Page 4 of 4 FirstFirst ... 234
Results 46 to 53 of 53

Thread: English Summaries - Easy reference for the Translator Teams

   
  1. #46
    Points: 152,225, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 19.0%
    Achievements:
    Three FriendsOverdrive50000 Experience PointsVeteran

    Join Date
    Sep 2009
    Location
    USA
    Posts
    15,467
    Points
    152,225
    Level
    100
    Thanks
    437
    Thanked 34,536 Times in 7,317 Posts

    Default Re: English Summaries - Easy reference for the Translator Teams

    Murray Trial Day 20 October 28, 2011

    Morning Session

    Dr White Testimony


    Flanagan Direct

    They still discuss the variability between people. Propofol’s effect site is the brain and the amounts in the brain are not measurable in living humans so they use alternative measures such as EEG.

    Flanagan shows several papers and graphs that show that levels and effects in patients vary a lot. White explain why models are not representing each and every patient and models are just an average.

    Flanagan switches to Dr. Shafer’s graph for Lorazepam (2 doses of 2 mg). White says this is accurate for an average patient but not for MJ. White says if MJ was taking oral Lorazepam, you would expect to see residual levels of Lorazepam from previous days. Walgren objects to the use of word “oral”.

    White says as CM said he treated MJ with Midazolam and Lorazepam, he would expect to find residual levels but White doesn’t know how much MJ was given to make this determination.

    Flanagan shows Shafer’s graph for Midazolam (2 doses of 2 mg given at 3AM and 7:30AM). Actual blood concentration for midazolam in autopsy report was close to Shafer’s model.

    Flanagan shows graphs done by Shafer that combines Midazolam and Lorazepam, another graph that shows 25mg Propofol given over 3 to 5 minutes and another graph combining all (25mg Propofol, 2 doses of 2 mg Lorazepam and 2 doses of 2 mg Midazolam).This combination doesn’t show a dangerous situation.

    Flanagan and White goes over a study and based on that White says that 25mg of Propofol would provide minimal sedation and help with anxiety relief and bring a little sleepiness. White says that CM gave minimal sedation.

    Flanagan asks what is moderate / mac/ conscious/ procedural sedation. White says there’s verbal response, airway is unaffected and cardiovascular functions will be okay.

    White says hospitals require doctors that use conscious sedation be trained so that if they mistakenly sedate the patient in a deep sedation they can rescue the patient.

    Flanagan shows that CM has a certification from Sunrise Hospital in Las Vegas for moderate sedation. That allows CM to evaluate the patient, administer sedation, manage a compromised airway, provide adequate ventilation in case of apnea, rescue a patient from deeper sedation, and monitor the patient to evaluate sedation.

    Flanagan shows Shafer’s graph for 40mg Lorazepam. Initially the doses started around 12:00AM but later Shafer corrected the time. White says the average patient would be dead at the very least comatose for several hours, receiving 40mg over 5 hours. Shafer did that simulation because of the 10ml vial found at the house. For Shafer’s modified simulation ( 9 doses of 4 mg each starting at 1:30AM), White says it doesn’t fit with the vial found in the house. Also last doses would have been given when he was still asleep.

    Flanagan shows the graph with 40 mg Lorazepam with 2 doses of midazolam and Lorazepam. White says that it doesn’t make sense when MJ was highly sedated with Lorazepam, Midazolam would be given to him.

    Flanagan shows a computer simulation: 2 doses of 2 mg Lorazepam (2AM and 5AM) and an oral dose of 20 mg (10 pills taken at the same time) at 7AM. This graph assumes there was no residual Lorazepam from previous days.

    Flanagan shows another graph. It’s the same but assumes a residual level for 10mg for last 5 days. It would achieve the same result with 16 mg oral Lorazepam (8 pills) taken at 7AM.

    Flanagan says the amount of Lorazepam in MJ’s stomach was very low. White says the pill will dissolve in 15 minutes and the absorption halftime is 22 minutes. White says that it’s normal that there was a little Lorazepam found in his stomach.

    White says that his Lorazepam simulations are more reasonable and that 40 mg simulation of Shafer is irrational. White says the simulation with residual level is more realistic.

    White says that maybe MJ didn’t take 8 pills at once. Maybe he took a few at one time and then later took some more such as at 6 AM and 8 AM. White says it’s a speculation but it’s more reasonable than 4mg boluses every 30 minutes.

    White explains the small amount of Lorazepam in the stomach by absorption half-life.

    Flanagan mentions another article and asks finding equivalent of 1/300th of a pill in stomach is consistent with White’s simulation. White says you would not expect to find free Lorazepam in the stomach if it was given via IV.

    Mid morning break.

    White says that as there was free Lorazepam in the stomach it has to be oral consumption.

    White goes over Dr. Shafer’s simulations. White says Shafer’s simulations have Propofol injections in 30 seconds to 60 seconds and say that it’s inconsistent with CM’s interview. White says Shafer’s simulation of 100mg bolus is inconsistent with lidocaine. White says such injection would burn tremendously in small veins.

    White says multiple injections of 50mg is inconsistent with lidocaine levels found at autopsy. White says it would be difficult for MJ to draw Propofol himself 6 times and the defense never claimed that.

    White says 25mg scenario is less absurd as its minimal sedation. Flanagan asks if a person could be awake to do a 25mg injection over 30 seconds and White answers yes. White adds that the blood concentration depends on how fast the injection is done. Slow injection would have less effect on the heart and respiratory system.

    Flanagan shows a graph with Lorazepam and Midazolam and a rapif 25mg bolus Propofol. White says if a fast bolus was put on the Lorazepam levels , the combination could be lethal.

    White says Shafer’s 100ml infusion (IV) was inconsistent with CM’s interview. White says that an IV system was needed and the handle of Propofol was not used. White says bottle in the bag would be too low and it would be dangerous. Also White says if the patient moves or someone touches the tube the bottle could fall. White says he can’t think of a reason to not use the handle and go to the hassle of cutting the bag with a knife.

    White says before the infusion pumps the practice was to empty the propofol bottle into the saline bag. If you do that when the bag is empty you would see the Propofol residue on the bag and the chamber. There was no propofol in the bag or in the long tube.

    White says there’s no evidence that there was an IV and says that he think there was no infusion.

    White again mentions Shafer’s simulation of 100ml IV. He says it’s an incredible coincidence that the patient dies when the bottle runs out.
    White also says that Propofol in the urine doesn’t support the 100ml IV over 3 hours. White says according to urine levels the most consistent scenario is a self injection of 25mg Propofol between 11:30AM and 12:00PM.

    White says that Shafer’s scenarios don’t reconcile with CM's statement, evidence at the scene, urine concentration. White says his scenario with self injection fits fit everything.

    Court ends early. Media reports that Prosecutor Walgren asked for time to get ready for cross.
    Twitter : Ivy_4MJ

  2. The Following 5 Users Say Thank You to ivy For This Useful Post:


  3. #47
    Points: 152,225, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 19.0%
    Achievements:
    Three FriendsOverdrive50000 Experience PointsVeteran

    Join Date
    Sep 2009
    Location
    USA
    Posts
    15,467
    Points
    152,225
    Level
    100
    Thanks
    437
    Thanked 34,536 Times in 7,317 Posts

    Default Re: English Summaries - Easy reference for the Translator Teams

    Murray Trial day 21 October 31, 2011

    Morning Session

    Dr White Testimony

    Walgren cross


    Dr White is retired after 30 years of clinical care, teaching and research. White says he’s an expert in the use of Propofol, not expert in pharmacokinetics and dynamics modeling. He asks other people to do that such as Dr Shafer.

    Walgren asks if there were instances Dr Murray deviated from standards of care on June 25th and the preceding 2 months. Dr White agrees.
    Walgren asks what did Dr. White understood from CM’s police interview. White says he understood CM gave 25mg to 50 mg Propofol with 5 CC of lidocaine. Based on interview, could not say how CM administered the drip. White says there could be a number of possibilities about the drip and multiple IV tubes as described by Dr. Shafer is one of the possibilities.

    White agrees and says that giving Propofol without proper monitoring could be dangerous and could result in cardio-respiratory depression. White says at the minimum he would want to have an ambu bag.

    Walgren asks White if he has given Propofol in a bedroom. White says he has never heard of it. White says that he knows Propofol being given in medical offices and clinics.

    Walgren asks about the suctioning equipment. White says it’s desirable to have it but vomiting is fairly rare. White says pulse oximeter is essential and blood pressure cuff is important. White says for an infusion you measure blood pressure every 5 minutes and for minimal sedation you measure it every 5 minutes. Capnography is not utilized everywhere, White finds it useful but not very precise.

    Walgren asks if failing to maintain medical records is egregious deviation from standard of care. White says charts are needed but in this case it didn’t contribute to death. White also classifies it as minor to moderate deviation from standard of cares.

    Walgren asks about pre procedural assessment. It’s when the patients overall condition is evaluated to see if there are any factors that can increase cardio respiratory depression. Respiratory depression from Propofol is mentioned to be rare and generally happens when narcotics are present.

    Walgren asks how much Dr. White has been paid by the defense. White says that he was paid $11,000 so far. White says he also charges $3,500 a day for court appearances but he didn’t ask that because defense doesn’t have the resources.

    Walgren asks if White ever had a patient that stopped breathing after Propofol. White says he did (after general anesthesia) and he assited them with an ambu bag and mask or other ventilation techniques such as endotracheal intubation or laryngeal mask.

    Walgren mentions doctor’s oath of “do no harm” and asks if CM violated this by giving Propofol. White says CM did not harm.

    Walgren asks who makes the final decision – the doctor or the patient. White says both share the responsibility but the doctor have the option to walk away. White says he would never administer something he considers inappropriate, he would walk away.

    Walgren asks if it is easy to go from a level of sedation to the other. White agrees that the monitoring is required but 25 mg dose is a very minimal dose that would wear off after 15 minutes. He says monitoring a patient for that dose for around 15-30 minutes would be enough and then it’s okay to leave the patient.

    Walgren asks about pulse oximeter without an alarm. White says it has no value when you are out of the room. White also states that 25 mg propofol wouldn’t have effects after 25-30 minutes. Walgren asks if benzodiazepines would have an effect, White says if they have been given hours before they would have little effect.

    White tries to justify CM’s treatment saying that this was an unusual case with the goal being sleep and what CM leaving MJ was acceptable.

    Walgren asks what if the patient liked to push Propofol. White says he would not left the room.

    White asks about failure to call 911. White says he cannot justify it but also adds the situation was different, CM didn’t know the address and the house was not easily accessible. Walgren pushes White. White says CM should have called 911 sooner but it wouldn’t have made a difference in this case. White says he would have started resuscitation and call 911 within 3 to 5 minutes.

    White say he doesn’t think everything CM said to the police is true. White says in emergency situations it’s hard to remember the details and CM could have overlooked to mention Propofol and didn’t do it in a devious way. Walgren suggests that the other alternative is that CM lied. White reluctantly agrees.

    Walgren does over the letter White gave to the defense. In the letter it’s written that sedatives, analgesic and benzos may increase the risk of Propofol. White says high concentration of lorazepam and 25mg propofol given too fast causes arrhythmia, and a rapid demise.

    White mentions although CM bought Propofol MJ had his own stocks of Propofol. Walgren asks where he saw this information. White says CM told that to Dr. White.

    Walgren shows the IV tubing found in the scene and asks if it is easily concealable and fits in the hand or in the pocket. Dr White admits to that.

    Walgren mentions how White speculated that MJ drank propofol and now White rejects that's the cause of death. White says Dr Shafer explained why there could be propofol in the stomach and why it would not cause death.

    White says he did his 3 page letter in a very short time as Flanagan needed something from him. White says he did not write any other report. In the letter White wrote MJ self administered either by injecting or orally. Flanagan had mentioned oral Propofol before he wrote the letter and White say he did a search but did not find anything about it.

    Walgren asks if according to White the only option was to blame the victim. White says if CM only given what he said he did, there was to be something else. Walgren asks if White now blames MJ for Lorazepam as well. White says yes. Walgren asks if White took everything CM said to be the truth. White says yes. White says what CM said in regards to drug administration is consistent with the autopsy report.

    Walgren goes over the report and point outs that White now says MJ died of a rapid bolus but he never wrote that in his report / letter. Walgren asks if he came up with any other theory that does not attribute the drug taking to MJ. White says no.

    Walgren asks who Dr. Gabriella Ornelas is. White says she’s a PhD in biomedical engineering. White met her for the first time last week and asked is she could calculate the amount of free propofol you would expect to see in the urine after a 3 hour 100mk infusion.

    Mid morning break

    .... will post the rest of the morning session momentarily.
    Twitter : Ivy_4MJ

  4. The Following 2 Users Say Thank You to ivy For This Useful Post:


  5. #48
    Points: 152,225, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 19.0%
    Achievements:
    Three FriendsOverdrive50000 Experience PointsVeteran

    Join Date
    Sep 2009
    Location
    USA
    Posts
    15,467
    Points
    152,225
    Level
    100
    Thanks
    437
    Thanked 34,536 Times in 7,317 Posts

    Default Re: English Summaries - Easy reference for the Translator Teams

    Walgren mentions that Dr. Shafer provided software for the models to the defense and White only provided computer codes on paper.

    Walgren goes over the 10 AM Lorazepam theory. As the peak effect will be in 2 hours it first nicely with 12 AM. Last week when Dr. Shafer testified that Lorazepam had to be taken at least 4 hour prior to death that’s when White met with Ornelas. She created several scenarios. White says he was not aware of the 10 AM Lorazepam theory.

    Walgren asks if MJ came and asked him to work for him to give Propofol , if he would accepted the job. White says absolutely not. He says no amount of money could convince him to do it because of time required, the responsibility and off label use of propofol.

    Walgren asks if White’s 11:40AM self administration theory is based on a lot of assumptions for the lack of medical records. White agrees.

    Walgren asks if for his theory he used CM leaving the room for 2 minutes. White says no.

    Walgren asks about the beagle Propofol study. White says that Flanagan knew a veterinarian that could do the study and he had no part in it. White says he only got a report from Flanagan that oral propofol had no effect on beagles.

    Walgren asks when White assumes that MJ took Lorazepam was CM out of the room as well. White says MJ was walking around. Walgren objects as White is telling what CM told him. White says he understood that CM was in the another part of the room (adjacent bedroom etc) or not watching. White says CM wasn’t aware that MJ took Lorazepam.

    Walgren asks White if he’s aware that CM left the room only once. White says yes. He also says that he believes CM was away around 7 AM. Dr. White says when CM was on the phone he was presumably away from MJ because he was sleeping.

    White’s theory is that CM drew 50 mg Propofol and lidocaine and gave half of it to MJ and left the half full syringe. White then says CM was in the corridor, Walgren objects as he is once again telling what CM told White. White thinks after CM gave MJ the half the syringe and observed him left him to talk on the phone and went to the bathroom. White thinks MJ could have injected in that 40 minutes.

    Walgren asks if MJ injected through the IV port and the syringe was originally on the chair. Walgren asks if wouldn’t it raise an alarm when CM found the syringe in the injection port. Walgren also asks if according to his theory MJ fell back to bed in the same position.

    Walgren asks if it’s White’s understanding that MJ moved around the house wheeling an IV stand with a condom catheter on him and a urine bag attached to his leg.

    Walgren asks if isn’t it a possibility that CM injected the additional Propofol. White answers yes if he wanted to harm MJ.

    Walgren asks if putting MJ to sleep was mild/ minimal sedation which means response to verbal stimuli. Walgren asks if it makes sense to him. White says providing sleep doesn’t need a higher level of sedation.

    White says he believes that MJ didn’t receive Propofol on the 23rd and 24th based on the urine levels.

    White says during the 6 weeks prior CM gave MJ 1 or 2 boluses of Propofol (25 to 50 mg) and followed it with an infusion with the Propofol bottle. Walgren again objects as White is once again telling what CM told him. White speculates that it was minimal to moderate sedation.

    Walgren cites several articles written by Dr White. One article says that MAC (moderate sedation) requires the same level of standard of care as general anesthesia.

    Guidelines for Office based anesthesia (written by Dr White) :
    1-appropriately trained personnel
    2-anesthesia equipment
    3-complete documentation of care provided
    4-monitoring equipment
    5-recovery area with appropriate staff
    6-availability of emergency equipment
    7-plan for emergency transport of patients to a site that provides more comprehensive care, should a complication occur
    8-documention on a quality assurance program
    9-continuous training of physician
    10- safety standards that can't be jeopardized for patients' comfort or cost

    Walgren asks if these standards should apply if Propofol is administered in a bedroom ? White says that he wouldn’t give it in a bedroom and White eventually agrees that giving Propofol in a home requires the minimum requirements of office based anesthesia

    Lunch break
    Twitter : Ivy_4MJ

  6. The Following 3 Users Say Thank You to ivy For This Useful Post:


  7. #49
    Points: 152,225, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 19.0%
    Achievements:
    Three FriendsOverdrive50000 Experience PointsVeteran

    Join Date
    Sep 2009
    Location
    USA
    Posts
    15,467
    Points
    152,225
    Level
    100
    Thanks
    437
    Thanked 34,536 Times in 7,317 Posts

    Default Re: English Summaries - Easy reference for the Translator Teams

    Murray Trial Day 21 October 31, 2011

    Afternoon Session

    Dr White Testimony


    Walgren cross

    Walgren continues with quotes from Dr. White's books/articles: "because of the profound risk of cardio respiratory depression, propofol should always be administered by anesthesiologists, not by gastroenterologists, etc (other doctors)". White states that the book was published in 1996, things have evolved since then. White states that he would agree that propofol has profound a risk of cardio respiratory depression, but it can be administered by trained doctors other than anesthesiologists, in a proper setting.

    White states that the guidelines for sedation, for non anesthesiologists are: "even if moderate sedation is intended, the same standard of care should be applied as for deep sedation" and that "because it's not always possible to predict how a patient will react, the caregiver needs to prepared to rescue a patient from deep sedation."

    Dr White agrees that for moderate sedation (when an infusion is used), the patient should receive the same care as for deep sedation.

    For mild sedation, Dr. White states that the doctor should be prepared in the event that the patient goes into moderate sedation, not deep sedation.

    Dr. White states that he wouldn't administer propofol in a home, but thinks that these guidelines should be followed with an infusion. White states that he doesn't know if a second person is necessary, assuming the doctor is monitoring the patient, while the propofol is being administered.

    Walgren asks what about administering benzodiazepines and a propofol bolus? Dr. White states that in an ideal situation, it would be great to follow the guidelines.

    Walgren shows Ornelas model with 25mg propofol infused over 3 to 5 minutes versus a 25mg fast injection and the differences in blood concentration and free propofol in urine levels. Her model is based on a 1998 article.

    Dr White has not read the article in detail. Dr White had a conversation with Ornelas at the Flanagan’s house for a few hours at the end of last week. The models Dr White testified to, were not done by him, he is not an expert in models.

    Walgren again shows the model with Murray infusing 25mg at 10:40 am versus MJ self injecting at 11:40 am. Before the self injection, blood level was near 0.

    Walgren shows a zoom of the same graph, zooming on the self injection. Dr White believes that self injection occurred later than 11:40.

    Dr White thinks this scenario is the most likely as it’s consistent with Murray's interview with LAPD, not recovering the tubing, matches the concentration of free propofol in the urine, matches blood concentration.

    Walgren shows another zoom of the same graph, over 10 minutes, showing only blood concentration. The circulation stops almost immediately. Dr White says it could have been arrhythmia, the cause is unclear.

    Walgren brings up the autopsy report: MJ had no heart problems. Dr White says that doesn't preclude an arrhythmia.

    Murray told LAPD that when he returned to the room, MJ's heart rate was 122. Dr White said it's unclear what 122 was and it could have been the saturation. Walgren reads the police interview; Murray also reported that he felt a thready pulse. Dr White says that Murray might have felt his own pulse, he was under stress. He might not have felt a perfusing pulse. Walgren: "This fits with you new theory that MJ died instantly"

    Dr White states he doesn't see any evidence of respiratory arrest, or cardiac arrest, or both combined.

    Walgren goes back to March 8th letter White sent to the defense. First cause of death Dr. White thought of is respiratory depression. Dr White corrects "cardio pulmonary depression" among other things. Walgren mentions the oral consumption is one of the other things.

    Walgren shows models of lorazeapm (multiple 4 mg injection, 2 X 2 mg IV +16mg oral).

    The graph shows 0.0013 mg in the stomach, Dr White doesn't know where this number comes from, but it is smaller than the 0.006mg.

    White states that the fact that there is free lorazepam in the stomach suggests oral ingestion.

    White states that residual lorazepam is an assumption of 10mg for the past 5 nights.
    Walgren shows the graph where Murray would have injected 25mg of propofol, and where MJ would have self injected. When MJ self injected, the lorazepam was a little lower.

    Walgren again goes back to Ornelas model with 25mg propofol over 3 to 5 minutes, 25mg fast injection blood concentration and free propofol in urine levels. Walgren asks why it doesn’t show the effect site (brain). White says it’s because she was only asked about the free propofol in the urine.

    Graph by Dr Shafer added effect site concentration to Ornelas graph: the levels at effect site are the same in both Murray's injection, or the supposed MJ's self injection. Dr White says these numbers are meaningless, because of variability. Dr White would be more interested in the heart concentration.

    Afternoon break


    Walgren asks White if he did any research to make sure that the 0.3% used by Ornelas (0.3% of the propofol is excreted unchanged) was accurate. White says it’s his feeling that it was the most conservative number.

    Walgren shows an article used by Dr Ornelas as a basis for her analysis. It was published in 1988. It indicated that less than 0.3% of propofol is excreted unchanged, but the model uses 0.3%. Dr White recalls a paper that said 1% .

    Walgren asks based on this paper (less than 0.3%), could it be 0? Dr White doesn't agree.
    Walgren says that the article says that 0.3 could be an overestimate. Dr White says that the difference with a 3 hour infusion would still be huge.

    Walgren shows a 1991 article about animals (dogs, rat). There was no unchanged propofol at all whether it was bolus or infusion. Dr White says he doesn't rely on articles about animals, he would prefer to rely on articles about humans.

    Walgren shows a 1999 article: they found no free propofol in the urine. Dr White indicates he did not search the subject

    Walgren shows a 2002 article in which the levels found were much smaller. Objection, sustained. The judge asks Walgren to change the subject.


    Flanagan redirect

    Flanagan talks about 911 not being called for 20 minutes. Flanagan says mentions that it was a large house, fenced, gate closed that can only be opened by security, guards were just outside the kitchen, incident happens upstairs , there are no landlines. Flanagan asks would it be unreasonable to ask a person in the kitchen for help.

    White says he would resuscitate the patient and ask the person in the kitchen, it sounds more reasonable than going to security.White says that CPR should be given within 1 to 2 minutes, and sustained for at least 3 minutes, before leaving the patient.

    Flanagan asks what kind of CPR should be given. White says mouth to mouth and adds that an ambu bag would be better but mouth to mouth is a possibility.

    Flanagan asks Dr. White what would be his assessment if the patient was not breathing and his eyes and mouth were open. White says he would assess the patient to see if they are alive as they are often a sign of death.

    Flanagan asks if the patient was dead at 12:00PM, could anything be done. White says if the patient was dead, not keeping a chart would not have changed anything.

    Flanagan asks White if he would suspect Propofol to have anything with the death. White says if the propofol was given at 10:40 and the patient was dead at 12:00 he wouldn’t suspect propofol.

    Flanagan asks after the EMT’s received the authorization to declare the patient dead if the further attempts was realistic and had a chance of saving the patient. White says no.

    White says even if the ER doctors had known about propofol, it would not change the outcome.

    Flanagan and White talk about 25 mg Propofol bolus over 3 to 5 minutes. White says if it had any negative effects it would be apparent by the end of the bolus and there would have been no reason to suspect anything at a later time.

    Flanagan asks about concelling the IV tube and White says it’s easier to conceal an IV tube than an IV bag but if the IV tube was in a pocket there would be liquid in the pocket.

    Flanagan mentions that at preliminary hearing 2 witnesses indicated the possibility of oral consumption of propofol.

    Flanagan asks if Walgren has contacted Dr. White. White says Walgren called him and they talked. White said that he was contacted by the defense. Walgren asked him if he was paid and White said he was. White says this is his only source of income.
    Twitter : Ivy_4MJ

  8. The Following 3 Users Say Thank You to ivy For This Useful Post:


  9. #50
    Points: 152,225, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 19.0%
    Achievements:
    Three FriendsOverdrive50000 Experience PointsVeteran

    Join Date
    Sep 2009
    Location
    USA
    Posts
    15,467
    Points
    152,225
    Level
    100
    Thanks
    437
    Thanked 34,536 Times in 7,317 Posts

    Default Re: English Summaries - Easy reference for the Translator Teams

    Murray Trial Day 22 November 1, 2011

    Dr White Testimony


    Flanagan redirect

    Flanagan again mentions the variability in the models.

    Flanagan shows the Lorazepam model that includes 16 mg oral consumption which is based on 0.0013 mg in the stomach content. If you move the oral intake to 8 AM, the amount of free Lorazepam in the stomach would equal to the 0.008mg found in the autopsy and the concentrations find in blood.

    Flanagan goes over the 0.3 free Propofol in the urine. In a model about 100 ml Propofol infusion over 3 hours the level of propofol would range from 1 to 3 mg in urine. 1 mg is the 10 times the amount found at autopsy.

    Flanagan mentions the burn feeling of propofol will be increased by small veins, the concentration of the drug and the speed of the injection. Lidocaine is given before the infusion, or at the beginning. White says given the half life of lidocaine and with a 3 hours infusion there shouldn't be lidocaine found at autopsy, and there was 0.84 mg/ml at autopsy.

    White says if there were 2 injections, Lidocaine would have been given twice and White would expect the lidocaine to be around the levels found at autopsy.

    Flanagan mentions standard of care versus standard of practice. White says standard of care is the ideal that they would seek for every patient but it's not always possible.

    Flanagan goes over minimal sedation. There would be normal response to verbal simulation. Flanagan asks if he took an ambient if White would be able to wake up by talking to him. They discuss 25 mg Propofol. White sys it would reduce anxiety and generally would not produce sleep. White says it could create a restful state if the patient is very tired. White also says that any noise in the room would wake the patient up. White says with minimal sedation airway, breathing and cardiovascular functions will not be affected.

    Flanagan’s redirect of Dr. White is over. Walgren does not recross.

    Off camera judge asks Dr. Murray if he will testify. Murray says that he won’t testify.

    Judge gives a 30 minute break so that the prosecution can decide whether they would do a rebuttal.

    After the break Walgren calls Dr. Shafer for rebuttal.

    Dr. Shafer Rebuttal Testimony


    Walgren direct


    Walgren asks if Lorazepam is given IV would some of it go to the stomach. Shafer says yes and it has nothing to do with post mortem distribution.

    Walgren asks and Shafer agrees that there’s no way to differentiate between MJ taking oral Lorazepam and CM giving MJ oral Lorazepam.

    Walgren brings up Shafer’s 100 ml Propofol infusion over 3 hours. Shafer says it doesn’t show when MJ died and it was not necessarily at 12:00PM. Shafer says it was basically to show that MJ died with infusion running.

    Walgren asks about the IV setup. Shafer says controlling the rate with the clamps are commonly done with some medication that you don’t need to precisely set the rate but a pump is required for Propofol.

    Shafer says the Lidocaine levels found at autopsy is not inconsistent with 100 ml infusion over 3 hour simulation. Shafer says Lidocaine could have been mixed into the Propofol bottle.

    Walgren asks about the main risk of Propofol and Shafer says its failure to breath and the lack of oxygen in the heart kills the heart.

    Walgren brings up the article the defense used in their simulation about the unchanged Propofol in the urine. Shafer says he researched the literature. 1988 article that the defense used says they found very little (0 to 0.3) unchanged propofol in the urine but they didn’t know if it was free propofol or its metabolite.

    Shafer says there are newer articles on the subject. The most detailed one is a 2002 article. 2002 article measured the actual unchanged propofol and the level was between 0.002% to 0.004%.

    Autopsy urine propofol was 0.15 mg/ml . 500 ml of the urine = 82.50 micrograms of propofol .

    Walgren shows a table from the 2002 article. The average Propofol found is 70.71 micrograms of propofol in the urine; it corresponds to a dose of 2000 mg.

    Shafer says this absolutely rules out Dr White's theory and it actually suggests that MJ received more propofol that what even Dr Shafer thought.

    Walgren asks about standard of care such as for an anesthesiologist providing care in a remote location (ex: radiology suite, etc..), . Shafer says you have less tolerance for error, because you have no back up. You should not take short cuts. Shafer says if there was such a thing as bedroom based anesthesia, if you have an error, you have mortality. So the standards of care would actually be higher.

    Flanagan cross

    Flanagan argues with Shafer about what he wrote in his report about lidocaine. Shafer thinks Flanagan misunderstood what he wrote. Flanagan asks Dr Shafer to read a paragraph from his report.

    Flanagan goes over the 2002 article and if the 25 mg propofol dose was a sub anesthetic dose. Shafer says in most patients it's a sub anesthetic dose and it depends on what other medication is on board. Flanagan is trying to say that the article didn't mention sub anesthetic doses.

    Walgren redirect

    Walgren tries to clear the issue about the article and the use of sub anesthetic dose, Shafer says the use of a larger doses makes the result more precise, that's all.

    Both sides work on a stipulation. Stipulation 52a says that Peoples 52 reflects the accurate phone numbers.

    Both prosecution and the defense rest their cases. Judge informs the jurors that both sides asked for a day to prepare for their closing statements. Judge excuses the jurors. In a not televised afternoon session judge and the both sides work on jury instructions.

    There will be no court on Wednesday November the 2nd. Closing statements and jury instructions are set for Thursday November 3rd. Court would start at 9 AM.
    Twitter : Ivy_4MJ

  10. The Following 4 Users Say Thank You to ivy For This Useful Post:


  11. #51
    Points: 152,225, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 19.0%
    Achievements:
    Three FriendsOverdrive50000 Experience PointsVeteran

    Join Date
    Sep 2009
    Location
    USA
    Posts
    15,467
    Points
    152,225
    Level
    100
    Thanks
    437
    Thanked 34,536 Times in 7,317 Posts

    Default Re: English Summaries - Easy reference for the Translator Teams

    Murray Trial Day 23, November 3, 2011

    Morning Session


    Court starts with Judge Pastor reading the jury instructions.

    Judge tells the jurors the evidence that contain medical items will not be in the jury room but it will be brought to them by a bailiff if they ask.

    Important points from jury instructions
    - Pastor tells the jurors they must follow his instructions about the law even though they might not agree with it.
    - Pastor says People need to prove guilt beyond reasonable doubt. He explains that it doesn’t need to eliminate all possible doubt.
    - Pastor says what the attorneys say and ask aren’t evidence.
    - Pastor says things can be proved by direct or circumstantial evidence. He says they are equal.
    - Pastor says if they can come to 2 reasonable conclusions – one showing innocence and the other one showing guilt- they must find the defendant not guilty.
    - Pastor says they can find the witness testimony truthful or not – in full or in partial.
    - Pastor says people can forget or make mistakes and 2 people can witness the same thing but remember it differently.
    - Pastor says in regards to expert witnesses their education, qualifications, the information they relied on while forming their opinion and why they made a certain statement should be considered.
    - Pastor says character witness testimony can be considered and can create a reasonable doubt.
    - Pastor tells the jurors not to be influenced by the fact that Murray didn’t testify.
    - Pastor explains involuntary manslaughter. People claim that Murray did 1) committed a lawful act with criminal negligence and 2) failed to provide a legal duty with criminal negligence.
    - Pastor tells that there could be more than one cause of death and it’s required that the actions of Murray must be a substantial factor in causing the death. It doesn’t need to be the only factor.
    - Pastor says Michael could have failed to use reasonable care and may have contributed to death. However if Murray’s actions were substantial he’s still responsible for the death.

    David Walgren Closing Statement



    Walgren starts by thanking the jurors to their services.

    Walgren mentions that CM does not need to be the sole cause of MJ’s death; he only needs to be a substantial factor.

    Walgren says that CM caused MJ’s death and left Prince, Paris and Blanket without a father. “For Prince, Paris and Blanket this trial will not end today for them it will go on forever”.

    Walgren mentions trust and the relationship between a doctor and patient and “do no harm”. Doctor decides what the proper care is for the patient. All the doctors testified said they would never do such thing. Walgren expresses that CM violated that trust between doctor and patient "each and every day."

    CM was an employee for money. “MJ trusted CM. He trusted him with his life. He trusted CM with his individual life and the future lives of his children. CM would care for him as he slept so in the morning he could share a meal with his children”. “MJ paid with his life”.

    On June 24, 2009 MJ performed at the Staples Center and gave a great performance. He was optimistic and looking for future. 12 short hours later he was laying dead in his bed palms up, had tilted to the side – dead - in his home.

    MJ was a 50 year old man anxious about the upcoming tour. MJ wanted to satisfy his fans that have been loyal to him for so long, his family, and his children. MJ was a creative genius who was striving for perfection. He was looking to the future. He was making long term plans for both himself and his children to whom he was so dedicated.

    MJ wanted to share his message with the world. He wanted to satisfy his fans. He wanted his children to see him perform.

    For MJ his children were paramount. He wanted a house for his children so they wouldn’t be cooped up in a hotel. MJ wanted to do a movie based on Thriller and wanted to direct movies. MJ wanted to open a children's hospital. He wanted to give this to the world. He had plans and hopes and dreams.

    The tour would have expanded around the world. He was excited his kids would get to see their dad perform in London. But none of this came to be because on June 25, 2009, MJ just 50 years old was pronounced dead. Paris had to see her dead in that situation and scream “daddy”, Prince was shocked. That’s what CM did to MJ and his kids.

    Walgren mentions that CM is charged with IVM and Walgren goes over the law. Walgren says there could still be questions unanswered and they only need to answer 3 questions.

    The law recognizes the special relationship between doctor and patient. Doctors have a legal duty of care to their patients and the failure to act on that duty would be IVM. Walgren goes over criminal negligence and causation.

    Walgren mentions that the defense’s theory is MJ injected himself with Propofol and caused his death. Walgren says CM is criminally negligent if he could have foreseen what happened. By his own admission, Conrad Murray knew MJ liked to push his own Propofol. He should have never left him alone in a room full of drugs. Walgren says even if true, it was foreseeable.

    Walgren says misleading statements can show guilt. Dr. Murray made misleading statements when he failed to tell paramedics and doctors he administered Propofol. That is consciousness of guilt. “That is putting CM first”. Walgren says CM was intentionally giving false statements.
    Walgren goes over the background of the case. CM had signed a contract. He was going to get $150,000 a month and housing. CM sent letters to his patients saying he was taking a sabbatical and ceasing practicing medicine “indefinitely”.

    Walgren goes over the shipments of medicine and he told jurors that CM ordered more than four gallons of Propofol and had it shipped to his girlfriend's apartment in LA.

    Walgren mentions May 10 recording. CM says he realized there was a problem in June but the recording was 1.5 months ago. Murray couldn't bother to keep records ... but had no problem recording a drugged up MJ and then for some reason keeping it.

    Even in vulnerable state MJ talks about the future and his desires. He’s talking about a children’s hospital. He has no reason to believe that anyone will hear him; he’s talking about his true feelings and his true desires.

    2 days after that recording, CM orders the largest shipment of drugs. Walgren says that they couldn’t find the other propofol bottles with search warrants.

    At a meeting in early June, Murray assures everyone MJ is doing just fine. On June 19, 2009, director Kenny Ortega is so concerned about MJ's health and sent him home. Ortega sends an urgent email to Randy Phillips saying MJ is in a bad state. Ortega tried to reach CM but couldn’t. June 20th meeting CM was upset that MJ was sent home. CM insists MJ is doing fine ... lashing out at Ortega for sending MJ home from rehearsal. Murray sternly told Ortega to mind his own business. “Unfortunately, that's what happened”.

    On June 21, 2009, MJ was complaining he was half hot and half cold. FM called a nurse who told them MJ needed to go to the hospital.

    On June 23 MJ performed at the Staples Center. By all accounts it was a great performance. There was light at the end of the tunnel. MJ's last rehearsal on June 24 was, again, a success. Everyone was excited that the tour was going to finally happen. MJ was particularly excited about the "illusion" that was to be performed the next day. Walgren goes over MJ’s final goodbyes with Ortega and Phillips.

    CM’s version of events changed. June 25th he said he witnessed the arrest. After MJ's death an arrangement was made to meet with CM at Marina del Rey. CM was there with his lawyers. At this point, investigators knew very little. The cause of the death had not yet been determined. Detectives were working in the dark. They sat down to listen to Conrad Murray to listen to what he had to say. Detectives did not have medical knowledge. CM told detectives he was giving MJ Propofol. When detectives ask how frequently did this happen? Murray tells them every day. CM admitted he gave MJ 50 mg Propofol injections followed by a drip almost every night for two months.

    During his interview, CM told cops he was worried about giving MJ Propofol at 10:00 am because MJ had to be up at noon -- 2 hours later. CM says he agreed to give Propofol when MJ said he didn’t need to get up at noon. This suggests that CM intended to give MJ a drip, because a 25 mg injection would only put someone to sleep for 5 minutes. CM intended to knock him out.

    Walgren says CM didn’t call 911 and it’s bizarre and he aimed to protect himself. CM never called 911 because, as he claimed, speaking to an operator would be negligent ... so what does he do instead? He calls Michael Amir Williams and leaves him a message. Setting aside all the other bizarre behavior, all he needed to say was, "Call 911..." but he didn't. CM knew what he did and his actions killed MJ. Walgren says CM intentionally didn’t call 911.

    Walgren goes over CM’s phone records and emails. Walgren asks jurors if they believe MJ was paying him $150,000 and awake and complaining and CM was away on the phone. Walgren suggests that CM was able to spend all that time on the phone because MJ was asleep on a drip.

    Walgren asks why CM called his female friend Sade Anding at that time. What was so pressing to call her? Sade Anding heard voices in the background at the exact time Murray drops the phone. “Was Conrad Murray in another room? How long was MJ in that condition? Was MJ calling for help? Did he gasp? Did he choke? We don't know ... and we'll never know.”

    Alberto Alvarez comes to the home. CM grabs vials of medicine and instructs him to put them in a bag. Only then does CM asks him to call 911. It took 20 + minutes to call 911. FM finds the children crying. Paramedics responded in 4 minutes. They were a mile and a half away. Walgren says CM put himself first and put MJ last. Blount was able to get ventilation quickly but it was too late.

    As paramedics transport MJ to the ambulance, Senneff finds Murray is picking stuff off the floor and putting it in a trash bag. Walgren asks the jurors to why? They were trying to get MJ to the hospital but CM was in the room alone picking up stuff. Walgren mentions CM’s cargo pants pockets.

    In the hospital doctors ask CM what drugs administered ... again CM never mentioned Propofol. After MJ was pronounced dead, CM is concerned about retrieving a "cream" which he claimed MJ didn't want people to know about. Walgren says CM knows that his bags, drugs, syringes were at the house. CM was not concerned about a cream... he was worried about himself.

    Walgren mentions that detectives found the bags because CM told them where they were. Walgren says CM went into this interview assuming the police had found his bags. He came forward for the self preservation of CM. CM thought his bags were discovered. He knew the toxicology report was about to be completed. He came forward to get ahead of the story. Unfortunately his story doesn't match up with the evidence.

    Walgren switches to standard of care. “Every single doctor has told you they would never have done what Murray did.”

    Propofol should be used in a highly monitored setting. No one had ever heard of anyone using Propofol in a bedroom EVER until CM. There’s no backup. It's an egregious violation of medical care. It's gross criminal negligence. Walgren says the setting is direct cause for MJ’s death.
    Propofol is not used for insomnia. The article the defense used is written after MJ’s death.

    Walgren mentions the equipment needed and being able to use them. None of the required equipments was there. Again this was criminal negligence.

    Walgren goes over the abandonment and the patient should not be left alone because things can happen very quickly. Murray's preoccupation with emails, texts and calls constitute abandonment.

    Walgren says benzos contributed. Walgren mentions what White said about variability and that’s why all the precautions was needed because you cannot know how a patient would react.

    CM kept record in the previous years but he didn’t do for his last 2 months treatment. CM chose not to keep any medical records because he didn't want his bizarre treatment to be documented.

    CM deceived the paramedics and the doctors at UCLA Medical Center.

    Walgren says there had been some speculation with scenarios as they had no medical records. Dr. Steven Shafer said the most likely scenario is that Murray gave Jackson a drip. It's based on the evidence such as the propofol shipments, a cut saline bag, Propofol bottle with CM’s finger prints on it and a spike tear. It’s not unusual Murray admitted he did that every night, a 50 mg injection followed by a drip.

    Walgren says it was perhaps MJ’s idea to put the bottle in the saline bag to hide it.

    Walgren says drip theory explains the blood levels and phone evidence. Walgren says CM was an employee and it’s unrealistic to think that MJ was lying there complaining and CM was ignoring him and being on the phone. MJ wasn't complaining he couldn't fall asleep because he was asleep because CM put him on a drip.

    White’s theories of self injection and lorazepam pills happened during not in 2 minutes but during other times of abandonment.

    CM's former patients say he was a good doctor. They were all treated in a hospital for heart conditions CM was trained to do. Walgren mentions we didn’t hear from CM’s current patients and how they felt about receiving the letter and feeling abandoned.

    Walgren plays defense's own witness Dr. Allan Metzger’s statement that he said there no amount of money would get him to agree to give Propofol in a bedroom. Lee’s statement is played in which she says MJ told him he would be safe as long as he’s monitored by a doctor.

    Walgren says there’s no evidence to suggest that MJ seek propofol without a doctor present. MJ was not reckless. He had a life ahead of him. He had 3 children he loved dearly. He wanted Propofol to sleep but he also wanted a doctor monitoring him at all time to be safe.

    Walgren mentions that Lorazepam is a controlled substance and it should be kept under lock and key and their usage has to be recorded.

    Defense expert Dr. Paul White presented was junk science. It was garbage. It was sad for science and for truth seeking. White has been consistent to blame MJ. When he’s debunked by Dr.Shafer, he goes and picks another theory.

    Walgren goes over what White said about the Beagle study under direct and cross. During direct by Flanagan White says it was his idea. During Walgren’s cross he says he had nothing to do anything with it and didn’t study it.

    White during testimony said he would not administer Propofol in a home setting, a pulse oximeter without an alarm has no value, he wouldn’t leave a patient that liked to push to Propofol alone and he would have called 911 earlier.

    Walgren says White didn’t do the models, didn’t provide any information for the models, he didn’t read the article and he’s not an expert in this area. Walgren says he didn’t research or studied. Walgren says the theories constantly changed.

    Walgren mentions the IV tubing is very compact and concealable. Walgren later plays the video of Flanagan asking White if he has another IV line and White pulling one out of his pocket. Walgren says the IV line was concealable.

    Walgren mentions the 1988 article was old and the 2002 article confirms Shafer’s theory of IV drip and debunks the defense’s self administration theory.

    MJ trusted CM. He trusted him with his life. He paid with his life. CM lied, deceived, obscured but more importantly. CM acted with negligence and he looked out for himself. That's not what a doctor does. CM action directly caused MJ's death. But the People do not need to prove that because all it needs to be proven is that CM is a substantial factor in death. Even if you accept defense's facts CM should still be held responsible.

    Walgren ask the jury to find Murray guilty of manslaughter because he abandoned his patient. "Justice demands a guilty verdict," he concluded.

    lunch break
    Twitter : Ivy_4MJ

  12. The Following 2 Users Say Thank You to ivy For This Useful Post:


  13. #52
    Points: 152,225, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 19.0%
    Achievements:
    Three FriendsOverdrive50000 Experience PointsVeteran

    Join Date
    Sep 2009
    Location
    USA
    Posts
    15,467
    Points
    152,225
    Level
    100
    Thanks
    437
    Thanked 34,536 Times in 7,317 Posts

    Default Re: English Summaries - Easy reference for the Translator Teams

    Murray Trial Day 23 , November 3 2011

    Afternoon Session

    Ed Chernoff Closing arguments


    - Walgren's argument is exactly why we have a jury trial in America.

    - Walgren gave bits and pieces of statements from witnesses regarding propofol, rather than the whole context.

    - Defense team has never stated that Conrad Murray did not make mistakes. But this case is not a medical board hearing or a civil lawsuit. For a crime to be proven, the prosecution has to show that Conrad Murray actually killed MJ. Prosecution must show criminal negligence, but also the specific act was the cause of death, otherwise this is not a crime.

    - What defense believes is that Murray found MJ in distress, at 12 pm. The very first thing Murray did was try to revive MJ. At 11:51 Sade Anding received a phone call from Murray. From Anding's testimony defense believes she listened for about 2 minutes before hanging up. From 11:18 am until 12 noon, Murray was on the phone. If Murray had found MJ anywhere between 11:18 am and noon, the same thing would have happened that Sade Anding reported when she was on the phone with him (Murray would have dropped the phone and tried to revive MJ). Defense states that from 11:18 am to 12 noon, Murray never found MJ not breathing.

    - The nature of propofol, is a 10 minute drug. The only way to keep propofol actually working after that is through an IV drip or IV injection. The prosecution spent 6 weeks trying to prove a drip theory, because the evidence proves that Murray injected propofol into MJ's IV prior to him leaving the room. The prosecution wants the jury to convict Conrad Murray for Michael Jackson's actions.

    -Alberto Alvarez stated that he has had a hard time finding steady employment since MJ died, and that he was offered $500,000 for his story. Alvarez stated when he first talked to police, all he claimed he did was call 911. But when Alvarez spoke to police in August 2009, he then stated he comforted the children, he hid evidence for Murray and he comforted the children. The story became monumentally more compelling and valuable. Chernoff asks the jury if they honestly believe that Alberto Alvarez, after this trial is over, is not going to cash in on MJ's death story?

    -Alvarez stated that he grabbed MJ's legs, Murray got MJ's shoulders and they took him and placed him on the floor. Alvarez stated that Murray asked him to take the IV bag off the stand and that there was a milky substance in the bag, but when tested there was nothing in the bag. Chernoff reminds the jury that the EMT's stated that they found MJ on the floor not the bed.

    -The problem with prosecution theory starts with Alvarez inconsistencies, but moves on to Elyssa Fleak, and that she never mentioned a bottle in a bag originally. In the notes that she didn't destroy, there is no mention of a propofol bottle inside a cut IV bag, and there are no photos of it either. Fleak only mentions it 18 months later in testimony.

    -Detective Smith, who Chernoff claims is a methodical, consummate professional, took notes of a smaller bottle of Lorazepam with an IV bag inside a bag fromt eh room where MJ died but did not remember seeing a vial of propofol inside a cut IV bag. Chernoff says that the reason Smith never saw it is because it never existed.

    -April, 2011: Alvarez is interviewed by LAPD, and draws a picture of the IV bag. Chernoff states that the tubing, the IV bag, insinuating that LAPD coached Alvarez into drawing a bag that was similar to the bags the LAPD had at the interview. Chernoff states that the prosecution's theory was solidified then.

    -Chernoff questions Dr. Shafer's testimony: stating that the IV tubing was hung to prove the prosecution's theory that Murray used an IV drip. Chernoff states that the short tubing used for testimony is used for an IV drip, the short tubing that Murray claims he used would be for IV injection. Chernoff states that Shafer testified he was wrong the next day, even though Murray's life is on the line. Chernoff states that the short tubing is proven to be used by Murray from medical records that show Murray ordered the short tubing only, and no long tubing, therefore showing that Murray did in fact, use an injection IV rather than a drip IV.

    -Chernoff states that Dr. Shafer is a pharmacokineticist first and an anesthesiologist second. Chernoff stated that the prosecution turned Shafer into a cop, and that Shafer stated what he believed he happened as if it were true, but it's merely opinion.

    -Chernoff on Dr. White: White is completely honest and said when needed, I don't have those qualifications to comment on certain testimony, but Shafer never said that. Chernoff states that White knows more about propofol than Shafer will ever, ever know. White just tried to tell the jury the truth, for $11,000. Chernoff states that Shafer gave simulations, one right after another, and none of them have anything to do with the case except for one, and that one is because the defense asked him to do it. Shafer showed a rapid bolus demonstration, when nobody from the defense ever asked him to do that. Shafer worked backwards on his theory (from concentration to dose), and when someone does that, there are a million different outcomes.

    -MJ could not have died from what Murray admitted he did (25 mg injection to IV) and Shafer admitted that. Chernoff questions whether Shafer is a scientist or a prosecution advocate.

    -Chernoff states that prosecution cannot prove a crime. When Chernoff asked Shafer about oral Lorazepam ingestion, Shafer stated that MJ's stomach held 1/300th of a tablet. Chernoff states that defense knows MJ orally ingested Lorazepam, and that's Shafer's exhibits are nothing representative of any proof, it represents nothing.

    -Chernoff states that there are two reasonable scenarios about Lorazepam. First is MJ went into his bathroom and swallowed Lorazepam and Murray didn't know. Chernoff states that if this case were about anyone else, Murray wouldn't be on trial.

    -Chernoff states that Murray's patients were willing to come to court and testify in front of cameras for him. People that know Murray believe that he could never have a disregard for human life as prosecution has claimed.

    -Chernoff states that if Murray is such a liar, why did he tell LAPD he had been giving MJ propofol for 60 days straight?

    -Definition of criminal negligence: prosecution has shown negligence, in many different respects. Three aspects of criminal negligence (as stated on jury instructions) #1 With the act (of propofol in a home), is it the direct cause of MJ's death, and #3, is it the natural probable consequence of the act (the death).

    -Chernoff states that it's easy in hindsight to say that Murray is a lousy doctor, but the prosecution witness doctors have never walked in Murray's shoes. It's easy to judge when people have a miniscule amount of compassion, but do not question his motives. Murray's biggest personality defect is his also his greatest strength; he thought he could help MJ, he thought he could help him sleep. But Murray was wrong, he was a little fish in a big dirty pond.

    -Chernoff states that Murray had no idea why when he came back in the room, MJ looked like he was dead. Chernoff states that Murray should not have been expected to call 911 first, but to try to revive the patient (MJ) first. Chernoff states that Dr. Steinberg stated that maybe two minutes for revival, after that, it's a felony not to call 911.

    -Chernoff states that Murray injected MJ with Flumanezil, runs down and gets Kai Chase, and then says that Chase got Prince I (MJ's oldest son), not Murray.

    -Chernoff states that Steinberg stated that Murray performed substandard CPR, but it's based on testimony that the compressions were done on the bed. Chernoff states that compressions with Murray's hand behind MJ's back, and one hand compressing MJ's chest is not a violation of standard of care. Chernoff states that the prosecution stated Murray deviated from care from the standard of care because he did not provide sufficient for MJ, but Chernoff states that an ambubag was on the floor. Chernoff states that every single thing Murray did, the prosecution claimed that it was a deviation from the standard of care.

    -Chernoff states that the prosecution brought in MJ's kids to gain sympathy. He states that the prosecution brought in Nicole Alvarez for no reason. He states that the prosecution wants to paint a perfect villain and a perfect victim, but there are neither. Chernoff states that the only reason that the fact that Murray helped with the press release at the time of MJ's death was because the defense brought it into testimony.

    -Chernoff states that it is believable that Murray wanted to back to MJ's house from the hospital the day MJ died because his car was there, and it was believable that he wanted to go eat. What is not believable is that Murray wanted to go back to the house to get some cream, that Amir Williams was so disturbed by that, that he locked the house down, but never mentioned it to the police.

    -Chernoff plays the voicemail from Frank Dileo to Conrad Murray again (6/19/09 stating that MJ had an episode, he was sick and Murray should get a blood test on MJ)

    -Chernoff states that MJ was under tremendous, abnormal, impossible pressure from AEG. Chernoff concedes that giving propofol in the home was not an appropriate thing to do. But Murray gave an uncontrolled substance, not Demerol, to MJ. Chernoff states that when Murray went home, the other life of MJ took over.

    -Chernoff repeats Steinberg's testimony that Murray giving propofol to MJ was "like a baby on a countertop". Chernoff states that this was insulting MJ, as if MJ was a baby, couldn't make contracts for himself, couldn't raise his children for himself, because he was just a baby. Chernoff asks if Murray was supposed to watch MJ all the time to save him from himself?

    -Chernoff states to take this case away from MJ, in a psych unit, and some patient kills himself, overdoses. If jury is going to hold Murray responsible, don't do it because it's MJ. This is not a reality show, it's reality, and it's how it affects a real person and the people who love him.

    David Walgren Rebuttal Closing

    -Walgren states that they are not on trial because the victim is MJ.

    -Criminal gross negligence, giving propofol, which is known for respiratory depression, as a one man operation, no safety measures, nothing. Bizarre, unethical, unconscionable behavior that has never been seen before, and that is why Murray is on trial.

    - Murray's patients who were witnesses had the benefit of a hospital, a team, monitors and were being treated for heart conditions, MJ did not have any of those benefits. MJ was being treated for insomnia that Murray knew nothing about.

    -Walgren questions why the witnesses that were called who were Murray's patients were patients from over a decade ago. Walgren questions why none of Murray's current patients were called to testify.

    Walgren: "Poor Conrad Murray. Everyone is just working against him." Defense blamed Elyssa Fleak, Alberto Alvarez, Shafer, AEG, Randy Phillips, Michael Amir Williams, Kai Chase. "Poor Conrad Murray." Walgren states that witness Mr. Ruben states that Murray was grieving, Walgren states that is because it's about Murray and nobody else.

    Walgren states defense contends that Alvarez and Fleak are lying, Shafer is a cop, Kai Chase failed to get security, and "if allowed more time I'm sure they would find a way to blame Michael's son, Prince." Everyone is to blame except for Conrad Murray, according to defense. If Alvarez wanted to lie, he could have done a lot better than a bizarre story with an IV bag and propofol inside of it. Walgren states defense is claiming it's a conspiracy between LAPD, bodyguards, and others to pin this on Murray. Poor Conrad Murray. Everything Conrad Murray did in his treatment was bizarre. Waited 20 minutes to call 911, bizarre. Gave propofol in home setting for 60 days, bizarre. Lied to EMT's and UCLA doctors about giving propofol, bizarre. Is it surprising that Murray had some usual setup for the saline bag? Walgren states nobody knows, but that MJ was sensitive to getting all of the medical stuff cleaned up each day so the children did not see it. Everything Murray did was bizarre, and none of it was consistent with a trained competent medical doctor, who was putting his patient first.

    Walgren states defense blames MJ, that Murray left him alone. MJ sought out propofol to sleep, but only one doctor said yes to administering it. Poor Conrad Murray. MJ is dead. Poor Conrad Murray. Nobody knows what it's like to walk in his shoes. Walgren: "You got that right. Because I haven't seen a doctor in this case that said they would ever do what Conrad Murray did. Ever. Including the defense experts."

    Walgren states that defense closing arguments said nothing about Dr. White's testimony because it was junk science. Shafer on the other hand, did this pro bono, and showed true science to show how MJ died.

    Walgren states that Murray had a legal duty to provide the standard of care for his patient, MJ. If Murray hadn't have left the room, this wouldn't have happened. If Murray had attached a monitoring system to MJ, this wouldn't have happened. If Murray knew how to effectively revive a patient, this wouldn't have happened. The law says that causation only be a natural and probable consequence. If you administer propofol in a bedroom, a natural and probable consequence is that there could be death. It's a respiratory depressant, it has unpredictable effects as both Shafer and White says, it's dependent on your fasting, how much food you ate, other drugs in the system, how dehydrated you are. It is entirely foreseeable and predicatable that death would occur. White, defense witness stated that if he had a patient that liked to push propofol, he would not leave him alone.

    Walgren states that Alvarez could have easily made up easier lies. There's no evidence that Alvarez had any animosity toward Murray, thought he was a good doctor until MJ died. Alvarez nor Fleak have any position in this case, no reason to lie.

    Walgren states that Shafer provided all graphs and data to the defense at their request. Shafer told the truth.

    Walgren states MJ's fingerprints were not on the syringe. Alvarez fingerprints aren't on the saline bag. Conrad Murray's fingerprint is on the propofol bottle found in the saline bag.

    Walgren asks the jury to evaluate the lies Murray told: Murray lied to Ortega, Gongaware, Phillips, Jorrie that MJ was in great health. Murray emailed Bob Taylor in London and lied about MJ's health. MJ lied to EMT's , to UCLA Dr. Cooper and Dr. Nguyen. Murray lied to Tim Lopez, about the propofol being shipped to his clinic rather than Nicole Alvarez apartment. Murray lied when he said he insisted on an autopsy, when he played no role in that whatsoever. Murray lied when he said he got a social group together for the family at UCLA, when it is UCLA protocol. Murray lied when he said he pulled Katherine Jackson aside and asked if there was anything he could do, she asked what happened, and he said he didn't know. Poor Conrad Murray.

    Walgren states law is clear about causation. Defense theory does not fit causation. Murray said he knew MJ was dependent on propofol, Murray said MJ liked to push the drug, and Murray was the one who gave MJ the valium, midazolam, lorazepam and the propofol and abandoned Michael Jackson.

    Walgren concedes that the People cannot prove exactly what happened behind the doors. But jury knows what happened every night, propofol being shipped, and that MJ died. It was a foreseeable and predictable consequence, and what is unusual is that MJ lived as long as he did receiving propofol in this setting.

    Walgren states that if Murray was so concerned, why did he record Michael in his bedroom? This was supposed to be a relationship based on trust, and MJ clearly trusted Murray. Murray brought propofol into the house, administered, abandoned MJ, failed monitoring, failed to call 911, Murray is responsible. Murray is criminally negligent not because this is MJ, but because he behaved in a criminally negligent way. Murray was a substantial factor in MJ's death.

    Walgren asks to jury to consider all evidence, and that he trusts that the jury will find that Murray was criminally negligent, because this was a pharmaceutical experiment in a bedroom. Walgren asks the jury to come back with the only right and true verdict in this case, and the only just verdict in this case. Walgren asks that the jury come back with a guilty verdict for the solitary count of involuntary manslaughter based on Murray's actions and his actions alone.
    Twitter : Ivy_4MJ

  14. The Following 2 Users Say Thank You to ivy For This Useful Post:


  15. #53
    Points: 152,225, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 19.0%
    Achievements:
    Three FriendsOverdrive50000 Experience PointsVeteran

    Join Date
    Sep 2009
    Location
    USA
    Posts
    15,467
    Points
    152,225
    Level
    100
    Thanks
    437
    Thanked 34,536 Times in 7,317 Posts

    Default Re: English Summaries - Easy reference for the Translator Teams

    November 7 , 2011 Verdict Day

    On the second day of deliberations and after deliberating for 8.5 hours jurors reached to a verdict of GUILTY in Conrad Murray trial. DA Walgren asked Conrad Murray to be remanded without bail. Judge Pastor citing that Murray was a danger to the public and he had contacts out of State of California remanded Conrad Murray without bail. Conrad Murray was handcuffed by Deputy Jones and later taken to prison awaiting sentencing. Sentencing hearing is set for November 29, 2011 8:30AM PST.

    Video of the verdict



    Picture of Conrad Murray being handcuffed



    DA Press Conference

    Twitter : Ivy_4MJ

  16. The Following 2 Users Say Thank You to ivy For This Useful Post:


Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •