27 September 2011

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.

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