Never get a cardiologist to do an anesthetist’s job – sounds like an old medical idiom – but if you read the following, you’ll be saying this yourself.
In the wake of Dr. Conrad Murray’s plea of not guilty to involuntary manslaughter charges stemming from Michael Jackson’s death, new revelations have come from the Los Angeles coroner.
The freshly released 51-page autopsy report reveals intricate details about Jackson, the main one being that the case is a homicide as a result of acute propofol intoxication – the anesthetic administered to Jackson regularly, along with the local anesthetic lidocaine every night through an IV drip.
Bruce Cranner, a New Orleans defense lawyer, said prosecutors could have a good case against Murray if they can prove he did not take proper precautions when giving Jackson the anesthetic. He also said involuntary manslaughter is an unusual charge against a doctor.
Of Jackson’s cosmetic features, the report states “The decedent’s head hair is sparse and is connected to a wig. The decedent’s overall skin has patches of light and dark pigmented areas.” The front of his scalp was tattooed to mask frontal balding, with his eyebrows and borders of his eyes tattooed as well. In addition, there was a pink tattoo in his lip region.
Selma Calmes, a pathologist who was asked to be a consultant for the autopsy said that the anesthesia was given sans the advised equipment being present, including a continuous pulse oxymeter, EKG and blood pressure cuff. She wrote that the use of anesthesia requires “full patient monitoring by a person trained in anesthesia.” Conrad Murray is a cardiologist. “There was no evidence of an infusion pump for control of an IV infusion. No monitors were found at the scene; a blood pressure cuff and portable pulse oxymeter were recovered from a closet in the next room,” she added. Supplemental oxygen should always be administered when using an anesthetic.
An oxygen tank found near Jackson was empty, according to the report.
The report also states that a number of opened propofol bottles were found at the scene. The problem there is that they should be thrown away after 6 hours to avoid bacterial growth.
Getting to the cause of death, Calmes said that the high levels of the anti-anxiety drug lorazepam in his body “would have accentuated the respiratory and cardiovascular depression from propofol.”
In another dark explanation, she added “The levels of propofol found on toxicology exam are similar to those found during general anesthesia for major surgery.”
The report asks the question “Could the decedent have given propofol to himself?” The report states that due to the location of the IV catheter, which was in his left leg, and the injection port being 13.5 cm from the catheter tip, Jackson would have had a very difficult time of administering it to himself. It states “he would have to bend his knee sharply or sit up to reach the injection port and push the syringe barrel, an awkward situation especially if sleep was the goal.”
Along with broken ribs, the autopsy report goes on to say that Jackson’s left lung was affected by “widespread respiratory bronchiolitis and chronic lung inflammation” that could have had an “adverse health effect.” But it was not “considered to be a direct or contributing cause of death,” according to Calmes.
Murray was hired by Jackson to help him prepare for his comeback concerts. Murray was called to Jackson’s home on June 25, and administered the propofol and lidocaine to help Jackson sleep, as he was complaining of dehydration and insomnia. He said he had been giving him the drip for six weeks. Two nights before his June 25 death, he said he gave him a combination of different drugs to help him sleep.
The charges state that his actions were without malice, but without caution.
If convicted, Murray could face up to 4 years behind bars.
For the full autopsy report, visit this site: http://www.thesmokinggun.com/archive/years/2010/0208101jackson1.html