27 September 2011

Conrad Murray Trial - Day 1 - Witness: Paul Gongaware

The state calls Paul Gongaware as its next witness. Deputy DA Deborah Brazil conducts the exam.

Gongaware is CEO of AEG. He produces and promotes concert tours, has done so about 30 years. He had occasion to work with Jackson in the past, the first being the "Dangerous" tour, then the "History" tour. He was involved in the "This Is It" tour as well, as producer and promoter. Gongaware says that he interfaces between art and commerce. He says Jackson was very excited and a brilliant guy.

PG was not responsible for planning rehearsal schedule. He was, however, involved in the tour scheduling. Initially, there were 31 shows contracted by AEG and Jackson for the "This Is It" tour. Prince had done 21 shows at the O2, and Jackson wanted to do 10 more; hence, the 31 scheduled shows. PG says people registered online to buy tickets. They did an initial offering of 10 shows which sold out instantly, so they added more shows in that cycle. The 31 shows sold out instantly as tickets were put up for sale. There were still 250,000 people in queue to buy tickets after the 50th show's tickets sold out.

Brazil gives witness an 11-pg document, and he reviews it and identifies it as the schedule of the rehearsals and shows for London. It consists of calendars beginning in May. PG created the calendars. The witness identifies where rehearsals were calendared to take place and when.

In July 2009, there were to be 8 performance dates at O2 Arena and 5 rehearsal dates, with remainder of months being days off. In August, 10 shows and no rehearsals. In September, 9 shows and no rehearsals were scheduled for O2 Arena. No performances scheduled for Oct, Nov, Dec because the arena was booked by other performers. Jan 2010 - 10 performances and 3 rehearsals, with rest of the month being days off. Feb 2010 - 10 shows, no rehearsals. March 2010- 3 shows scheduled. On days with no performances, Jackson was free from performance/rehearsal obligations.

Rehearsals in May/June 2009 in LA. PG was present during rehearsals in Burbank. Had opportunity to interact with Jackson, who PG says was excited and wanted to work, seemed happy. Also interacted with Jackson when performances moved to The Forum, where he again found him to be very enthusiastic about working and performing. PG attended some meetings at Jackson residence. One particular instance, Jackson was late. He can't recall the date. PG came to find out Jackson was late because he'd been at the doctor. PG believes it was Dr. Klein. PG noticed Jackson was a bit off, speech slightly slurred when he arrived. Nonetheless, the planned meeting occurred and Jackson participated in it.

In May had discussion with Jackson about his wanting to hire Murray as a personal physician for the tour. PG didn't know Murray at all, but since they were going to London, he would've preferred to hire a London doctor who was familiar with the medical establishment there. Jackson told him, "This is a machine [referring to his body] and you have to take care of the machine."

So PG contacted Murray to try to make a deal with him. Murray wanted to participate. PG asked him what he wanted. Murray told him he had four clinics he had to close, would have to lay off people, and that he'd need $5 million per year to do that. PG told him there was no way that was going to happen, Michael couldn't afford it. PG felt he could obtain services of doctor in London for far less, so PG ended negotiations.

PG testifies that Jackson brought the matter up again. Jackson's assistant called PG, saying he wanted PG to hire Murray. He heard Jackson in the background saying, "Offer him $150k, offer him $150k." PG took this to mean per month and called Murray with that offer. Murray initially said he couldn't do it for that. He told Murray the offer came directly from the artist, and Murray immediately said, "I'll take it." Murray told him not to worry about the licensing in London, he'd take care of it. Said he would need equipment, an assistant, and housing for his family in London. PG then put the wheels in motion for Murray's contract to be drafted.

In early June 2009, PG attended meeting at Jackson's home. Ortega felt Michael wasn't where he needed to be in order to be engaged and prepared in time for opening date in London. PG says it's sort of like a football game, where you have to train and get ready, then kick it up ten notches when you hit the stage. Ortega felt Jackson wasn't where needed to be with it at that point in time. Meeting was to address that concern. Jackson, Ortega, Phillips, Dileo, PG and Murray were in attendance. Jackson wasn't defensive, knew they wanted to do what was best for him in preparing for the tour.

Purpose of meeting was to see what they could do for/give to Jackson to get him where he needed to be - eating habits, rehearsal habits, whole engagement process. Jackson was receptive. Murray was very engaged. He listened a lot and tried to understand situation, expressed that he did and knew what he needed to do to get Jackson ready.

Court is adjourned for the day. Jurors are released for the day and will reconvene Wednesday morning at 8:45am PT.

***Please note - since I have several upcoming obligations, I won't have the time to devote to this case as I devoted to the Anthony case. I wanted to get opening statements down for you, and I will blog or tweet other testimony as time allows. Thanks! :)

Conrad Murray Trial - Day 1 - Witness: Kenneth Ortega (Part 2)

Direct examination of Ortega by Walgren continues after the afternoon break. Ortega plays a June 23 2009 video of Jackson performing "The Way You Make Me Feel" for the jurors. Jackson appears in excellent form, singing and dancing. There is discussion, fine-tuning of the performance as they go along. Ortega testifies the back-up dancers are average age 18-24 [less than half Jackson's age].

Walgren now plays video of "Earth Song," which Ortega says was his last performance/rehearsal ever. Again, Jackson appears fully possessed of his talents in the video. Ortega says after that song, Jackson came down and the two of them watched the rest of the rehearsal with a stand-in doing Jackson's part so they could assess staging, lighting, etc. Ortega testifies that he and Jackson discussed future plans, aside from the "This Is It" tour. Jackson wanted to take it out into the world, perhaps the US. He also wanted to make movies. Jackson invited him to collaborate on a full-length feature of Thriller and his Smooth Criminal character.

End of direct exam.

Ed Chernoff conducts cross-exam of Ortega. He asks about June 20th, when the meeting at Jackson's house occurred. Ortega says he did not speak to the others on the phone about the incident with Jackson prior to sending the email. Ortega thought it was Gongaware who scheduled the meeting, but he is not sure. Chernoff asks if Ortega understood part of purpose of meeting was to discuss missed rehearsals. Ortega said it wasn't brought up to him. Ortega says his comments in email referred to meetings that had occurred prior to that night about Jackson making rehearsals.

Ortega says that was the only meeting he was included in. He wasn't aware of another meeting, but assumes must've taken place regarding the rehearsals, scheduling of Jackson's practice times. Chernoff asks if Ortega knows when Murray made the schedule was made for Jackson. Ortega does not know.

Ortega had expressed concerns prior to the week before Jackson's death about his missing rehearsals. He had conversations with a few people about those concerns, including Paul Gongaware, Randy Phillips. Chernoff was concerned they might not make the goal without Jackson's timely participation in rehearsals.

During the meeting at the house, Ortega said he felt Murray had the impression that Ortega had pulled Jackson off rehearsal instead of Jackson's being unable to perform, as if Jackson had told him one thing, then Ortega another.

Chernoff asks if Ortega remembers telling Karen Faye to read Jackson the riot act, not to placate Jackson. Ortega says he would've never used that word, says he might have told her Jackson told him he was taking the reins and could use their support.

Chernoff: Would you agree your success was somewhat tied to Jackson's success with the tour? Yes, says Ortega. Agrees that Jackson's not showing for rehearsals would impact everyone, including him - he'd be unable to do his job.

Chernoff asks whether Jackson was intimately involved in decision-making of production. Ortega says yes, he was. The idea for the 3D effects came from Jackson. He had a hand in all details. Ortega agrees with Chernoff that Jackson understood the historical significance of the tour.

Ortega agrees with Chernoff that Jackson's condition on June 19th scared him; had never seen him before like that. Chernoff: Ever occur to you he might've been on drugs? Ortega: Yes. Chernoff asks if Ortega knew Arnold Klein. Ortega says he'd heard about him but didn't actually know him.

Ortega testifies that he doesn't recall seeing Murray at Staples, but did at The Forum. Had some conversation with Murray. Murray invited him to call if he ever had any concerns about Jackson/scheduling. Murray brought scheduling suggestions to Ortega. One suggestion was that Jackson be allowed to have lunch at home with his children.

Ortega testifies that through April and May, he and Jackson had creative collaborations. As they moved to The Forum/Staples, the scope of production and discussion about them increased. Ortega believes they moved to Staples the week immediately preceding Jackson's death. Thinks they had only 2-3 rehearsals there. Those rehearsals were recorded, as were rehearsals from June 15-19, per Jackson's request (but only when Jackson was there; when he wasn't, they didn't record).

Ortega was hired to help edit videotape for "This Is It" movie by Sony Pictures after Jackson's death. There was footage of behind-the-scenes interviews with staff/performers to be used in a possible video release later.

Chernoff: Is there tape showing Jackson sitting in a chair with a blanket wrapped around him? I haven't seen it, says Ortega. [End of cross, no further direct. Witness is excused, subject to recall.]

Conrad Murray Trial - Day 1 - Witness: Kenneth Ortega

The state calls Kenneth Ortega as its first witness. He lists his extensive background in choreography, stage production. He met Jackson in 1990 when Jackson called to express interest in working with him on the "Dangerous" tour. Ortega was the co-creator of the show and director of the production. Also partnered with Jackson for the "History" tour and some charity productions.

Ortega describes his collaborations with Jackson as fun, inspirational. They collaborated on everything that contributed to the whole of the production - music, effects, costuming, staging, lighting, etc. Michael did the choreography on his own and with others. Ortega supervised the choreography but did not create the dances himself.

"We had a great friendship working together as professionals." Ortega says he didn't see him a great deal outside of that, though in latter years, it was more often contact.

Ortega said he was informed by AEG that Michael had a tour, then Jackson reached out to him personally to be part of the tour. Jackson used the phrase "this is it" several times during their conversation, and Ortega suggested that's what he should name the tour - "This Is It." Ortega began working on the production in mid-April as co-creator and co-director.

Ortega worked with Jackson 4-5 times per week on the preparations. Jackson was very excited, convinced this was the time and that he had great reason to do it. Ortega says Jackson wanted to share what he did with his children (were then of an age to appreciate what he did), wanted to do it for his fans, felt his music applied to the world situation more than ever.

Walgren asks if Jackson's children attended rehearsals. Ortega says they did not, that Jackson was waiting to bring them on tour to the shows in London and wanted them to keep up with their schooling.

Ortega says Jackson told him his songs he'd written about the environment, the planet, the children, were more important than ever and wanted them to be out there and part of the show experience.

During June 2009, production was held at The Forum. Near end of June, moved to The Staples Center, about a week before he died. It was larger and more comparable to the O2 Arena in London where they'd be opening. It was going to be a huge production with enormous, 3D movie screen. All sorts of sets, props, costumes, lighting, special effects, pyrotechnics. The movie screen was Jackson's idea. He and Ortega had created short 3D films to accompany live production so that audiences would have a live 3D experience during the show.

Ortega describes his work with Jackson at The Center Stages. Once at The Forum, the production moved into the staging phase. At Staples Center, they did technical rehearsal, lighting, other elements of the show.

Jackson's rehearsal times were almost always late afternoon into the evening, lasting between five and seven hours. This time included creating, decision-making, rehearsal. Jackson always had the last word on any differences of opinion on creative matters.

Ortega identifies defendant as Dr. Murray. Says he met Murray at Jackson's house when he was there for creative meeting with Jackson one day, he believes April or May. Murray attended a few of the rehearsals at The Forum, but doesn't believe he came to the other two venues.

During a period in June, Jackson wasn't showing up for rehearsals - mid to latter part of June, before they went to Staples. It was the last week at The Forum, approximately. Ortega testifies that he would expect him each day, and it became a continued absence. He was only told that it was a scheduling issue. Didn't have reason to doubt that.

On Friday, June 19, 2009 (he believes it was still at The Forum), Ortega observed that his friend, Jackson, "wasn't right, wasn't well." It deeply troubled him. He was chilled, appeared lost - sort of lost and a little incoherent, although we were conversing and he could answer questions. I did feel he was not well at all, not well enough to rehearse. Ortega offered him food, which he accepted. He put a blanket around him, rubbed his feet, put a heater in the room next to him. They just talked and Jackson asked if he could just sit with him that night and watch rehearsal. That's what they did, for a little less than 2 hrs. Jackson seemed not to be "there," like there was something wrong. He'd never seen Jackson like that before.

Jackson left before the end of rehearsal. Ortega suggested he leave and Jackson agreed. Ortega expressed his concerns in an email to Randy Phillips. He wanted others to know of his concerns about Jackson after his encounter with him that night at rehearsal. Ortega reads the email aloud. He notes in email that Jackson is in perilous shape and desperately needs a therapist to help him; that he may not be able to go forward; terribly worried about him.

Ortega noted in his mail they'd "brought the doctor [Murray] into the fold." He says Murray was setting the schedule for Michael so that he could make rehearsals. "The tough love, now-or-never card" reference was about a meeting outside Ortega's presence wherein Jackson was told unless he showed for rehearsals, they might not be able to make the shows in London.

Ortega mentioned in email that he'd called Jackson's doctor [Murray]. Ortega says he was unable to reach him. "It would shatter him [Jackson], break his heart, if we pulled the plug. He's terribly frightened it will all go away." Ortega says Jackson was always positive and optimistic about the show. He really wanted that tour.

A meeting was held at Jackson's house later that day. It was not previously scheduled. Ortega says he got a call asking him to come to the house, late morning/early afternoon. He assumed meeting would be about Jackson. Randy Phillips, Frank Dileo and Dr. Murray, along with Jackson, were in attendance.

Murray confronted Ortega, upset that Ortega didn't allow Jackson to rehearse and had sent him home. Murray told him he should not try to be the doctor or an amateur psychologist, to leave the medical issues to him and just direct the show. Ortega told Murray it wasn't his choice - Jackson asked to sit it out. Murray told him Jackson was capable of handling all the responsibilities of his show. Ortega was shocked because Jackson did not appear at the time to be physically or emotionally stable.

Ortega says Murray was stern with him, and he responded in kind. Ortega asked Jackson to tell the doctor what happened, that it was his choice to sit it out, and Jackson agreed with Ortega. Jackson told him he was ready and capable and asked him to stay with him. Ortega says he told Jackson he only brought the issues up because he didn't want something bad to befall him. They hugged and Ortega left.

No rehearsal for Sat/Sun/Mon. Next rehearsal was the 23rd of June. Jackson's condition was improved on that date. Was full of energy, enthusiasm, desire to work. "It was a different Michael," Ortega says. On June 24th, Jackson came to rehearsal and was a full participant.

After two successful days of rehearsal, Jackson was feeling great. He asked Ortega if he was happy and Ortega said yes. He asked Jackson if he were happy, too, and Jackson said he was.

June 25, 2009, an illusion was scheduled to take place. It transitioned Jackson from one musical event to another. Michael would stand on a bed in silk flames and then float out over audience in a cherry picker. Jackson was very excited - he loved magic and illusion and was excited the apparatus had arrived and they were going to rehearse it. The night before (the 24th), Jackson asked him to thank everyone and tell them that he loved them. Ortega told him all would be ready when arrived the next day so he could step right into the illusion rehearsal. They said I love you to each other and hugged, then Jackson left.

Ortega arrived the next day to begin working on the illusion. He received a phone call from Paul Gongaware that an ambulance picked Jackson up and that he was at the hospital, in with the doctors, and that he'd call back when he knew more. Paul called him again to tell him that they'd lost Jackson. Ortega says it took a while to feel his feet on the ground, and it was clear everyone in the room was getting messages and calls, that the word had spread. He called everyone together. They joined in a circle, and he informed them of Michael's passing.

Judge calls the mid-afternoon break.

Conrad Murray Trial - Day 1 - Defense Opening Statement (Cont)

After the lunch break, Ed Chernoff resumes his opening statement for the defense:

Dr. White will tell you that both administration of Propofol is a matter of degree. Like with other medicines - with Tylenol, taking 1 might get rid of headache, but taking too many might get rid of your liver.

Propofol dissipates. Clinical effects disappear much more quickly than other drugs, regardless how much someone is given. When given 25mg, it will dissipate and not be in the blood in ten minutes. Same is true for larger amounts - after 10 mins, nothing is left. [I'm wondering why any was found at all, then.]

The amount found in toxicology is consistent with major surgery, invasive surgery. We believe experts, both state and defense, will say that is an amount larger than 100mg. You'll hear testimony from a coroner investigator of what was at the scene, things that were found.

We will demonstrate that it was not only improbable that there was a drip, but that it was impossible. So the question you will have in jury room will be, "How did Michael Jackson get more Propofol?" This is what you will wrestle with.

An act cannot be cause of death unless it's a "substantial factor." This is the language we believe you will have in jury room - you will be told that an act can only be a cause of death if it is the natural and probable consequence of the act, one a reasonable person is likely to know might happen if nothing intervenes.

We believe Dr. White will tell you that Murray could not have killed Jackson, could not be responsible for his death; that the amounts Murray gave weren't capable of causing death; that the precautions taken were sufficient; that if Murray had given such amount, it would not be measurable after ten minutes. Science will prove that there had to be more Propofol taken by Jackson when Murray left the room. If the drugs Jackson received on the 25th were exactly what Murray reported, would that have killed Jackson? Every one of them will tell you no, that there had to be more delivered/provided/taken by Jackson after Murray left that room.

The defense believes the delivery of that Propofol was by Michael Jackson himself.

We believe what happened with the Lorazepam shows the state of mind Jackson was in. It was in great, high amounts in his system. Murray gave him 4mg. If he'd given enough to Jackson to reach the level found in toxicology, he'd have to have given Jackson a huge number of shots [didn't catch the number per hour]. Amount in Jackson's stomach was four times greater than in his bloodstream. He had to have swallowed them for it to show up in his stomach, not by injection.

Because Murray wouldn't give him the Propofol he wanted, Jackson swallowed up to 8 pills on his own without permission from his doctor. When Murray left the room, Jackson self-administered an additional dose of Propofol, and it killed him instantly - no way to save him.

This is an emotional case. The whole thing is tragic, Chernoff says, but the evidence is not going to show Dr. Murray did it. He is an imperfect man, as we all are, but in this criminal court, he is not guilty. [End of Defense Opening Statement]

Conrad Murray Trial - Day 1 - Defense Opening Statement

After a brief break, Ed Chernoff delivers the defense's opening statement:

At the end of the trial, you'll be asked to determine whether Dr. Murray committed a crime, not whether he was a good doctor in the abstract. You'll be asked to determine who/what was the cause of Jackson's death. We believe the pure science will show you that, despite anything in the past or earlier that day, Jackson was frustrated because his doctor wouldn't give him the medication he wanted. He committed an act that caused his own death. Jackson swallowed numerous Lorazepam, enough to put six people to sleep. He did this when Murray was not around.

When Murray left the room, Jackson self-administered propofol. Along with Lorazepam, it created a perfect storm that killed him instantly. When Murray came back into the room, there was no doctor or machine that could revive Jackson. He died instantly, so quickly he didn't even have time to close his eyes.

The defense is not required to put on evidence, but we will...we will put on the science to show you what happened. We will provide you answers to two questions: First, how did Jackson get to this desperate point? Second, what happened when Murray was out of the room?

Jackson wanted to create history with his O2 Arena concert. You'll hear from witnesses that Jackson had not performed for 10 yrs. This particular series of concerts was going to be his absolution - he needed to do these shows. They will tell you he was intimately involved in every aspect of production.

Jackson wasn't just brilliant artistically; he was a smart man and was involved in every aspect of planning. The dance, the music, the writing - it was all his. This was going to be his memory - he needed to do these shows.

Randy Phillips will tell you it wasn't going to end with "This Is It." If he completed the series, he had the opportunity for a world tour, in four segments. You'll see in his own handwriting his plans for 4 or 5 movies. This equated to hundreds of millions of dollars for Jackson. All he had to do was complete the O2 series.

The problem was that he was never going to be able to do these shows. Jackson had a problem that no amount of determination and talent would ever overcome. He knew he needed help. In the spring of 2009, he went out looking for that help.

Randy Phillips will tell you that in summer of 2008, there were initial negotiations for "This Is It." In October 2008, he met with Jackson and others at a hotel to discuss the parameters of the show.

Jackson cried during the meeting. He said, "I'm tired of being a vagabond. I just want a house for me and my kids."

In January 2009 Jackson met with Phillips again to sign the contract. Jackson signed for himself and as president of Michael Jackson Company. Jackson was nervous. Contract read "for up to 31 shows," and Jackson was afraid he wouldn't sell the tickets. It sold so quickly that a mere week after pre-sales, they had to increase the shows to 50. Jackson agreed to that on 2 conditions: 1) that he had a house for him and his children with 16 acres and horses; and 2) that Guiness Book of World Records would be there to document the historic event.

In March 2009, the announcement was made at O2 Arena. During the entire process - negotiations, contract signings, discussions about the tour - Dr. Murray was helping patients. You'll hear during trial who Murray really is. He is no celebrity doctor - has no office dispensing pills to rich and famous. He's an interventional cardiologist. He has two offices - one in Houston and one in Vegas. He performs angioplasty every week, procedures that require anesthesia/sedation. He takes care of people who have had, or are about to have, a heart attack. That's who he was, who he is.

Mr. Walgren said the $150k/month was so lucrative that Murray would provide any medication for Jackson. We'll bring you patients of Dr. Murray who will testify about what means most to Murray.

Chernoff relates story of one witness who will tell how Murray opened up cardiac care clinic in poorest part of town, where there's no money to be made. When patients came to see Murray, he didn't ask how they were going to pay. He would treat them anyway, even if they couldn't, even bought medicine for some patients. You need to hear the full story about Murray, and we'll provide it.

Murray met Jackson in Vegas in 2006 when one of Jackson's bodyguards (whose father Murray had saved) called on Murray when Jackson's child was sick. From 2006-2008, Murray treated Jackson for things like toe fungus, broken foot, lab work. They were friends. On two occasions, Jackson told Murray that he had anxiety and trouble sleeping. Murray, who did not know of "real" problem Jackson had, prescribed Restoril. For Jackson, it was about as effective as water.

Jackson didn't have insomnia. He didn't have trouble going to sleep. He had an absolute, total and thorough inability to sleep. Not for minutes or hours, but for days.

Chernoff says that on June 27, 2009, two days after Jackson's death, he and Dr. Murray met with detectives. The only thing that we chose was the location (because we were staying there) and the time (because we had to fly in). Everything else was decided by police.

We scheduled meeting for 2pm, but they rescheduled it for 4pm. Det. Smith had already toured Jackson home twice, attended autopsy, interviewed hospital staff, all prior to speaking to Dr. Murray. No limitations on what could be asked of Murray, no time limit. He answered all questions thoroughly.

Murray told detectives, "I don't know what killed Michael Jackson; I want to know also."

At the meeting with detectives, Murray told them about Jackson's sleep problems. He told them about the discussions in spring 2009, when Jackson came to him and asked him for help. What you will hear is Dr. Murray talking about Jackson's desperation, his need. He told Murray he had an inability to sleep, and the only way he could sleep was on Propofol. He told Murray how it needed to be applied (with Lidocaine). He had a nickname for Propofol - "milk." He nicknamed Lidocaine "anti-burn."

Murray said Jackson was going to use it with or without Murray's help, so Murray agreed to help him sleep, to provide the Propofol. Chernoff says the state claims that the mere act of providing Propofol is negligent. "What you'll learn, though," he says, "is that Murray provided Propofol for sleep for 2 mos for Jackson. For those 2 mos, Jackson slept, woke up and lived his life. He went to work and continued what he felt he needed to do."

Evidence will not show you that Jackson died when Murray gave him Propofol for sleep. It will show Jackson died when Murray stopped giving it. What you will learn is that Murray told police he felt his role was to help Michael Jackson find a way to sleep, but he discussed with Jackson that he couldn't keep using Propofol forever.

Murray ordered benzos, hoping he could switch to those to wean Jackson off of Propofol so he could sleep naturally. What he told police was that the day Jackson died was the 3rd day of a weaning process. Three days before he died, Jackson finally agreed to cooperate to get him off of Propofol. On that day, Murray gave half the amount he'd normally give (normal would be 25 mg + drip to keep level up). He gave him 25 mg and the benzos. And Jackson slept, then got up and went to work. The next day, he gave Jackson no Propofol at all. First night in 2 mos he slept without Propofol, used only the benzos.

The night before he died, the plan was not to give Propofol, but to go to the benzos. For 10 hrs, Murray refused to give him Propofol, instead giving benzos. As 10:00am approached, Jackson started begging for Propofol. Murray was confused - didn't understand why the medications weren't making him sleep. Felt under bed to see if meds had leaked out.

Evidence will reveal certain personality traits Jackson had. He had a habit of compartmentalizing relationships, packaging them, like spokes in a wheel. The wheel turned, but the groups of people were like spokes - they rarely, if ever, touched. His security staff knew where he went because they took him, but they weren't allowed inside the house. President of AEG had to go through Michael Amir Williams, his assistant, in order to talk to Jackson.

You'll hear about situations with Jackson's family. One of the spokes in Jackson's wheel was a Beverly Hills doctor - Dr. Arnold Klein. We can't call him as a witness, nor his staff, but we can provide medical records subpoenaed showing treatment he received in Klein's office.

Klein is a dermatologist. You will learn that Jackson would visit him up to 3-4 times per week and receive Botox or Restalyne, perhaps a blemish removal. On each of those occasions, though, he'd also receive a shot of Demerol - sometimes 100, 200, 300mg. There were weeks where he received over 1,000mg in one week.

We will present an addiction specialist, a doctor. We will show Dr. Arnold Klein addicted Jackson to Demerol. One of the most insidious things about Demerol and its withdrawal for some patients is an absolute inability to sleep. When Murray was checking under sheets to see where medicine was going, Murray wasn't part of the package - he didn't know Jackson was receiving this Demerol.

The addiction specialist will talk about events in the week leading up to death. He will tell you that Jackson was suffering from the Demerol withdrawal, and the insomnia was a result of that. Jackson told Murray he couldn't sleep because his mind was always racing with plans, ideas. But it was also the Demerol.

Murray explained in great detail what happened when he agreed to give the 25mg of Propofol. You will hear what transpired between Murray and Jackson at that time. Jackson told Murray around 10:50am that, "If I don't sleep - if I don't get some sleep - I can't complete my rehearsal. If I can't complete rehearsal, I can't do my show. I will disappoint my fans. I will fail if I can't perform."

The conversation at the emergency meeting at Jackson's house was actually about pulling the plug on the tour, Chernoff says. When Jackson told Murray the above, he meant it and Dr. Murray knew he meant it.

Murray knew Jackson had to be up at noon. Knew Jackson already had benzos in his system. He agreed to give Propofol, but only 25mg injection. He pulled Lidocaine into the syringe as well. Toxicology will bear that out. When Murray did this, Jackson finally went to sleep. Murray checked pulse oximeter - saturation was in the 90s, very good. Pulse was in 90s, normal for Jackson.

He left only when he felt comfortable about Jackson. When Murray left that room, there was zero Propofol in Jackson's system, and we'll explain why that was. As I told you during jury selection, this is a scientific case. Listen to the science, and you'll know the truth.

I want you to know exactly what Propofol is and what it isn't, because in this case, that's going to matter. We will put experts on the stand. Dr. Paul White is the preeminent expert on Propofol. He is internationally known for IV Anesthetic Medicine. One of the state's experts was his student. He is known by his peers as the "father" of Propofol. He developed the protocol for using Propofol for conscious sedation in this country.

White will tell you things about Propofol you may not have heard:

Propofol is normally used as intraveneous drug (injected or dripped).

Propofol is not a poison, not a neurotoxin. Has one job - to induce sleep, including general anesthesia for invasive surgery. PDR states that amount of Propofol used for that is 2mg per kilogram of body weight - approximately 130mg for Jackson's size.

With that much Propofol, there is not just a danger it will stop your heart, but a risk of an apnea event. If you have that much Propofol, you can't wake up to stop the apnea. But Propofol is most often used not for invasive surgeries, but for sedation - in amounts far less than it would be for those dangerous procedures.

Chernoff says it's a matter of degree. Given in amounts of 25-50mg (conscious sedation), there is no danger of an airway restriction. No risk of cardiac effect. That info comes from the American Anesthesiology for Non-Anesthetists protocol, he says. "It's a known fact."

Murray gave Jackson 25mg on the day of Jackson's death. It's a matter of degree, Chernoff repeats.

The noon recess is called by Judge Pastor. Court resumes at 1:30 PT (4:30 ET).

Again, remember I'm blogging as we go along, so please overlook typos.

Conrad Murray Trial - Day 1 - State's Opening Statement

The Conrad Murray trial began today. Murray is charged with involuntary manslaughter based on gross negligence in his extreme deviation from standard of medical care of Michael Jackson. I'm live blogging as we go, so please forgive any typos. Will try to catch/correct as time permits. Please note that I am not in the courtroom (using a live stream).

David Walgren delivers the state's opening statement. Walgren says that Michael Jackson "literally put his life in the hands of Conrad Murray."  "That misplaced trust, in the hands of Conrad Murray, cost Michael Jackson his life."

Propofol and other drugs were administered by Murray on the date of Jackson's death. Levels of Propofol were similar to those for general anesthesia. Lorazepam also present in significant amount and heightened effects of Propofol.

The investigation centered on the day before and day of death. The day before, Jackson was strong and practicing "The Earth Song" at rehearsals. The next day, he was dead. What happened during that time frame? The actions of Murray directly led to Jackson's premature death.

Murray repeatedly acted with gross negligence and denied appropriate care to his patient. His repeated incompetent and unskilled acts led to Jackson's death.

Jackson was preparing for the "This Is It" tour, to begin in London. He wanted his children to have the opportunity to see him perform before a large crowd. Rehearsals began in May 2009 in Burbank with various members of production team. They then moved to The Forum for most of June, then moved to Staples Center.

Murray was a medical doctor. Was not anesthesiologist, was not board certified as cardiology specialist, nor any other specialty. Murray and Jackson met in Vegas in 2006. Murray treated Michael and his children for various minor ailments in Vegas. They maintained contact.

Offer was made for Murray to accompany Jackson on his tour. Murray wanted $5 million, but that was rejected and a counteroffer of $150k per month was offered and accepted instead. The contract, however, was never signed by all parties. Conrad Murray signed it June 24, 2009, but neither AEG nor Jackson reps had signed it.

Murray sent a goodbye mail to his clients saying that, due to a once in a lifetime opportunity, he was suspending his practice of medicine indefinitely.

What is Propofol? It's a general anesthetic. It's not a sleep aid or sleep agent - it's a general anesthetic. It is a wonderful drug if used by someone who knows what they're doing. It has a quick onset of sedation and rapid return to consciousness with minimal postoperative nausea.

Unfavorable properties must be respected by doctor administering such a dangerous drug, including respiratory and cardiovascular depression. If not knowledgeable and prepared, those dangers can become deadly quickly. Continuous monitoring is mandatory, according to the included prescribing information.

Propofol comes in 100ml and 20ml vials. For each ml, there are 10mg propofol. Murray sought out pharmacy, was not honest with pharmacist. Told him he had a clinic in CA, but it was actually the apartment of his girlfriend. Shipments began from Applied Pharmacy in Vegas to the apt of that girlfriend on April 6, 2009.

In that April 6th shipment were 10 of the 100ml vials and 25 of the 20ml vials. On April 28th, there was a shipment of 40 of the 100 ml vials and 25 of the 20ml vials. On April 30th, a shipment of 10 vials of lorazepam and 20 of midazolam.

May 10, 2009, Murray made voice recording on his iPhone. On that recording are the voices of both Jackson and Murray. The recording documents Jackson highly under the influence, with Murray nearby, recording on his phone. It reveals Murray's knowledge of Jackson's state on May 10th.

Walgren plays clip:

Audio is Jackson describing that he wants people to come to his show and leave thinking it was the greatest show and he was the greatest entertainer ever, and he wanted to take the money and set up the biggest children's hospital in the world. His speech is extremely slow and slurred.

Despite seeing Jackson in that state, Murray orders even more medication - a total of 45,000 mg of propofol. June 10th, Murray orders additional 50,000 mg of propofol. From April to June, he ordered 155,000 mg or 15.5 liters/4.09 gallons of propofol, all within span of 80 days. Based on those shipments, that equals dosing of 1937.50 mg of propofol per DAY.

June 19 2009, Jackson showed up in poor shape for rehearsal - chills, trembling, cold, rambling. Kenny Ortega was concerned. Had never seen Jackson in that state before. Jackson did not rehearse that day. Ortega put a blanket around him, massaged his feet to try to warm him. Jackson ended up going home because of his poor physical state.

Meeting was called at Jackson's house among Murray, Ortega and others the next day concerning Jackson's health. Murray scolded Ortega for his concern, told him to leave the doctoring to him.

Rehearsals did not take place 21st or 22nd, but did resume June 23rd. Video from that day shows Michael appearing strong, looking forward to the tour. The next day, same thing. Michael was excited because the next day they were going to practice an illusion for the show. He never returned to Staples Center.

Murray spent the night at Jackson's house every night for almost 2 months. In his own words, his purpose was to put Michael to sleep with Propofol.

Walgren shows the jury a diagram of Jackson's home, along with photos of rooms in the house, including Jackson's bedroom and the bed in which he died.

What transpired from 1:00am until Jackson's death the next day? Law enforcement investigation shows Murray very busy on the phone that night/morning, including phone calls, emails, text messages. There was an email from the insurance broker in London trying to collect medical records so they can get the insurance set up. Murray responded at 11:17am on June 25th, saying that reports about Jackson's poor health were "fallacious."

Walgren shows chart of phone calls made/taken by Murray that morning. For the couple of hours prior to his noticing Jackson dead, there was heavy phone use. At 12:12, Murray calls Michael Williams and leaves a voicemail to call right away. Williams returns call, and Murray tells him Jackson had a "bad reaction" to the medication. No mention of anyone calling 911.

Alberto Alvarez gets to the bedroom and sees Jackson in his bed, appearing to be dead, with Murray doing CPR with one hand. Jackson has a catheter in his penis. Murray directs Alvarez to grab vials of medicine and put in a bag, along with the IV bag. This was corroborated by LE during search - they found empty saline bag, slit top to bottom, with Propofol vial inside.

Alvarez was then told to call 911. He called at 12:20pm. Call was not made at 11:56 when Sade Anding put the phone down during their call, nor at 12:15 when Murray called Williams. Emergency response were on scene immediately after call, but it was too late. They did all they could to try to resuscitate him. Pupils dilated, no pulse. Murray said it had only just happened, that he had just been talking to him. When asked what he'd given him, Murray only said Lorazepam - never once revealed he'd given Propofol.

Murray rode along in ambulance and took over care en route. At ER, he was asked by doctors what Jackson had taken and what he'd given him. Murray said Flomax and Lorazepam. Said the only thing he'd given him was Valium. Never once told anyone there that he had given him Propofol.

Propofol bottle was found on floor of home, along with syringe on nightstand that tested positive for Propofol and Lidocaine. There were other prescription drug bottles there as well. There was also a Cardiology Board Review book found (text one would study to pass the exam to be board-certified in that specialty).

Initially, detectives were unsure what might've caused Jackson's death since toxicology had not yet been done. Murray met with detectives and told them he was Jackson's personal physician and was accompanying him on his tour. He told them that for over 2 months, he was giving Michael Jackson nightly doses of Propofol. In the two days since Jackson's death, it was the first time he ever mentioned to anyone that he'd administered Propofol.

Murray says he put IV in Jackson's leg to hydrate him. Valium at 1:30am; Lorazepam at 2:00am; Midazolam at 3:00am. At 4:30am he was still wide awake, and Murray says Jackson told him he had to get some sleep, even if it meant missing rehearsal, so Murray says he gave Jackson 25mg of Propofol, which would've put Jackson to sleep (according to experts) for about 10 mins.

However, Walgren says since Jackson told Murray to cancel the noon rehearsal and let him sleep, Murray gave him more than 25mg. Based on shipments of Propofol to Murray, he had been regularly giving him far more than 25 mg.

Murray said he went to the restroom and, when he came back, Jackson wasn't breathing. Medical experts call this "medical abandonment" (leaving patient on such medications unattended).

Evidence shows phone records detailing phone calls around this time, the same time he indicates he gave the Propofol. He was emailing insurance brokers saying poor health reports were fallacious, even while Jackson lay in the bed heavily sedated.

Murray said he didn't tell Williams to call 911 because he would've wanted to know what was going on and Murray had a patient he needed to work on, didn't want to waste time explaining.
Walgren says Murray acted with "gross neglicence," an element of involuntary manslaughter, in his actions/inactions regarding Jackson. Propofol is utilized in hospital setting, with appropriate equipment/personnel to revive a patient if something goes wrong - it's not for use outside that setting. Propofol is not an agent to relieve insomnia. Using it as such is an extreme deviation from the standard of care and is grossly negligent.

There was no monitoring equipment used for Jackson as is required when administering Propofol. What appears to be a pristine, unused blood pressure cuff was found. Murray was using the cheapest pulse oximeter without a monitoring screen. It would have at least sounded alarm when oxygen levels became dangerously low.

Propofol requires immediate access to all standard emergency resuscitation equipment - crash cart, automatic defibrillator, emergency respiratory rescue (trach tube, etc.).

Benzodiazepenes combined with Propofol heighten the effects of Propofol and add to the danger. Again, all with no monitoring equipment. Extreme deviation from the standard of care amounting to gross negligence.

In addition, no informed consent signed by patient indicating they are aware of risks. Another extreme deviation from standard of care. Charting and documentation absent - extreme deviation of standard of care. Basic common sense requires 911 be called immediately, but not done - another extreme deviation from standard of care that amounts to gross negligence.

Walgren says there was no doctor-patient relationship wherein doctor advises the patient and refuses to provide inappropriate care, and even walk away if necessary. Instead, it was employer-employee relationship, where Murray wasn't working for the health of Jackson but for $150k per month. He was an employee and acted as such, did not act as medical professional. Egregious and unethical violation of standard of care.

Walgren says Murray deceived paramedics. Never mentioned Propofol, even as they worked to bring him back to life. Extreme, unethical, unconscienable violation of standard of care. Same when asked specifically by emergency room doctors - he made no mention of Propofol.

Doctors will tell you that Murray's actions (or lack thereof) represent unskilled, non-medically trained professional. His breaches of duties directly resulted in Jackson's death. Gave Jackson unlimited access to Propofol without regard to Jackson's safety or life. He acted with an extreme departure from standard of care that resulted in Jackson's death.

Murray had a legal duty of care to use his best judgment, to "do no harm" to Jackson. Instead, with eye on lucrative contract, he agreed to provide Jackson with massive doses of Propofol on regular basis. Murray figuratively and literally abandoned Jackson on June 25, 2009. He left a vulnerable man, filled with all those medications, with no monitoring equipment - left him there to fend for himself. It violates not just every medical standard, but decency of one human being to another.

Murray's gross negligence and unskilled hands, along with desire for lucrative contract, led Murray to not only abandon his patient but all principles of medical care. His actions and omissions to act directly caused Jackson's death. State asks for guilty verdict of involuntary manslaughter based on Murray's gross negligence.

06 July 2011

Casey Anthony Trial - Verdict &Taking Comfort Where We Can

I was all set to spend the first day away from constant tweeting of court action breaking down the closing arguments and jury instructions. But we got a verdict much more quickly than I expected, so I'm jumping straight to that. I waited until I'd had time to put emotion aside and read the jury instructions again and try to understand the verdicts in that context.

Were the verdicts just? It all depends on your perspective. Let's look at the Murder count first.

1st Degree Murder/Aggravated Child Abuse

If a juror believed Casey Anthony used chloroform or duct tape on Caylee and she died as a result, even if accidentally, that is plenty to find Casey guilty of at least felony murder (Aggravated Abuse) or one of the lesser included offenses of 1st Degree Murder (2nd degree, Manslaughter or 3rd degree).

If a juror felt the state failed to prove that Casey used either chloroform or duct tape on Caylee, then it would indeed be incorrect to convict of M1 or a lesser included, or of the aggravated child abuse charge.

I went back and re-read the jury instructions twice tonight. For the murder charge, jurors first had to believe Casey killed Caylee before going any further with determining what degree of murder she committed. They didn't go on to consider any lesser includeds because they felt the state didn't prove Casey actually killed Caylee.

Connectors-of-Dots vs. Need-a-Smoking-Gun Jurors

There are two types of thinkers -- those who are comfortable connecting dots and working through to a logical conclusion in determining guilt, and those who don't accept the inferences of non-smoking-gun evidence as proof enough to form a conclusion of guilt beyond reasonable doubt.

I submit both are reasonable positions for the person making the call. Jurors are told to give testimony/evidence whatever weight they feel it deserves. So while I personally feel there was plenty to connect the dots for at least aggravated child abuse, and while I'm surprised all 12 jurors felt differently, I am not shocked that Casey wasn't found guilty of 1st Degree Murder.

We all come to the table with our own mindsets, methods of thinking and reasoning, and the influence of our own life experiences. What's obviously important in pointing away or toward guilt for one person might not be to another. Some people are minute-detail types while some others tend to be more big-picture types. Neither is a faulty way to think. It's just who we each are.

So I can see how jurors might have rejected Murder and, therefore, have gone no further with the lesser includeds (remember, the instruction said they first had to determine that Casey killed Caylee -- if they think that went unproven, then game over for the Murder count and any of its lesser included offenses).

Aggravated Manslaughter of a Child

When we move on to Aggravated Manslaughter of a Child, however, I truly am stunned at the not guilty verdict on that count. The element to be proven was that Caylee either died as a result of Casey's act(s) OR her culpable negligence:

"Culpable negligence is consciously doing an act or following a course of conduct that the defendant must have known, or reasonably should have known, was likely to cause death or great bodily injury."

Even if you discount the state's theory and buy 100% into the theory of defense -- that Caylee died in the pool -- then it happened as a result of Casey's culpable negligence.

Neglect of a child is defined as "a caregiver’s failure or omission to provide a child with the care, supervision, and services necessary to maintain a child’s physical and mental health...that a prudent person would consider essential for the well-being of the child."

Is not failing to properly supervise your child to ensure she doesn't go outside unattended and climb into the pool neglect? You know she can open the door because you've seen it with your own eyes. You even fricking photographed it -- you know full well she can do it. You know she can climb the pool ladder - you've seen her do it and have photos of that as well. And you know she lives for playing in that pool.

And yet you do nothing to secure the sliding glass door leading to the pool? No childproof lock or bar across it? If not drown in the pool, she could wander into traffic and be killed. She could even be kidnapped...for real. And because she loves that pool so much and can open the door you failed to secure and drown if your back's turned, you at least check that the ladder is down each night before bed, when you're cooking, showering, anytime you can't be constantly attentive, right?

The negligent behavior does not need to be a series of events either. The instruction reads: "Repeated conduct or a single incident or omission by a caregiver that results in, or could reasonably be expected to result in, a substantial risk of death of a child may be considered in determining neglect."

The defense in closing insinuated it was the fault of the parents -- Cindy for having left the pool ladder up the night before and George for it having happened "on his watch." But the thing is, Casey had custody of her own child. She and she alone was responsible for Caylee's safety and, in her scenario, failed to provide the supervision necessary to maintain her well-being.

In addition, she failed to call 911 when George allegedly found Caylee in the pool. She did not try to see if she could be revived. She did absolutely nothing to help save her child. She is not qualified to determine whether Caylee was dead or unconscious, nor whether she could possibly be revived. That is a failure to provide a service necessary to maintain her child's health and well-being. I would argue that's a second instance of culpable neglect.

Because of these two instances of neglect (or take your pick of the two), Casey Anthony was at least culpably negligent in her daughter's death and should have been found guilty of Aggravated Manslaughter of a Child -- and that's if you buy her OWN story. And you know that that's the absolute minimum she's responsible for. I mean, who the hell is going to make up a story that makes them even more criminally responsible than they actually are? Could we at least connect those 2 dots?

I defended jurors on the murder verdict even though I very much disagree with them (I think she did apply duct tape and that it caused Caylee's death, hence aggravated abuse). But I can't do the same here. I don't understand how they could not find guilt on this count. It's not a reasonable conclusion to me. You've even got the admission from the defendant herself. I think they got it very wrong on this particular count.

I've read and re-read the instructions and definitions for the Aggravated Manslaughter count. I'm a layperson and am certainly not above being corrected; in fact, I welcome it. So if someone can explain why this interpretation is wrong, please do.

Taking Comfort Where We Can

This is the end of the road as far as hoping for legal justice for Caylee. That will never happen now. But as I told someone earlier, things have a way of coming full circle in one way or another...eventually. I have to hope and believe they will in this instance. The alternative is too heartbreaking.

Someone said that Caylee had no one seeking justice for her. Let me tell you that in addition to law enforcement and the prosecutors, there are people all over this world who love Caylee and wanted justice for her. I have Twitter followers from the US, Canada, several countries in Europe, Asia, Africa -- you name it -- all of whom care deeply about Caylee and followed this trial hoping to see justice done for her.

Who could look at that sweet little face propped on her hands or see her reading her kitty cat book, hear her singing, "You Are My Sunshine" at the nursing home and not fall head over heels in love with her? This darling, darling child touched so many hearts around the globe. She has had millions of advocates, each in our own ways.

If love reaches across time and space and beyond this world, then I think Caylee must feel like the most loved child ever.

Caylee, you are the sunshine, honey.