Conrad Murray trial: Sleep expert criticizes Murray's treatment


Murray described to investigators the nine-hour ordeal to get Jackson to sleep, and it involved multiple doses of four types of sedatives, and then a bit of the hospital anesthetic propofol.

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Finally, Jackson dozed off. The defense argued the fast-acting propofol was well worn off, and Jackson was sleeping naturally before Murray stepped away.

But on Thursday, Dr. Nader Kamangar, said there was only one way to know Jackson was all right, especially without proper monitoring equipment. Rouse Jackson to make sure he was OK.

"So, you would have wakened him up?" Defense attorney Michael Flanagan asked Kamangar.

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"I owed that to the patient if I felt like it could have been due to the medication. That is my primary responsibility, the well being of the patient," he replied.

Kamangar was the second of three expert witnesses. Like other prosecution witnesses, Kamangar testified that Murray was poorly equipped to handle an emergency, and he focused on Murray's failure to call 911 as soon as he saw that Jackson was not breathing.

"He immediately performed CPR, didn't he?" Flanagan said to Kamangar. "And you think that's wrong? He shouldn't have done that?"

"I think he should have called for help," Kamangar said.

The defense did not get any answers in support of Murray's actions. Even if Jackson was starved for sleep and anxious about his upcoming world tour, his personal physician should never attempted experimental therapy that called for powerful sedatives in combination with a surgical anesthetic, Kamangar testified.

"Ultimately, this cocktail was a recipe for disaster," Kamangar said.

Flanagan brought in all he could to raise questions about Jackson's history and previous doctors, pointing out that Dr. Arnold Klein, a Beverly Hills dermatologist, had given Jackson about 6,500 milligrams of demerol in the past.

Murray's defense argued that Jackson kept Murray in the dark, but Kamangar pointed to many clues that Jackson was getting the powerful painkiller demerol, which can cause insomnia, including statements from AEG technicians and bottles on Jackson's nightstand that named other doctors.

Flanagan raised the question of whether propofol was an accepted tool in combating insomnia, which Jackson suffered from.

But Kamangar did not budge and maintained that it was not, and he suggested that Murray was following Jackson's orders rather than the best medical practices.

"I recall Dr. Murray stating that that is what Mr. Jackson was asking for, but as physicians, we are not just there to enable and provide patients with what they ask us for, but to do what's right," Kamangar testified.

The defense objected to Kamangar's response, and it was stricken from the record, but the statement was already heard by jurors.

Karen Smith, a professor at Southwestern Law School in Los Angeles, said the prosecution has effectively conveyed that Murray provided an unacceptable standard of care.

"This may have been an accident, but it was an accident that was criminal because it could be anticipated. It was bound to happen," she said.

Murray's defense team says Jackson gave himself the deadly dose of propofol when Murray wasn't looking, and in court, they cited a study in China where propofol was used to treat insomnia.

"Clearly, the defense is trying to show in advance of their expert that Murray was just doing something that was an alternative way of administering this drug," Smith said.

Dr. Steven Shafer, the prosecution's last witness, took the stand late Thursday before court adjourned early. Shafer is a propofol expert and helped craft appropriate dosing guidelines for propofol.

Due to scheduling conflicts, court will not resume until Monday. Shafer was expected to finish his testimony when court was back in session.

Murray is on trial for involuntary manslaughter for Jackson's sudden death on June 25, 2009, at the age of 50. Prosecutors allege Murray tried to hide the fact that he had been giving propofol to Jackson.

Murray, 58, has pleaded not guilty and has denied any wrongdoing. If convicted, he could face up to four years in prison and lose his medical license.

The trial is expected to last five weeks, with Oct. 28 being the estimated last day.

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