Conrad Murray Preliminary Hearing Day 3 Thursday 6th January 2011.
by Reflections On The Dance, An Honest Look at Michael Joseph Jackson on Wednesday, January 19, 2011 at 7:20am
Transcripts compiled and typed by Sharon Longhurst
Katherine, Latoya and Randy Jackson were in the courtroom.
9.25am Court called to order.
Richard Senneff (one of the paramedics on the scene) takes the stand to continue the cross examination by Defense Attorney Joseph Low.
“We left off where the hospital gave you the chance to call it (the death)” said Low.
“That’s not correct. When we give our third round of meds we update vital signs of any changes, read all the information. There was no change in the patient. They (UCLA) said “We’d like to call it”. It’s their call. They wanted to speak to the physician. Be advised this is a very high profile VIP. They said “No,call it,put Dr Murray on the line” so then I handed the phone to him”
Dr Murray was assuming the care and we were going to the hospital. He didn’t want to make the call either” said Senneff.
Senneff went on to say that Dr Murray assumed control of the resuscitation effort.
“He said he wanted to insert a central line?” asked Low.
“That’s correct” replied Senneff
“Another idea he had was to administer magnesium?” Senneff answered “Yes”
“They don’t give you all the equipment (medications) as a hospital?” asked Low.
Senneff replies “That’s correct. We’re not trained in central lines. I’ve never been trained on it or read up on it and it’s out of our range/scope of training”
At some point Senneff is informed of the name of the patient. “I’m not sure who said it but somebody said it in the room. No one was insisting that we do anything because of who this was”.
“Did Dr Murray assist you bringing the patient downstairs?” asked Low
“No, not at that point. He went to get his gear and we left the room before Dr Murray left the room” replied Senneff.
“Was there at some point did Dr Murray say that he had found a pulse?” asked Low.
“Yes he did” replied Senneff.
Dr Murray had claimed he felt a pulse in the femoral artery; a large artery in the leg close to the groin.
“As soon as he said it, the first thing I did was look at the monitor” said Senneff.
Low then asked “When you do good CPR, it’s common to get a pulse?”
“I believe what I said was, stop compressions, continue ventilations. If you stop compressions then you feel a pulse, then it’s obviously not the compressions. Stop for a few seconds, check the monitor. It also gives you a clear opportunity of the EKG machine”.
“Now downstairs at the ambulance there were a lot of people out there with cameras. Would you describe an accurate term, paparazzi? Asked Low.
“Big cameras, little cameras, video. There were a lot” replied Senneff.
Senneff then gave a list of who was in the ambulance.
“Dr Murray asked us to give another round of epinephrine. We gave that through a saline line” Senneff told the court.
Senneth then went on to describe what happened when they arrived at the UCLA Medical Center.
He described the crowd as being all over the place and that Dr Murray made a request to put a towel over to cover Michael Jackson’s face. Senneff thought it was a reasonable request as when they left the house a man with a camera started running down the street and put the camera right up against the window and was running with the ambulance, filming.
Because of the event it seemed a reasonable request by Dr Murray to cover Michael Jackson’s face.
UCLA tried to revive Michael Jackson and while at the hospital Senneff heard that the death had been called by UCLA. He didn’t remember exactly how long the time lapse was that passed but guesses 45 minutes to an hour after arrival at the hospital.
DDA Walgren then asks about the femoral pulse during treatment.
“When Dr Murray said he felt a pulse, not one of the other paramedics had felt a pulse.
There can be a false pulse during CPR compressions. They stopped compressions for a few seconds and then resumed. He did not feel a pulse” replied Senneff.
“Did Dr Murray offer to insert a central line from his equipment?”
“No” replied Senneff.
“Did Dr Murray offer magnesium from his equipment?”
“No” replied Senneff.
“When you first came in the room and saw that Dr Murray identified himself, was that unusual?”
“Yes” replied Senneff.
“The fact that there was an IV there, was that unusual?”
The patient seemed thin to him and pale.
DDA Walgren continues “Your opinion of this patient was based on the surroundings, the IV, the look of the patient, quite thin and pale, the doctor being there. In fact, it was your opinion that the patient was dead. No other indication of other type of illness or drug use, other than your observations and the defendant telling you he gave him lorazepam”.
“No, it was just unusual to see a doctor in a patient’s home, the IV and oxygen bottle” replied Senneff.
“You thought it was inaccurate that the doctor said the patient had just gone down with the call?” asked Walgren.
“Yes sir” replied Senneff.
Walgren then re-verifies with the witness that he was comfortable with a time that the patient went down prior to his arrival.
“20 minutes to an hour” replied Senneff.
“At any time did any of your team feel a pulse on this patient?”
“No” replied Senneff.
“What time was the 911 call?” asked Walgren.
“12.21pm” replied Senneff.
“That wasn’t the time of the call, that’s when you received it correct?”
Senneff then checks the run sheet.
“Call came in at 12.21pm and they received it at 12.22pm”
Richard Senneff is then asked to stand down from the stand.
Prosecution Witness Number 7 Paramedic Martin Blount.
Deputy District Attorney David Walgren begins by establishing a background through questioning.
Martin Blount has been a firefighter for 20 years and a paramedic for 11 years. He was working as a paramedic on the 25th June 2009 and was the driver on the call.
Once on the property, he was directed into the house and up the stairs. He was towards the back of the line of people who entered the home. Blount was shown exhibits/layout of the home where he treated his patient.
When he first saw the patient, he was not on the floor, he was on the bed.
Blount identifies the defendant, who identified himself as the patient’s personal physician.
Dr Murray was the one who opened the door and requested help. He noticed that Dr Murray was sweating profusely. Blount clarifies that when he entered the room the patient was on the floor. He also testifies that he noticed an IV stand in the room and that the patient was moved to a better area of the room.
He then went on to explain why he was the last person in the room. As the driver, he got the gurney out of the back of the ambulance and other gear. His role as driver is to be available to the patient so he positions himself at the patients head.
Blount did hear Dr Murray being asked if the patient had been given any drugs and Dr Murray said no. Dr Murray explained that the reason why there was an IV was because the patient had been dehydrated.
Blount’s police statement said that Dr Murray had said that the rehearsals the previous day had been for 16 hours.
Walgren then asked Blount if he remembers Dr Murray saying something about a physical.
Blount said that he heard Dr Murray say that the patient had been down five minutes prior to calling 911.
Blount was then asked to describe the scene and what medical equipment was available.
“I saw an o2 cylinder, oxygen tank”.
Walgren then asks “Anything else? Heart monitor?”
“No sir” Blount replies.
“Did you see a nasal cannular?”
“Yes, that’s tubing that would go around the nose and connected to an oxygen tank. I did not observe any other type of medical equipment” replied Blount.
Blount then described that his primary job is to get air going via an endotracheal tube (ET) and let the patient know how he’s doing. The patients head was at his knees and Blount was able to quickly place and insert an ET tube. Once the ET tube is in place the patient is getting air. It’s a hand pump device (Ambu bag). The other paramedics are giving chest compressions, etc.
Blount noticed that the IV wasn’t working properly so they were looking for a site on the arms to insert a new IV. Blount said “To me the temperature of Jackson’s skin was cool”.
While this was going on he was also observing the heart monitor and making observations on the capnography readings. It confirmed that the tube was properly placed and filling its function.
While looking for an IV site, another paramedic decided to stick via the jugular.
Blount observed that the patient’s eyes were “blown” (blown means large an unresponsive to light). It was Blount’s opinion from observing the body that the patient was dead.
At that point Dr Murray holds up a hypodermic needle with a blue color and said “We could use this here”
The team said, “That’s okay”, meaning no thank you.
Blount thought that was odd because they had asked about drugs and Dr Murray said he hadn’t given any.
The size of the needle caught his attention. It was a 24 gauge needle.
Blount noticed small bottles of Lidocaine (a form of anesthetic). There were bottles on the floor. He thought that was odd because they had asked Dr Murray if he had given any drugs and he said no.
Walgren then asks “Skipping now to when UCLA took care of the patient over Dr Murray, when you read through the monitors was there any variable heart rhythm?
Blount answers “No”.
“Do you remember Dr Murray telling you he felt a femoral pulse?”
“Yes” answered Blount.
“Was there something you saw that you thought was odd?” asked Walgren.
“The patient had a condom catheter” replied Blount.
Blount was then asked if he knew what a condom catheter was.
“Its commonly used in surgical proceedings when a patient is unconscious”.
Blount said he observed Dr Murray scoop the three Lidocaine bottles off the floor and put them in a bag. Blount said that he never saw those bottles again.
When Blount and everyone else was out at the ambulance getting ready to leave for the hospital, Blount said he looked around to see where Dr Murray was and he was nowhere to be seen. Upon glancing up at Michael’s bedroom window he could see Dr Murray walking around Michael’s room. They had to wait for him to join them before they could leave.
Blount then went on to say that he observed Dr Murray in the ambulance take out his cell phone and make a phone call.
While working on the patient Blount heard that it was Michael Jackson and he recognized him as Michael Jackson.
At the hospital while restocking his equipment Blount asked a nurse to locate a piece of equipment and he briefly saw doctors working on Michael Jackson. Dr Murray was in there with the doctors while they continued to work on Michael Jackson.
CROSS EXAMINATION BY DEFENSE ATTORNEY LOW.
Cross starts going over his testimony of questions that Dr Murray was asked.
He begins by questioning Blount on how long he thought Michael Jackson had been down.
Blount verified that it was his impression that the patient looked deceased when he first came in the room. He also verifies that he testified that he thought the patient’s skin was cool.
“Do you recall what date it was that you told detectives the patient’s skin was cool?” asked Low.
Blount doesn’t recall and apparently he said earlier that the patient’s skin was “not warm; not cool”
They then proceed to go over when Blount remembers Dr Murray say he wanted them to take over, and continue to the hospital.
Low asks for a moment to check his notes.
Blount was then asked whether he thought the patient may have taken recreational drugs.
“I did not ask him (Dr Murray) if the patient took recreational drugs, one of my team did. The answer from Dr Murray was no”.
Blount then verifies that one of the paramedics tried at least three times to find a vein in the hands or arms.
“Do you have any reason why they could not find a vein? Is it in your experience, people who are as skinny as they are that in drug addicts it is difficult to find a vein?”
This is met with gasps in the courtroom.
Blount answers no and then gives an example of a known drug addict with tattoos and that he is still able to find a vein.
“Even so, at the same time it can be difficult” Low asks.
The witness Martin Blount agrees.
DDA Walgren then asks “If someone has no viable heart rhythm then the blood cannot be circulating through the body and one of the things that happens is the veins collapse and they can be difficult to access?”
Blount answers “Correct”.
Walgren then asks “Did you count the number of sites that paramedic Goodwin tried to access to get a line in?”
“No” answers Blount.
Blount is then asked to leave the stand.
The morning break is called.
10.58am Back inside the courtroom.
Prosecution Witness Number 8- Harry Daliwal (ATT iphone employee)
Co prosecutor DDA Deborah Brazil directs.
Through questioning it is established that Daliwal has been an ATT employee for 15 years and is the area retail sales manager of eight stores and has access to phone records and text messages.
DDA Brazil shows Daliwal Exhibit 19 which consists of 72 pages. He recognizes the document as he has reviewed the document before, it is cell phone records.
Defense attorney Chernoff states that he is not familiar with the document and examines it as Chernoff had received the phone records but not the text records. He has no objection.
Daliwal is directed to page 2 of the document.
“Does page 2 provide information to whom those records belong?” asks DDA Brazil.
Daliwal replies “Conrad Murray”.
DDA Brazil then reads the phone number from the record.
Daliwal explains that the exhibit contains cellular call information and data information for that phone. Data information is all text messages, email or if the owner checks the Internet.
Daliwal is familiar with ATT’s iphone he then tries to explain when data is “pushed” through a phone.
It’s when data information automatically comes into the phone via email, web etc. Each one of those data pushes would be recorded on the phone.
DDA Brazil then directs Daliwal to page 66 of the document and asks him to describe for the court the information contained on the page, left to right in the columns.
Daliwal tells the court that there is the item number which is the serial number and as actively happens it is chronological to time. The next column is the sent or received column but there is no information and he explains that he has seen this sometimes.
The next column is the amount of kilobytes. The higher the number the more data, more character, a larger piece of information, larger email, text, etc. SMS indicates that this is a text message.
Daliwal can’t tell from this page whether the message is incoming or outgoing but he can tell that on the client’s bill. In the next column are the charges for this particular entry and also shows the servicing area. There is a state abbreviation TX which is for Texas.
DDA Brazil directs Daliwal’s attention to the cell phone activity starting on June 25th 2009 which is on page 66 of the document. Daliwal starts going over those entries.
DDA Brazil asks “Starting with serial number 870, is that the first entry on that date?”
“Yes” replies Daliwal.
“What time?” asks DDA Brazil
Daliwal starts to describe the phone activity.
“12.04 am received data entry. 1.04 am, 2.04 am , 3.04 am and so on. 871 received data entry all the same all the way through with 876 data entry at 6.04am. It is very possible that this was the setting on the phone. It’s possible that the phone was set and the automatic activity would occur”.
Daliwal went on reading the records saying 6.25 am text message, next entry 7.03 am data, 7.20 am data, 8.14 am data. The next text message was from Texas. 8.54 am data.
Daliwal is then asked to turn to page 67 of the cell phone records.
At 9am there was a text message sent to or from someone in Texas.
9.11am another text message to or from Texas.
8.35am data, 10.04 am data,10.15 am data, 10.26 am text message Texas (there were a couple of other listings that were missed by the person in the courtroom taking notes).
12.03 pm text, 12.04 pm text message to or from Texas, 12.13 pm data, 12.18 pm data, 12.53 pm text message California, 1.23 pm text message Nevada. There were various other messages and times relayed in court but they were being read out very fast which was difficult for the person taking notes to keep up.
DDA Brazil then refers to the pages 1-24 of the document.
DDA Brazil then asked Daliwal what type of activity is reflected in the pages. Daliwal said that it showed the cell phone usage to and from. Page 21 read from the first top column across with various descriptions.
Item = serial number
Date= date of call
Calls to= incoming or outgoing call
Minutes used= length of call
Usage type= what type of phone call it was
Charge= cost of call, text
Roaming type= if on a home system or other network.
Code= Area code of call.
DDA Brazil and Daliwal then begin to discuss the phone activity on the 25th June 2009 which was shown on page 319 of the document.
At 9.23am there was an incoming number and the call lasted for 22 minutes.
Next several items, serial numbers 312-328 calls made on June 25th as well.
DDA Brazil then produces a copy of Exhibit 20 and Daliwal confirms that he had examined this document before coming to court that day.
They then compare the information on this document to the cell phone records.
They begin to read a list of call times on Dr Murray’s phone.
At 10.29am there was a call to Dr Murray’s phone which lasted 22 minutes.
11.07am Dr Murray received a call from (6xx) 994-3233 which lasted 1 minute.
11.18am call from (7xx) 862-0973 placed (2xx) 866-6802 and that call logged at 32 minutes.
There was then another call which the reporter in the courtroom missed.
11.49 am call placed from Dr Murray to (702) xxx-4989 which lasted 3 minutes. The area code is Las Vegas.
11.51am A call placed from Dr Murray to (832) xxx-3832 which lasted 11 minutes. The area code is Houston, Texas.
12.12pm from Dr Murray’s phone to (562) xxx-2570 which lasted 1 minute. The area code being California.
12.15pm Call from (562) xxx-2570 to Dr Murray which lasted 1 minute. The area code being California again.
The cross examination then begins with Ed Chernoff.
He asks “Is there a way for the prosecution or the defense to retrieve the content of the text messages?”
Daliwal replies saying “There is a way, however I’m not familiar with it. I’m not in that process so I don’t know”.
Chernoff then asks “What about the content of voice mail? Is there a way for ATT to retrieve that voice mail?”
Daliwal replies “It can be done but I am not an expert”.
Chernoff has finished asking questions and the witness is asked to leave the stand.
Prosecution Witness Number 9 Jeff Strohm (Sprint Nextel Communications) Dr Murray’s second phone provider.
DDA Walgren begins by establishing Strohm’s background.
“I work for Sprint Nextel Communications where I am a custodian of records. As a custodian I’m responsible for testifying”.
Jeff Strohm is responsible for various types of legal commands.
DDA Walgren produces Exhibit 21.
Strohm says that he is familiar with the document. They are the phone records for subscriber information and phone calls of Conrad Murray.
DDA Walgren asks “Are these records prepared near the time that the activity occurs? Are these documents regularly maintained in Sprint Nextel activities?”
Strohm replies “Yes”
Walgren then goes to the entries for the date of June 25th 2009, page 123 of 183.
He then asks Strohm to briefly describe the information contained in the header.
Strohm explains: Calling number initiation, next call receiving, dial digits (numbers actually entered), 4 mobile roll number (inbound or outbound or routed),start date, date and time of call (it will be the time of the tower that gets the call, military 24 hour clock time).
Walgren then asks if all the calls on June 25th were based in LA?
Strohm replies correct and that he had reviewed the calls from 7.01am to 8pm on the 25th June 2009.
Strohm then confirms that he had seen exhibit 20 before he came to court that day and he also verifies the information regarding Nextel phone on the document (outlined in blue) to be accurate.
They then go over the calls on the document.
7.?? am from (xxx) 792-709 made to ??? call lasted 25 seconds.
8.49 am from 5217 to Conrad Murray Nextel 3437 call lasted 53 seconds.
10.22 am from 0124 to 3747 111 seconds
10.34am from Conrad Murray 3747 to 3233 call lasted 8 and a half minutes.
11.26 am from 9566 to Conrad Murray 3747 call lasted 7 seconds.
1.08 pm from Conrad Murray to (310) xxx-070 call lasted 2 minutes.
The document (exhibit 21) focuses on two calls one at 8.49am and one below it stating 48 seconds.
Strohm is asked what it reflects.
Strohm replies saying “If you look at the call detail, one is a routed call, and the second is the inbound call. That is actually one call because the times overlap so the 53 seconds would be more accurate”.
Ed Chernoff then cross examines the witness.
Chernoff asks “What is a routed call?”
Strohm replies “Theres two examples of routed calls. Temporary local dialing number, that’s a bridge number when they are in an area that they can’t find service. That number is used so the person can complete a network connection. Routed aspect and inbound aspect and the overlapping times tell you that “.
Witness is then asked to leave the stand.
Breaks early for lunch. Time is 11.50am
To sum up what was said in court, it was established that Conrad Murray had TWO phones that he used on June 25th 2009,an iphone and a Sprint cellphone.
Records showed 26 cellphone activities from 6.30am- 4.03pm. They showed that Dr Murray never called 911. The area codes for the calls were for Las Vegas and California.
Two of the calls were made at 12.03pm and 12.04pm.
Conrad Murray also sent text messages at 12.15 pm,12.18 pm and at 12.53 pm. He also made a phone call to his girlfriend Nicole Alvarez at 1.08pm the records show.
1.21 Back inside the courtroom.
Prosecution Witness Number 10 Dr Richelle Cooper (UCLA Emergency Medicine Physician).
Dr Cooper has been attending at the UCLA Medical Center since 2008 and on June 25th 2009 she confirmed that she was the ER physician at UCLA.
DDA Walgren begins by asking Dr Cooper if she remembered being consulted by a bay station call-in on that day.
Dr Cooper replies “There is a care nurse assigned to answer radio calls”.
Walgren continues “That nurse is charged to radioing back to the care for the patient to be given?”
“Yes” replied Dr Cooper.
Dr Cooper then recalls what she learnt when she was first made aware of the radio call. She looks over the base hospital form which she has in front of her.
“My understanding that the arrest was around 12.18pm” She says she needs to review her records.
12.18pm was the estimated time of cardiac arrest as this was the information that came from the radio and the nurse relayed it to her. While the bay station call was continuing Dr Cooper was only being consulted as needed.
Dr Cooper said “I was told that reputation (at the scene) did not pronounce any response. I gave permission to pronounce at 12.57pm”
Dr Cooper said that she told the EMT’s at the scene that the physician would have to assume control and would have to arrive with his patient. Dr Cooper was there when the ambulance arrived.
“I had already prepared a team. As the patient rolled past I was introduced to Dr Murray” Dr Cooper told the court.
Dr Cooper identifies Dr Murray for the record.
“I asked him what had happened. The doctor reported that the patient was not ill and that he had been having trouble sleeping and that he was dehydrated and had not been sleeping. He reported that he had given the patient 2mg of Lorazepam (Ativan) and then later another dose. He did not mention that he had given the patient any other drugs”
Dr Cooper told the court that Dr Murray had told her that he witnessed the patient’s arrest.
Dr Cooper continued to tell the court that she had asked Dr Murray about reported past drug use and Dr Murray then told her that the patient was taking Valium and Flomax. He told her that there was no chest pain or seizure activity prior to the arrest.
DDA Walgren asks “Dr Murray stated there was no report of chest pains or anything of that nature?”
“Correct” answers Dr Cooper.
Dr Cooper then continued to tell the court about Michael’s condition on arriving at UCLA.
The patient had no sign of life. The pupils were fixed and dilated. The patient was dead on arrival to UCLA.
Despite that condition, they attempted to administer other drugs.
Dr Cooper said that the patient was still being ventilated and CPR continued and cardiac monitors continued to monitor the patient.
Walgren asks “Did you ever note or feel or observe a pulse on the patient?”
Dr Cooper replies “I did not. There was report of a pulse being felt on the nurse call sheet”.
Dr Cooper then went on to list the heart starting drugs that were additionally given to Michael Jackson. They were not effective. The total time spent on the patient was 1 hour and 26 minutes Dr Cooper said. She made the decision at 2.26pm to call the patient deceased.
Blood was drawn from Michael Jackson for later medical testing. When Michael arrived at UCLA he was given a medical record number/name to track everything until the patient is formally registered.
Gershwin was the name given to Michael Jackson, so that things could be recorded and labelled immediately so they could perform care.
Walgren asks “What is a urinary catheter?”
Dr Cooper tells the court that a urinary catheter is put on the penis for those that are incontinent or when they are sedated.
Dr Cooper observed that when Michael had came into UCLA he had on a condom catheter.
DDA Walgren then asks “At any time did Dr Murray indicate that he had administered Propofol or any other benzodiazepine?”
Dr Cooper replied “No”
DDA Walgren then asks “Have you ever been involved in or witnessed or was present in a situation where a medical doctor administered propofol in a home setting?”
“No” Dr Cooper replies.
Cross examination takes place by Defense Attorney Flannagan.
He begins by asking “Do you yourself use propofol?”
“Personally I’ve administered it to patients” replied Dr Cooper.
As an ER physician Dr Cooper explains that she doesn’t need to be licensed to use it.
Dr Cooper confirms that she pronounced the patient originally at 12.57pm but there was a report by Dr Murray that he had detected a pulse which was in conflict so she made the decision to attempt.
Flannagan then asks “There was one other person who said that they detected a pulse?”
Dr Cooper replies “I cannot confirm”.
“Was it Dr Wang? Do you have your medical records with you? Did you write in the name of the person who felt the pulse?”
Dr Cooper replies saying “No I did not”.
Flannagan asks if anyone has Bate stamp 2132 as he has left his in the car. DDA Walgren complies.
Dr Cooper on looking at the document says “This is a nurse-scribed note” (about the feeling of a pulse).”I don’t know who reported the pulse. Dr Murray was in the room and did have gloves on” Dr Cooper explains.
Flannagan asks “Was Dr Murray hands on in the room?”
Dr Cooper replies “When he arrived, yes. I was never able to confirm a pulse. Sometimes people feel a pulse that isn’t there. I began questioning him as soon as he came to the door. He reported to me that he was there when the patient stopped breathing”.
Flannagan then asks “What is it that you see when you are witnessing an arrest?”
Dr Cooper replies “ I heard him to mean that he saw the patient stop breathing and administered CPR”.
Flannagan asks her to explain what she would consider “witnessing an arrest”.
“It’s a common phrase that we would use regarding.. if I was in the room” replied Dr Cooper.
“My recollection and from my notes that’s what I was told that Dr Murray witnessed the arrest” continued Dr Cooper.
Flannagan goes on to ask “Does it have the same meaning for all medical people?”
Dr Cooper replies “I can’t speak for all people but I would say for all physicians they would say “witnessed arrest”.
Dr Cooper said she did not ask Dr Murray to elaborate on what he meant. She also said that she asked Dr Murray if Mr Jackson had used any recreational drugs.
“I had a 50 year old male that was dead. I didn’t know why. This is a common question” Dr Cooper told the court.
Flannagan then asks “You did not ask Dr Murray what time he gave the Lorazepam?”
“The exact time, no” replies Dr Cooper.
Dr Cooper said she didn’t ask and she wasn’t given any time frame.
Flannagan then questions about the drugs given to Michael Jackson.
“Isn’t the timing of the dose important?”
Dr Cooper pauses before answering. “I suppose you could say the timing would be important if I was administering more sedative medication”.
Flannagan then asks “In which situations is propofol used?”
“Amount used for procedural sedation?” Dr Cooper asks back and then continues “Every patient is a little bit different”.
Flannagan mentions Michael Jackson’s weight “136 pounds, how much (propofol) for that weight?”
Dr Cooper replies “Generally 60mg is what we usually start with”.
Flannagan asks if that is a little conservative.
Dr Cooper replies that “In Michael Jackson it could produce sedation. Sometimes we have patients where that happens”.
Flannagan then asks about the 25mg dose (that Dr Murray said he gave Michael).
Dr Cooper replies “Generally 60mg would last 10 to 20 minutes. You wouldn’t expect a sedation of more than 5-10 minutes on only 25mg. I don’t know how long that dose would last. A dose usually takes 20-30 minutes to wear off. Everyone’s different. I wouldn’t know why someone would use that amount. I would not expect that 40 minutes later that medication would have any effect”.
Dr Cooper explains that if you’re not giving continual medication then the meds clear within 10-20 minutes.
Flannagan then asks if she had known propofol was administered would she of treated any differently.
Dr Cooper replied that she was specifically treating a cardiac arrest as that was all she was told. Dr Cooper said “If there is one dose of propofol, I would not expect an hour later the propofol would have any effect”.
DDA Walgren “Mr Flannagan wanted you to assume that Dr Murray gave propofol around 10.40am -10.50am only 25mg. However if that was not a truthful statement your answer would differ significantly. If the drugs on top of the other drugs were given to Mr Jackson would that be an accumulative effect?”
Dr Cooper replied that protocol requires certain monitoring to administer Propofol. There needs to be equipment available to monitor the airway. There must be heart monitoring. There has to be a staff person available as their only job to monitor the equipment/patient.
Walgren asks “So the patient doesn’t die?”
“Yes” replied Dr Cooper.
“When a physician takes a history, it is for purpose of treatment?”
Dr Cooper replies “Yes”
Dr Cooper clarifies that when she asks for history of drug abuse it is relevant to the treatment at hand. She tries to get a medical history of the treatment at hand.
Answering the defense attorney’s question, Dr Cooper said she would want to know about any medication that was given to the patient as it would have been helpful. It would of given her a fair interpretation as to what had occurred.
Prosecution Witness Number 11 Dr Thao Nguyen (Cardiologist at UCLA)
DDA Walgren takes Dr Nguyen through her credentials. He begins by asking her how long she had been working as a cardiologist fellow at the cardiac intensive care unit on the 25th June 2009.
Dr Nguyen replies “Three and a half. In June I had finished my fellowship”.
She told the court that she is responsible for the whole unit and the entire staff.
DDA Walgren then asks what her role was on June 25th 2009.
Dr Nguyen replies “I was called to the ER by Richelle Cooper. When I came down Dr Cooper was working on the patient. Dr Cooper introduced me to Dr Murray. I met him in the ER and I asked him what happened”.
“He told me he was the physician for the patient and that the patient was preparing for a tour in England and had some difficulties sleeping and had been giving some medications for sleep. I asked him what did you give? He said “4 milligrams of Ativan (lorazepam) via IV”.
Walgren asks “At that time were you aware of the condition of the patient?”
“Yes” replied Dr Nguyen.
“What follow up questions did you ask?” asks Walgren.
“I asked him if he gave any other medications” replied Dr Nguyen.
“What did he tell you?” asks Walgren
“No” replies Dr Nguyen.
“What did you ask him next” continued Walgren.
“I asked him “Did you try to reverse the effect of the Ativan? He said no”
Dr Nguyen told the court that she asked Dr Murray what happened after he gave the medication. She said he told her that he later found the patient not breathing. She said she asked him when he found the patient not breathing but he did not know the time.
Dr Nguyen told the court “He said he did not have a watch and he did not have the time”.
Dr Nguyen told the court that Dr Murray didn’t know the time lapse and that he couldn’t give any kind of time estimate as to when the drug was injected, when the patient went down or when the patient was found not breathing.
DDA Walgren then asks “Were there any other questions directed at Dr Murray or does that sum it up?”
Dr Nguyen replies “Dr Murray did tell us, he asked me to save the patient”.
“Did he ever mention giving the patient Propofol?” asked Walgren
“No” replied Dr Nguyen.
“Did he ever mention giving the patient any other benzodiazepine medications?”
“Absolutely not” replied Dr Nguyen.
Dr Murray didn’t want them to give up on his patient even though they could clearly see he was dead.
Dr Nguyen told the court that she did place the balloon pump after the initial time of death was called but she didn’t think it would work based on all that had been done already. So an agreement was made with Dr Murray that if the balloon pump failed then they would call the time of death. When the time of death was first called she looked at her pager and she noticed the time of death was 1.35pm.
Afternoon break is called.
2.55pm Back inside the courtroom.
Session begins with Dr Nguyen taking the stand and being cross examined by Defense attorney Flannagan.
He begins by asking “In your practice do you use the drug lorazepam?”
Dr Nguyen replies “Yes sir”
“Four milligrams of the drug in a 136 patient, how long would it keep him to sleep?” continued Flannagan.
“It takes about 15 minutes or so to be put to sleep” answered Dr Nguyen.
Dr Nguyen then went on to describe what type of drug lorazepam/Ativan was. “It is used for anxiety and is also used to induce sleep”.
“If it is used to induce sleep in a 136 pound patient, how long should it induce sleep for?” asked Flannagan.
“It’s half life is about 14 hours. But you have to take into consideration the prior use of the drug in this patient.”
Dr Nguyen then describes what half-life is. “It’s the time it takes for the medication to have half of the effect”.(Note Dr Nguyen is not totally accurate here. Half life is the amount of time it takes the body to metabolize and excrete the drug. Knowing a drug’s half-life helps doctors know how often to prescribe a medication. The drug may not have an effect on the patient at this time, but can contribute to an accumulative effect).
Dr Nguyen tells the court that she would start with a very small dose of 1mg and that she would not start with 4mg. She tells the court she knows nothing about Dr Cooper’s report.
She states that if you keep using the same medication you would have to use a higher amount before you reach a higher concentration if the medication is given via an IV depending on the metabolism through the liver. She concludes that she is not aware of the blood level of this patient.
Flannagan asks “Would you expect the blood level 169 to produce sleep?”
Dr Nguyen replies “We do not usually measure that. When you give lorazepam or/and benzodiazepine, you are expected that you give a certain dose per weight. I thought I had explained that it’s not known in relation to blood levels”.
Flannagan then asked “Do you know anything about blood levels?”
“Again that’s not how we measure” replied Dr Nguyen
“When you were talking to Dr Murray, you said he had no concept of time”
“It’s not my conclusion. I am not saying as to how he appeared. This was his answer to my question” replied Dr Nguyen.
Flannagan continues “Did you have an impression of his emotional state?”
“Do you want my opinion of his emotional state? He appeared devastated” replied Dr Nguyen.
“What do you mean?” asked Flannagan.
“You want the definition of devastation?” replies Dr Nguyen
(Laughter in the courtroom)
“What was it that caused you to believe he was devastated?” continued Flannagan.
“His facial expression” answered Dr Nguyen.
“What about his voice?” asked Flannagan.
“His voice was normal. He appeared calm. The voice was calm”.
“That facial expression, that just caused you to determine he was devastated?”
“Yes, the body language. I did not ask him if he gave lorazepam. I asked him what drugs he gave. I asked him what time and he could not give a time. He could not give an estimate. This was the time I saw on my pager that I started talking to him 1.35pm”.
“Was there a lot of confusion?” asked Flannagan.
“There was no confusion” replied Dr Nguyen.
“Not at UCLA?”
(Judge Pastor, may of stated there was activity)
“This questioning of Dr Murray took place at 1.35pm in the room where there were five or six people working on Michael Jackson?” asks Flannagan.
“Correct” replies Dr Nguyen
“It was at this time did you think you had his full attention?”
“Yes. He was not watching the patient while he talked to me. He had established eye contact with me throughout the conversation” replied Dr Nguyen.
“How long was the conversation” asks Flannagan.
“About 2 minutes. He was standing at the left leg of Michael Jackson. The size of the room was about a quarter of this room”.
Dr Nguyen was then asked about Dr Cruz.
She tells the court “Dr Cruz did not arrive until I asked him to come down”.
“Dr Cruz was the one who used the balloon pump?” asked Flannagan.
“Dr Cruz and I both operated the balloon pump” Dr Nguyen replied.
“And whose idea was it?” continued Flannagan.
“Dr Cruz” replied Dr Nguyen.
“You did the balloon pump?” asked Flannagan
“Yes. We continued on the request of Dr Murray. He did not want us to give up” replied Dr Nguyen.
“When you learned there was Ativan in the patient, did you use any drugs to reverse the lorazepam? Did you use any drugs to reverse the effects of the lorazepam?” asked Flannnagan.
“I asked why. Before I decided not to use, I asked Dr Cooper if lorazepam had been used/reversed, she said no” (so the time of reversal was lost).
“At the first time of distress that’s when the drug needs to be administered” continued Dr Nguyen.
Flannagan then asks “Dr Murray didn’t give the order for the balloon pump did he?”
“No it was not on his advice to put in the balloon pump” replied Dr Nguyen.
“The indication was cardiac failure” continued Dr Nguyen.
“Did the balloon pump, that was the purpose to reverse the drug that induced cardiac arrest?”
“No sir that’s not what I said. The indication of the balloon pump is to assist the heart when it is failing. But it doesn’t reverse the drug it only assists the heart” replied Dr Nguyen.
Defense has no further questions.
DDA Walgren then asks “When you were presented with a number of hypothetical’s by Mr Flannagan and when you would give 1 “p.o” that would be giving by mouth orally because it would be safer?”
“Yes “ replied Dr Nguyen.
Dr Nguyen then clarifies to the court that she clearly heard and understood Dr Murray when questioning him at the hospital.
Witness is asked to leave the stand.
Prosecution Witness Number 12 Dan Myers, Detective for the LAPD.
Judge Pastor asks if he has heard the previous admonitions. Detective Myers replies that he has.
Detective Myers background was established for the court. He is employed at LAPD and is currently working in Robbery-Homicide and is the lead investigator.
Deputy District Attorney Walgren begins by asking about Dr Murray’s phone cell records.
“On examination of Dr Murray’s cell phone calls, Dr Murray had two cell phones in his name. Is that correct?”
“Yes” replies Myers.
Detective Myers had examined the cell phone records provided by the vendors.
Myers is then asked if when examining the phone records if he focused on the phone activity from midnight on the 24th June 2009 through to the conclusion of June 25th 2009.
Myers replied “Yes I did”.
Walgren asks “What was the purpose of contacting the phone numbers?”
“To identify the person or persons who were dialled” replied Myers.
Exhibit 20 is now presented to the court.
Walgren asks “First call 7.01am call from 3747 (Dr Murray) to 0266? Did you call that number on the 17th November?”
Myer replies that o266 belongs to Andrew Butler.
“Important question. How long have you been employed by the LAPD?” asks Walgren
“A little over 23 years” answers Myers.
Walgren asks “Did he verify that it was in fact his residence phone number? Did you ask him if he knew Conrad Murray?”
“He identified him as his friend and doctor” replied Myers.
“You asked him if he received a phone call?”
“He said he did not recall receiving a call from Dr Murray” replied Myers.
Walgren then asks “8.49 am (702) 683-xxxx from to 3747 (Dr Murray).Did you dial that number?”
Myers replies that the number belonged to a Ms Angelette Guild and that he had spoken with her and asked if she knew Dr Murray. She said he was a friend and her doctor. She said that she had received a letter in the mail that he would not be in the office and she called the doctor to inquire.
DDA Walgren then asks about a 9.23 am call, from 2909 to Dr Murray 0973 and asks who used the number.
Myers said he spoke to a Marissia Bioni. Myers asked her knowledge of Dr Murray and she answered that he was her friend’s father. Her friend being Chanelle in California.
Walgren then asks about another call from 4955 to Dr Murray’s phone. Myers said he called that number to identify the owner of the phone and he confirmed it belonged to Acres Home and Cardiology Clinic in Texas.
At 10.22 am another call was recorded from 0124 to Dr Murray. Detective Myers said he talked to a Dr Prechad (sp?). She indicated that she was in a post-op room at a hospital and was ready to perform a procedure and she needed to know what kind of medication that patient was receiving and she also needed to know from Dr Murray if she should continue medication. She said she did talk to Dr Murray and they discussed the care for his patient.
Walgren asks if Dr Murray was able to assist her with the information?
Myers said that he had been told that Dr Murray had recalled the patient by memory. The patient was a few months post-op from a stent. Dr Murray did recall the patient and the amounts of medication. She indicated that in her short telephone call of less than 111 seconds, Dr Murray was able to recollect the patient, provide her with necessary information as medications as well as info on the procedure conducted 2 months earlier.
10.34am call from Dr Murray 3747 to (619) 994 xxxx.Myers told the court the owner of this number was a Stacey Howel-Ruggles who said she knew Conrad Murray and that she was his personal assistant.
Walgren asks “Did you ask Ms. Howel-Ruggles if she had a conversation?”
“ She said she did remember a conversation because it was an anniversary” replied Myers.
“Ms Ruggles told you that Dr Murray was directing her, requesting of her, drafting a letter concerning the upcoming tour in London”.
“Did you ask her if he seemed distracted during the phone call?” asked Walgren.
“She did not indicate that he appeared to be distracted or tired” replied Myers.
“Did you ask her directly- did Conrad Murray appear distracted? And what was her response?” asked Walgren
“That he did not appear to be distracted” answered Myers.
“11.07 am Same Ruggles phone number.11.18 am placed call to 6802” read out DDA Walgren.
“Contacted that number, 32 minute phone call” replied Myers.
“Who was that? What is that location?” asks Walgren
“It’s Dr Murray’s practice in Las Vegas” replied Myers. Detective Myers physically went to that location.
“That call duration to Global Cardiovascular”.
11.26 am another call placed to Conrad Murray.
“A Miss Morgan. She confirmed that was her number” replied Myers.
Another call was then placed from Dr Murray to a Robert Russell. It was Mr Russell’s number and Dr Murray was his cardiologist.
11.51 am Call placed from Dr Murray 093 to 3832.Detective Myers contacted that number.
“Who did you speak to?” asked DDA Walgren.
“Ms. Saday Adinie. She knew Conrad Murray” replied Myers.
(Objection to the conversation, but what the conversation was about is not relevant)
Ms Adinie confirmed to Detective Myers that she did in fact receive a phone call and that she did speak to Dr Murray on the telephone.
DDA Walgren then mentions the 12.12pm telephone call from Dr Murray to Michael Amir Williams that the court had heard testimony from earlier in the court proceedings.
At 1.08pm a call from Dr Murray to Ms Nicole Alvarez took place. This is the call that took place inside the ambulance.
Myers said he contacted Ms Alvarez.
“Did you determine how she knew him?” asked Walgren
“He is the father of her child” replied Myers.
End of direct.
Judge Pastor asks if the defense has a few questions, no more than 5 minutes or whether this would be a good point to break which is what they agree to do.
Resume at 9.30am tomorrow.
Sources www.justice4mj.com www.sprocket-trial.blogspot.com and thanks to Erin for reporting back for us on Ustream.