Conrad Murray

Dr. Conrad Murray sits in court during his trial in the death of pop star Michael Jackson, Oct. 7, 2011 in Los Angeles. Jurors hearing the involuntary manslaughter case against Michael Jackson’s doctor on Friday heard the physician begin to describe his relationship with the singer in detail for the first time. (Photo courtesy of The Associated Press)

LOS ANGELES — A medical examiner struck a major blow to the defense of Michael Jackson’s doctor Tuesday, saying it is unreasonable to believe Jackson could have given himself a fatal dose of the powerful anesthetic propofol.

Dr. Christopher Rogers, who conducted the autopsy on Jackson, testified it was more likely that Dr. Conrad Murray overdosed the singer when he incorrectly estimated how much of the drug he was giving Jackson to induce sleep to fight insomnia.

Rogers said Murray had no precision dosing device available in the bedroom of Jackson’s rented mansion.

“The circumstances, from my point of view, do not support self-administration of propofol,” said Rogers, chief of forensic medicine in the Los Angeles County Coroner’s Office.

Murray has pleaded not guilty to involuntary manslaughter.

Rogers analyzed two possible scenarios for Jackson’s death. The first was the defense theory that while Murray stepped away to go to the bathroom, Jackson gave himself an extra dose of the drug he called his “milk.”

“In order for Mr. Jackson to have administered the propofol to himself, you would have to assume he woke up and although he was under the influence of ... propofol and other sedatives, he was somehow able to administer propofol to himself,” Rogers testified.

“Then he stops breathing and all of this takes place in a two-minute period of time,” Rogers said. “To me, that scenario seems less reasonable.”

“Less reasonable than what?” asked Deputy District Attorney David Walgren.

“The alternate scenario would be in order to keep Mr. Jackson asleep, the doctor would have to give him a little bit every hour, two or three tablespoons an hour,” Rogers said, noting that propofol is a short-acting drug that wears off quickly.

“We did not find any precision dosing device, so the doctor would be estimating how much he was giving,” the medical examiner said.

Murray told police he gave Jackson only 25 milligrams of the drug, a very small dose that usually would have kept him asleep for no more than five minutes.

Rogers said he examined evidence found in Jackson’s bedroom and noted there was an empty 100 milliliter bottle of propofol.

Rogers said the cause of death was “acute propofol intoxication and the contributing condition was the benzodiazepine effect.”

Two sedatives from that drug group — lorazepam and midazolam — were found in Jackson’s system after he died.

Rogers said he considered a number of factors in ruling the death a homicide. Among them were Murray’s statements to police and the lack of sophisticated medical equipment in Jackson’s bedroom, where the superstar had been receiving the anesthetic.

He said there was no EKG monitor and no resuscitation equipment present in the room.

Rogers also testified it would be inappropriate to use propofol outside a hospital or medical clinic.

Later in the day, defense attorney Michael Flanagan spent more than two hours trying to show on cross-examination that Jackson indeed could have self-administered drugs — not just propofol but the sedative lorazepam, which could be taken in pill form.

Flanagan suggested to the witness that once Murray had started an IV drip of propofol for Jackson and left the room, “it would be easy for someone to inject into that IV?”

“Yes, “ Rogers replied.

“But if they pushed it all at once, that can stop your heart, can’t it?” the lawyer asked.

“Yes,” said Rogers.

The implication was that if Jackson was desperate for sleep and in a hurry to administer more propofol before his doctor returned, he might have pushed it through the IV tube all at once rather than in the recommended slow drip.

“We don’t really know what happened when Dr. Murray went to the bathroom,” Rogers said. “So we have to consider what is reasonable.”

He reiterated his opinion that self-dosing by Jackson was an unreasonable theory.

Under questioning by Walgren, the coroner also said that even if Jackson had given himself propofol or lorazepam, his death would still be a homicide because Murray left him alone with the drugs within reach.

Walgren illustrated testimony about the autopsy by showing a stark photograph of the singer’s body on an examining table with his genitals covered. He appeared thin but not emaciated.

“I believe he was healthier than the average person his age,” Rogers said, explaining Jackson had no fatty buildup in his arteries common to people his age.

Rogers’ testimony came after jurors heard the end of Murray’s recorded interview with police two days after Jackson’s death, in which he first disclosed he had been giving Jackson propofol to help him sleep.

Conrad Murray watches the testimony of paramedic Richard Senneff during his involuntar manslaughter trial in downtown Los Angeles. (Photo courtesy of The Associated Press)

Photo Credit: The Associated Press

LOS ANGELES — Michael Jackson was clinically dead when he arrived at a hospital and two emergency room doctors said they thought it was futile to attempt to revive him. His doctor, however, insisted that they try.

Both doctors, testifying at Dr. Conrad Murray’s involuntary manslaughter trial Monday, said Murray failed to tell them that he had been giving Jackson the anesthetic Propofol or when Jackson had been medicated or stopped breathing.

“He said he did not have any concept of time, that he did not have a watch,” said Dr. Thao Nguyen, a cardiologist at Ronald Reagan UCLA Medical Center, where Jackson was taken on June 25, 2009.

“Dr. Murray asked that we not give up easily and try to save Michael Jackson’s life,” she said. “ ... In Dr. Murray’s mind, if we called it quits, we would be giving up easily.”

Nguyen said Murray “sounded desperate and he looked devastated.” But, she said, without knowing how much time had passed since he stopped breathing, resuscitation was a remote hope.

“It was not too little too late,” she said. “It was a case of too late. I feared that time was not on Mr. Jackson’s side.”

Murray, 58, has pleaded not guilty. Authorities say Murray administered the fatal dose and acted recklessly by providing Jackson the drug as a sleep aid at his home when it is supposed to be administered in a hospital. The defense argues that Jackson gave himself an additional dose of the drug when Murray was out of the room.

Nguyen and Dr. Richelle Cooper, who oversaw Jackson’s care in the emergency room, said Murray never mentioned that he had given the singer the Propofol. They said he told them that he had given two doses of Lorazepam, also known as Ativan, trying to get him to sleep.

“Did he ever mention Propofol to you?” Deputy District Attorney David Walgren asked Nguyen.

“Absolutely not,” she said in a firm voice.

Before leaving the stand, Nguyen said, “I’ve never heard of Propofol being used outside of a hospital.”

She said at least three medical personnel, including an anesthesiologist, should be present when the drug is given. Walgren asked her: “Have you ever heard of Propofol being used in someone’s private bedroom?”

Nguyen replied: “That would be a first. I’ve never heard of it.”

In cross-examination, defense attorney Michael Flanagan was able to get Cooper to say that, even if they had known about the Propofol, they could not have saved Jackson’s life.

“Michael Jackson had died long before he became my patient,” she said. “It is unlikely with that information I could have done something that would have changed the outcome.”

She also said that the amount of Propofol which Murray has since claimed he gave Jackson would not have put him to sleep and would have dissipated from his body in five to seven minutes.

Murray claimed he administered 25 milligrams. An autopsy showed that he died of an overdose of the drug.

Cooper said Jackson was “clinically dead” by the time he reached the hospital and she had advocated pronouncing him dead at his home when she received radio calls from paramedics describing his condition.

“Mr. Jackson was my patient and I didn’t really have an explanation of why he was dead. I knew it would be a coroner’s case,” she said and suggested he should have been pronounced dead at 12:57 p.m. when the radio call came in.

But she yielded to Murray and Jackson was brought to the emergency room where more than 14 people worked on the effort to revive him.

“My assessment when he arrived was he was clinically dead and given the time — it was about an hour — I thought the attempt at rescue would be futile,” Cooper said. She has said more than an hour of resuscitation efforts at the hospital did nothing to improve Jackson’s condition.

Cooper also told jurors about trying to speak to Jackson’s children after he was pronounced dead at the hospital at 2:26 p.m.

“They were crying,” Cooper said. “They were fairly hysterical.”

Murray’s phone records are a central part of the prosecution case. Two staffers from cell phone providers identified records of his calls on the day of Jackson’s death.

Prosecutors intend to show records of Murray’s phone calls and emails from the hours before Jackson’s death to show that Murray had other things on his mind — getting his $150,000 a month deal to serve as Jackson’s personal physician approved, running his medical practices and fielding calls from mistresses.

One of Murray’s former patients, Las Vegas salesman Robert Russell, detailed one of those calls for jurors last week and the phone traced a call to his number.

Later in the case, prosecutors will further detail calls and messages Murray fielded that day, including several the physician apparently made to his girlfriend as he rode in the back of the ambulance on the way to the hospital.

Michael Jackson fan Bristre Clayton of Las Vegas stands outside court during the trial of Conrad Murray, Michael Jackson’s doctor who has been charged with involuntary manslaughter in the pop icon’s death, in Los Angeles, Tuesday, Sept. 27, 2011.

Photo Credit: The Associated Press

First, prosecutors showed a photo of Michael Jackson’s pale and lifeless body lying on a gurney. Then, they played a recording of his voice, just weeks before his death.

Slow and slurred, his words echoed Tuesday through a Los Angeles courtroom at the start of the trial of the doctor accused of killing him. As a worldwide audience watched on TV and Jackson’s family looked on from inside the courtroom, a drugged Jackson said:

“We have to be phenomenal. When people leave this show, when people leave my show, I want them to say, ‘I’ve never seen nothing like this in my life. Go. Go. I’ve never seen nothing like this. Go. It’s amazing. He’s the greatest entertainer in the world.’”

Prosecutors played the audio for the first time during opening statements as they portrayed Dr. Conrad Murray, 58, as an incompetent physician who used a dangerous anesthetic without adequate safeguards and whose neglect left the superstar abandoned as he lay dying.

The theme was Jackson’s quest for sleep and propofol, the potion he called his “milk.” Jurors were told that it was a powerful anesthetic, not a sleep aid, and Murray misused it.

Defense attorneys countered that Jackson caused his own death by taking a drug dose, including propofol, after Murray left the room.

Nothing the cardiologist could have done would have saved the King of Pop, defense attorney Ed Chernoff told jurors, because Jackson was desperate to regain his fame and needed rest to prepare for a series of crucial comeback concerts.

A number of Jackson’s family members were in the courthouse, including his father Joseph, mother Katherine, sisters LaToya and Janet, and brothers Jermaine, Randy and Tito.

The family’s most emotional moment came when the prosecutor played a video excerpt from Jackson’s “This Is It” rehearsal in which he sang “Earth Song,” a plea for better treatment of the environment.

As Jackson sang the words, “I used to dream. I used to glance beyond the stars,” his mother, Katherine, dabbed at her eyes with a tissue.

Prosecutor David Walgren noted it was Jackson’s last performance.

Murray, who arrived at court holding hands with his mother, has pleaded not guilty to involuntary manslaughter. If convicted, he could face up to four years in prison and the loss of his medical license.