sorry again for the delay .. 1st part
Dr Shafer
Walgren
stipulation : tap handle = plastic handle at the side of the bottle that can be used as a handle
Dr Shafer has reviewed the coroner's toxicology report , has confimed this is the pure drug , as opposed to any metobolite. Dr Shafer sas reviewed their procedures , their results do not iclude the metabolites for propofol and lorazepam.
Dr Shafer confirms the real slit bag and bottle can be used as demonstrated
Dr Shafer made a spreadsheet software available to the defense so they culd do their own models.
At time of death, wether eyes are open or close doesn't mean anything about slow death o quick death.
It's possible that MJ moved the infusion line, and changed the speed of the infusion. CM wuld still be responsible because CM left the room and set up a very dangerous IV set up.
Cross by Chernoff :
pharmacokinetics : deals with the movemet of drugs.
There are several ways of getting a drug into the body : IV, IM, oral, through the skin, anal, inhalation, missed one, sorry.
Number of doses given matter to calculate the concentration
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ususallu dr Shafer's work is to determine the concentration from the dose, usually he knows the dose given.
Dr Shafer has created a computer programmes to do this calculation. Because people are different, the models provide ranges, to alow for this differences.
Data is based on human people that are studied, people vary : example : Chernoff says if I take a 2mg loarzepam pill, i might fall asleep an you migt be awake = Dr Shafer says yes, people vary , but not that mutch
The mean represent half of the people response (to a particuar drug). Median would be a more representative term.
In this case dr Shafer had to do something different : he only had the concentration to calculate the dose. There is no computar programme that could possibly do this. Dr shafer agrees
You explained the method (IV set up demonstrated yesterday ), and you said you had never seen this done before.
Is what you think happened ? Yes . Is it a bold statement ? No, it's an honest statement
Chernoff : there was only one IV line at the scene.
Why did you bring that IV line : Dr Shafer contacted Sea coast, but Sea coast was unable to ship it quick enough, so Dr shafer took it from Columbia. The one Cm bought was another one, it was an Excel 00774.
Chernoff has the sea coast excel 00774, asks Dr Shafer if he was aware that the prosecution had one. Dr Shafer says he was ot aware of that, Chernoff brings it to Dr Shafer.
The line Chernoff brought is dirty, dr Shafer asks what the brown stuff is, chernoff says it's milk, and the brown substance is not blood
Chernof brings Dr Shafer the tubing he used yesterday
Chernoff : You said that it was impossible to use the line without the saline. Dr Shafer says the excel set could not be used because it was not vented. Without a vented line, you can not infuse the bottle.
Chernoff asks why he assumed CM had used that type of line : Dr Shafer reads the Saecost report : 25h march CM orders safesite lines , his credit card is declined . April 13th : CM asks for it to delivered to a California home. Sea coast refuses. Dr shafer says that it suggested to him that CM intenteded to use it. CM had oredered these in 2007, 2008. He ordrerd them frequently , 4 times over 3 years. (2007, 2008?2009)
did he use it in MJs room : yes, CM needed a vented set , and because of the tear in the bottle. There was no trace of needle in the propofol bottle in the bg. If there was a needle hole, he could have used another type of tubing, but on this particular bottle, that day, there was a tear, not a needle hole.
Chernoff : or there was no tubing at all. Dr Shafer : how would you draw the propofol ?
Chernoff t's your opinion (emphasises the word opinion) ? (discussion about the word opinion) Dr Shafer : Yes it's my opinion, for example it's my opinion that one should not lie to Ucla doctors.
Chernoff : what you stated was the actual setup used on MJ, or your opinion ? Did Mr walgren ask you to do that demonstration ? Dr Dhafer : Mr Walgren didn't ask me to do that, I just did that demonstration . It is my opinion that's what happened
Chernoff would you be surprised if other experts had a different opinion ? ,Objection, sustained
Dr Shafer : CM requuested this IV, and asked it to be sent to califorrnia
Chernoff : is there Anyhting else that shows it was at Mjs house ? Dr Shafer says it's the only vented set that he saw. Referred to that particular bottle , because of the tear. CM needed a vented set.
Chernoff : Police didn't find that vented line, but they found a lot of other stuff, but not that IV line. Dr Shafer : It's not evidence that it was not there, it's easy to hide, vials are bulky, needles can hurt.they are less easy to hide.
Chernoff : CM said he gave 25 mg = 2.5 cc , in a 10cc syringe. You used a 20 CC syringe : Dr Shafer : yes , I thought the size of the syringe was irrelevant.
Cm did say 2.5 cc propofol, CM said one to one, so Ss asumed it was 2.5 + 2.5
Chernoff : CM said he pushed the syringe into the y connector.
Chernoff : you used a different line, and a diffrent syringe. Port of the line CM used was actually substantially closer (to the spike I think). Dr Shafer agrees to this.
Chernoff : you used a diffrent propofol bottle. It's thinner and taller; the propofol you put in the bag had some propofol out of it, Dr shafer estimates 6 or 7 Ccs were out of the bottle.
Dr shafer used pictures to estimate the tear of the bag. He paid 150$ to buy 3 bags and have them shipped overnight. He had never seen that, it picked his curiosity.
How do you know CM did it this way ? : Dr Shafer because the slit bag was at he scene Chernoff : «*that's what I thougt*» (sarcastic)
Dr Shafer was contacted on march 31st by the prosecution, who told him dr White had made a report, the prosecution sent Dr Shafer CM statements, staff statements, paramedics records, medical records, Alberto Alvarez' statement. Walgren did not say to Dr shafer AA's testimony was interesting. Dr Shafer read dr Larson report, doesn't know if it was sent to him before his report or not. Dr Shafer says he did not rely on it to form his opinion.
Chernoff : when D Walgren called you, the case set for trial in may ? yes
Chernoff asks questions about Dr Shafer's report : Looking at page 14 : 3rd paragraph, to understand what «*might*»(emphasis on might) have happened . Dr Shafer : AA statemet «*I saw a propofol in the bag*». AA made a very intersing reference a blue bottle, milky substance . Dr Shafer has never met AA, not listened to the recording of his statement to the police, has read a report, is not sure if it was the transcript.
Chernoff brings AA statement. It looks familiar to Dr Shafer, that's what he saw. He has not read anything else, doesn't recall if there was another one.
Chernoff : You based it on the assumption that AA was telling the truth.
Chernoff : you said that u had never seen that before : yes
Chernoff : the bottle (peoples 30 the one in the bag) had a hanging tab, that was not used. Dr Shafer knows that they stipulated to that, but doesn't know if it was used .
Chernoff ; you showed that CM didn't use the tab, you testified that what you thought happen. Dr Shafer : that's irrelevant, wether the bottle was in the bag or hung on the pole would't have changed anything.
Chernoff : CM would have gone through all steps : cut the bag, put bottle in , do you find that reasonable ? Yes.
Chernoff : what you claimed is axtroardinary : Dr Shafer not at all.
Sidebar
Cernoff : do you understand this is a criminal trial, not a malpratice trial ? Dr shafer has testified for one case , against Dr Katz, but consults about twice a year.
chernoff : You didn't like dr Katz : Dr Shafer : not very much (Dr Shafer smiles)
Chernoff goes through Dr Shafer's resume :
Stanford 1978 to 1983 , dr White was an assistant professor in anesthesia.
First published paper was in 1988, published 2 papers with Dr White.
After medical school, residency in pennsylvania, was a medical intern, then an anesthsia intern. Went back to san francisco in 1986,
About a paper written with r White : Dr Shafer was invlved in the computer program, and the maths , created a software to do calculations.
Dr white was the principal investigator. Dr Shafer believes dr White study was to show the benefits of the use of infusions of propofol for anesthesia (to mainatin anesthesia, at tht time propofol was only used for induction) . Dr Shafer wanted to help, he provided mathematical models.
Astra Zeneca propofol insert : Chernoff shows the graph that dr Shafer provided for the astra zeneca insert. This graph withstood the test of time. Shows the numbers Dr Shafer provided for the insert, for MAC sedation.
Break