Murray Trial Day 10 October 11, 2011
Detective Smith LAPD Testimony continued
Walgren Resumption Direct
They finish playing the Murray interview tape.
Smith states that the first time propofol was mentioned was in his interview with LAPD two days after MJ died, and that prior to that Murray had only mentioned he administered a sedative.
Smith states that he responded to UCLA and also attended the autopsy but that his knowledge was limited.
Smith states that very little of the questioning of Murray was limited, but that they allowed Murray to speak freely. Smith states that Murray did not mention the phone calls he placed or received on June 25, and was unaware of Sade Anding at that time.
Smith states that Murray was surprised by the fact that LAPD had not recovered Murray's medical bags at the time of the interview, dated June 27, 2009.
Smith states that on June 26, 2009, there were some business cards belonging to Conrad Murray and David J. Adams found in the Carolwood home. Smith states that the business cards were recovered from MJ's master bathroom by a LAPD detective. Smith states that also recovered were Latanoprost, a skin cream, and three vials of eye medication from the master bedroom, prescribed by Arnold Klein. Smith states that a large plastic bag with Applied Pharmacy on it, inside with benoquine to Dr. Murray was recovered the bathroom area of MJ's bedroom.
Smith states that there were a series of search warrants issued, the first being on June 29, 2009, to 100 North Carolwood Drive and the tow yard where Murray's BMW was. Smith states that a contract recovered from the pocket of the door, and a few business cards. Smith states no propofol bottles were recovered from the car.
Smith states the next search warrant issued on July 22, 2009 to Murray's cardiology practice and a storage unit in Houston, but that no propofol bottles were found.
Smith states that next search warrant issues on July 28, to Murray's Las Vegas office, home or storage unit were done, no propofol bottles found.
Smith states that the next search warrant was issued on August 11 to Applied Pharmacy at Las Vegas, owner Tim Lopez. Smith states that this is when LAPD discovered that propofol was being sent to an apartment in Santa Monica, CA belonging to Nicole Alvarez. Smith states that then a search warrant was issued for Alvarez Santa Monica home, on August 13, 2009. Smith states that there were no propofol bottles recovered from Alvarez' home.
Chernoff Cross Examination
Smith states that attempts had been made to contact Murray by the LAPD by phone, but that he did not personally make those calls, and that the detective who had made those calls, states that the calls went to voicemail.
Smith states he was aware that the press release for MJ's death was done by Jermaine Jackson, but not aware whether the press conference was actually done.
Smith states that he and Detective Orlando Martinez were initially assigned to MJ's death case, but that Detective Porsche was the original detective who tried to contact Conrad Murray.
Smith states that on June 27, 2009, the initial meeting between Murray and LAPD was set up for 2 pm, but it was rescheduled for 4 pm by LAPD.
Smith states the he spoke with Michael Amir, Faheem Muhammad, Alberto Alvarez, Larry Tolbert, Nanny Roslyn Muhammad, Kai Chase, MJ's family members, some housekeepers, Larry Muhammad had all spoken to LAPD on June 25, 2009. Smith states that Chernoff/Murray never made any limitations as to what he did not want to talk about or time limits, during the initial meeting with LAPD.
Smith states that he did meet with Michael Amir Williams on August 31, 2009 and that he vaguely remembers that Williams had to leave the room briefly at one point to speak to his attorney. Smith states that Murray did not leave the room, nor did he put time limitations on the interview with LAPD on 6/27/09.
Smith states that he had been with robbery/homicide for 1 and half years, before that he worked in another division for 10 years, 24 years as a police department, 14 in homicide. Smith states that he is an avid note taker, and that he took notes for various individuals and evidence collected regarding MJ' death, because he understands the importance of those notes. Smith states that he was in and out of the room while Elyssa Fleak was investigating on June 29, 2009. Smith states that while Fleak was removing items, he did not make notes about what she was removing them, but after that when all items had been laid out for display purposes for photographs.
Smith states that on June 29, 2009, he never mentioned that he never mentioned that a propofol bottle was found in an IV bag. Smith states that he was very specific with miligrams, lot numbers, etc., empty IV bags, empty pill bottles. Smith states that on June 29, in the search, he found Murray's medical bags exactly where Murray said they were.
Smith states that there were Lorazepam bottles found in the master bathroom of MJ's bedroom, but that he was not the person who found them. Smith states that the business cards were found in the vanity of the master bathroom, and that Detective Sanchez told him where they were found.
Smith states that he interviewed Dr. David Adams in Las Vegas.
Smith states that while he was at UCLA, he spoke to Alberto Alvarez. Smith states that Alvarez said he was called into the bedroom, and that Alvarez was told that MJ was having a bad reaction. Smith states that Alvarez never mentioned CPR, or that the propofol bottle was inside the IV bag was on August 31, 2009. Smith states that Faheem Muhammad made a statement on June 25, but that he said nothing about Murray wanting to go back to the Carolwood home on that date, nor did Michael Amir Williams until 8/31/09.
Smith states that there was another interview with Alberto Alvarez after August 31, 2009, and but he can't remember when. Smith states that he requested fingerprints from Alvarez, and he did turn them in, and they were analyzed.
Smith states that SID came in and downloaded surveillance video, that there were video cameras were not pointed toward the front door of thehome door, but there was one on the front gate, on the keypad at the front gate, and one in the back of the house. Smith states that the video that was selected to download was made collectively, but Detective Martinez did the actual downloading. Smith states that they never requested any more video surveillance after June 25, 2009. Smith states that although the Carolwood home was locked and guards were there, that there were people allowed in the home for the 26th, 27th, 28th of June, 2009. Smith states that he does not know if a log had been kept regarding visitors at Carolwood after MJ died through June 29, 2009.
Smith states that he never talked to the new security at Carolwood to get a list of the people who had been in the house on the 27th, 28th, 29th. Smith states that marijuana was found by family members in MJ's closet in a suitcase.
Smith states that he asked upon leaving Carolwood if he the home would be sealed, he stated that he was told no.
Smith states that Conrad Murray told Detective Porsche that he would not sign a death certificate because an autopsy needed to be performed.
Smith states that he interviewed other doctors besides Dr. Adams and Dr. Murray.
Smith states that Murray gave him the keys to his car in order to search it.
Smith states that he did not go personally to search Murray's property in Houston. Smith states that in Las Vegas, Smith recovered Murray's cell phone from his home, computer hard drives from his office, paperwork involving his practice from his offices in Las Vegas.
Smith states that he can't recall if he interviewed a Patrick Muhammad was interviewed, Isaac Muhammad was interviewed, and a Derek Cleveland was interviewed by Smith, all of whom were security at Carolwood.
Smith states that MJ's death was deemed a homicide case on August 27, 2009. Smith states that there was some discussion and that the lieutenant from LAPD told Ed Winter from the coroner's office to stop looking into other doctors besides Murray.
Smith states that a lieutenant from LAPD contacted Ed Winter, who had already contacted Arnold Klein, which caused some friction between the two. Smith states that the DEA was assigned to look into specific doctors ultimately and that LAPD was to focus on the homicide investigation.
Smith states that when Conrad Murray stated he gave MJ milk, Smith asked whether the milk was hot or cold. Smith stated he had no idea that milk meant propofol.
Smith states that only one IV bag was recovered on June 25, 2009. Smith states he was not present when the propofol bottle inside the IV bag was discovered, but was present when it was all laid out on a table.
Smith states regarding video cameras, first pointed at gate area on the outside of gates, second on an entrance underneath the residence but inoperative, third and fourth were on either side of the back side of the entrance facing pool and backyard, fifth pointed at right portion on exterior of house, one pointed facing at the inside of the gate. Smith states no camera showed any door entrances, primarily for exterior perimeter video surveillance.
Smith states that when he found an empty Lorazepam bottle inside an empty IV bag, he starred it and underlined it, marking the lot number. Smith states that he did not note that the propofol bottle was inside an IV bag in his notes, as he did with the Lorazepam bottle.
Smith again states he did not see the propofol bottle inside the IV bag, and that is why he did not document it.
Smith states that the DEA was going to investigate Mickey Fine Pharmacy, and that Arnold Klein was linked to the pharmacy.
Dr. Christopher Rogers LA County Coroner's Office Testimony
Rogers states that he is a deputy medical examiner for LA county, and that he does autopsies to find cause of death, and that he has done this since 1988. Rogers' current position the Chief of Forensic Medicine.
Rogers states he has been present for several thousand autopsies over his career. Rogers states that he did the autopsy report for Michael Jacksonon June 26, 2009. On that specific day, Rogers states he was not able to specify a cause of death, there was nothing anatomically obvious to state cause of death.
Rogers states that MJ was healthier than the average person of his age. Rogers states that there were incidental findings, that MJ had an enlargement of the prostate gland which meant that it was difficult to urinate so he was retaining urine, he had vitiligo, and he also had a polyp in the colon. Rogers states that the nervous system showed mild diffuse swelling, lung exam showed chronic inflammation and scarring, radiology showed an extra rib and also some arthritis. The dental examination showed root canals and implants were done. Rogers states that an anesthesiology consultation was also done.
Rogers states that a previous scalp injury caused an area of pigmentation at the top of the scalp which was scarred, Rogers was aware of the scalp injury. Rogers states that MJ was 5'9" and that he weighed 136 pounds, BMI index was within the normal range, however a thin individual.
MJ's autopsy photo is shown in court. Rogers states that is, indeed Michael Jackson. Rogers states that also the autopsy photo shows 8-25-09, the date is incorrect.
Rogers states that MJ did not have heart disease and no abnormalities were detected in the heart. Rogers states that coronary arteries were clear, and that almost everybody has some athrosclerosis in their coronary arteries, but that MJ had none, meaning no fat or cholesterol in MJ's arteries.
Rogers states that initially he felt there was no natural disease that caused his death. Rogers states that MJ's esophagus was intact, and that there was no white, milky substance in the esophagus.
Rogers states that the stomach content was examined, and that Rogers found 70 grams of drug fluid but did not show pills or capsules. Rogers states that he looked for that specifically to determine cause of death.
Rogers states that he checked the mouth and upper airway (meaning the entrance to the breathing passages, mouth down the throat into the windpipe or trachea) and found no foreign material.
Rogers states that he requested toxicology reports to assist him to report cause of death. Rogers states that he sought out other doctors in specialties to help him with cause of death. Rogers states he read Conrad Murray's interview with LAPD to help him and asked for medical records from Murray, but was never able to obtain any records from Murray.
Rogers states that he was at some point, able to determine cause of death, and the manner was homicide. Rogers states that he based his homicide report on 1) Murray's statement to the police he administered the propofol and benzodiazepines 2) it's not appropriate to give propofol for insomnia, that the risk outweighs the benefit, and in addition, the setting in the home did not provide for the use of an EKG monitor, a precision dosing monitor, equipment available to revive MJ adequately, not an endotracheal tube, no meds to improve circulatory function and 3) and that the circumstances do not support self-administration of propofol, because Murray stated that he only gave MJ 25 mgs, went to the bathroom, returned from the bathroom to find MJ not breathing. Rogers states that you would have to assume that even though MJ was under the influence under the influence of propofol and other sedatives, injects himself with propofol, seems less reasonable than Murray giving MJ propofol from time to time.
Rogers states that since they did not find a precision dosing device, and that he feels that it would be easy for the doctor to give too much propofol, rather than MJ self injecting propofol himself.
Rogers states that the cause of death was acute propofol intoxication, and the contributing condition was the benzodiazepine effect. Rogers states that Lorazepam and Midazolam, both sedatives were a smaller contribution to MJ's death, and could exacerbate respiratory depression, causing someone to stop breathing. Rogers states that it could have also stopped the heart from beating.
Rogers states that a diagram was made of MJ's body during the autopsy, noting various IV puncture marks during revival efforts. Rogers states that on MJ's right arm, left arm, neck, just below the left knee (where Murray had administered the IV, not revival puncture mark). Rogers states that he observed the empty propofol bottle that was found in MJ's bedroom, noting that it was unusual as the stopper had a center which had a linear opening, showing that it did not show any needle punctures. Rogers states that the linear opening is an opening from side to side in the center of the rubber stopper of the empty bottle of propofol, indicating it was not made by a syringe needle. Rogers states that the linear opening could have been made by a spike.
Murray Trial Day 10 October 11, 2011
Dr. Rogers Testimony Continued
Walgren Direct continued
Walgren asks if Roger checked the autospy picture during the lunch break and if the picture was corrrectly dated as June 25th. Rogers says yes.
Walgren reminds that when they went to break they were talking of a spike. Walgren shows a spike and asks Rogers to identify it.
On March 2011 Rogers reviewed some evidence. Rogers identified what Fleak called a needle as IV catheter with a needle still present. It appeared unused. Rogers also examined the syringe from the nightstand. According to Rogers it did not appear to fit.
Defense asks if Rogers reviewed his preliminary testimony, the coroner's report,his notes, expert reports to refresh his memory before today's hearing. Rogers says he reviewed those items as well as another autopsy report and reviewed toxicology results. Flanagan asks if he reviewed a report from Dr. Shafer who is an anesthesiologist in Columbia University. Rogers reviewd that as well. Flanagan asks if he has reviewed toxicology results from outside labs about stomach and urine. Rogers did not see those.
Flanagan asks if Midazolam, Diazapem and Lidocaine toxicology results are consisted with what Murray told the cops. Rogers answers yes.
Flanagan asks if it's correct that what Murray said about Lorazepam in his interview doesn't match with the toxicology results and also mentions that Propofol is hard to determine as it metabolizes fast. Rogers says it's true and they also don't know how much and how fast Murray gave MJ Propofol.
Flanagan asks if they can't be sure who gave it. Rogers says yes.
Flanagan asks why would IV bottle be spiked. Rogers says it's done for giving it continuosly to maintain sedation. Flanagan asks if spiking would also help to emptyPropofol bottle quickly than getting it out with syringe. Flanagan asks if you wanted to mix Propofol with saline spiking it would make it faster to pour it into the saline bag.
Flanagan mentions a way of doing Propofol drip by mixing with saline solution. Flanagan again mentions that emptying the Propofol bottle with a spike would be more efficient than using a syringe to get it out.
Flanagan asks if propofol - saline mix was done, you would expect to see an IV bag with Propofol in it. Rogers says there was no Propofol found in the bag. Flanagan asks if any evidence of propofol was in the y connector, syringe and the tubing below the y connector. Rogers answers yes. The portion above the y connecter was negative for Propofol.
Flanagan mentions Propofol's shelf life of 6 hours. If it's not used it has to be thrown out. Flanagan says that it doesn't make sense if one will only use 5ml of Propofol to get it from a 100 ml propofol bottle as they will need to throw away the 95 ml.
Flanagan asks about lidocaine and Rogers explains why it's used.
Flanagan asks about if Propofol needs to be slowly infused and not rapidly. Flanagan asks what the blood levels will show if a person is given 25mg of propofol. Rogers doesn't know. Flanagan asks how much sleep would such dose of Propofol would bring. Rogers says 5 minutes and Propofol would have no effect after 5 -10 minutes.
Flanagan asks what happens if 25 mg is injected rapidly. Rogers say that you'll have a locally high concentration and it would mean a higher risk of cardiao respitory arrest. Flanagan goes over the information that propofol needs to be slowly administered. Flanagan asks if someone is slowly administering Propofol if they would see any negative effects such as breathing stopping. Rogers answers yes.
Flanagan asks if a slow injection is given and the patient is watched for 15-20 minutes and if after that time period if something goes bad if it wouldn't be due to Propofol. Walgren objects because it's not considering other benzos. Flanagan changes his hypothetical to ask if a person is sleeping more than 5 minutes that wouldn't be due to Propofol and if he could be sleeping due to being tired / fatigue. Rogers agree.
Therapeutic level of Propofol. Rogers says it's dependent on intended use. MJ had 2.6 mg Propofol in his femoral blood. Flanagan asks if due to post mortem redistribution if that numbers could be problematic. Flanagan goes over articles to say that Lorazepam does not redistribute and ask Rogers about the Lorazepam amounts. Rogers say that they are very close and it might or might not show that there was no redistribution.
Pills in stomach. They wouldn't distribute to the body until they are disolved. Flanagan switches to stomach contents. It was a dark liquid. Flanagan asks if there could be fruit juice in the stomach and asks if they ever identified the content of the stomach. Rogers say they didn't. Flanagan asks if they saw any tablets or capsules. Rogers says they didn't. Flanagan says they could get dissolved and they can't tell if a person has taken tablets by looking to stomach contents. Toxicology would be needed to determine it. Flanagan asks if toxicology results show that Lorazepam , would it mean consumption of Lorazepam. Flanagan shows the Lorazepam in stomach toxicology results. Flanagan mentions Lorazepam concentration being 4 times higher than the femoral blood levels. Flanagan mentions the amount equals to 1/43 of a tablet but it doesn't show how many tablets are actually taken as the pills dissolve over time.
Lorazepam levels in the blood didn't cause any red flags because it wasn't too much. Flanagan shows 2 Lorazepam pill bottles found in MJ's house. Both had 30 pills (60 total), one bottle is empty the other one has 9.5 pills left in it.
Flanagan mentions that Rogers thought benzodiazepines had an effect on the death. Midazolam and Diazepam found in the blood was low and insignificant. Flanagan asks what level one Lorazepam pill would cause. Rogers says it should be at therapeutic level. Flanagan brings out the Baselt book that says for 1 pill .018 in 2 hours. Flanagan tries to ask if 1.69 blood level would mean it would require 9-10 pills. Objection.
By judge's order Flanagan goes into hypothetical scenarios. Rogers can't understand questions. A lot of objections and judge sustains them one after another very quickly.
Mid afternoon break
Flanagan mentions half life of Lorazepam (9 to 16 hours) and bioavailability. It's beyond expertise of Rogers.
Flanagan asks if what level of Propofol would be lethal. Rogers says 1 to 17 mg per ml. Flanagan asks if a person with 2.6 level of Propofol would feel pain. Rogers says yes.
Flanagan again asks Lorazepam levels of 1.69 and how many pills it would mean. Overruled due to improper hypothetical. After several hypotheticals Flanagan gets Rogers to say it would equal to 9 pills.
Flanagan mentions that stomach and urine wasn't tested for Lorazepam. Flanagan talks about urine samples. If urine sample in autopsy has higher levels of Lorazepam then the scene urine, would the blood would have higher level of Lorazepam then the blood at 7:30 AM as well. Rogers says he can't answer because there are too many variables. Flanagan gives the scenario of 2 mg Lorazepam at 2AM and 5 AM and then 8 pills being taken around 10 AM , if the urine level of Lorazepam would be higher at autopsy urine then the scene urine. Rogers answers yes.
Flanagan goes over the homicide conclusion. Rogers mention 4 factors contributed to that conclusion.
1st factor propofol and benzodiazepines is administered by another. Flanagan again asks questions about Lorazepam which is beyond expertise of Rogers.
2nd factor non hospital setting. Flanagan asks if chronic insomnia cannot be treated by Propofol. Rogers says that it's not general way to treat it. Flanagan mentions insomnia has different levels and if Propofol might be used. It's beyond Rogers expertise.
3rd factor standard of care. Rogers made that determination with the help of the anesthologist.
4th factor Circumstances do not support self administeration. Rogers says that he thought what was reasonable. To Rogers it's reasonable to believe that Murray miscalculated and gave too much Propofol. He finds it less reasonable for Michael to wake up and while still under influence of sedatives and manage give himself Propofol and it killed him and all these happened within 2 minutes.
Flanagan talks about the positioning of the IV line. IV was beyond left knee and it was 6 inches long till the y connector. Flanagan asks if a person can touch an area around their knee. Rogers agree. Flanagan asks about if anyone can do a bolus injection and if it can stop the heart.
Flanagan asks if someone else was giving the injection other than MJ would they see if there's a problem. Rogers say you hope that they do.
Walgren brings up what was mentioned earlier and asks is it true if a person found with eyes open it would mean they died quickly. Rogers says it's not true. People can die slowly and still have eyes open.
Oxygen tank was analyzed at july 13, 2009. It was empty.
Walgren says that most of the defense questions pharmacology - what happens to drugs when they enter into the body. It's not Rogers area of expertise. Rogers is an expert in determining cause of death. He's not an expert in propofol or lorazepam.
Walgren mentions the lethal levels of 1 to 17 mg Propofol and asks if smaller numbers than we have seen in MJ can cause death. Rogers answer yes.
Walgren goes over Lorazepam bottles. They are both prescribed by Murray. One is filled April 28, 2009. It was for 30 pills - 9.5 remaining. Second one is filled April,2.2009. It was for 30 pills and it's now empty.
Walgren mentions the hypotheticals Flanagan asked. Tells Rogers to assume Murray was telling the truth in his interview and gave MJ Valium and then 2 injections of midozolam and lorazepam and then propofol. In that scenario if he left the patient alone to swallow lorazepam pills, and there's no monitoring equipment, no airway management equipment and no resusitive equipment. Rogers says it's still homicide. Walgren gives the same sets of events but the scenario self administration of Propofol instead of Lorazepam. Rogers would still classify it as homicide.
Flanagan asks about the oxygen and asks if the valve was open or closed. Rogers doesn't know. Flanagan asks how long would it take it to become empty. Rogers say it depends on how open the valve is. Flanagan asks if it's in therapeutic levelswould it empty in 2 weeks. Rogers say probably.
Flanagan mentions Rogers answers about how he's not knowledgeable about Lorazepam and asks doesn't he need to be knowlegeable about that to make determination in this case in regards to the cause of death. Rogers says he doesn't know how these levels are achieved but they are the cause of death.
Flanagan talks about Lorazepam levels being close to the levels required to be unresponsive to painful stimuli and Propofol levels are half the required to be unresponsive to painful stimuli.
Flanagan asks Rogers to assume that Murray was telling the truth in his interview. Flanagan mentions the midazolam and diazapam numbers match but Propofol and Lorazepam levels are a lot higher.
Walgren asks why he do an consult with an anesthologist. Rogers says because it was a comples problem. The doctor he consulted told him that the levels was consisted with general anesthesia.
Flanagan mentions rapid injection again and asks if rapid injection would have negative effects of respitory and cardiovasculary depression