just got back, missed the entire testimony so far, so thanks for updates, will have to severly depend on them, as I'll have to leave in 20 mins again. Just a quick question did they already show the patient going into cardiac arrest or does the judge even allow to bring it in?
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suzynyc
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But very seriously, this video just makes Murray look even guiltier if that was even possible. He SHOULD go straight to hell for what he did to Michael.
gerryevans
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I know it's been said before, but it bears repeating again and again...the up to the minute updates are so VERY APPRECIATED!
suzynyc
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Been wondering about that as well.
suzynyc
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Hmmm I took note of that too as Shafer said it (hope the jury did as well).
Naturelle
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That was an excellent demonstration. It didn't seem that complicated. so, why didn't murray follow instructions? Oh yeah, he was too busy doing other non-important things.
The defense should just give up.
The defense should just give up.
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myosotis
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It would explain why Michael wasn''t eating his supper when he arrived home after rehearsals.......
Bonnie Blue
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The video is finished. The cardiac arrest wasn't painful to watch, just showed a flat line on the monitors - nothing distressing.
Soundmind
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The drip theory for days , weeks and months seems more and more BIZZARE to say the least. Simply the idea that he spiked the vial and hung it there using gravity to infuse propofol is impossible after hearing what Dr.Schafer said .Propofol woud not be infused !!!!
Or he was using 10cc syringes to withdraw propofol from large propofol vials and put it back into the cut saline back to infuse it !!!
Am I to believe that was happening every day for months!!! how many vials needed every day ? at least 3 . How much time and effort did Murray need to withdraw propofol using those small syringes?!!! IF TRUE at least he should have used a larger syringe !!
waiting for the amounts found in MJ's body !!
Or he was using 10cc syringes to withdraw propofol from large propofol vials and put it back into the cut saline back to infuse it !!!
Am I to believe that was happening every day for months!!! how many vials needed every day ? at least 3 . How much time and effort did Murray need to withdraw propofol using those small syringes?!!! IF TRUE at least he should have used a larger syringe !!
waiting for the amounts found in MJ's body !!
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Bonnie Blue
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Soundmind - I know you don't think murray had been using propofol for the past 2 months as he said in his interview, but i just don't know why he would admit to doing so as it makes him look very bad. He didn't have the correct equipment or kept records, and it seems like it was just an accidient waiting to happen.
bouee
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Dr Shafer
Walgren
goes through the basic terminlogy and equipment, Dr Shafer has brought equipment to show the jurors
0.9% sodium chloryde bag (saline bag) : it's salt water. Used for patients who are dehydrated . Gives the patient fluid, it's an «* IV gatorade*». Similar to the white substance in blood. Always used in anesthesia to get a drug into a vein. A saline bag is always running to get drugs in. Shows a port in the lower part of the bag : you can insert a syringe, mix drugs. Rubber that seals when there is no needle. Rubber for a spike at the bottom of he bag : the spike gets the saline out of the bag into a tube.
IV : saline bag and tubing (whole IV set up).
IV injection : injection into the tubing, or into the vein. Describes the route used for the drug.
2 ways of giving drugs : shoot the whole thing all at once = bolus. Infusion = drip
Drip : no used by doctor, used for lay audience. Professional word for drip is infusion. Drip = drop by drop.
Propofol vial, shows how to remove drug from vial. Vial has a rubber stopper wih a foil over it. Showing a propofol vial. 100 ml = 1000 mg; Vial made of glass, sterile. Rubber stopper at the top. Has to go throgh the rubber with a needle, or with a spike.
A saline bag gets smaller when saline comes out, it shrinks. Propofol vials are made of glass, they don't shrink, you have to get air into the vial to be able to get propofol out.
Walgren show the jury shows another propofol bottle for demonstration :
Dr Shafer shows how you take the drug out of the vial :
Removes the foil, exposes the stopper
Walgren gives a syringe and a needle to dr shafer. A 20cc syringe , pushes the plunger to the maximum (makes an airtight seal inside the syringe)
Sticks the syringe into the vial, and shows that this way you can draw very little propofol, it's hard, has to put air into the syringe ; takes the syringe out, pulls the plunger back, injects the air into the vial, and now can pull the propofol out. Needs to replace the vacuum in the vial with air.
Stopper now has a very small hole.
Now talking about People's thirty (propofol bottle found at Mjs home, in the saline bag with the tear) : rubber not so good quality, desnt self seal. The line in the stopper indicates that a spike, not a needle, was used, and so it was connected to an infusion line; A needle would never do that. That's what you expect to see from a spike.
Dr Shafer has evaluated the standard of care provided by murray to MJ
Dr Shafer has made a video for his case, to demonstrate what is necessary for sedation, even for 25mg propofol.
Playing the video : «*an over view of safe administration of sedation*»
1 st prepration of the room, checks the equiment. Shows airway equiment tube for the throat (if the tongue blocks airway), a nose to throat tube. Shows a laringoscope, if previous equipment didn't work an you need to intubate . Endotracheltube : gets air directly into the windpipe. You need a laringoscope to put the endotracheal tube. Dr Shafer says the most imptant part of or job is to get air to the patient.
Laryngeal (spelling ???) mask airway : goes in the back of throat, wraps around the larynx , so there's an unimpeded flow of air and oxygen into the lungs. Insists it's the most importat part of the job.
Organisation is important, you have to respond in a matter of seconds.
Primary oxygen delivery : checks if the oxygen supply work.
Nasal cannula /capnometer : one small tube per nostril : one tubing contains oxygen, the other measures carbon dyoxide and is connected to a capnometer. Checks with his own breath to check that it works.
Anesthesia breathing circuit : something has got to move the air in the patient. Normally it's the diaphragm and the chest. If the patient is not brething you have to do it for him. Shows mask and bag, to push the air into the lungs. Checks that its working.
Suction apparatus : is essential : the fear is that the content of the stomach gets into the lungs. Acidity will destroy the lungs, bile in the lungs is very feared, because it destroys the lungs quickly. If bile gets into the lungs, the patient can die. That's why you don't eat or drink prior to an anesthesia. If it happens, you have to be very fast, romove evrything, before the next breath. Checks the suction apparatus. The anesthesiologist is responsible for the equipment, has to check before sedating the patient.
Oxygen tank : back up in case the oxygen circuit fails. Has a bag attached to it. If for some reason the breathing circuit fails, you have two ways to force air into the lungs
Setting up infusion pump : pump is a mechanical device that will set the rate precisely. The pump needs to be setup very preciseley. Takes 5 to 10 mn to set.
Propofol : 100 ml galss vial. Remove the foil , draws into a syringe. First pulls air into the syringe, takes multiple draws to fill the syringe, takes a few moments. Insists on the fact that it's not easy to draw propofol from the vial.
Narrow tubing : les 1 cc of propofol in the whole tubing. Wide tubing is problem cause it can expand or «*shrink*» or fold (not sure I got that right, it's the general idea).
Loads syringe into the pump (the pump will push the plunger automatically)
programms the pump : chooses the drug (propofol OR), (and by the way you saw that midazolam was in the settings of the pump ), enters the weight of patient, sets initial infusion rate. Then verifies the settings again.
Then goes to see the patient, to assess the patient. Wether you do it before or after the room setting , you always assess the patient. Anesthesiologist is repsonsible for knowing his patient. Makes a physical examination, first thing is airway, listens to the lungs, checks the heart. Always done for each procedure, for every patient. No exception.
Informed consent : that's the doc you sign, and the process in which the physician informs of possible risks, the foreseeabale risks; you need to be able to suggests alternative treatment if needed. Physician explains what he is going to do, answers questions from patient. Not oly a doc, it's a whole process The document is important, it shows that the process has been done. Oral consent is not binding, and is not recognised, doesn't exist.
Not shown in video : patient put on table. blood pressure cuff, pulse oximeter, ECG are put on patient. Oxygen in place, intravenous catheter is put into the patient. Pauses to verify again , one last check before injecting he propofol.
Pulse oximeter is on patient, infusion pump is set, airways equipment right nest to the patient, nasal cannula on the patient, infusion pump is started.
Popofol is injected; Anesthesiologist is close, can touch the patient, taps shoulder to check if patient is sleepy. Anesthesits writes down everything : pulse oximetry, BP, heart rate, drugs , everything.
Charts is part of therapy : used to keep track of drugs, tracks of vital signs. If there a problem, you can go back and see what happened; patient might need it. It's a responsability to the patient
Anesthesists checks the patient , shows the monitor , with the vital signs. Vital signs in this case are normal.
Checks the infsion pump.
Checks he saline carrier infusion : shows the spike in place. You can see the drip in a chamber;
Writes down things on the chart again.
BP drops : sees that every day, propofol lowers BP. Especially if the patient is dehydtated. It's no big deal. Gives ephedrine, through the IV line, and flows into the patient along with the saline. BP comes back up.
Carbon dyoxide : Carbon dyoxide stops, means the patient is not exhaling. Shows the airway is obstructed. Anethesiologist knows in seconds
Jaw thrust / Chin lift : shows how it's done. It's done routinely. Most commonly the tongue comes out of the way and patient breathes. If doesn't work , you grab the jaw and push it foward.
Nasal cannula, if you need you push oxigen into the lungs until the patient breathes.
Apnea : it's a prolonged period with no breathing; patient is not even trying to breath; you have to take over and force the air into the lungs. Applies the mask and squeezes bag to force oxygen into the lungs.
Aspiration (not shown) : patient starts to vomit : patient is turned sideways, before he next breath you need to suction everything out. It is critically imprtant. No more than one second to react.
Cardiac arrest : heart stops beating, patient is not bretahing. You have to respond instantly. Instant assessment of patient, to make sure the monitor has not failed. and calls for help. First thing you learn in BLS, ACLS , or as anethesiologist is to call for help. One person begins CPR, another person is ventilating, another gives specific medication. All this will keep the patient alive enough time to fix the problem that caused the arrest. This continues until the patient revives, or is pronouced dead.
Lunch break
great great great witness, very easy to understand
Walgren
goes through the basic terminlogy and equipment, Dr Shafer has brought equipment to show the jurors
0.9% sodium chloryde bag (saline bag) : it's salt water. Used for patients who are dehydrated . Gives the patient fluid, it's an «* IV gatorade*». Similar to the white substance in blood. Always used in anesthesia to get a drug into a vein. A saline bag is always running to get drugs in. Shows a port in the lower part of the bag : you can insert a syringe, mix drugs. Rubber that seals when there is no needle. Rubber for a spike at the bottom of he bag : the spike gets the saline out of the bag into a tube.
IV : saline bag and tubing (whole IV set up).
IV injection : injection into the tubing, or into the vein. Describes the route used for the drug.
2 ways of giving drugs : shoot the whole thing all at once = bolus. Infusion = drip
Drip : no used by doctor, used for lay audience. Professional word for drip is infusion. Drip = drop by drop.
Propofol vial, shows how to remove drug from vial. Vial has a rubber stopper wih a foil over it. Showing a propofol vial. 100 ml = 1000 mg; Vial made of glass, sterile. Rubber stopper at the top. Has to go throgh the rubber with a needle, or with a spike.
A saline bag gets smaller when saline comes out, it shrinks. Propofol vials are made of glass, they don't shrink, you have to get air into the vial to be able to get propofol out.
Walgren show the jury shows another propofol bottle for demonstration :
Dr Shafer shows how you take the drug out of the vial :
Removes the foil, exposes the stopper
Walgren gives a syringe and a needle to dr shafer. A 20cc syringe , pushes the plunger to the maximum (makes an airtight seal inside the syringe)
Sticks the syringe into the vial, and shows that this way you can draw very little propofol, it's hard, has to put air into the syringe ; takes the syringe out, pulls the plunger back, injects the air into the vial, and now can pull the propofol out. Needs to replace the vacuum in the vial with air.
Stopper now has a very small hole.
Now talking about People's thirty (propofol bottle found at Mjs home, in the saline bag with the tear) : rubber not so good quality, desnt self seal. The line in the stopper indicates that a spike, not a needle, was used, and so it was connected to an infusion line; A needle would never do that. That's what you expect to see from a spike.
Dr Shafer has evaluated the standard of care provided by murray to MJ
Dr Shafer has made a video for his case, to demonstrate what is necessary for sedation, even for 25mg propofol.
Playing the video : «*an over view of safe administration of sedation*»
1 st prepration of the room, checks the equiment. Shows airway equiment tube for the throat (if the tongue blocks airway), a nose to throat tube. Shows a laringoscope, if previous equipment didn't work an you need to intubate . Endotracheltube : gets air directly into the windpipe. You need a laringoscope to put the endotracheal tube. Dr Shafer says the most imptant part of or job is to get air to the patient.
Laryngeal (spelling ???) mask airway : goes in the back of throat, wraps around the larynx , so there's an unimpeded flow of air and oxygen into the lungs. Insists it's the most importat part of the job.
Organisation is important, you have to respond in a matter of seconds.
Primary oxygen delivery : checks if the oxygen supply work.
Nasal cannula /capnometer : one small tube per nostril : one tubing contains oxygen, the other measures carbon dyoxide and is connected to a capnometer. Checks with his own breath to check that it works.
Anesthesia breathing circuit : something has got to move the air in the patient. Normally it's the diaphragm and the chest. If the patient is not brething you have to do it for him. Shows mask and bag, to push the air into the lungs. Checks that its working.
Suction apparatus : is essential : the fear is that the content of the stomach gets into the lungs. Acidity will destroy the lungs, bile in the lungs is very feared, because it destroys the lungs quickly. If bile gets into the lungs, the patient can die. That's why you don't eat or drink prior to an anesthesia. If it happens, you have to be very fast, romove evrything, before the next breath. Checks the suction apparatus. The anesthesiologist is responsible for the equipment, has to check before sedating the patient.
Oxygen tank : back up in case the oxygen circuit fails. Has a bag attached to it. If for some reason the breathing circuit fails, you have two ways to force air into the lungs
Setting up infusion pump : pump is a mechanical device that will set the rate precisely. The pump needs to be setup very preciseley. Takes 5 to 10 mn to set.
Propofol : 100 ml galss vial. Remove the foil , draws into a syringe. First pulls air into the syringe, takes multiple draws to fill the syringe, takes a few moments. Insists on the fact that it's not easy to draw propofol from the vial.
Narrow tubing : les 1 cc of propofol in the whole tubing. Wide tubing is problem cause it can expand or «*shrink*» or fold (not sure I got that right, it's the general idea).
Loads syringe into the pump (the pump will push the plunger automatically)
programms the pump : chooses the drug (propofol OR), (and by the way you saw that midazolam was in the settings of the pump ), enters the weight of patient, sets initial infusion rate. Then verifies the settings again.
Then goes to see the patient, to assess the patient. Wether you do it before or after the room setting , you always assess the patient. Anesthesiologist is repsonsible for knowing his patient. Makes a physical examination, first thing is airway, listens to the lungs, checks the heart. Always done for each procedure, for every patient. No exception.
Informed consent : that's the doc you sign, and the process in which the physician informs of possible risks, the foreseeabale risks; you need to be able to suggests alternative treatment if needed. Physician explains what he is going to do, answers questions from patient. Not oly a doc, it's a whole process The document is important, it shows that the process has been done. Oral consent is not binding, and is not recognised, doesn't exist.
Not shown in video : patient put on table. blood pressure cuff, pulse oximeter, ECG are put on patient. Oxygen in place, intravenous catheter is put into the patient. Pauses to verify again , one last check before injecting he propofol.
Pulse oximeter is on patient, infusion pump is set, airways equipment right nest to the patient, nasal cannula on the patient, infusion pump is started.
Popofol is injected; Anesthesiologist is close, can touch the patient, taps shoulder to check if patient is sleepy. Anesthesits writes down everything : pulse oximetry, BP, heart rate, drugs , everything.
Charts is part of therapy : used to keep track of drugs, tracks of vital signs. If there a problem, you can go back and see what happened; patient might need it. It's a responsability to the patient
Anesthesists checks the patient , shows the monitor , with the vital signs. Vital signs in this case are normal.
Checks the infsion pump.
Checks he saline carrier infusion : shows the spike in place. You can see the drip in a chamber;
Writes down things on the chart again.
BP drops : sees that every day, propofol lowers BP. Especially if the patient is dehydtated. It's no big deal. Gives ephedrine, through the IV line, and flows into the patient along with the saline. BP comes back up.
Carbon dyoxide : Carbon dyoxide stops, means the patient is not exhaling. Shows the airway is obstructed. Anethesiologist knows in seconds
Jaw thrust / Chin lift : shows how it's done. It's done routinely. Most commonly the tongue comes out of the way and patient breathes. If doesn't work , you grab the jaw and push it foward.
Nasal cannula, if you need you push oxigen into the lungs until the patient breathes.
Apnea : it's a prolonged period with no breathing; patient is not even trying to breath; you have to take over and force the air into the lungs. Applies the mask and squeezes bag to force oxygen into the lungs.
Aspiration (not shown) : patient starts to vomit : patient is turned sideways, before he next breath you need to suction everything out. It is critically imprtant. No more than one second to react.
Cardiac arrest : heart stops beating, patient is not bretahing. You have to respond instantly. Instant assessment of patient, to make sure the monitor has not failed. and calls for help. First thing you learn in BLS, ACLS , or as anethesiologist is to call for help. One person begins CPR, another person is ventilating, another gives specific medication. All this will keep the patient alive enough time to fix the problem that caused the arrest. This continues until the patient revives, or is pronouced dead.
Lunch break
great great great witness, very easy to understand
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as always it was exaggeration on defense part to take the video out. from the commentary we understood that it was just a demonstration. Dr. Huang (I believe) shot the video with his kids acting as medical personnel and a friend of them acting as patient. The only cardiac arrest that we have seen was the monitors going flatline and then a hand doing cpr , a person giving resuscitation drugs and the doctor using an ambu bag. It wasn't graphic at all.
xthunderx2
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Shafer NEVER said that the propofol was NOT being infused...on the contrary that is where this demonstration is going. Know what else...at this point .,,it doesn't really matter if the propofol was infused or bolused...Michael is dead...and he is NOT coming back. So whatever the outcome is...it won't bring Michael back. Now THAT is FACT. Murray will do his time...and then he will move on with his life...but still...Michael is gone.
Soundmind
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well after hearing what Schafer said , how could have he possibly sedated MJ for hours without infusion pump?
He said it back then because he wanted the detectives to believe MJ was addicted to it and was getting it every day thus when he declined to give him his milk on June 24 and June 25 he suffered from withdrawal caused by his "mental and pshychological dependency !!( propofol is not addictive per his own admission ) and eventually got it himself .
I mean the guy is a pathological liar , just from hearing schafer words and watching that video how could you expect me to believe MJ SUVIVED being put under for almost 500 hours !!!!
He said it back then because he wanted the detectives to believe MJ was addicted to it and was getting it every day thus when he declined to give him his milk on June 24 and June 25 he suffered from withdrawal caused by his "mental and pshychological dependency !!( propofol is not addictive per his own admission ) and eventually got it himself .
I mean the guy is a pathological liar , just from hearing schafer words and watching that video how could you expect me to believe MJ SUVIVED being put under for almost 500 hours !!!!
rita.gibson
Proud Member
I'm sure he'll be asked.
Murray has performed surgery himself and knows full well what preparation and monnitering equipment an anesthesiologist uses, he was far more than just negligent.
gerryevans
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Actually, it could have just the opposite effect of making him look bad. That is, if he had been using it for 2 months without incident, that proves he'd been successful in his using it, and what made the 6/25th outcome different is that MJ out of desperation took matters in his own hands.
Autumn II
Proud Member
Of COURSE. At that time (interview) Murray didn't know what the police knew, and what they didn't. I hardly think he would have said he was "giving propofol for two months," if he was not? That only served to make him look more irresponsible, so why say it, if it was not the truth? Now that we've seen the video, I'm wondering if the jury will find anything Murray did right? At all?
qbee
Proud Member
Murray is not a heart sugeon. I think that was stated early on. He is a cardiologist.
but he still should be at least familiar with these proceedures and the dangers of
anisthetics.
I just dont know how Dr White can contradict anything Dr Shafer has stated.
will be interesting to say the least
Bonnie Blue
Proud Member
The steinberg dealt with that by using the baby on the kitchen top example. Constant monitoring was essential even if the chances of something bad happen was relatively slim.
And did mj understand suction and letting in air into a glass bottle when he was supposedly busy filling up the syringe with prop - all whilst under the influence of a load of lorazepam? That was clever of the pros to have that demo.
indranee
Proud Member
Yep, and no wonder he was losing weight. he was pretty much having one full meal a day, if that.
I missed the video 'cos we had to go to a meeting at work
Will see how fast youtube uploads this one. Was the video traumatic, guys?
Popescu
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No. They make patients fast before being given general anesthesia because they put them under in "deep sedation". Propofol can be used for sedation that does not require intubation (the patient can breathe on his own, but is still sedated) or for deep sedation (the patient can no longer breathe and has to be ventilated, either with a ventilation mask or by intubating him). As a prior witness indicated, the line between those two is very thin and it happens all the time that a patient would go into deep sedation even though he was not supposed to, according to the dosage that he received.
When a patient requires intubation, that means the muscles in his body are not functioning properly or at all. If there is food in the stomach, it can come up the esophagus (no more muscle function) and since there is no gag reflex (again, no muscle), the food may go into the lungs and the patient might die.
The dose that Murray gave did not require intubation (until it did), so there was no reason for fasting.
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No. It wasn't a dramatization or a reenactment. It was a simple demonstration video with nothing disturbing.
elusive moonwalker
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Off to work now guys. Appreciate it if u can keep the updates going so i can follow