Friday, October 28, 2011

Michael Jackson Doctor Acted With 'Gross Negligence'

Fellow doctors take Conrad Murray to task for his treatment of late pop star.
By Gil Kaufman


Dr. Nader Kamangar
Photo: Pool/ Getty Images

A day after the pathologist who did the autopsy on Michael Jackson said in court that evidence did not support the argument that the pop icon self-administered a fatal dose of the surgical anesthetic propofol, the defense team for Dr. Conrad Murray appeared to be shifting its strategy.

Lawyers for Murray, who is charged with involuntary manslaughter in the death of Jackson at age 50 in June 2009, seemed set on their plan to convince jurors that Jackson self-administered a dose of the drug while Murray was out of the room. Let's take a look at what went down in court.

Day 12
The Witnesses
» Dr. Alon Steinberg, cardiologist
» Dr. Nadar Kamangar, pulmonologist and sleep medicine specialist

Testimony Highlights
» According to TMZ, one of Murray's lawyers, Michael Flanagan, announced in court that an independent study conducted by the defense found that swallowing propofol could not be fatal. And while lead attorney Ed Chernoff said in his opening statements that the defense would show that MJ self-administered a fatal dose of the drug, the site pointed out that Chernoff could still claim that the singer injected himself with the killer dose after waking up from a fitful sleep.

» Cardiologist Dr. Alon Steinberg said fellow cardiologist Murray displayed an "extreme deviation" from standard practices in his treatment of Jackson based on his review of the case from transcripts of a police interview. He pointed to six distinct deviations from standard care procedures, dubbing each one "gross negligence."

» As independent experts have claimed to MTV News, Steinberg said propofol should only be used for surgical procedures in a hospital setting and never used to induce sleep, something he'd never heard of. Jackson, a chronic insomniac, reportedly used propofol as a sleep aid. In addition, Steinberg said Murray appeared to lack the basic emergency equipment needed and assistance in case something went wrong and that he took the wrong measures when Jackson was in trouble, including not giving the star an antidote — Flumazenil — instead of chest compressions, which were unnecessary. He also faulted Murray for not immediately calling 911, which might have saved Jackson's life, but instead waiting 20 minutes as he summoned the singer's entourage. "Every minute counts," he testified.

» Steinberg had plenty more criticisms, among them shock that Murray did not take explicit notes, another huge deviation from procedure. He said that even if MJ had self-administered the fatal dose, Murray was at fault for leaving his patient alone. "When you monitor a patient, you never leave their side, especially after giving propofol. It's like leaving a baby that's sleeping on your kitchen countertop," he said.

» Pulmonary and critical care physician Dr. Nadar Kamangar later took the stand and agreed with Steinberg's comments that Murray exhibited "gross negligence" with his treatment of Jackson. The sleep medicine specialist told the court that while insomnia is a common condition and that he administers propofol on a daily basis, the dosage must be monitored very carefully — with an automated pump — as its effects can be unpredictable, particularly when mixed with other sedatives. Kamangar also stated that Murray's failure to call 911 immediately was an "unconscionable deviation of care" and that his choosing to ignore Jackson's "clear signs" of drug abuse were completely unethical.

Murray has pleaded not guilty to the charge of involuntary manslaughter. He faces four years in prison and the loss of his medical license. With just a few more witnesses to go, the prosecution could wrap up its case by Thursday.

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