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Murray Trial - 12 October - Day 11 - Discussion

82Thriller84 said:
Dr. Steinberg is aware that Murrary was not Board Certified on June 25th 2009.

Dr. Steinberg works with 9 other Cadiologists who are ALL board certified & he's a Chief Caridologist in Verntura.
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I can't remember, what's the different between Board Certified and not being Board Certified?
 
I like this guy, lets hope he's as good on cross when FlanChern confuse him with their cross
 
I really like Dr Steinberg. He knows what he's talking about, and is giving plenty of information to the jurors. Will be interesting to see what else he says!
 
Did expert review in this case, had conducted other expert reviews, approx 8, about in half found no deviation, this first time hs's found an extreme deviation.

Cardiologist use sedatives all the time, so you're relaxed during procedure, are instances when propofol are used in cardio eg in TEE procedure put in a probe with ultrasound in your oesophagus to get pictures.

Cardio's are experts in mild and moderate sedation ie conscious sedation still able to respond to verbal or tactile touching. You have to show have had training in moderate training.

Deep Sedation - you're only responsive to painfull or repeated stimulus and could stop breathing, one procedure that requires this is electro cardio ie have an arrythmia and shock your heart back to normal as can be painful.

They ask anastesologist to doing it.

(sorry about my awful spelling)
 
Ramona122003 said:
I can't remember, what's the different between Board Certified and not being Board Certified?
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While being board-certified guarantees a doctor has met a minimum competency requirement, the same cannot be said for those who are not board-certified. Non-certified doctors may be more or less competent.

They may not be board-certified because they have not made application for their certification credential, because they have been turned down for membership, or because they have lost the credential for failing to continue meeting the minimum requirements.
 
Extreme deviation from the standard of care is defined as gross negligence.
Conducted a review of this case invlovling MJ. Found extreme deviations
 
yea I like him too lol... He is taking digs at muarry and Muarry is side eying the hell out of him.

sn: he is arrogant
 
This guy is like a 'reason why you suck' speech to Murray. I swear, Murray looks like he wants to strangled this guy.
 
Only time propofol is used, an anethesiologist takes care of the administering of the propofol when in Steinberg's place of work.
 
Explains different levels of sedation. Mild, Moderate, Deep & General Anaesthesia.

Dr. Steinberg wanted to make his opinion, based purely on Murrays' words and he found & listed 6 things that were classed as gross negligence.
 
Lisitng the Six extreme departure of standard of care found in CM treating MJ
 
Straight away mentions how they only use propofol when doing a complex procedure. Always discuss risks, benefits and perhaps other methods.
 
This witness comes across as someone who's very confident and on top of his game. He gives thorough explanations of all the medical stuff, very easy to understand. Can't wait to see Chernoff/Flanagan try and confuse this guy! Ohhh it's going to be hilarious. lol
 
I can't wait to see defence try and rip into this guy! Definitely knows what he's talking about. Really good witness so far, impressed.
 
This guy is awesome! I love how he takes digs at Murray, but does it well in a professional way....Good on him...
 
Explaining now that Murray's machine did NOT have an alarm and saying why there SHOULD be an alarm on such a machine, when Propofol is being administrated.
 
Saying that Murray's oximeter did not have an alarm, which is crucial when person is under propofol. Would need to watch the monitor constantly to ensure person did not enter problems. Also did not have automated blood pressure cuff. Had a manual cuff but it was not in use.
 
As well as those oxygen is needed, which Murray had. Also need suction, because under propofol people can regurgitate and this can enter the lungs.
 
He said an ambu bag would have been needed, but that Murray did mouth to mouth, though there was an ambu bag on the floor...
 
Steinberg is really good! So informative, and does it so that the jury/everyone else can understand it. No medical jargon that can confuse people. Brilliant!
 
Yes!! He mentioned the lack of use of the Ambu bag. This was something I noticed in the transcripts as well. Murray NEVER mentions using it but we see it in the pix. I was wondering WHEN or IF he ever used it and if not, why not? If he hates mouth to mouth why not use the ambu bag. It was the 1st thing the paramedics used when they came into the room. They put their own ambu bag on MJ to work on respiration. Murray is toast. He screwed up in sooo many ways. He killed him over and over again!!
 
A lot of special drugs are needed when using propofol, to reverse the effect. Murray only had one of them.
 
He decided to judge Dr Murray on his own words...relied solely on his testimony (bet defence regret doing that interview know)

Found 6 extreme deviations each one distinct and amounting to gross negligence:

1) Propofol not medically indicated - ie don't use it for sleep or psychological reasons, need written informed consent, it's a basic tenet, risk of stop breathing, never heard of any doctor using propofol to treat insomnia,

2) Giving Propofol in some ones house, unmonitored without proper equipment and , proper personnel or attending (each individually would be counted as gross negligence but listed them together) - Going over equipment should have eg pulse oxymeter with alarm, Murray had no automated blood pressure as should check blood pressure every 5 mins, EKG monitor to monitor heart rythm which he didn't have, oxygen is needed nasal or mask, suction is needed as can regurgitate into your mouth, ambubag is needed he didn't use it even though he had one (took that from his statement when he said gave mouth to mouth). A way to summon for help eg a nurse or button, backboard is needed if you need to give CPR, backup battery if have black out for equipment he's discussed above. Device to keep airway open, equipment to rescue airway so can intubate patient ie endotrachail tube, defribrilator, lots of special drugs to reverse he had one flum (he mentions others needed including lidocaine). Should have assistant to help whose ACL (advance life support) and BLS (basic live support) certified

3) inadequate preparation - need to be prepared to use the equipment and the equipment be ready

4) Improper care during the arrest - when he was trying to resuscitate didn't follow proper protocol, explaining what an cardi arrest is, need defrib to shock person, do CPR and chest compression must be on flat surface need to use two hands and go down two inches.

Respitory arrest that Michael had - heart is beating fine, this is where Dr Murray found MJ according to his testimony, He said he left for two mins, should have called 911 first, try to arouse MJ, grabbed ambubag tilted his head and start using to try and get oxygen and giving flumaz asap. He started doing CPR which is inexcusable as there was a blood pressure - counter productive on hear already working. His CPR was poor quality have to go two inches cant do that with one hand or underneath a soft bed, should have put him on the floor with two hands. Aware MJ was 136 pounds would get behind MJ and slide him down ( Walgren demonstrates on Ms Brazil :) ) - thinks would be an easy procedure.
 
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