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Murray Trial - Day 19 - October 27 2011 - Discussion

Flan is trying to criticise Shafers study of oral drinking as some of the subjects were the investigator, at least one of them was..and white is saying was not a blind study...saying one of subjects only had 2miligram less than mj had
 
I thought the case of oral intake was thrown out? If it was, why bother even going over it? Just get to the point.
 
flew to L.A met chernoff and flanagan then agreed to work with them. he was given transcripts from the prelim. he made some preliminary findings/opinions based on the prelim. he formed conclusions then that he doesnt believe now. oral ingestion he thought played apart then. now hes trying to play it down. saying it could be a possibility but was speculation on his part.
did u know of the pig report? no not until shaffer did his report. u know theres been a human study on it? yes iam. mentions shaffer and goes through it. shaffer showed him the report and white commented on it. he had some issues with it as one of the students was the chillian dr and they do blind studies/placibos. that is irrelvent as its not a mental issue. either u fall asleep from drinking the stuff or you dont. 5 out of 6 had no effect. but another had quite a high level near to what was in mj. that prob happened through the windpipe he says. talking about the beagal test. says he didnt publish it cause he didnt think it was relevent. more like they didnt want the pros to find out about it
 
Flanagan doesn't understand what "Five-fold" means and thinks 500% means 500 times! He's a moron! Yes, I do understand that lawyers have to make sure everything is clear for the jury, but Flanagan himself was genuinely clueless then.
 
he wont be on for ages like shaffer.chernoff stated how long they would take. if it hadnt finished early yesterday he said they would have been done today
 
They are trying to shows Shafers senarios could be wrong. I think
 
paitents concentration levels vary. ie u can give a low amount of diprivan and the concentrations can still be a high or give a large amount and the concentrations can be less. think he said that. models work for a large group but individuals are all different.

mid afternoon break. why do they need onethey had an extended lunch. jees just get one with it
 
is it me or is white not as good as Shaefer was at explaining things and keping my attention more...he seems to be implying models are not truly accurate, if so why did he ask Shaefer to do his models...
 
ilmjj said:
They are trying to shows Shafers senarios could be wrong. I think
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They're showing that Shafer's model regarding Michael could be wrong since it's hard to predict the propofol levels in an individual compare to doing a general average.

Although, doesn't what White said proves that Murray could had killed Michael with 25mg since the effects of propofol on an individual can be unpredictable.
 
I'd rather have the prosecution cross on monday than today that way they'll have more time, there's no need to rush the trial now. especially not at the end.
 
I don't know if it's just me, but I just can't seem to hold my attention with Dr. White. I wish there hadn't been a scheduling issue yesterday, we'd have been a lot further along than we are now. Can't be helped though.
 
Although, doesn't what White said proves that Murray could had killed Michael with 25mg since the effects of propofol on an individual can be unpredictable.
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yeah thats what im thinking aswell. so lets say murray only gave 25mg and nothing else. and that means mj didnt self inject yet they got high readings. so in one sense they are descrediting their own theory of slef injection. although the problem u have then is the prosecutions claims of an IV being used. and this theory would discredit that. so the defence think if they can discredit the drip as there is another way for those high levels then it ruins a key part of the pros case. and white can say mj still could have self injected because the concentration levels arent as fixed as shaffer says
 
^^I think with the 25mg of prop, shaffer suggested it could be in the apnea range, but he assumed all in one bolus injection whereas murray did say in interview he did it over 3 -5 mins so making it safer. In fact i found murrays statement that he injected 25mg in 3-5 mins hugely suspicious when i heard shaffer say that the recommended time on the label of prop for initial injection was - 3-5 mins! Seems murray had done some homework before the interview.
 
Dr White didn't want to get involved with the case initially because it involved the death of an icon. But if he is helpful in getting Michael's killer off the hook then Michael Jackson fans everywhere will remember his name as the guy who was partly responsible for letting a murderer go free.
 
twinklEE said:
I'd rather have the prosecution cross on monday than today that way they'll have more time, there's no need to rush the trial now. especially not at the end.
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we have tomorrow aswell.
 
volitional said:
He just called him Dr Shaeffer
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Flalaanagan again sleep at the wheel, Flanagan, leave the jack daniels bottle at home! You too may not be under the influence in my court room admonishments are relvevent in this court room as well says the judge...... Just kidding, But at least know the name of your witness Flannypack. gees
 
White is lying trhu his teeth while stating he doesn't want all the attention he craves it. I can see him making the rounds after this is done
 
It is so tedious to listen to these two, I miss chernoff. I just can not concentrate of either of them, well, except for the Shaeffer faux pas :)
 
Doesn't look like we're gonna get any cross-examination today. The direct will prob go well into tomorrow.
 
yeah for someone not wanting attention he had no problem calling walgren a scumbag to the press and getting a contempt hearing set. wlagren should be allowed to bring it up seeing as hessaid he doesnt like to be in the spotlight. trying to act like hes pure
 
Dr White

Flanagan

is retired, still consulting, still involved in research project. Retired last september. Was an anesthesiologist, researched acute pain management

Education : Berkeley, majored in biochemistry in 1970, worked as research chemist for 1 year, biochemical research for 6 months, had a renal problem, it picked his interest in medical research, studied pharmacology, phd in pharmacology and medical degree in 1977. Internship in internal medicine in San Francisco, 2 years second residency in anesthesiology, professor of anesthesia , studied for about 10 years.

Board certified in inernal medecine and anesthesia.

Professor of anesthsia in 2 different universities

directs research in anesthesiology in Cedars Sinai, LA

Received 25 awards. Gives lectures in pharmaocolgy in neural drugs, anesthesiolgy for ambulatory surgery, acute pain management

Ambulatory surgery : patient is discharged same day or less than 24h

Director of ambulatory and outpatient anesthesiology : researched drugs & techniques that would facilitate the recovery of the patients. Medicine used at the time for anesthesia had side effects (hangover, nausea , vomiting).
Dr White was introduce to propofol by a european doctor, at the time emulsion of propofol created allergies,propofol was withdrawn.
Dr White suggested a fatty emlsion to avoid allergies. Developed a protocol, sarted the study in 1983, 1984. A protocol is a template of the study : aim of the study, criteria, methodology, etc.... Took 6 months to do the protocol, did it on his own, with medical students. Recruited 2 Stanford students, and started the study : aim was to compare propofol to barbiturates for induction and maintenance of anesthesia.

Had published 15 papers at the time

In the US, induction of anesthesia was IV, maintenance was through gaseous or volatile medication , Dr White has studied IV anesthesia (induction and maintenance)

435 articles published on pub med

propofol has 50% less side effects than other anesthetics used at the time

started to work on propofol in 1983, propofol was FDA approved in 1986

shows 36 studies Dr White has done about propofol.

Met the Shafers at Stanford, the Shafers were students.

Has studied midazolam (2 studies)

18 studies involving benzodiazepines

has written 15 books, 2 of them are text books about anesthesia
Has written 21 chapters about propofol

for this case, was contacted by Flanagan in january 2011. h
Had heard of CM. Didn't want to get involved in a case about the death of an icon, doesn't like the attention. As a specialist in opiates, anesthesia, benzodiazepines, agreed to review the docs.

Can not justify the elephant in the room : CM infused propofol to MJ , anbandoned his patient

His first evaluation was based on CM police interview, autopsy report, 13 experts opinions

Was perplexed : if CM had done what he said he did in hie police interview, MJ wouldn't have died

Asked to meet CM.

Did you meet CM ? Obection, sustained, sidebar requested by Walgren

Then flew to LA, met Flanagan and Chernoff, agreed to participate.

Was given the transcipts of the prelimanary hearing.

Gave conclusions in a letter, that he doesn't currently hold. Oral consumption was a speculation, based on other experts testimony; was not aware of oral availability , searched the wrong terms «*oral administration (? not sure )*»

Was not aware of the studies about oral bioavailability , became aware of them through dr Shafer's report.

Dr shafer himself drank propofol, felt bad about it

Has issues with chilean study : there was no blind test, one of the subjet (Dr Sepulveda) had 2mg/ml after 2mn, levels similar to MJs , suspects transmucosis absorbstion (through the mouth an oesophagus) , agrees there si no absortion by the stomach.

Did an animal study , inserted a tube into their stomachs, the result negative , there was no harm done to the animals. Did not publish that study, thought it was not useful.

Talked with dr Shafer, about the subject who had 2mg/ml, they agreed it was transmucosis tranmission, they thought of doing a lollipop to sedate patients non invasively .

Pharmaco dynamics and variability
PD = dose to blood level
Use model to calculate a blood level from a dose. But it can vary from the model in a certain range : Example : for the same dose of propofol , you could get a blood level from 1mg/ ml to 5 mg/ml

pharmacokinetics and variability
PK = blood level to effect
same thing with effects : effects vary from patient to patient for the same blood level.

Shows an example (graphs), effects some patients are correctly or incorrectly anesthesised with very different blood levels

break
 
dmehta said:
Doesn't look like we're gonna get any cross-examination today. The direct will prob go well into tomorrow.
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I hope not...I'm not sure I can take much more of this...I have to keep pinching myself to stay awake.
 
ilmjj said:
Dr White didn't want to get involved with the case initially because it involved the death of an icon. But if he is helpful in getting Michael's killer off the hook then Michael Jackson fans everywhere will remember his name as the guy who was partly responsible for letting a murderer go free.
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This isn't a popularity contest. So far White has been sticking to the facts and science of the case. As long as he does that and doesn't show biases like the last doctor, fans can be mad all they want, but it still won't change the science.


Anyway elusive, you're right about self-injection, but how did Michael self-inject and not put his finger prints on the bottles on the needles? Also if it was that easy to prove self-injection, why did the defense decide that Michael had to eat 8 Lopz pills at the beginning? We may have to wait for the cross to get more detail.
 
twinklEE said:
oh gosh in my mind it was aleady friday. thx elusvie
anyway , so what cross tomorrow and rebuttal on monday? Didnt the judge say he'd give both parties the weekend for reb?uttal and closing arguements?
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can

cant see this taking all tomorrow he will have had 1.30 by the end of today. chernoff said that if there hadnt been the early finish yesterday they would have been done today. so hes not gonna be on for hours and hours. the judge said even if they finish thurs as expected b4 yesterdays delay he would give them the weekend to do closing statements and jury selection not rebuttal as that would have been done friday if it had finished today
 
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