Murray Trial Day 8 October 6 ,2011

Elissa Fleak Testimony continued

Walgren direct continued..

Walgren enters more photographs into evidence. 

Walgren talks about "broken syringe". EF says she shouldn't have described it at broken syringe. She says she misdescribed the item, she should have written them seperately. She made an assumption that it was the pieces of the same syringe but she was wrong. EF says that she later realized that they have different tips (one square, one circle) and they don't fit together. 

Fleak's thumb print was found on the syringe. She doesn't know when that happened. EF says it might have happenned when she was moving the tables to take photos or repackaging the items. 

EF subpeonad CM through his counsel Chernoff. EF wanted any and all medical records of MJ on July 1. Chernoff provided records to her. Walgren asks if the records covered April, May, June 2009. EF says they were all dated before that date. 

Walgren goes over the medical records they are from 2006 , 2007, 2008 and use the names of Michael Jackson, Omar Arnold and Paul Farance (also Mike Smythe but letter crossed out).

Chernoff Cross

Chernoff asks if EF took more photos then it was shown to the jury. EF says yes. 

Chernoff talks about EF's role in this case. Chernoff talks about being a coroner investigator and the importance of her job. EF's job is to collect as much as information about the cause of the death and the motive for death. Chernoff mentions the importance of being accurate and being through with the investigation. 

Chernoff is asking who was there on June 25th. Detective Scott Smith from LAPD, her supervisor coroner Ed Winters and LAPD Crime Scene photographer. EF took notes, took photos and collected evidence. 

June 29. She went to the residence based on the information she got from Detective Smith. Smith told her that there would be additional medical evidence to be collected from the room next to the bedroom. EF didn't ask any more questions and she said that she would meet him at Carolwood. In Carolwood Smith told her where the bags he was told to would be. EF , Smith , another detective (possibly Myers) and LAPD crime scene photographer was at the house collecting evidence. 

They got the items out of the closet and placed it on a table. They took pictures. EF doesn't remember if she or LAPD took the pictures. She laid items out on the table. Defense shows a picture of items on the table. She and Smith was taking notes and observing. 

IV bag with slit and Propofol bottle. Chernoff asks if there were more photos taken of it. EF doesn't remember. 

3A form- evidence log form to record medical evidence in coroner's office. She did 3 3A forms on June 25, June 29 and July 8th. 

EF goes over her June 29 record. In her handwritten notes she list the cut IV bag and the propofol bottle. Chernoff asks if any of her reports that she mentioned the propofol bottle was in the IV bag. She says no. Chernoff says that "propofol in IV bag" was added to her notes in March 2011. Chernoff tries to ask question about her revised notes. A lot of objection and sustained. 

A week before she revised her notes , EF met with Chernoff at Coroner's office with other coroners and lawyers. Chernoff says he asked her about the IV bag and what was in it. EF says she doesn't remember. Chernoff asks when was the first time she told prosecution about the propofol bottle in the IV bag. Chernoff asks if she heard about Alberto Alvarez and his testimony. EF says that he didn't know him or didn't hear about his testimony saying that he saw a bottle in an IV bag. 

Chernoff asks about her handwritten notes from June 25th. She says after she copies her notes to her reports, she destroys her handwritten notes intentionally in all her cases. 

Chernoff asks if she would agree that she made substantial mistakes. She doesn't agree. Chernoff asks if not keeping her notes was a mistake, she says no. EF says she has her report and put everything from her notes to the written report. 

Flumanezil bottle found on the floor but she moved to the table. Syringe Chernoff asks if she moved the syringe from the floor to the table. EF says no, she found it on the table. 

Chernoff again mentions the "Broken syringe" - EF says she should have described it as two pieces and not broken. Chernoff asks about her scene report and how she wrote there was gloves on the floor and asks her to show it in the picture. She says it was closer to the urine bottle chair and cannot be seen in the current picture. Chernoff shows a picture of gloves on a chair and asks if she wrote about them in her notes. She says no. Chernoff asks if that's a mistake, EF says no.

Chernoff asks about the droplets in the IV bag and argues that they are clear and it's not a milky liquid. Chernoff asks if the IV bag was tested. Yes it was. 

June 25 . She was primarily working on the bedroom. Chernoff asks if she went into other rooms. Chernoff asks if she went into the far left bedroom or not. EF says she did not go to that bedroom. That bedroom also has a bathroom attached to that bedroom. Coroner collected some items from that bathroom on June 26. 

mid morning break

Several photos of urine on the chair from different angles marked by the defense. Pictures of EF shown. Chernoff asks when those pictures was taken. EF doesn't know the exact dates whether it was June 25th or 29th.

Chernoff asks how far was the table from the bed. EF says a couple feet. 

Syringe on IV. Chernoff asks when that picture was taken. Chenoff shows 2 different pictures one taken on June 25th and another taken on June 29. One of the pictures showing the tubing around the IV pole and one does not. Chernoff says that someone was moving evidence.

Chernoff asks who's decision was to not the secure the house. EF says such decisions are up to LAPD. EF also doesn't know if the house was open for access of not. 

Detective Smith informed her about the additional medical items CM mentioned there. EF went to the house on 29th. EF says she doesn't know if LAPD went to the house between June 27 and June29.

Chernoff mentioning some items such as the IV stand and IV bag being collected on June 29. EF also did not mention the IV stand, saline bag or the syringe in her June 25 record. EF mentioned those in the case notes in June 27 case notes. She wrote she had additional items to write that she did not mention in the first narrative.

After June 29, EF did not go to Carolwood. EF collected medical records from other doctors as well. EF collect those to get a better understanding of MJ's medical history. She requested medical notes from Murray, Klein, Metzger, Adams, Tadrissi, Slavit, Rosen, Lee, UCLA medical center, Kopplen, Hoefflin. Objection. Sidebar. She collected extensive records. There were other doctors that said there wasn't any records or did not treat MJ.

Chernoff asks about the juice bottle on the stand. EF says that she did not collect the juice bottle. 

Walgren redirect

Walgren goes over the documents EF prepared. Investigator's narrative : Overall description of the scene. Evidence log : things are itemized and logged into evidence. Case notes : additional information for a case is listed here. 3A form medical evidence form that will detail the medical evidence versus the physical evidence or trace evidence. 

Handwritten notes from June 25 was put into these documents. 

Walgren asks she observed the IV stand on June 25 and have it photographed. Yes she did. On June 27 she mentioned IV stand in her notes. June 29 she picked up the IV stand and the bags from residence as evidence. 

Walgren mentions her preliminary hearing testimony and how she mentioned Propofol bottle inside IV bag in January 2011. EF removed the propofol bottle from the IV bag to see what it was. She put propofol bottle on the IV bag to photograph it. Walgren asks if there was a reason if she photographed them together. She says she intentionally photographed them together because they were found together inside one another. 

March 2011. Walgren, EF, Dr. Rogers examined some evidence. At that time Dr. Rogers mentioned that it was an IV catheter and EF found out that they don't go together. 

Walgren asks if this was a perfect investigation, she says no. Walgren asks if she ever conducted a perfect investigation , EF says no. Walgren asks if she in other investigations she thought she could do a better job. EF says yes and she did her best.

Chernoff cross

Chernoff again goes over to say EF didn't take the picture of the Propofol bottle in the IV bag. 

Chernoff shows a bunch of photos asking if EF took them. 

Fingerprints information is stipulated

Murray's fingerprint was found on 100ml Propofol bottle found inside the IV bag. 
Fleak's fingerprint was found on the syringe on the table.
IV bag with the slit had 4 fingerprints on it. 2 fingerprints was found on saline bag and 20ml Propofol . 1 fingerprint was found on 20 ml propofol bottle. but no identification was made about these fingerprints. The following people were eliminated by manual comparison: Michael Jackson, Conrad Murray, Alberto Alvarez, Michael Amir Williams, Faheem Muhammed, Scott Smith, Mark Goodwin, Martin Blount, Jimmy Nicholas, Blanca Nicholas, Elissa Fleak, Kai Chase. 
No useable fingerprints on : 2 midozolam vials, 1 lorazepam vial, 2 lidocaine vials, 1 lidacaine vial, eyedrops, tube marked bq, a bottle labelled ephedrine/caffeine/asprine , 2 100ml propofol vials, 7 20 ml propofol vials, 2 lidocaine vials, 1 lidocaine vial, 2 lorazepam vials, 4 flumanezil vials, 3 midazolam vials, IV tubing, IV y connector tubing, syringe with needle. 

In short MJ's fingerprints was not on any of the items. Murray's fingerprints was only found on a 100ml Propofol bottle.

Dan Anderson Testimony

Walgren direct
Anderson is employed by LA Coroner as a toxiologists for 21 years. His current position is the supervisor. He's responsible for the people and the results. Anderson mentions his education, work history and certifications. 

Anderson talks in detail about toxicology, the type of tests they do ,the terms used and how they do the tests and the equipment they use. 

Walgren starts talking about this case. Anderson received 4 samples of blood taken at the hospital and hand delivered to him by Fleak. 
June 26. Anderson attended to the beginning of autopsy to tell what he wanted as samples. June 26 afternoon they started testing. Tests take several hour and days. They started evaluating them by Monday. They generated a 8 page report about all the samples tested. 

ng/ml - nanogram ug/ml - micrograms. micrograms are 1000 times bigger than nanograms. 

lunch break

Murray Trial Day 8 October 6, 2011

Afternoon session

Dan Anderson testimony continued

Walgren direct continued

Anderson goes over each of the findings in the report. Most majority of the test is done is using heart blood. It's the starting point. 
-Femoral blood is taken from leg. 
-Heart blood is taken from heart. 
- Hospital blood is taken at hospital. 
- Vitreous fluid is taken from behind the eyeballs. 
- Liver they took a portion. 
- Gastric contents are stomach contents. 
- Urine samples : Urine from scene brought in a plastic urine bottle also they collected urine from the bladder during autopsy

Anderson lists all the findings. You can see some of them in the following pictures. For full details check the the autopsy report.

Important findings: MJ had no alcohol, no Demerol (Meperadine) , no metabolized Demerol (normeperidine) and no Cocaine, Marijuana and such. MJ had Valium, Lorezepam and Midazolam, Propofol in his system. They tested femerol blood, heart blood and hospital blood. They did 2 tests on liver for lidocaine and propofol - both was detected in liver. Stomach contents showed Lidocaine and Propofol. Urine from autopsy shows lidocaine, Midazolam, Ephedrine and Propofol. Jug of urine was tested and it showed Lidocaine, Midazolam, Ephedrine and Propofol. Vitreous (clear fluid behind the eye) showed Propofol. 

Anderson made a summary about positive toxicology findings. 

Walgren again clearly states that there was no Demerol in MJ's system. Anderson says correct. 

Walgren mentions Propofol in MJ's stomach. Anderson compares amount of propofol in MJ's stomach is equivalent to 'specks of sugar granules'. So they are basically saying that it's too small. 

Syringe on the nightstand was tested. They found 4 drops of liquid in it. They detected propofol and lidocaine in it. 

Saline bag, tubing, Y connector and syringe on the IV was tested. They draw a diagram and determined how to test it. Walgren identifies each of the items.

Propofol, lidocaine and flumazenil was found on the IV on the syringe and the short side of the tubing. Saline bag and long section of IV tubing had no drugs detected.

mid afternoon break.

Flanagan Cross

Flanagan is going over the summary report about positive toxicology findings. 

Flanagan asks why Propofol was tested on 3 different blood samples. Anderson says they generally make tests on 2 samples : general blood and peripheral blood (such as from the leg femoral blood) due to postportem distribution. Anderson explains that the body tissue releases the drugs back into the circulation after death and moving the body will also distribute the drugs. On this instance they also got hospital admittance blood. 

Flanagan asks if the reason for hospital blood result be higher is due to the drugs not having chance to be redistributed. Objection. Judge finds the question vague. Flanagan " Do you know why the hospital blood results are higher?" Answer : No. Flanagan "why is the femoral blood results are the lowest?" Answer : Postportem distribution. Flanagan confuses the witness to the point that he can't understand what is being asked. Flanagan "Why is femoral blood has the lowest results?" Answer : That's typical because tissues release drugs to the central cavity artifically raising the heart blood. 

Lidocaine higher in femoral blood then the heart blood. Anderson says it's drug dependent. Some drugs might have different distribution pattern. 

Flanagan asks why the eye fluid was analyzed. They analyzed it for Propofol because Propofol was the real issue. Anderson says that they didn't have enough fluid to make a full analysis. It tells him that Propofol doesn't distrubute very well to the eyeball fluid. They didn't give an exact number amount for Propofol in the eye fluid because they didn't have enough sample. Protocol tells that they can't give exact numbers in such instances as they can't gurantee the accuracy.

Urine from the scene. Flanagan asks why they couldn't get the exact number amount for Propofol amount. Again It was below their lowest caliber. It was almost negligible.

Ephedrine was present in the urine but wasn't in blood. It's because bladder can store things for a long time. Flanaggan asks how long ago it was used. Anderson says it can't be recent as it's not in the blood and it could be used anywhere between 24 to 72 hours ago.

Propofol was found in the urine from the scene. Flanagan asks if it could be from a few days ago as well. Anderson agrees and says that it could also be recent. Flanagan asks if the urine from the scene was accumulated before urine from autopsy. Anderson says he has no idea when it was collected or even it's from MJ. 

Flanagan gives a scenario that the urine from the scene was in 7 AM and the time of death being around 12:00 and 2:26 and says that not much urine is collected after death. Anderson corrects him that they actually had over 500 ml of autopsy urine which he says to be alot. 
Flanagan is trying to say that MJ got/given propofol after the urine in the scene was deposited in the plastic bottle because the propofol level was higher in the autopsy urine. Flanagan again confuses the witness and no one can understand what he's asking. 

Lorazepam. Flanagan asks if it's high. Anderson says it's normal high therapeutic range. Flanagan asks how much lorazepam MJ was given in mg. Anderson says that calculation could be done but it would not be a perfect calculation as there has to be several assumptions made. Anderson says it shouldn't be done. 

Anderson mentions assumptions that needed for such calculation :drug fully distributed, redistrubution didn't happen after death and the heart blood level is not falsely elevated. 

Flanagan shows a book saying that Lorazepam is not subject to redistribution after death. Anderson doesn't agree with it and says there have been only 2 cases stating that but he wouldn't be comfortable with generalizating it to the whole population. 

Flanagan still asks Anderson to give a mg number. Anderson goes over his records saying that based on several assumptions, it's approximately 11 mg. Anderson says that they can't determine how Lorazepam was given (orally or IV) from a blood level and he doesn't know when it was given. 

Flanagan asks if the results indicate that lorazepam has been in the system for a while. Anderson says yes. Propofol levels was not equilibrium. Flanagan asks if a person was on a drip , would he expect the propofol levels to be in equilibrium. Anderson says he doesn't know how Propofol metabolizes. 

Flanagan mentions that the summary Anderson did has no information about Lorazepam in the stomach contents. Anderson says that they only analyze stomach contents for overdose cases. Their blood test results showed Lorazepam to be in the acceptable range so they didn't test it in the stomach. 

Defense has tested the stomach for Lorazepam , it was .634 micrograms/ml. 

Flanagan says Lorazepam is 4 times concentrated in the stomach then the blood. Anderson disagrees saying that it's not significant in it's opinion. Flanagan asks if it's consistent with oral digestion. Anderson says no and explains that drugs will be in stomach in small levels due to "ion trapping" and doesn't necessarily mean that it's taken orally. Anderson converts it to mg : 0.046 mg , that means 1/40th of a normal 2 mg pill. Anderson says that it could come from the blood.

Flanagan asks questions about Midazolam. Anderson has not made calculations about it because the amounts are really small. 

Flanagan by looking to urine level of Midazolam trying to establish blood levels for it. Anderson says it's not a comparison that could be done. 

Flanagan talks about urine and whether it would be representative of the metabolization of the drugs such as if a person urinated at 1 AM and then at 7 AM , Flanagan asks if the 7 AM urine would be representative of the 1 AM - 7AM period. Anderson says there will be some contamination. Flanagan asks if the autopsy urine would be an average level of 12:30 - 7:30 AM time period. Anderson is having trouble with understanding the question. Judge and Walgren also doesn't understand the questions. Flanagan asks if urine would be in equilibrium with the blood, it's beyond Anderson's level of expertise. Anderson says just from the urine results he cannot tell when the person would have higher levels of Midazolam in his system. Anderson says he can't do it for Propofol as well. 

Back to stomach contents and not analyzing it for Midazolam and Lorazepam. Switching to IV set testing. Saline bag and the tubing that goes down to the y port had no propofol or lidocaine. Propofol, lidocaine and flumazenil was found in the syringe and short tubing. Flanagan asks about the amounts of those drugs. Anderson says that they didn't quantify them because they didn't think it was relevant and they didn't have a standard procedure to quantify fluids from medical evidence. Flanagan asks if they can tell the proportions of lidocaine and propofol and flumazenil. Anderson says they can't. Anderson says they also had a very small amounts of liquids that complicated the testing as well. 

end of day 8