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People vs. Dr. Conrad Murray

Anesthesiologist:

My Patients Fear Propofol

10/21/2011 8:00 AM PDT BY TMZ STAFF

Anesthesiologist -- Dr. Steven Shafer Testifies
Updated 10/24/11 at 8:49 AM

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**For today's testimony, click to continue below.**

Leading Propofol expert Dr. Steven Shafer --  the final witness for the prosecution -- told the jury,  Dr. Conrad Murray corrupted his patients ... because now, they're all terrified of Propofol.

He told the jury today -- "I am asked every day I'm in the operating room ... 'Are you going to give me the drug that killed Michael Jackson?'"

In his review of Dr. Murray's conduct, Shafer testified he found 17 "egregious violations" of standard medical care that contributed to the singer's death.

* Last Thursday, Shafer told prosecutors he was hired 20 years ago by the company that produces Propofol to calibrate the correct dosing for the drug.
* Shafer said the exact dosage of Propofol is crucial -- because even a slight discrepancy could be the difference between a patient sleeping for a few minutes, and one sleeping for several hours.
* Jurors then watched a video that showed how Propofol should be used in the OR. The clip showed nurses and doctors successfully reviving a patient -- played by an actor -- suffering from a cardiac arrest. Prosecutors were trying to show the jury Dr. Murray was not equipped to handle an emergency situation when he treated MJ.
* Shafer explained to the jury that Jackson probably died because his tongue blocked the back of his throat ... but could have been saved with a simple chin lift.

* As the video was played, Dr. Shafer gave a blow by blow how Propofol is administered.
* Shafer's key points:
-  Infusion of drugs should be done ONLY through a pump to avoid overdosing.
- "Informed consent" is not just a piece of paper but a process in which the doctor informs the patient of all the risks, benefits and alternatives.
-  A verbal consent is NOT binding.
- Record keeping is paramount
- If the patient stops breathing, the first thing a doctor should do... call for help.
* Shafer told prosecutors even when administering "a little bit" of Propofol, guidelines should be strictly followed because the worst disasters occur during sedation ... when doctors "cut corners."
* Shafer said Murray's treatment of MJ is both an "egregious" and "unconscionable" violation of standard care. 
* He also called the 15.5 liters of Propofol Murray bought -- about four gallons worth -- "an extraordinary amount" for one person.
* Shafer said Murray's lack of basic and essential monitoring devices are an egregious violation of care and contributed to MJ's death.
* The fact that Murray never kept any records is "unbelievable," according to Shafer.
* He said Murray "left the steering wheel" when he went to bathroom to relieve his bladder calling the doc "quite clueless."
* Shafer told prosecutors there is practically no research on Propofol use to treat insomnia ... adding, "We're in a pharmacological Never-Never Land."
* Shafer took a shot at his former colleague and friend, defense expert Dr. Paul White... telling the court he was "disappointed" to learn that  White thought MJ could have died from drinking Propofol. Shafer went over several studies on rats, dogs and even humans that show the drug doesn't work when it's swallowed.
*  Shafer also bulked at the defense's argument that Jackson may have caused his own death by swallowing 8 pills of Lorazepam ... because the toxicology report showed the amount of Lorazepam found in MJ's stomach was "trivial." According to his calculations, Murray would have had to inject MJ with 10 consecutive shots of 4 mg each to reach the the blood levels in the toxicology report.
* Dr. Shafer debunked another theory by the defense, telling jurors there is no way Jackson woke up and then injected himself with a fatal dose of Propofol. He said people don't wake up  "hell-bent" on grabbing the next dose, calling it a "crazy scenario."

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* Shafer said the only theory that fits is this: Murray started MJ on a 1000 mg Propofol drip at around 9 AM ... which caused the singer to stop breathing around noon.
* Had Murray been in the room he would have noticed MJ's breathing slowing down around 11:45 AM and could have saved him by stopping the drip.
* In a dramatic moment, Shafer demonstrated  to the jury how, he believed, Murray set up a Propofol drip ... inserting a Propofol bottle into an empty saline bag.
* Shafer said Murray never used an automated pump, which caused the anesthetic to drip at a dangerous rate. The defense claims Murray only gave MJ a single dose of 25 mg of Propofol with a syringe on the day the singer died.
* Defense attorney Ed Chernoff came out swinging during cross examination, challenging Shafer's testimony from Thursday in which he said there is no way Jackson killed himself with either Propofol or Lorazepam. "That's a bold statement isn't it?" Chernoff  "asked " ... "That's what I think happened," Shafer shot back. "Everything you said is an opinion..." Chernoff said... to which Shafer responded, "To say that one should not lie to UCLA Medical Center is my opinion."
* Chernoff  tried to discredit Shafer's testimony ... saying the IV tubing he used in his demonstration was not found at the scene. Shafer said Murray could have easily shoved it in his pocket before leaving MJ's room.
* Chernoff also pointed out Shafer used the wrong size syringe and IV bag in his demonstrations. Shafer brushed it off, saying he didn't think  "size mattered."
*  Chernoff also asked Shafer about his relationship with Dr. Paul White, the defense's Propofol expert... asking him if it's true that he nominated White for an "Excellence In Research" award. Shafer said he did.
* During his cross examination on Monday, Shafer told Chernoff it's hard to know the precise effect Propofol may have had on MJ because the singer had been given so much of it in the 2 months before he died.
164 COMMENTS

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3.

Stiletto    

They could just stipulate to each witnesses field of experience and expertise...but why cut back on their hourly fees.

1074 days ago
4.

Straight Talkin Texan    

Amen! Preach on Mr. Witness!

1068 days ago
5.

Kelly    

Most patients / people do fear being put to sleep I often wondered if MJ didnt have a death wish and didnt care of he woke or not.
As a patient myself of many surgery's I can also say not once have I woke up and felt rested, it's just not that kind of sleep!
Maybe had I been put under and no surgery performed it would be different but even so the drug leaves either a hung over feeling or one of being a little high but once you come down (which is pretty fast) I slept for hours.
It's just not a natural restful sleep using the drug imo anyone who thinks it is is fooling themselves.

1068 days ago
6.

Lynn    

Listening to Dr.S, he is so totally correct when he said he gets asked every day will I die if I get what MJ got when you put me under. Several days after MJ passed my daughter 19 years old then had to have all 4 of her wisdom teeth out. Went to a oral surgeon, when he explained what type of meds he was going to give her she went hysterical afraid she would not wake up. The Dr. talked to her for awhile with me in the room and convinced her she would not die. It was a horrible expierence for her. She did have her teeth pulled out and was okay but woke up crying and kept saying am I dead .....So the Dr. on the stand is so totally correct. Damn you CM may you go pass go and straight to jail. How you going to support all those kids now?????

1068 days ago
7.

Caroline    

After hearing the prosecution's experts I'm wondering if the defense is going to be able to produce a credible expert who will defend Murray's actions as reasonable. If there is such a person I sure hope I never wind up in their care.

1068 days ago
8.

lala    

Ive had that and it is AWESOME. They shot it into the corner of my arm Its like BAM! and you are out in a split second. Then you wake up with no recollection of the hours you slept and its like being born again. It doesn't leave you feeling drugged or high, it doesnt give you a high whatsoever, its the being knocked out so fast and then waking up to total amnesia of being down that is like super cool. If I could choose a way to die, that would be it. I am jealous of Mj in a sense. I would have taken it too. No lie. Ever heard the Song by Garbage Milk? I think of him when I hear that.

1068 days ago
9.

yvonne from uk    

One sad comment that Dr Shafer said was that Michaels heart was dying, not true Michaels heart will never die, it will go on forever.

1068 days ago
10.

mj fan forever    

PATIENTS HAVE THE RIGHT TO EXPECT THAT DOCTOR TO BE HONEST DR SHAFER IS A TRUE DOCTOR MURDERER IS NOT A DOCTOR IS A MURDERER!!!! MURDERER DID NOT PUT MICHAEL - HIS PATIENT FIRST HE PUT HIMSELF MURDERER FIRST - ALWAYS!!! HE WITHHELD INFO TO PARAMEDICS AND UCLA DOCTORS MICHAEL COULD BE SAVED EVEN AFTER HIS HORRENDOUS TERRIBLE ACTIONS HE DID NOT KEEP MEDICAL RECORDS BECAUSE HE DID NOT CARE ABOUT MICHAEL HE DID CARE ABOUT MONEY HE COULD GET FROM HIM!!!! NO INFORMED CONSENT MURDERER SHOULD HAVE INFORMED MICHAEL OF ALL RISKS COZ IF HE HAD KNOWN THEM HE WOULD HAVE NOT REQUESTED PROPOFOL TO SLEEP HE HAD NO AUTONOMY MURDERER SAID YES HE SAID IT'S GOOD PROPOFOL TO SLEEP IT'S GOOD USE PROPOFOL IN HOME SETTINGS HOW COULD MICHAEL KNOW IT WAS NOT IF MURDERER WHO WAS HIS DOCTOR DID NOT TELL HIM ALL RISKS THE RISK OF DEATH?!!!???? MURDERER IS FULL RESPONSIBLE HE VIOLATED STANDARD OF CARE DOCTOR-PATIENT RELATIONSHIP NO MEDICAL JUDGEMENT - HE IS A MURDERER!!! - CONVICT HIM REVOKE HIS DAMNED LICENSE FOREVER AND LET HIM ROT IN HELL!!!! JUSTICE FOR MICHAEL JACKSON!!!!!!

1068 days ago
11.

Brigha from UK    

Well, full credit to the prosecution.
Okay, I still haven't forgiven him for showing the autopsy photo but apart from that, Walgren has done a fine job, and the three expert witnesses have been excellent.

Murrays team will not be able to find anyone to disagree with them. All he can do now is simply parade a bunch patients to vouch for his character.

He's basically saying 'Okay, so I killed MJ, but hey - some of my patients are still alive!'

It won't work.

Betting odds for an acquittal now 5000 to 1.

1068 days ago
12.

Just Reading    

That was pretty damning testimony..makes you wonder why the penalty is only four years. Anyway, there's nothing the defense can defend regarding the extreme deviations from the standard of care. Even the study using profotol as a sleep aid was just a study...conducted a year after MJ's death AND in a controlled properly equipped medical enviroment. So what now? Ask the usual endless cross questions about what percentage of this or that would be found here or there after a hypothetical amount of time? Still doesn't excuse the deviation. The defense should really start considering a plea...all their working for now is to try to convince the jury that MJ self injected AND even if that where true, it was with a drug provided by Murray in an non medical enviroment. Buh bye Connie.

1068 days ago
13.

MiMi    

Dr Shafer provided excellent testimony regarding Conrat and his total lack of doctor patient ethics along with providng details regarding Conrats lack of knowledge regarding administration of propofol and common pharmaceuticals.


Conrat you are going down.....

1068 days ago
14.

igotfleasfromtmz    

I will be taking notes on the defense witnesses. If one of them even indicate it was safe to give propofol under these cir****tances- They will be reported to the CA State Board. Just saying.

1068 days ago
15.

igotfleasfromtmz    

As a matter of fact I will look them up and see where they have LIc. in what states and if any hospitals have granted them privilges they will be contacted also.

1068 days ago
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