Murray Trial Day 9, October 7, 2011
Dan Anderson Testimony continued
Flanagan Cross continued
Flanagan starts off by asking about the IV bag on the stand in MJ's room where he died. Flanagan asks if the bag was analyzed for all chemicals and the only thing was saline solution, Anderson states they do not analyze for solution, but there were no drugs found in it. Flanagan asks about the tubing (hanging from the IV stand), and Anderson states that it was not found to have any drugs in it.
Flanagan asks repeatedly whether the tubing and the IV bag were attached, Anderson repeatedly states that they were not attached when received into medical evidence, according to notes. Flanagan asks if Anderson tested two syringe barrels, Anderson states yes and when asked, states that both barrels tested positive for propofol and lidocaine. Flanagan asks if Anderson tested any apparatus that had only propofol in it, Anderson states no. Anderson states that the only medical equipment that had propofol and lidocaine in them were the Y tubing (connector) and the syringe barrels. Anderson states that each of the syringes and the Y tubing each had Flumanezil. Flanagan asks if the proportion of propofol and lidocaine were the same in both the Y tubing and the 2 syringe barrels, Anderson states that proportionality testing was not performed.
Flanagan asks for Anderson to define equilibrium as it relates to bodily fluids, Anderson states he believes it is when the samples of the drug or their concentrations are equal. Flanagan asks how long it takes for the blood system to come to an equilibrium, Anderson states its beyond his scope of expertise. Flanagan asks Anderson to define therapeutic range (of a drug), Anderson states that a concentration of the drug that achieves the desired effect, generally it is a safety concern because they are not safe at all concentrations. Flanagan asks what determines therapeutic range, Anderson states clinical trials from the FDA, as well as the literature provided with each drug. Flanagan asks if there is a therapeutic range for propofol, Anderson states no. Flanagan asks about therapeutic range for Lorazepam, Anderson states that it averages 100-200 micrograms per mililiter. Anderson clarifies that the average can be 180, but that everybody tolerates medications differently, and he cannot give specific ranges.
Flanagan shows a Lorazepam bottle, prescription for MJ, asks Anderson to read the bottle, Anderson reads Lorazepam 2 mgs, 1 tablet by mouth. Flanagan asks about MJ's blood concentration of .16% and asks if that would equal about five Lorazepam tablets, Anderson states yes, regardless of the route, whether it was in tablet or IV form. Flanagan asks if MJ had the equivalent of 11 mg of Lorazepam, Anderson states yes, approximately. Flanagan asks how many pills would MJ have to take to get to that level (11 mg), Anderson states that it could be an accumulation over several days, and that he does not feel comfortable with assumptions of routing of medications or form of medications.
Flanagan asks about ion trapping with respect Lorazepam, Anderson states that he knows little about Lorazepam and postmortem redistribution. Anderson states that the only way to get propofol in the stomach is through oral ingestion or ion trapping, it's not postmortem redistribution.
Flanagan asks Anderson to define the term ion trapping. Anderson states that an acidic environment traps the ions of the drug in that environment, beyond that, is beyond his area of expertise. Anderson states that other than ingestion, the only way propofol can get into the stomach by diffusion of the surrounding specimens. When Flanagan asks about the surrounding specimens, Anderson answers that the liver is close, blood samples and blood itself are close to the stomach.
Flanagan states that Anderson is saying that Lorazepam can get into the stomach through redistribution, Anderson states that it can get into the stomach by ion trapping. Anderson states time and time again that this information is beyond the scope of his expertise. Anderson states that he has seen many different decendents who had stomach contents with drugs in them, and that the drugs were not given orally.
Anderson states he does not have personal experience with a decendent that had Lorazepam in their stomach.
Flanagan asks Anderson about ephedrine. Flanagan asks if Anderson came to understand that propofol was the most important drug in the case, Anderson states yes he did. Flanagan asks if Lorazepam was important, Anderson he thinks it has its importance, but that it does notraise a flag. Anderson states that propofol in any case is important, Lorazepam was in therapeutic range, and that he previously testified that propofol was within range only a proper setting. When Flanagan asks what does a setting have to do with therapeutic range, Anderson states that it's very important. Flanagan states that therapeutic range is desired effect, Anderson states yes. Flanagan states that the literature does not take into consideration the setting, Anderson states that every drug literature takes setting into consideration.
Flanagan asks if Anderson did the calculations with regard to Lorazepam last weekend, Anderson states it was two weekends ago, Anderson states that he did them because of the Lorazepam in the gastric sample, and the two urine samples done by the defense. Anderson states that the urine is a historical perspective, and could be an accumulation from several days. Anderson states that the Midazolam testing was done in the urine because the concentration is much higher, which helps to confirm the blood level of Midazolam. Anderson states that Lorazepam levels were much more elevated in the urine than the Midazolam. Anderson states Lorazepam 12,974 nanograms/ml (13 micrograms/ml) Midazolam 0.025 nanograms/ml. Anderson states that the Lorazepam concentration goes up in the autopsy urine, and with Midzolam much less than Lorazepam.
Anderson states that the half life of Lorazepam is 9-16 hours, and that he looked it up in a medical reference book to gain that information. Anderson states he doesn't know what the absorption time and/or the peak time of Lorazepam, that it is in the book, but he doesn't remember what it said.
Anderson clarifies that he never went to 100 North Carolwood. Anderson states that he received vials of blood, a broken syringe with plunger, an IV catheter from Investigator Fleak. Anderson states that the IV bag and IV tubing was brought to him at the lab, simply marked medical evidence #2.
Anderson states that the difference between blood sample and urine sample, is that the blood is what is usually happening in the body, and in the urine represents everything that the body is metabolizing out, and that the urine concentration expectation is that it would be much higher. Anderson states that the urine is historical in nature and what is being expelled from the body over a certain amount of time.
Anderson states that the PACTOX gastric contents analysis, shows 634 nanograms/ml of Lorazepam. Anderson states that the lab measured in concentration, he was provided 73.5 mls of gastric contents, in which he would multiply the two numbers to get the nanograms of stomach contents which would be 46,599 nanograms of Lorazepam left in the stomach. But the numbers Anderson should have used for calculation (micrograms not nanograms) he needed to divide by a thousand, so 46,599 divided by a thousand equals 46.599 divided by another 1000 to get a mg amount, equals 0.04599 of Lorazepam in the stomach. Anderson states that he went further and got a more exact amount and arrived at 0.046599. Anderson states that with a 2 mg Lorazepam pill, the gastric contents are equal to 1/43rd of a single 2 mg tablet, which is a very small amount
Flanagan asks if there is a high concentration of ephedrine in the urine, but a low concentration in the bladder, would it be fair to say it was recently taken, Anderson says it’s a fair assumption. Flanagan asks if it's the same with propofol, Anderson states that he is not familiar with the excretion patterns of propofol.
Flanagan asks if a person were to take 7 or 8 Lorazepam tablets, and he found 14 miligrams in the stomach, would Anderson state that the person had taken it recently, Anderson states yes. There are numerous questions asked after this by Flanagan, but prosecutor Walgren objects and judge Pastor sustains them.
Elissa Fleak recall testimony
Walgren goes over evidence collection and when Fleak recovered multiple evidence items. Walgren asks if there are a lot of photographs taken on multiple days. Fleak looked over the photos to identify which photograph was taken which day (June 25th or June 29th). Fleak says she went into the master bedroom briefly, looked around but did not search it.
Walgren talks about IV stand and the photographs about it. 2 photos of IV tubing taken on June 25th. Tubing is draped over the handle. June 29 photos of IV stand /tubing. June 29 it's still draped over as it was on June 25. Later photos taken same day, it's no longer draped over the handle. One June 29, the investigators freed the tube (undraped it) so that the syringe can be photographed.
mid morning break
Chernoff again questions about whether she went into MJ's master bedroom or not. And again brings the subject of master bathroom and photographs taken in it.
In MJ's master bedroom fire place is on , TV is on as well. Chernoff shows pictures inside the master bathroom and asks if Fleak remembers the pill bottles. Fleak says she wasn't there in June 26 and those bottles were collected on June 26. Fleak says she doesn't know who collected them and who took those pictures. Chernoff shows a picture where there's no pill bottles. Chernoff asks about the briefcase in the pictures.
Detective Scott Smith Testimony
LAPD Detective for 20 years. He was assigned to robbery-homicide division in June 25, 2009. He learned about the death of MJ 3:30PM from his supervisor. He arrived at UCLA at 4:25 PM. Smith went to the emergency area. He stayed there till 7:00PM. Smith did not see Murray at UCLA. Smith obtained security footage from UCLA showing Murray. They got footage of Murray leaving at 4:38PM.
Walgren plays the video and then shows an aerial photo of UCLA and asks Detective Smith to mark the way Murray let the hospital.
Smith talked with Faheem Muhammed, Alberto Alvarez at UCLA very briefly. FM just told he was employed by MJ and gave his contact information. AA said the same things and also mentioned he went into the room to help MJ and called 911. Detective Smith didn't do any more interviews at that day. He arrived to Carolwood around 7:30PM.
Smith didn't know the cause of death at that point of time. At that time this was a death investigation and not a homicide information. Death investigation could be natural causes and detectives may or may not be involved. If it is homicide investigation the police department takes full responsibility. It becomes a homicide investigation if there's an obvious cause of death such as gunshot etc. This was a death investigation and coroner was leading the investigation not the police department. Detectives was on the scene to assist and support coroner's office as needed.
Walgren asks if this had been an homicide investigation would LAPD be leading the investigation and collect evidence. Smith says yes. On June 25th evidence was collected by coroner's office. Det. Smith was assisting and overseeing the LAPD photographer. Smith says they left the residence around 9:30 PM. They released the house at the request of Jackson family to private security.
June 26, Detective Smith attended the entire autopsy of MJ. He didn't have cause of death by the end of autopsy. They had no information to assist with the investigation. It was deferred pending toxicology results. At this time it was still a death investigation and not a homicide investigation. On June 26th Smith went to Carolwood again. Coroner Ed Winters called him and said some items were given to him by family. Smith went to take those items. They initially thought it was tar heroin which turned out to be old rotten marijuana. It was found in a shaving kit. Those items had no relevance to MJ's death and determining the reason of his death.
In the shaving kit there was also temazepam bottle prescribed by Murray. Smith had also found some empty pill bottles on June 26 in MJ's masterbathroom.
Walgren goes over the pictures of MJ's master bathroom taken over several days. June 25th pictures. Bathroom appears to be messy, drawer doors open, a few notes taped on the bathroom mirror. Pictures from June 26. There was no empty pill bottles or briefcase on June 25th pictures. On June 26th there's a briefcase, Smith doesn't know whose suitcase it is. June 26 pictures show empty pill bottles on a ledge. Smith says that he placed them on the ledge to photograph them.
On June 27 Murray's attorney Michael Pena spoke with Detective Martinez. They made arrangements to meet at Ritz Carlton at 4 PM. Murray's attorneys had chosen the place. Detective Martinez and Smith met with Murray and his lawyers in a room at the hotel. They conducted and recorded the interview.
Audio of Murray’s interview with the police is played
June 27th Ritz Carlton. Murray is at the interview with his lawyers Chernoff and Pena. Detective Smith and Martinez is doing the interview.
First part of the interview: Officer is going through and asks Murray basic information as his address, phone number, weight, when he was born, how tall he is etc.
Detective says the detectives at the hospital was from another division and was not handling the case. They took some notes but didn’t do a formal interview. Murray seems surprised to hear that other detectives took notes after he left.
Murray talks about how he met Michael. They met in 2006 and saw MJ on and off since 2006. The first time Murray saw MJ was because MJ and his kids had the flu, a bodyguard of MJ whose parents were patients of Murray referred him.
Murray says he had been caring for MJ for the last 2 months. Murray tells that he received a phone call from MAW. MAW said MJ was going to do a concert-tour in London and MJ wanted Murray with him. Murray said he needed more details before accepting. He then say MJ called and said he was happy Murray was going to join him – although he had not yet committed to join MJ’s team.
Detectives ask about who is Murray is working for AEG or MJ. Murray says he’s an employee of MJ but paid through AEG.
Murray Trial Day 9 October 7 2011
Audio of Murray’s interview with the police is continued
Murray says he had no idea that AEG were going to pay him.
Detectives ask about MJ’s general health. Murray says generally speaking MJ did not eat well and was very thin. He did not find any major physical change in MJs condition except for something called subluxation of his right hip (MJ’s right hip would slip out and slide back to the joint). MJ had fungal disease on his toes which was treated. Nothing more that Murray noticed.
On June 24th – Murray got a called from MAW around 12:10 am that MJ was done with rehearsals. MJ had attended meetings and did a partial performance (not a full rehearsal). MJ wasn’t complaining about anything but wanted Murray to be at Carolwood by the time he came home.
Murray spent every night at Carolwood except nights he where off, which were Sundays. He spent the night there per MJs request.
Murray arrived to MJs home at 12:50am before MJ and waited at MJs room. MJ arrived shortly after, around 1am. Once MJ arrived, they greeted each other and talked about their days. MJ told Murray he was tired and fatigued and was treated like a machine. MJ took a quick shower and changed and came back to the room.
When MJ came back to the room, Murray put on some cream/lotion on his body and back for Vitiligo.
Detectives ask Murray about the bedroom. Murray tells that MJ had 2 bedrooms. No one not even cleaners would be allowed to go into the master bedroom and it would be in a bad state. Murray would see MJ in the second bedroom , the one that had IV stand and oxygen tanks.
After cream, MJ wants to sleep. Murray says MJ is not able to sleep naturally. Murray says he would put an IV for hydration on MJ’s right or left leg below the knee. They then talked a bit and he gave MJ Valium 1 pill 10 mg orally.
As Valium’s effect was delayed so around 2 AM Murray gave MJ 2 mg of Lorazepam which it was IV pushed slowly. Murray says he observed MJ but he continued to be awake for 1 hour, he says he watched him because he wanted to be cautious. So Murray decided to give him Midazolam (2 mg injected slowly) around 3 AM. Murray waited again but MJ was wide awake. MJ said he couldn’t sleep. Murray suggested to lower the music MJ likes to sleep with and dim the lights and told MJ to meditate while he rubbed his feet. MJ did that reluctantly and MJs eyes closed. Murray estimates that MJ closed his eyes around 3:15-3:20; he doesn’t know it for certain because he wasn’t looking at his watch at that time. 10-15 minutes later MJ was again awake.
MJ was surprised that he managed to sleep after he had meditated. And they tried mediating again but by 4:30 AM MJ was sill wide awake. MJ starts to complain saying that says he has rehearsals he needs to perform and tomorrow he will need to cancel his rehearsals because he can’t function if he can’t sleep. Murray says then he gave MJ another 2mg of Lorazepam at 4:30 – 5:00 AM because a safe time had passed. That didn’t put MJ to sleep as well.
MJ complained that if he can’t perform he would have to cancel the rehearsals and it would put the show behind and cannot satisfy fans if he’s not rested well. Murray says that it put a lot of pressure on him. Murray tells MJ he isn’t normal and the medications that he gave would make a normal person sleep for 1-2 days. (due to wanting the medications/can’t sleep)…
By 7:30 MJ was still that time he gave another 2 mg Midazolam. There was still no effect. Murray says he cautiously checked the IV site to make sure the fluid and medicines was going to MJ because he wondered why MJ wasn’t responding to medications.
At this time Murray says Michael also urinated.
10 AM in the morning. Nothing has worked. Murray was watching and trying to get MJ to sleep. MJ is complaining he can’t sleep, he has to cancel the dates and everything has to be pushed back.
MJ at that time asks “Please give me some milk so that I can sleep, because I know this is all that really works for me”. Detectives think that they are talking about actual milk and asks if MJ wanted hot or warm milk. Murray tells them it’s a medicine Propofol which is “a sedative that could also be used for anesthesia”. Murray gave MJ propofol through IV around 10:40. Murray had asked him how long he would sleep if he gave him Propofol because MJ needed to get up at a certain time. MJ told him it doesn’t matter when he wakes up, told him to just make him sleep.
Murray say he gave him small amounts to get him to sleep, he administered 25 mg of Propofol together with Lidocine, he pushed it slowly. This time it must have been 10:50, effect is quick and Michael was sleeping now.
Detectives ask if Murray had any monitoring equipment. Murray says he took all the precautions that were available to him such as oxygen andpulse oximeter.
Detectives questions Murray about the dosage. Murray says 50 mg propofol was the highest amount propofol he had given MJ ever. That night he gave less due to the other medications he had given to MJ. Murray says he roughly gave MJ Propofol every day, there were rarely exceptions. Murray also says that three days leading up to MJs death, he tried to wean MJ off propofol
He was not aware that MJ was taking this on a daily basis before he was hired. Murray was surprised by MJs pharmacological knowledge and his mention of “milk” and “antiburn”. MJ said he had taken propofol before.
MJ said he used it in Germany but never disclosed other doctors’ names. MJ never told him he administered it himself but other doctors let him infuse it by himself.Murray told him NO he wouldn’t let him to that.
Murray says MJ knew that propofol was the only thing that worked for him. Murray says he often warned him about it.
MJ told him he was seeing a Dr Lee that she was giving him a cocktail for energy. Murray says there were a lot of IV sites on MJ’s body and his veins were sclerotic. Murray asks MJ what is in the cocktail and wants to review it. MJ says he doesn’t know. Later they got of Lee because MJ felt she was unprofessional and cancelled an appointment. MJ felt she wasn’t telling him the truth.
Once in Las Vegas Murray got a call from MAW. MJ was in Vegas with his children for a show and he was staying at Wynn Hotel. MJ says he having difficulties to sleep. Murray tells MJ to use sleep medications (lorazepam or restoril) that he gava to him. MJ tells Murray nothing that he or Klein or Metzger gave to him works. Murray says he doesn’t have any other alternatives. MJ then asks about Diprivan / Propofol and says that he knows that it works. Murray says he doesn’t have it. MJ mentions Dr. Adams and that he gave him Propofol. Murray doesn’t know Adams. MJ gives Murray Adams phone number. Murray calls Adams. The plastic surgeon’s office Adams used doesn’t allow them in the office so Murray lets them into his office on a Sunday. Adams puts MJ on a Propofol drip for 6 hours. Murray says he had monitoring equipment. Murray comes back to his office after 6 hours and MJ says he’s feeling wonderful because he has slept.
MJ tells Murray that this is divine guidance and other doctors helped MJ sleep for 15 10 18 hours. MJ mentioned of having another doctor – Adams- on tour with them. Adams was willing on to go on tour with them and wanted $1.2 - $1.3 million a year. Murray told it to MJ but there was no follow up and Adams didn’t end up joining the team.
Murray mentions that MJ wanted him to be around forever, after the tour. Murray mentions MJ’s plans for a children’s hospital and wanted Murray to be medical director.
Detectives go back to the night of June 25. Murray gave MJ 25 mg Propofol. MJ falls to sleep but he’s not snoring. Generally when he’s in deep sleep he snores so he’s not in deep sleep. Murray monitors him. Everything looked stable and he was comfortable. Murray needed to go to the bathroom to pee and empty MJ’s urine jar.
When he came back after 2 minutes he sensed MJ wasn’t breathing because he usually looked at his chest to see if he was breathing. He immediately checked MJs pulse and got a thread pulse from the femoral area and MJs body was WARM and he assumed everything happened quickly and immediately started CPR and mouth-to-mouth. He wanted to apply medicine as well but not first because he wanted to ventilate and compression first. He saw MJs chest rise. Murray says he couldn’t move him from the bed to the floor by himself. He then got his left hand under MJs body and then gave him CPR and also ventilating him and made sure his chest was rising completely. He looked for the phones but phones do not work in the house. He doesn’t know the address zip-code; only know its North Carolwood. The house is closed during nights and only MJ, he and the children would be there. Murray tells that security doesn’t come to the house. Murray thinks it’s inhumane that the security are not allowed into the house to pee.
He says to talk to 911 would be to abandon him and he didn’t wanted abandon him. He reached his cell phone and called MAW. Murray tells MAW to send up security. Murray says he didn’t ask MAW to call for 911 because then MAW would have asked why and Murray was trying to assist MJ. Murray realizes that MJ doesn’t have a pulse now so he lifts MJs legs for a brief moment for auto transfusion and continue to do CPR etc. No one came to the door, no one knocked on the door. So he gave Michael 0.2 mg Flumazenil because he wanted to reverse the affects of the other drugs but MJ would not still breathing and no help was coming. He then opened the door and ran down to the kitchen and saw the chef (Kai Chase) to have the security immediately and security (Alvarez) comes upstairs. Murray tells Alvarez to call 911 and want help to move MJs body to the floor and still helps with chest compression.
Alberto talked to 911 but Murray told him to just tell the paramedics to hurry up because he wanted help to move MJ to the floor. Paramedics came and called UCLA, MJ was not breathing. They were doing chest compressions. Murray says Michael was PEA –pulseless electrical activity – which means you don’t shock a patient. MJ was given starter drugs. Murray says that he felt the communication and the orders coming from UCLA was kind of slow.
After 20 minutes of effort – which Murray thinks was limited – he knew MJ hadn’t been gone too long and he had felt a femoral pulse. So Murray asked UCLA instead to calling MJ dead to transfer the patient to him. Murray took over the care and they took MJ to UCLA. Emergency personnel met them. They worked on MJ for an hour. Murray says probably they would have stopped sooner if Murray wasn’t insisting. They don’t know why MJ died but thinking pulmonary embolism could be a reason (a clot in the lungs that would shut the circulation in the lungs). MJ is pronounced dead. Murray doesn’t want to sign the death certificate as he doesn’t know the cause of death.
Chernoff jumps in and changes the topic to Murray trying to wean off MJ 3 days before leading up to MJs death. Murray says he didn’t know MJ used propofol before and that it was kind of a habit. Murray says he wanted to MJ to sleep naturally and tried to wean him off. Murray asks what MJ would do once the tour was over; MJ tells him he thinks he can be able to sleep then. Murray switches to lesser drugs (such as Lorazepam) to wean MJ off. Murray says MJ knew it but he was reluctant. Murray says he never told MJ that he believed he had drug dependency. He was trying a strategy and was trying Michael to transfer his confidence in Propofol to something lesser. First night Murray reduces Propofol and starts Lorazepam and Versed. Second night he removed Propofol and only gave Lorazepam and Versed. Michael told him he felt a little hangover in the day. The night MJ died Murray started with Lorazepam and Versed but nothing was working. Murray doesn’t know if it was withdrawal from Propofol or if it was psychological. Murray says after trying all night with those 2 drugs he finally gave MJ Propofol so that he can sleep and so that he can produce the next day. Murray says he didn’t want MJ to fail and he cared about him.
Judge stops the tape.. Rest will be continued on Tuesday.
Court ends early due to Yom Kippur (Jewish Holiday)