.m., demonstrate unequivocally that Murray was
not paying attention to his patient in the last moments of his
life. The records are relevant for one other outstanding reason;
none of Murrays numerous calls was to 911.
Mr. Jackson was pronounced at 2:26 p.m. at UCLA medical center.
According to the autopsy report, Mr. Jackson suffered respiratory
arrest while under his physicians care.
Conrad Murray has been charged with involuntary manslaughter,
which, under California Penal Code 192(b) is defined as an unlawful
killing that takes place:
1.during the commission of an unlawful act (not amounting to
a felony), or
2.during the commission of a lawful act which involves a high
risk of death or great bodily harm that is committed without
due caution or circumspection.
In response to the charges, his attorneys will be mounting a
defense that (1) Michael Jackson was a drug addict and (2) that
while Conrad Murray was out of the room, Michael Jackson self-administered
Propofol, resulting in an overdose.
Many will recall Ed Chernoffs initial diatribe that Murray
did not know what other drugs Michael was taking. Problematic
with the addict theory is that, according to the toxicology
report, Propofol, Lidocaine, Lorazepam, Midazolam, Nordiazepam
and Diazepam all drugs prescribed and administered by
Murray were found in Jacksons blood samples. No
other drugs were found. Therefore, the first defense is a dead
end.
Murrays attorneys must have mounted the second defense
that of Jackson self administering Propofol once
the phone records demonstrated that Murray did not leave his
patient alone for two minutes as he told police investigators.
But, as the records show, Murray spent up to two hours on the
phone before discovering Michael in distress.
According to Murray, Michael Jackson told him that while treating
with other physicians, he had pushed the IV line
into his veins. Even if he had inserted the IV line on previous
occasions, that does not change the fact that a physician always
monitored him. Indeed, for Murray to be acquitted, his attorneys
would have to convince a jury that a man who understood how
Propofol worked, who had stated on other occasions that he knew
he needed to be monitored while using the drug, would have self-administered
the medication while the doctor he was paying $150,000 per month
to watch him was chatting with girlfriends, business associates
and other patients.
To advance such a defense, Dr. Murray would have to take the
stand. If he takes the stand, he will have to explain (1) why
he didnt keep medical records, (2) why he didnt
perform a physical examination before administering new medication
to his patient, (3) why he did not understand the dangers in
combining benzodiazepines with Propofol, and (4) why he delayed
in calling for help. Then, Murray will have to find other doctors
willing to admit that Michael Jackson self-administered Propofol
in their presence. This, of course, is a double-edged sword
for the defense; even if they can elicit testimony about self-administration,
the defense team is highly unlikely to find a doctor who will
say that he, too, left the patient unmonitored while under sedation.
Should he take the stand, Murrays conduct in hiding, destroying
and concealing evidence may prove to be the most damning evidence
against him.
About 12:17 p.m. on June 25th, security guard Alberto Alvarez
received a phone call from Michael Amir Williams during which
he was told to go to the house. Alvarez noticed Dr. Murray standing
at the top of the stairs, but leaning over the railing. Alvarez
raced upstairs and saw Murray walking towards Michael Jacksons
room.
When he first walked into the bedroom, Mr. Jackson was flat
on his back with his hands to the side and his eyes and his
mouth were wide open. Alvarez then asked Dr. Murray what happened.
Dr. Murray said, He had a reaction! He had a reaction!
Alvarez was frozen. He surveyed the scene and noticed that Murray
had grabbed a handful of bottles from a nightstand. Murray then
instructed Alvarez to put them into a bag. After the bottles
and vials had been cleared from the room, Murray instructed
Alvarez to remove the IV bag. At the bottom of the IV bag was
a milk-like substance. Alvarez does not know what happened to
the IV bag. Once everything was cleared away, Murray told Alvarez
to call 911. Obviously, Dr. Murrays actions delayed emergency
treatment by paramedics.
Paramedic, Richard Senneff described a similar scene. After
administering emergency care at the home, on Murrays orders,
Mr. Jackson was to be transferred to the hospital. Mr. Jackson
was placed on a gurney and all of the attached equipment was
taken to the ambulance. Senneff returned to the bedroom to make
sure that he had all of his equipment. While there, he observed
Murray standing on the far side of the bed and, using a white
plastic trashbag, picking things up. Senneff was not looking
hard enough to see what Murray picked up.
Given Murrays elusive conduct, is it too far a stretch
to suggest that he could have used Michaels postmortem
hand to place fingerprints on syringes and medicine bottles
found at the scene? In either case, Murray will have to explain
what he did from approximately 11:56 a.m. when Sade Anding
heard mumbling and coughing and 12:17 p.m. when Alberto
Alvarez arrived.
Regardless of which aspect of Dr. Murrays treatment is
examined, it all falls short and is the very epitome of a lawful
act committed without due caution or circumspection.
--------------------------------------------------------------------------------
[1] This telephone call occurred during the time Murray claims
he was administering Propofol to Mr. Jackson.
[2] It is unclear how this call lasted as long as the records
reflect when other calls overlapped.
Comment by lynande51
The reason that Propofol is non addictive is because it does
not bind to the receptors in the brain. It has a half life if
10 minutes which means that it would be completely metabolized
by the liver in 20 minutes and on its way out of the body in
the persons urine. It does not come in an oral form. The
only reason that Murray and his lawyers even suggest such a
thing is because it was found in his stomach tissue and given
IV there is no reason for it to even be there. A medication
given IV bypasses the stomach during the metabolism process
so it should never have been found in his stomach tissue period.
The autopsy lists it being in his vitreous humor ( the liquid
part of the eye) and in his stomach, 2 places it should never
have been found unless he was given much more than Murray said
he gave.
Murray says that 50 mg per night was the max dose he gave him.
To induce sedation he would have had to administer 40 mg /kg
or 123 mg ( or in this case 12.3 ml.) to induce sedation and
he would have had to have to continue to administer the propofol
by IV drip to maintain sedation. This is calculated by micrograms
per kilogram of body weight.
We have no way of knowing how much Murray would have had dripping
on a continuous basis into Michaels veins because he removed
the IV tubing and bag of IV solution that he mixed it with lidocaine
(I will explain why this is wrong too) before the paramedics
and police got there. According to the toxicology reports I
can tell you that it was found predominately in his liver and
heart meaning that it had not completely metabolized. It means
that Michael died quickly once this drug was administered.
The drug Propofol is mixed in a fat emulsion to make a liquid.
When it is mixed in lidocaine it will separate from the rest
of the emulsion and become unstable meaning it would have had
time when there was more propofol and times when there was no
propofol because the drug actually separated from the fluid.
In other words he had no way of knowing how much of the medication
he was getting at any time. He might have been getting all drug
and then again he might not have been getting any. The propofol
was a lighter molecular weight that the fat emulsion so it would
have been at the top of any IV bag that was. The package insert
from propofol even says not to mix it with lidocaine. Lidocaine
IV is also used to treat heart arrhythmias in particular ventricular
tachycardia.
What was found at the scene were two and a half empty vials
of propofol. One of them was 1000/100ml and one empty 200/20
ml and half of a 200/20 ml. this actually equals 1300 mg of
propofol not 50 mg because it comes in 10mg/ml availabilities.
That is across the board that is the concentration of the drug
in the liquid.
Murray is supposed to be a Cardiologist meaning he was a heart
specialist. Even if he was not board certified he should have
known the effects of the lidocaine IV on the heart and if he
was a cardiologist (these are the guys that invented CPR) why
didnt he pull Michael off that bed to the floor to administer
CPR? If Michaels respiration was slowed due to the benzodiazepine
effect so was his heart and he should never have had lidocaine
in his vein let alone mixed with propofol. There really is no
excuse for Murrays actions that day.
Thank you Lisa for your generosity
sharing your investigation!
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