RedMaryFlint
Proud Member
Many things about Michael's death and Murray's actions have so far proved baffling. I was studying the police affidavits and the timeline of events in an effort to understand, when I noticed that it was after the medical scare on 6/21/09 that Murray changed the medication from weeks-long administration of propofol to eliminating it in favor of benzodiazepines. That indicated that Murray knew there was a problem, and suspected the propofol as the cause. Yet, two days later, he returned to administering the IV of propofol, and the worst happened. That night, by his own account, he first administered a series of benzodiazepines by the "IV push" technique -- inserting a syringe of medication into the IV line and slowly pushing the drug into the IV. But he must have used another method to administer the propofol consistently over the course of several hours, because otherwise Michael would have awakened due to the quick recovery time characteristic of propofol. A common way is through use of an infusion pump, which is a device that can be programmed to release a set amount of medication into an IV line. These devices aren't problem-free, however, particularly in inexperienced hands. I found the following two papers on line with a bit of searching:
http://www.anesthesia-analgesia.org/cgi/reprint/102/4/1154.pdf
This one describes an accidental overdose of anaesthetic in a hospital caused by a missing part of the infusion pump assembly, which caused the pump to falsely detect the syringe of the drug as smaller than it actually was. An alarm that was supposed to warn of incorrect syringe placement didn't go off. Apparently, a whole host of things can go wrong with infusion pumps, including using syringes not recommended by the infusion pump manufacturer, user error in pump setup, and no protection from free-flow of IV solutions. It also notes that using supplemental oxygen can disguise the fact that a patient has stopped breathing, whereas monitoring exhaled CO2 is a quicker way to detect it.
http://www.jointcommission.org/sentinelevents/sentineleventalert/sea_15.htm
This one is a study of accidents involving infusion pumps, which says that experts have found that the main problem is using pumps that don't protect against the free-flow of intravenous medication into the patient. Other similar problems occur when the wrong drug concentration is given or the wrong rate is set.
We know from the LA Coroner's statement that Michael died of acute propofol intoxication, exacerbated by benzodiazepines. The acute propofol poisoning is consistent with the most common problem occurring with the use of infusion pumps. Is it possible that Murray dismantled the IV and infusion pump setup after he was able to get Michael to sleep without propofol, thinking after the Father's Day incident that he would never use it again, then reassembled it improperly in the early hours of the 25th, flustered at his inability to get his patient to sleep? Could his use of an oximeter instead of monitoring exhaled CO2 have prevented him from realizing earlier that Michael had stopped breathing? Some of these devices have logs recording the circumstances of their use. Could the police yet discover from the log whether it was used improperly?
http://www.anesthesia-analgesia.org/cgi/reprint/102/4/1154.pdf
This one describes an accidental overdose of anaesthetic in a hospital caused by a missing part of the infusion pump assembly, which caused the pump to falsely detect the syringe of the drug as smaller than it actually was. An alarm that was supposed to warn of incorrect syringe placement didn't go off. Apparently, a whole host of things can go wrong with infusion pumps, including using syringes not recommended by the infusion pump manufacturer, user error in pump setup, and no protection from free-flow of IV solutions. It also notes that using supplemental oxygen can disguise the fact that a patient has stopped breathing, whereas monitoring exhaled CO2 is a quicker way to detect it.
http://www.jointcommission.org/sentinelevents/sentineleventalert/sea_15.htm
This one is a study of accidents involving infusion pumps, which says that experts have found that the main problem is using pumps that don't protect against the free-flow of intravenous medication into the patient. Other similar problems occur when the wrong drug concentration is given or the wrong rate is set.
We know from the LA Coroner's statement that Michael died of acute propofol intoxication, exacerbated by benzodiazepines. The acute propofol poisoning is consistent with the most common problem occurring with the use of infusion pumps. Is it possible that Murray dismantled the IV and infusion pump setup after he was able to get Michael to sleep without propofol, thinking after the Father's Day incident that he would never use it again, then reassembled it improperly in the early hours of the 25th, flustered at his inability to get his patient to sleep? Could his use of an oximeter instead of monitoring exhaled CO2 have prevented him from realizing earlier that Michael had stopped breathing? Some of these devices have logs recording the circumstances of their use. Could the police yet discover from the log whether it was used improperly?
