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elusive moonwalker
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finished my dinner. back to updates someone please hit chernoff. walgren and brazil looked like they want to deck him
elusive moonwalker
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where u gonna show the dip bottle was hanging on the IV stand? shaffer says where it hung was irrelvent. objections substained.
cross over. shaffer is done.
cross over. shaffer is done.
GThomson93
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Brilliant witness. He's had a long, LONG few weeks.
elusive moonwalker
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GThomson93
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Seems most news stations feel the defense have nothing to go on and Murray will be convicted.
wendy2004
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Murray looks PISSED. He's all puffed up and looking like he's about to explode.
Shafer is done and off the stand. He did great, imo. Defense didn't make much headway with him.
The only thing Chernoff brought up that made me go hmmm... was whether the urine concentration and other calculations (femoral blood concentration) were consistent with each other. Shafer hadn't done that test/simulation/scenario. Perhaps, Walgren will have him check on that. They can bring the results in, if necessary, in rebuttal.
Shafer is done and off the stand. He did great, imo. Defense didn't make much headway with him.
The only thing Chernoff brought up that made me go hmmm... was whether the urine concentration and other calculations (femoral blood concentration) were consistent with each other. Shafer hadn't done that test/simulation/scenario. Perhaps, Walgren will have him check on that. They can bring the results in, if necessary, in rebuttal.
HumanNature2210
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Wow, now that the saline line is vented, there would appear there might not be a missing line at all. Murray could just remove the propofol line and pop it in the saline bag to flush out the propofol. This now make it worst for Murray as there is no missing pieces now.
Murray is TOAST!!
Murray is TOAST!!
elusive moonwalker
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chernoff did his typical twisting of statments etc but he didnt get anything interms of getting shaffer to say anything to support their case imo.not that i can think of anyway. walgren does a great redirect as normal.
bouee
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Sorry again, Chernoff is a nightmare when you take notes
Dr Shafer
Chernoff
one of the dangers of a rapid bolus is apnea : yes.
FDA inserts are the same for all manufacturers, yes , except for one thing I didn't understand, sorry
Lists some of the propofol manufacturers, Teva doesn't produce it anymore, due to problems with the FDA
reads possible side effects from the FDA insert : cardio vascular effects from (rapid bolus ? ) and from rapid increses . Slow infusion techniques are preferred over rapid techniques . Mac iinduction ; slow thechniques preferred over rapid techniques, to avoid apnea or hypotension.
Shows Dr Shafer's simulations :
25 mg simultion , rapid bolus
50 mg simulation, rapid bolus
you said you would expect apnea , with the 50 mg dose within one or two minutes, upon initiation of injection, dr Shefer corrects : when it reaches the brain
25mg : apnea in about 2 minutes
25mg within 3 to 5 mn (defense EEE) : with no other medication , there is a low risk between 4 to 5 mn after starting propofol
Back to 50 mg immediate push, did you have evidence of the use of a 50 mg dose ? , Yes from Cms interview : saying mixing propofol and lidocaine 1 to 1, and there was a 10 cc sysringe. It was a hypothetical, with an immediate push
chernoff : If CM had pushed 50mg, there would hve been apnea between 4 to 5 mn. Dr Shafer : Difficult to say given Mjs pharamceutical state (medication abuse, being given propofol for 80 nights, Dr shafer doesn't kow what it would do)
25mg 3 to 5 mn (defense EEE) : propofol would not be a risk after 10mn
insert graph : 1 hour infusion, 10 hours, 10 days : the level of prpofol drops off rather rapidly
6 self injections, 50 mg each : any evidence presented to you to base this hypothetical : only the hypothesis of self injections in dr Whites letter
Chernoff there would be an infinity of possibillities : Dr shafer yes. 6 was an arbitrary number, could have been 8, etc
6 injections by murray (murray name is circled) : rapid bolus ; no evidence that CM did that : No
Chernoff , we have established that CM gave 25 mg in 3 to 5 mn, these are yur recommendations , because of the risk of apnea and hypotension.
Are you aware of health care providers who died because of self injections : yes, there were articles published about that.
6 self injections 50 mg : you said you ha to be awake to inject, the levels drop very quickly, works very quickly; I the person is self injecting, has to do it quickly. Dr Shafer agrees, they can't to it in 3 mn.
Goes to murray's 6 injection 50 mg : rapid blus, repeated : that's 30ml , no evidence at the sene that 30 ml were used ? No
Goes to 100 ml, rapid bolus : you made a hypothetical «*out of thin air*» , no evidence that it happened, ? No, i was based on dr White's letter, hypothesis of muliple injections.
Lorazeapm has a half life of 22 mn in the stomach . Base on Dr Greenblack's study : what is first order half life ? every 22 mn the amount is cut in half : if you start with 8 mg, 22 mn after its 4, after 22 mn 2. there are other half lives, (talk about a 15 mn lag time) Dr Shafer took the shortest, most conservative.
Your estimation is based on 22mn, not on the 40mn half life (22 mn + 15 mn lag time) : if I take 2 mg, 22 mn after there would be 1 mg, 22 mn after 0.5 mg in the stomach
8 mg swalloewed : 22 mn later would be 4, another 22 mn 2mg, another 22mn it would be 1 mg , so in 4 hours , there wuld be a very low amout of free lorazepam in the stomach
so the difference between 16 mg and 8 mg, would be 22 mn in the stomach
Dr Shafer just looked at the blood concentration, but there are different kinds of concentrations (in the tissues, in the urine)
Greenblack's study : lorazepam reaches a peak concentration in 2 hours , after an oral dose. : drug goses into the stomach, and is being removed by liver and distibution in the tissues. So as long as the drugs comes in the levels in blood raise , the concentration rises . When less drugs comes in , it is removed faster than it comes in, so levels drop. Peak is when as much drug comes in, as is removed with lorazepam it's 2 hours
So 0.125 isn the stomach in 2 hours 15mn = small percentage in the stomach, but levels would be at peak in the blood.
You can not discount the possibility that MJ woke up and turned up the IV : no
you cant discount the possibility that MJ woke up and swallowed lorazeapm : woud need to know at what time , not after 8 in the morning
the urie concentration used by is the one done pacific toxicology.
did you check he cencentration of metabolite in the urine with the coroner , needs to check the coroner 's report
Dr Shafer's request was to differentiate molecule and metabolite
Has not gone bckwards to the regimen, just checked if it was consistent with oral consumption , and iv consumption.
In the urine : it's mostly the metabolite, not the drug
metablite accounts for 93 % of the drug (lorazepam)
would the metabolising process would be affected by the metobolising of another drug : no
did you make an estimation about what urine concentration should be after 100ml propofol infusion ? No , Has not determined it, would have to find the model to do that.
after a 3 hour infusion,yje levels immediately drop off , the bottle ran out: by chance thee bottle ran out just when MJ died.
FDA inserts : glucorined conjugate is 50% of the drug (propofol) ; can't tell what amount of the metabolite would go into the bile, and how much would go into the urine; would have to do the reaserach
would you say that the urine in the bladder could be evidence for or against 100ml : no because doesn't know how much would go into the urine, and into the bile. Is not aware of the test of propofol glucoronide in the urine, deosn't recall if it was done
Chernoff shows the toxiclogy report . There were 2 urine samples : one of them was in the bladder; Could you , or any pharmacologist, and determine if consistent with the 100ml propofol
the coroner tested propofol, not propofol glucoronide, he would need the glucoronide to evaluate anything
your analysis is based on respitary arrest, you didn't take into account cardiac arrest. Dr Shafer : Correct
Use of demerol : have you no expertise on addiction, withdrawal, but you ventured an opinion of mjs demerol use; Dr Shafer says he's seen forms of addiction, but is not a specialist.
You estimated in your report that MJ liked demerol : objection : where in the report ? Page 18, 2nd paragraph from bottom . DR Shafer : Records from dr Klein showed that MJ liked demerol, but was not addicted to it .
You ventured outside your field of exp . Dr Shafer says he has talked to other doctors
what is rapid detox : anesthesia + antidotes to opioids, in ICU (patient go through withdrawal in icu)
are you aware of the dangers of opioids to the heart : yes , they are dangerous for many organss
sidebar
break
Dr Shafer
Chernoff
one of the dangers of a rapid bolus is apnea : yes.
FDA inserts are the same for all manufacturers, yes , except for one thing I didn't understand, sorry
Lists some of the propofol manufacturers, Teva doesn't produce it anymore, due to problems with the FDA
reads possible side effects from the FDA insert : cardio vascular effects from (rapid bolus ? ) and from rapid increses . Slow infusion techniques are preferred over rapid techniques . Mac iinduction ; slow thechniques preferred over rapid techniques, to avoid apnea or hypotension.
Shows Dr Shafer's simulations :
25 mg simultion , rapid bolus
50 mg simulation, rapid bolus
you said you would expect apnea , with the 50 mg dose within one or two minutes, upon initiation of injection, dr Shefer corrects : when it reaches the brain
25mg : apnea in about 2 minutes
25mg within 3 to 5 mn (defense EEE) : with no other medication , there is a low risk between 4 to 5 mn after starting propofol
Back to 50 mg immediate push, did you have evidence of the use of a 50 mg dose ? , Yes from Cms interview : saying mixing propofol and lidocaine 1 to 1, and there was a 10 cc sysringe. It was a hypothetical, with an immediate push
chernoff : If CM had pushed 50mg, there would hve been apnea between 4 to 5 mn. Dr Shafer : Difficult to say given Mjs pharamceutical state (medication abuse, being given propofol for 80 nights, Dr shafer doesn't kow what it would do)
25mg 3 to 5 mn (defense EEE) : propofol would not be a risk after 10mn
insert graph : 1 hour infusion, 10 hours, 10 days : the level of prpofol drops off rather rapidly
6 self injections, 50 mg each : any evidence presented to you to base this hypothetical : only the hypothesis of self injections in dr Whites letter
Chernoff there would be an infinity of possibillities : Dr shafer yes. 6 was an arbitrary number, could have been 8, etc
6 injections by murray (murray name is circled) : rapid bolus ; no evidence that CM did that : No
Chernoff , we have established that CM gave 25 mg in 3 to 5 mn, these are yur recommendations , because of the risk of apnea and hypotension.
Are you aware of health care providers who died because of self injections : yes, there were articles published about that.
6 self injections 50 mg : you said you ha to be awake to inject, the levels drop very quickly, works very quickly; I the person is self injecting, has to do it quickly. Dr Shafer agrees, they can't to it in 3 mn.
Goes to murray's 6 injection 50 mg : rapid blus, repeated : that's 30ml , no evidence at the sene that 30 ml were used ? No
Goes to 100 ml, rapid bolus : you made a hypothetical «*out of thin air*» , no evidence that it happened, ? No, i was based on dr White's letter, hypothesis of muliple injections.
Lorazeapm has a half life of 22 mn in the stomach . Base on Dr Greenblack's study : what is first order half life ? every 22 mn the amount is cut in half : if you start with 8 mg, 22 mn after its 4, after 22 mn 2. there are other half lives, (talk about a 15 mn lag time) Dr Shafer took the shortest, most conservative.
Your estimation is based on 22mn, not on the 40mn half life (22 mn + 15 mn lag time) : if I take 2 mg, 22 mn after there would be 1 mg, 22 mn after 0.5 mg in the stomach
8 mg swalloewed : 22 mn later would be 4, another 22 mn 2mg, another 22mn it would be 1 mg , so in 4 hours , there wuld be a very low amout of free lorazepam in the stomach
so the difference between 16 mg and 8 mg, would be 22 mn in the stomach
Dr Shafer just looked at the blood concentration, but there are different kinds of concentrations (in the tissues, in the urine)
Greenblack's study : lorazepam reaches a peak concentration in 2 hours , after an oral dose. : drug goses into the stomach, and is being removed by liver and distibution in the tissues. So as long as the drugs comes in the levels in blood raise , the concentration rises . When less drugs comes in , it is removed faster than it comes in, so levels drop. Peak is when as much drug comes in, as is removed with lorazepam it's 2 hours
So 0.125 isn the stomach in 2 hours 15mn = small percentage in the stomach, but levels would be at peak in the blood.
You can not discount the possibility that MJ woke up and turned up the IV : no
you cant discount the possibility that MJ woke up and swallowed lorazeapm : woud need to know at what time , not after 8 in the morning
the urie concentration used by is the one done pacific toxicology.
did you check he cencentration of metabolite in the urine with the coroner , needs to check the coroner 's report
Dr Shafer's request was to differentiate molecule and metabolite
Has not gone bckwards to the regimen, just checked if it was consistent with oral consumption , and iv consumption.
In the urine : it's mostly the metabolite, not the drug
metablite accounts for 93 % of the drug (lorazepam)
would the metabolising process would be affected by the metobolising of another drug : no
did you make an estimation about what urine concentration should be after 100ml propofol infusion ? No , Has not determined it, would have to find the model to do that.
after a 3 hour infusion,yje levels immediately drop off , the bottle ran out: by chance thee bottle ran out just when MJ died.
FDA inserts : glucorined conjugate is 50% of the drug (propofol) ; can't tell what amount of the metabolite would go into the bile, and how much would go into the urine; would have to do the reaserach
would you say that the urine in the bladder could be evidence for or against 100ml : no because doesn't know how much would go into the urine, and into the bile. Is not aware of the test of propofol glucoronide in the urine, deosn't recall if it was done
Chernoff shows the toxiclogy report . There were 2 urine samples : one of them was in the bladder; Could you , or any pharmacologist, and determine if consistent with the 100ml propofol
the coroner tested propofol, not propofol glucoronide, he would need the glucoronide to evaluate anything
your analysis is based on respitary arrest, you didn't take into account cardiac arrest. Dr Shafer : Correct
Use of demerol : have you no expertise on addiction, withdrawal, but you ventured an opinion of mjs demerol use; Dr Shafer says he's seen forms of addiction, but is not a specialist.
You estimated in your report that MJ liked demerol : objection : where in the report ? Page 18, 2nd paragraph from bottom . DR Shafer : Records from dr Klein showed that MJ liked demerol, but was not addicted to it .
You ventured outside your field of exp . Dr Shafer says he has talked to other doctors
what is rapid detox : anesthesia + antidotes to opioids, in ICU (patient go through withdrawal in icu)
are you aware of the dangers of opioids to the heart : yes , they are dangerous for many organss
sidebar
break
Last edited:
Mirabella76
Guests
Can't watch how Chernoff snaped Schaffer up!! He is so rude, so ridiculous, i can't stand him
Walgren stating no more witnesses are going to be called for prosecution. Court need a few minutes to look through evidence the defence are going to use, checking relevance (I think that's what the judge said) so jury have been excused for a few moments.
thrillerchild
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The People rest! And now the defence case...oh boy *sigh* :no:
What does this mean? There wasn't 2 lines?
82Thriller84
Proud Member
Just Made This! :happy:
elusive moonwalker
Guests
yes no traces of the drug or the metabolite. mj was last at kliens around the 22nd i think.
Vici
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wanna know something. ive seen karen faye tweeting stuff that if she is called she has to go, its the law. how does that work really?
because dr Barry Friedberg apparantly said he was asked by defense to testiy but he refused...
how come some people can refuse to testify for one side while others are more and less forced to??
because dr Barry Friedberg apparantly said he was asked by defense to testiy but he refused...
how come some people can refuse to testify for one side while others are more and less forced to??
Dr. Friedberg was asked to act as an expert witness and defend Murray's actions, while Faye was subpoened. You can't force random doctors/experts to testify for you.
HumanNature2210
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Sorry marebear if I confuse you. There could be 2 lines, we don't know. It seems like we now know that Murray ordered 150 vented set, not just 2! What I am merely stating is that it could possibly be that there is only 1 set (hence, no missing pieces) and Murray flush out the propofol with the saline. However, no propofol is found on the tubing but I don't know if sufficient flushing with saline could remove the propofol in the saline tube found.
In summary, we don't know if 1 or 2 line is used but then its now in a better position for the prosecutor.
it's a subpoena - court order - asking you testify and you have to do it if you get it.
in case of the experts there's so sense in calling an expert that won't support your idea