Jacksons vs AEG - Day 71 – August 16 2013 – Summary
In addition to testimony, one development this morning was that the plaintiff's rested their case. Attorney Brian Panish didn't want to but Judge Yvette Palazuelos told him she would tell the jury the plaintiff's case was done if he didn't. The judge said it didn't foreclose Panish from calling additional witnesses during his rebuttal case. Plaintiff's resting will allow for argument on an AEG motion to dismiss the case at some point. No word on when those arguments will happen. Panish told the jury that the plaintiff's case officially ended after Kenny Ortega's testimony was done. Judge called it a "formality." (AP) After jury entered the room, plaintiffs attorney Brian Panish announced he has rested their case in chief, subject to conclusion with Ortega
Dr. Gary Green Testimony
(Source : ABC7)
Attorney Jessica Stebbins Bina is doing direct examination.
Dr. Green is a doctor board certified in internal medicine and sports medicine. He's currently the head team physician for Pepperdine University and is the medical director performance enhancement drugs for MLB. He oversees medical care of athletes both in minor and major leagues of baseball, also sees general students at Pepperdine, not just athletes. The doctor conducts research on behalf of MLB at UCLA pathology department regarding enhancement drug use. He's also a clinical professor at UCLA and a partner at primary care group, sees general patients as well. Dr. Green is the team physician for the US Soccer team and Pepperdine, worked in Olympic Games of 2002, MLB, NCAA, was UCLA team physician.
Dr Green said sports medicine is somewhat like regular medicine. "Doctors should do no harm; doctors should do what's best for the patient" He said he always wanted to be a family doctor and treat patients for all their lives. Dr. Green said before athletes know what medical problem they have, they want to know when they can play next.
Dr. Green said he has similar or greater experience that Dr. Gordon Matheson, since Dr. Matheson doesn't have private practice. Dr. Matheson testified earlier in the trial on behalf of plaintiffs.
Dr. Green worked with O'Melveny & Myers before in a case involving Manny Pacquiao and Floyd Mayweather, Jr. The expert said he was surprise being called in this case, since it has nothing to do with athletes. Dr. Green reviewed extensive material, deposition and trial testimony in this case. The doctor said he spent about 115 hours in this case, bills $500 per hour. He said he's billed approximately $20,000 to $25,000 up-to-date. There will be about $25,000 to $30,000 to be billed, total approximately $50,000.
Bina asked if he agrees with Dr. Matheson this is a conflict of interest case. "I disagree with Dr. Matheson completely," Dr. Green said.
Dr. Green's opinion:
1- Sports medicine is the wrong analogy
2- Facts don't support conflict of interest alleged by Dr. Matheson
3- Conflict of interest alleged did not lead to poor medical care
4- Dr. Matheson disregarded key principles to reach his conclusions
Dr. Green said this case is much closer to regular doctor-patient medicine than sports medicine. Doctors have ethical obligation to do no harm to the patient," he said. "There's conflict of interest on a daily basis between doc/patient" Dr. Green said through experience doctors learn very quickly how to manage conflicts and have the patient's best interest first.
1- Sports Medicine is the Wrong Analogy
A: Who selects doctor?
Team Sports: Team/School
Primary Care Practice: Patient
This Case: Patient
Dr. Green said in team sports, the team or school chooses the doctor. In primary care practice and in this case, MJ chose the doctor. "In my private practice, I'm selected by the patient." Dr. Green said. "They choose whether they want to come see me or not." Dr. Green: MJ brought Dr. Murray to the attention of AEG Live and MJ insisted to bring the doctor on tour. At one point, AEG explored other options and MJ wanted his physician, Dr. Green testified. The expert said there's no evidence Dr. Murray has been asked to treat anyone else but MJ and perhaps the children.
Doc said in team sports player, coach, team, public have the right to information from doctor. In private practice/this case only patient. Dr. Murray was not allowed to share any information wit AEG Live or anyone else, the doctor testified. There's no release form to share info.
Dr Green said plaintiffs hired Dr Matheson to say that this was a sports medicine analogy. "It's just not the correct analysis in this case" Dr. Green said one of the articles Dr. Matheson used is entitled "The Unique Aspects of Sports Medicine," and this is not the same. Dr. Green explained the Jackson family claim there was conflict between AEG and Murray to influence the type of medical care used with MJ.
Dr. Green explained that in order for conflict of interest to exist, each party had to have different interests. "MJ wanted to remain healthy to do the tour," he said. "Dr. Murray wanted MJ to be healthy, it's his ethical obligation and he wanted him to complete the tour," he said. "AEG Live needed a healthy MJ to be in good health, this was a long tour," he expressed. Bina: If there were no tour, do you have any reason to believe Dr. Murray would be paid $150,000 a month? Dr. Green: No, I do not. "It was Dr. Murray's interest to keep MJ healthy to have him perform the shows," Dr. Green opined.
2- Facts Don't Support Alleged Conflicts
- Health interests of MJ, Dr. Murray and AEG Live were aligned
- - No secret arrangement
- Jackson requested Dr. Murray
- Dr. Murray demonstrated independence from AEG Live
---- Advised MJ not to go to rehearsal
---- Told tour personnel to "stay in their lane"
---- Refused to provide medical records to insurers
---- Requested contract changes to increase independence
- Evidence does not support claim that AEG Live directed medical care
- Timing of contract drafts doesn't support Matheson's claims
"There's no secret arrangement," Dr. Green said. "In this situation, everything was out in the open." Dr. Green: It was to be signed by Dr. Murray, MJ and AEG Live. There was nothing hidden. Dr. Green: Dr. Murray knew AEG Live would be advancing the money on behalf of MJ, MJ knew AEG would advance the money. "That was selected by Michael Jackson," Dr. Green opined. "There was no secrecy, he requested Dr. Murray to go on tour." "If there was any secrecy was between Murray and MJ," Dr. Green opined. "There's no evidence AEG was aware Murray was giving MJ Propofol." "AEG was not controlling Dr. Murray," Dr. Green said. "He acted independently from AEG." "If Dr. Murray were taking orders from AEG Live, he'd not have told people to stay in their lane," Dr. Green opined. Dr. Green said Dr. Murray refused to provide his own medical records of MJ to insurers. MJ denied releasing the medical history. The expert said Dr. Murray requested Kathy Jorrie to change the contract to have more independence. "He asked to keep money for the entire money should he be discharged mid-month," Dr. Green testified. Dr. Green pointed out Dr. Murray asked to change the contract to limit him to perform services requested by artist, not producer. "I believe that it further demonstrates Dr. Murray's independence from AEG Live."
Dr. Green said that it's not unusual for family/friends to call him to talk about a patient he's about to see. He said family/friends may tell him things that the patient wouldn't. The expert said that in all the meetings, there were several people present, which supports the fact there was no secrecy.
First draft of the contract was June 16. "Dr. Murray's behavior in this case and care to MJ began way before that," Dr. Green explained. "If Dr. Matheson is correct and terms of contract influenced Murray's behavior, he started treating him way before contract draft" he said “There's no evidence of Michael Jackson use of Propofol to AEG," Dr. Green opined. Timeline per Dr. Green: 2006 -- Dr Murray begins treating Jackson family January 2009 -- Dr. Murray treated Prince and Michael in LA. Dr. Green: MJ had a physical in 2009 with Dr. Slavit. He asked who was his personal physician and MJ said Dr. Murray. Kai Chase testified Dr. Murray was frequently at Carolwood house in April, May and June 2009. On April 6, 2009, Dr. Murray ordered Propofol to be shipped to LA, the expert said. Dr. Green pointed out that all of that happened before AEG Live had any knowledge of Dr. Murray. Dr. Green: I think it's very clear the relationship of Murray-MJ pre-date AEG being involved. Furthermore, his use of Propofol pre-dates AEG. Dr. Murray re-ordered Propofol on April 28, 2009, Dr. Green said.
"Not only do I disagree with Dr. Matheson's conclusion but the manner of which he came to his conclusion," Dr. Green said. "Patients and competent adults have the right to choose their own physician," Dr. Green testified. "In this case, MJ chose Dr. Murray as his own physician and wanted him to go on tour," Dr. Green opined. Dr. Green: AEG Live looked at other possibilities and in response MJ, a competent adult, said no, I want my own doctor. "Continuity of care is a very important principle," Dr. Green explain. That way the doctor knows the history of the patient. Dr. Green said Dr. Matheson wanted AEG to go around MJ and find another physician for him.
Dr. Green: Physician's duty to the patient is paramount, and that's the number one priority and what doctors should always be concerned. "Physicians are under the obligation, regarding any interest, to put their patients first," Dr. Green expressed. Dr. Green said Dr. Murray disregarded the Hippocratic oath, standard of care and probably violated prescribing rules.
Jacksons' attorney William Bloss did cross examination.
Bloss: Would you agree large incentives can create conflict of interest? Dr. Green: Yes, financial incentive can create conflict of interest. "Regardless financial incentive, it does not take away from physician's obligation to the patient," Dr. Green explained.
Code of Ethics of American Medical Association. Bloss showed opinion of "Financial Incentives and the Practice of Medicine." a) Large incentives may create conflict of interest that can in turn compromise clinical objectivity. AMA says: "It's important to recognize that sufficient large incentives can create an untenable position for physicians."
"Financial rewards do not obligate physicians to compromise their medical judgment," Dr. Green opined.
Bloss: Is $150,000 a month a large incentive? Dr. Green: It depends on the situation. Bloss asked how about a doctor whose house is about to go on foreclosure, $600,000 in outstanding debt, behind child support payment? "I'm sure many doctors have great deal of debt, possibly more than that, and still practice medicine in an ethical manner," Dr Green said
Bloss showed Kai Chase's testimony, where she said she didn't see Dr. Murray as much in April, was there about 3 times a week. Dr. Green said he was not accurate when he mentioned Chase said Dr. Murray was at Carolwood in March of 2009.
Dr. Green said on April 19, 2009, Dr. Metzger went to Carolwood to meet MJ. He said MJ asked for sleep medication. Bloss: Do you recall MJ asked Cherilyn Lee to give him sleep aid? I don't recall dates, need to see the testimony. Bloss: If a nurse says there were no equipments at the house 4 Murray to inject MJ w/ Propofol on Apr19 is that inconsistent? Dr. Green: No. Bloss: Do you have information MJ was seeking Propofol from people other than Dr. Murray? Dr. Green: Yes, Dr. Metzger and Cherilyn Lee. On Apr 19, MJ asked Cherilyn Lee to find someone to give him Propofol, Bloss said. He asked if it'd be consistent w/ Murray there same day. Dr. Green: We see addicts and they go to multiple sources, I could only speculate why MJ was seeking Propofol from more than one person. "It's not inconsistent somebody seeking drugs from several sources" Dr Green said. "Particularly with that drug which wasn't easy to obtain"
Bloss: Was Dr. Murray giving MJ Propofol on April 19th and 12th at Carolwood? Dr. Green: Yes. Dr. Green said he cannot testify to the exact date because Dr. Murray kept no records to maintain it secretive.
Dr. Green charges AEG $3,000 per half day of work, $6,000 for full day.
Bloss showed email from Ortega to Gongaware on Jun 14, 2009 saying "Are you aware MJ's doctor didn't permit him to attend rehearsals today?" "This just shows Dr. Murray independence to advise MJ not to attend rehearsal," Dr. Green said. Email from Gongaware: "We want to remind him that it's AEG, not MJ, who is paying his salary." Dr. Green said the best person to ask about this email is who wrote it/received it. Since he's neither, it'd speculation to interpret it. "I believe Mr. Gongaware didn't recall this email," Dr. Green said. "Mr. Ortega said he didn't understand what it meant." Bloss: Is this email material to your opinion? Dr. Green: Yes, I feel that it supports my opinion. Bloss: Even the part that says "AEG, not MJ, paying his salary?" Dr. Green: Yes. Dr. Green said in his deposition that nothing in the email supported his opinion. He said he testified differently at deposition. Bloss asked in deposition whether "AEG, not MJ, paying his salary" email did not influence his opinion, correct? "Yes," Dr. Green responded. Dr. Green: Now that I responded differently is because I had additional information. Dr. Green: One is Mr. Gongaware's testimony, and further reviewed evidence this was never communicated to Dr. Murray. "The fact that it was never communicated to Dr. Murray let me believe it was not influencing," Dr. Green explained. Dr. Green said he doesn't believe either Gongaware or anyone else at AEG told Dr. Murray "it's AEG, not MJ, who's paying his salary." "You need to look at the context of this email, you can't just pull out a word here or there," Dr. Green said. Bloss asked if "we want him to understand what's expected of him" mention in the email influenced his opinion. "No, it would not sway my opinion one way or the other," Dr. Green said. Dr. Green said he did not ask to meet with Gongaware or Phillips to try to get more information about the email and their intent.
Bloss asked about the meeting at Carolwood's house on June 16, 2009, which they called "intervention." He asked if Chase said Dr. Murray bursted out of the meeting and said "I can't take this s**t anymore." "I read the testimony of of Ms. Chase and that was her perception," Dr. Green said. Mr. Gongaware had a much different account of the meeting than what Chase testified, Bloss said. Dr. Green said Chase wasn't present for the entire meeting, but Gongaware was. He would give a little more weight to Gongaware since he was present for the full meeting. "Assuming that Chase's recollection is correct, I think there are many interpretations of Dr. Murray's outburst," Dr. Green said. Bloss asked if it could be that Dr. Murray was feeling pressured by AEG. Dr. Green: It could be that Dr. Murray could be feeling pressured he was giving unethical and illegal drugs. "That certainly could create pressure in Dr. Murray to make an outburst like that," Dr. Green said. "There was nothing to suggest in the meeting that Dr. Murray was in danger of losing the gig." Dr. Green said.
Dr. Green didn't receive the "Trouble at the Front" email chain until after he was involved in the case. Bloss showed Bugzee's email saying MJ was basket case. "Only information that MJ was not in good health on June 19," Dr Green said about it. "Dr. Murray wasn't keeping records at this time, but I believe MJ was under his care," Dr. Green said. Bloss showed the email where Ortega said "now that we brought the doctor in to the fold." Dr. Green said this email showed Ortega was concerned with MJ's health. He doesn't know what the director meant by "doctor in to the fold." Bloss: Because you didn't understand what this meant, this email didn't influence you, correct? "I think you have to put this entire thing in context and the context is that he was concerned with Mr. Jackson's health" Dr Green explained. Dr. Green said several people raised questions about MJ's psychological situation.
Dr. Green said he believes Dr. Murray was board certified but it had lapsed in 2008. Murray does not have psychiatry training.
Bloss talked about the lengthy conversation Randy Phillips with Dr. Murray. He asked if he knew for sure what they talked about. He said no. Bloss asked about another Phillips' email.
Panish laughed out loud when Dr. Green responded he recalls testimony but preferred reading again. Judge called Panish out, he apologized. Judge ordered all the attorneys in her chambers for quick sidebar. Back in the courtroom in front of jury: Panish: Your honor, I'd like to apologize to Dr. Green for that laugh. Dr. Green: Apologies accepted. Panish: I'm sincerely sorry Dr. Green: No harm, no foul
Bloss talked about "this doctor is extremely successful, we checked him out." Dr. Green said he thought Phillips meant that based on Kathy Jorrie's testimony regarding the check she did.
"I do not see anything to change my opinion of conflict of interest in this case," Dr. Green said. Bloss showed another part of the "Trouble at the Front" email with Phillips saying "Tim and I are going to see him tomorrow." Bloss asked if that statement was material to his opinion. "Only that AEG was concerned about what was going on and were doing something about it," Dr. Green said.
Dr. Green said he considered all the evidence in the case, since everything is important. Dr. Green sad he's not sure what Phillips meant when he asked "is it chemical or physiological." "I can only speculate."
Dr Green said he was asked to analyze if this is a sports medicine case and whether or not conflict of interest led to his poor medical care
Judge adjourned trial. Attorneys ordered back at 10:45 am PT on Monday, jurors at 1:30 pm PT. Dr. Green returns then.