Video shows 'safe' use of drug that killed Michael Jackson
By Alan Duke, CNN
October 19, 2011 -- Updated 1918 GMT (0318 HKT)
Los Angeles (CNN) -- Jurors in the trial of Conrad Murray watched a video Wednesday of an actor pretending to suffer cardiac arrest while being given the surgical anesthetic propofol in a hospital, which is what prosecutors contend killed Michael Jackson.
The video, however, showed doctors and nurses successfully reviving the pretend patient using equipment, drugs and staffing Dr. Murray did not have at Jackson's home when he realized the pop icon was not breathing.
It was played for jurors as anesthesiologist expert Dr. Steven Shafer narrated from the witness stand, explaining step by step how he prepares and administers propofol.
Shafer is crucial to the state's effort to prove Jackson's death was caused by the doctor's gross negligence in using propofol to help the entertainer sleep while he was preparing for his "This Is It" comeback concerts in London.
Murray, on trial for involuntary manslaughter in Jackson's 2009 death, has pleaded not guilty.
"It's a terrifying dramatization of a person experiencing cardiac arrest, complete with visual effects," defense lawyer Ed Chernoff said in his argument against letting jurors see the video.
While Chernoff argued it was designed to "inflame the jurors' minds," Deputy District Attorney David Walgren said it was only intended to inform them about the safe methods of administering propofol.
The prosecution contends that Murray's use of propofol to help Jackson sleep was so reckless that it was criminal and that it significantly contributed to his death.
Los Angeles County Superior Court Judge Michael Pastor ordered Walgren to edit several segments from the video, but he allowed much of it to be shown in court, including a demonstration of what happens when a patient experiences cardiac arrest while under propofol.
Walgren spent an extended midmorning break re-editing the video to delete scenes, including those showing the actor-patient suffering an airway obstruction and aspiration problems because the prosecution is not alleging those were involved in Jackson's death.
Shafer, who is one of the world's foremost experts on anesthesiology, testified that he is not being paid for his testimony because he did not want people to think money would influence his testimony.
"This is just a Steve Shafer thing," Shafer said.
He agreed to testify, at no charge, because he feared the publicity surrounding Jackson's death had harmed "the reputation of physicians," Shafer said. "I felt a need to help restore confidence that physicians put patients first."
"As an anesthesiologist seeing sedation given in ways that do not reflect how anesthesiologists practice, I wished to present how an anesthesiologist approaches sedation so that patients are not afraid," he said.
Propofol, which he regularly uses, has been given a bad reputation, he said.
"I am asked every day, 'Are you going to give me the drug that killed Michael Jackson?'" Shafer said. "This is a fear patients do not need to have."
Dr. Shafer's testimony was suspended last Thursday to enable his lawyers to study a new lab test and allow the prosecution's anesthesiology expert, Steven Shafer, to attend a medical convention. It was delayed again after a death in the expert's family.
The judge indicated if Shafer's testimony is completed Wednesday, court would recess the following day to allow the defense to prepare before presenting its case Friday.
Prosecutors are nearing a conclusion to their direct presentation, but rebuttal witnesses could be called next week after the defense rests its case.
Murray faces a maximum sentence of four years if convicted of involuntary manslaughter, but a new California law could mean the doctor would never see the inside of a state prison cell.
The law, intended to reduce state prison overcrowding, provides for most nonviolent offenders with no prior record to be kept in county jails.
A four-year sentence could become two years if Murray is ordered to serve his time in the Los Angeles County jail, according to sheriff's spokeswoman Nicole Nishida.
In addition, the Los Angeles jail is under court order to reduce overcrowding, which means many nonviolent, first-time offenders are allowed to serve the bulk of their time under supervised house arrest.
A conviction, however, would likely trigger the revocation of Murray's medical licenses in California, Texas and Nevada.
The trial, in its fourth week, is expected to conclude with the start of jury deliberations near the end of next week.
http://edition.cnn.com/2011/10/19/j...ad-murray-trial/index.html?section=cnn_latest
Jurors get crash course in anesthetic that killed Michael Jackson
By Associated Press, Updated: Wednesday, October 19, 9:59 PM
LOS ANGELES — Jurors in the trial of Michael Jackson’s doctor got a crash course Wednesday on the anesthetic propofol from an expert who showed them a graphic video of what he said was the right way to administer the drug that’s blamed for killing the King of Pop.
The video included numerous safety measures that were not employed by Dr. Conrad Murray when he administered the drug to Jackson as a sleep aid at the singer’s home, according to testimony.
Dr. Steven Shafer, a professor who wrote the package insert that guides doctors in the use of the anesthetic, lectured the panel as if they were in a classroom. He narrated while the silent video took jurors into an operating room to see the specialized equipment and procedures.
Shafer said standards and safeguards are essentially any time anesthesia is given to a patient.
“The worst disasters occur in sedation and they occur when people cut corners,” Shafer said.
In Jackson’s case, he said, “virtually none of the safeguards were in place.”
At one point during the video, Shafer noted that the doctor in the video was taking copious notes.
“Moment by moment, the anesthesiologist writes down everything that happens, as diligently as you are doing here,” he said as jurors scribbled in notebooks.
Testimony has shown that Murray took no notes on his treatment of Jackson and didn’t record his vital signs on June 25, 2009, the day Jackson died.
“The record is not just some static document,” Shafer said. “It’s fundamental to the care that is given.”
He also said Jackson should have signed a written informed consent form to show he knew the danger of his treatment.
“Verbal informed consent is not recognized,” he said. “It does not exist.”
Shafer, a practicing anesthesiologist who teaches at Columbia University Medical School in New York, said he was testifying for the prosecution without a fee because he wants to restore public confidence in doctors who use propofol, which he called a wonderful drug when properly administered.
“I am asked every day in the operating room, ‘Are you going to give me the drug that killed Michael Jackson,’” Shafer said. “This is a fear that patients do not need to have.”
He said he has not charged for testifying in recent years because “there’s a personal thing about not profiting from a medical misadventure” and he doesn’t want to be accused of compromising his integrity.
Shafer, who edits journals on anesthesia and is widely published on the subject, gave jurors a demonstration from the witness stand of how propofol is drawn into an IV bag with a large syringe. He produced a bottle of the white substance that Jackson referred to as his “milk” and showed the steps involved, which took several minutes.
The explanation by Shafer and the depiction in the video seemed to belie an early defense claim that Jackson could have administered the drug to himself. The process shown Wednesday appeared too complicated for self-administration.
The video also suggested the only place for propofol to be administered properly is in a hospital with medical personnel on hand. The video showed a printed warning if problems arise: “Call for Help!”
“You have to respond instantly,” said Shafer. “If there is a problem you call for help before you treat because you’re going to need it.”
Murray, who has pleaded not guilty to involuntary manslaughter, told police he delayed calling 911 because he was giving Jackson CPR.
Murray has acknowledged giving Jackson doses of propofol in the superstar’s bedroom as a sleep aid. However, his attorneys have said the amount of propofol given to Jackson on the day he died was too small to cause his sudden death at age 50.
Chief defense lawyer Ed Chernoff objected to showing the video, but Superior Court Judge Michael Pastor said it was relevant. He ordered a few segments excised by Deputy District Attorney David Walgren before he presented it.
Shafer is the final prosecution witness in the trial, now in its fourth week.
Murray’s attorneys will begin calling witnesses Friday. They plan to call 15 witnesses, including police detectives, character witnesses and Randy Phillips, the head of AEG Live, the promoter of Jackson’s planned series of comeback concerts.
Chernoff said the defense should rest its case by Wednesday.
Murray’s attorneys are also going to call one of Shafer’s colleagues, Dr. Paul White, as an expert to try to counter the prosecution case.
AP Entertainment Writer Anthony McCartney contributed to this report.
http://www.washingtonpost.com/natio...0/19/gIQAXwNgwL_story.html?wprss=rss_national
L.A. NOW
Southern California -- this just in
Conrad Murray jurors see video on 'drug that killed' Jackson
October 19, 2011 | 1:25 pm
After weeks of testimony about alleged failures in the medical treatment of Michael Jackson, jurors at the trial of his personal physician watched a video Wednesday of how prosecutors say things should have gone.
The video, prepared by a Canadian anesthesiologist, demonstrated how propofol, the surgical anesthetic that killed Jackson, is safely used in operating rooms daily and seemed intended as a final rebuke of the care Dr. Conrad Murray gave Jackson.
Played during the testimony of the last government witness, the video walked jurors through the many precautions doctors take, from checking each piece of equipment before administering anesthesia to using a mechanized pump to dispense exact amounts of propofol.
“This is done before each procedure for every patient. There are no exceptions,” Dr. Steven Shafer, a New York anesthesiologist who helped develop national guidelines for the drug, testified Wednesday.
Previous government expert witnesses have condemned Murray’s use of the drug in a home setting — Jackson’s rented mansion — without the proper monitoring or resuscitation equipment on hand. Witnesses have said Murray had only one inadequate monitor in Jackson’s bedroom.
Shafer repeatedly paused the video, made at his request by a colleague, to emphasize the ways Murray’s actions strayed from the appropriate administration of the drug.
When the anesthesiologist on screen discovered that his patient — a family friend drafted as an actor — was not breathing, the words “CALL FOR HELP!” flashed across the top of the video.
“The first thing you say, the first thing you do is call for help,” Shafer said, adding that it was a lesson anesthesiologists learned on their first day of training.
Murray’s delay in summoning an ambulance to Jackson’s home June 25, 2009, is among the reasons prosecutors have cited in urging a Los Angeles jury to convict the physician of involuntary manslaughter.
Prosecutors have suggested the 58-year-old doctor didn’t notice Jackson was in cardiac arrest immediately because he was on the phone and that even after he discovered Jackson stricken, he waited more than 20 minutes before asking that 911 be called.
The video also showed a close-up of the doctor administering two-handed CPR with a caption that said resuscitation efforts should continue until the patient was revived or dead. A Jackson security guard previously testified that Murray performed chest compressions sporadically and with one hand.
The video was presented to jurors over the objections of a defense attorney, who said its only effect would be to inflame jurors.
“The purpose of the video is not to provide information to the jury. It’s to leave an impression,” lawyer Ed Chernoff said. “This essentially is a demonstration of what the prosecution would like the jury to believe occurred.”
The defense contends Jackson caused his own death by swallowing a handful of sedatives and then injecting himself with propofol. They have said he died immediately and no efforts could have saved him.
Before playing the video, Deputy Dist. Atty. David Walgren asked Shafer why he had agreed act as an expert for the prosecution without any compensation. Shafer told jurors it was his practice not to charge because he was “uncomfortable profiting from a medical misadventure.”
He said consulting on the Jackson case was particularly important to him because it had raised questions about the safety of propofol, a drug for which he had helped established national guidelines.
Patients asked him daily, he said, “Are you going to give me the drug that killed Michael Jackson?”
“This is a fear that patients do not need to have. Propofol is an outstanding drug” when properly administered, Shafer said.
The defense is expected to open its case Friday. Murray faces a maximum of four years in prison if convicted.
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