Dr Kaimangar
Flanagan
MJ was dehydrated , it was a complicating factor; yes, based on CM's interview.
CM said he was treating dehydration : yes, there was a bag of saline, but there was no charts, so we don't know how fast, or how much saline MJ was receiving. Can't know if dehydration stament was appropriate. Can not determine if hydratation was appropriate based on urine production.
So you can not determine if MJ was dehydrated : No, CM said that in his interview.
25 mg propofol : would expect the sedation to last 6 to 10 mn, depending on what kind of other medication has been given.
About MJ's case : 25mg propofol would last 6 to 10 mn, if there is no other medication he would wake up after thes 6 to 10 mn
Would it be unusual for a patient to continue to sleep : yes, I would expect the patient to wake up. If If he doesn't wake up , that's very troubling.
Even if the patient is tired : yes, I have to make sure its not the effect of the sedative. I would assess if he's responsive to stimula, that is my responsability. The dose doesn't matter, you absolutely need to figure out what is going on. You need to continue monitoring and find out if this is sleep or sedation. My obligation is the well being of my patient, not what the patient considers important for him.
Nk thinks that additionally to the 25 mg, MJ had a drip, based on CM's interview.
NK thinks MJ had a respiratory depression that culminated in cardiac arrest, based on CM's interview.
What is the first thing CM should have done : given lack of tools (to ressucitate), should have called for help. Should have dealt with the airway and called 911 immediately. If there is somebody around, you ask this person to call 911. You ask them to call 911, you don't ask them to come or just ask for help. If you're alone, you put 911 on loudspeaker.
Were you aware that the front gate was locked ? Objection, sustained
Were you aware that there was no landline phone? Yes, but CM had a cell phone
Are you aware of the time to call 911 in this case : when you talk to the operator, the EMTs are on their way, so it doesn't matter how long you talk to the operator, the operator is able to guide you.
If MJ took lorazepam and propofol : would CM be responsible : yes, absolutely
If a patient was prescribed ambien, and took everything at once, would you consider the doctor who prescribed responsible ? No.
Walgren , re direct :
If Mr Flanagan fell to the floor right now, would you wait 12 mn, and then call his legal secretary to ask her to send a legal clerk ? Objection, sustained. (personal note : I loved that question)
You would call 911 immediately : yes.
Did I provide you with dr Kleins records : Yes
Was CM aware at least 3 weeks before MJ's death that MJ was seeing Klein, based on his interview : yes.
Taiwain study : highly monitored patients, and was only an experiment. So MJ was being subjetct to an experiment by CM ? Yes, but with no precautions.
Did CM have any idea if MJ had insomnia, or what kind of insomnia MJ had : no
Describe doctor patient relationship : it's putting the patient first, knowing when to say no, when the patient asks for inappropriate treatment.
Assuming MJ asked for propofol, a life threatening substance, it was CM's responsaillity to refuse, even if he was begging ? Yes, absolutely.
Lack of records : example of figures given by Murray about MJ 's oxygen levels : high 90s 90% : Without records you can not know, can not understand the figure. If a patient starts with 99s and 100%, then 90s 90% is a very dangerous figure, means that there is a problem.
CM was grossly negligent , and directly caused MJ's death. : Yes.
Flanagan , re cross :
CM shouldn't have done CPR first ? He should have called for help. He didn't ask the chef to call 911 specifically, he should have.
Are you aware that the chef was asked to call security and she didn't ? No
Are you aware that the call to MAW (head of security) was done a signifant time after CM asked Kai Chase to call security. No
Are you aware that when AA arrived, CM immediately asked to call for an ambulance : No
Walgren :
CM should have called 911, or asked to call 911 because as a doctor he understood the emergency and knew he had no tools to deal with it.
Dr Schafer
is an anesthesiologist, professor of anesthesiology at Columbia, adjoint professor of pharmacometrics at Stanford.
Designed the guideline for propofol dosing , showing package inserts for propofol.
Lost me, explains what pharmacology is, the importance of precision dosing, what happens when a drug is in the body, general terms.
Stipulation : relates to fingerprints, : saline bag that was cut : 4 latent prints in the black line. The prints are indentifiable, but no identification has been made.
Recess until Monday.
