Jackson probe deepens with anesthetic/sedative reports

Enlarge 2003 AP photo Sedatives and an anesthetic contributed to Michael Jackson's death, according to the AP. The slow-moving investigation of Michael Jackson's death inched forward Monday with word that the pop superstar died from an injection of a powerful anesthetic, possibly compounded by the administration of at least two sedatives.

The Los Angeles County coroner has determined that Jackson's death was a homicide, the Associated Press reported Monday. If so, that makes it more likely criminal charges will be filed against Conrad Murray, the doctor who was with the pop star when he died June 25 and injected him with several drugs.

USA TODAY could not confirm with the coroner or the Los Angeles Police Department that a ruling of homicide has been made; the AP's law enforcement source spoke on condition of anonymity because the findings have not been publicly released.

But in a search warrant affidavit, dated July 23 and unsealed Monday in Houston, L.A. chief medical examiner Lakshmanan Sathyavagiswaran revealed that preliminary toxicology results indicate Jackson's cause of death was a result of lethal levels of the hospital-only anesthetic Propofol. According to the affidavit, Murray said he administered Propofol around 10:40 a.m., hours after injecting Jackson with two sedatives in an attempt to help him sleep.

"Jackson remained awake," the affidavit read. "After repeated demands from Jackson, Murray administered 25mg of Propofol (Diprivan), diluted with Lidocaine (Xylocaine), via IV drip. Jackson finally went to sleep."

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Jackson referred to Propofol as his "milk" because of its milky appearance, the affidavit said. But it is not meant for home use nor for the purposes of battling insomnia.

Doctors use the drug only in hospitals before procedures such as heart surgery, says Christopher Gharibo, medical director of pain medicine at New York University-Hospital for Joint Diseases. It's used in roughly half of the 25 million surgeries each year, says David Zvara, chair of anesthesiology at the University of North Carolina-Chapel Hill.

Jackson's family reacted mildly to the news; some of his relatives, such as his father, Joe Jackson, have been saying for weeks that Jackson's death was the result of foul play.

"The Jackson family has full confidence in the legal process," a family statement said. "The family looks forward to the day that justice can be served."

Murray's lawyer, Ed Chernoff, said he would not comment on reports from anonymous sources saying the coroner's office ruled the death a homicide.

"We will be happy to address the coroner's report when it is officially released," Chernoff said.

According to the affidavit, Murray told investigators that he had been treating Jackson for insomnia for about six weeks with 50mg of Propofol every night via an IV drip. But he said that he feared Jackson was developing an addiction to the anesthetic and that he was attempting to wean his patient by lowering the dose to 25mg and adding the sedatives Lorazepam and Midazolam.

That combination helped Jackson sleep two days before his death, so the next day, Murray told detectives he cut off the Propofol — and Jackson fell asleep with just the two sedatives.

Then around 1:30 a.m. on June 25, starting with a 10mg tab of Valium, Murray said he tried a series of drugs instead of Propofol to make Jackson sleep. They didn't work.

After Murray finally gave in to Jackson's "repeated demands/requests" for the drug and the singer was asleep, the affidavit said, Murray remained with him for about 10 minutes, then left for the bathroom. No more than two minutes later, he returned — and found Jackson had stopped breathing.

"There's no surprise there" that death could result from such a combination of drugs, Zvara says.

Chernoff disputed the accuracy of portions of the affidavit.

"Most egregiously, the timeline reported by law enforcement was not obtained through interviews with Dr. Murray, as was implied by the affidavit. Dr. Murray simply never told investigators that he found Michael Jackson at 11 a.m. not breathing."

In the days immediately after Jackson's death, Chernoff vigorously denied that Murray had injected Jackson with Demerol or OxyContin, but he did not say anything about Propofol. Chernoff has said repeatedly that Murray did not administer anything to Jackson that "should have caused death."

But a ruling of homicide could be contrary to that claim; Murray could face criminal charges of second-degree murder or reckless homicide, says Jody Armour, professor at the University of Southern California School of Law.

Charges of criminal negligence also could be brought, he says. "For criminal negligence, you need basically what you need for ordinary malpractice negligence, plus an extra indefinable gross negligence. And gross negligence is whatever the jury says gross negligence is," Armour says.

If a jury concluded Murray was grossly negligent in the way he administered the drugs to Jackson, he could be criminally liable at least for manslaughter, Armour says. Evidence that other doctors administered similar drugs to Jackson previously would not be a full defense, he says.

"It's still going to be a question of whether he contributed significantly to Michael Jackson's death," he says. "He doesn't have to be the only cause. He just has to be a significant or contributing cause to be criminally responsible."

Michael Endelman, senior editor of Rolling Stone magazine, says reports of Jackson using anesthetics to sleep have circulated now for weeks.

"There's little surprise an accident, at the least, could have happened — it's not shocking or surprising," Endelman says.

"And I don't think it'll have any effect on what people think of Michael Jackson. The number of strange things in his life never seemed to touch his image as a performer, and this (latest news) is certainly not the strangest thing you could associate with Michael. "

J. Randy Taraborelli, a Jackson biographer and a longtime friend of the singer, says he has spent enough time with Jackson's doctors over the years to understand how they could be manipulated by Jackson.

"It's not to excuse any of them in any way, but when you have Michael Jackson staring you in the face, with tears in his eyes, in pain, it's difficult to make the right decisions," Taraborelli says. "And sure, for a lot (of doctors), there was financial reward involved, but I also think many really did want to help him."

Contributing: Liz Szabo and the Associated Press

AFFIDAVIT: TIMELINE OF EVENTS According to the search warrant and court affidavit, this is physician Conrad Murray's account of what drugs were administered to Michael Jackson, who had severe insomnia, in the hours before his death June 25: 1:30 a.m.: Murray gave Jackson a 10mg tab of Valium in an effort to induce sleep without Propofol (Diprivan). 2 a.m.: Jackson was still awake. Murray put 2mg of Lorazepam (Ativan) in the singer's IV. 3 a.m.: Jackson was still awake. Murray administered 2mg of Midazolam (Versed) via IV. 5 a.m.: Jackson was still awake. Murray once again put 2mg of Lorazepam (Ativan) in the singer's IV. 7:30 a.m.: Jackson was still awake. Murray once again administered 2mg of Midazolam (Versed) via IV. 10:40 a.m.: Jackson remained awake. After more demands, Murray administered 25mg of Propofol (Diprivan), diluted with Lidocaine (Xylocaine), via IV drip. "Jackson finally went to sleep," the affidavit read.

	DIPRIVAN: 'SOMEONE CAN'T GIVE IT AND WALK AWAY' Experts say Diprivan is not a sleep aid. Although the drug puts patients to sleep, that sleep isn't restorative, says David Zvara, chairman of anesthesiology at the University of North Carolina-Chapel Hill. "To use it for sleep is completely out of the ballpark," says Christopher Gharibo, medical director of pain medicine at New York University-Hospital for Joint Diseases. David Kloth, an anesthesiologist and pain management specialist in Danbury, Conn., says Diprivan should be used only by a board-certified anesthesiologist or nurse anesthetist, or by an emergency room doctor who has had special training. Diprivan is often used to rapidly help a patient lose consciousness before surgery, says Emery Brown, professor of anesthesiology at Harvard Medical School and Mass General Hospital and an operating room anesthesiologist. Other drugs are given to maintain sedation, Brown says. Patients must be closely monitored, Brown says. "Someone can't give it and walk away. You have to stay and watch vital signs: heart rate, oxygen saturation, blood pressure, respiratory rate," Kloth says. The drug can lower blood pressure and even cause patients to stop breathing, Brown says. An anesthesiologist may need to help patients breathe with oxygen delivered by a face mask. By Liz Szabo and Mary Brophy Marcus

By Maria Puente, William M. Welch and Marco R. della Cava,

pyl16349 (17 friends, send message) wrote: 6m ago

Another drug addict overdoses.... too bad but it happens all the time. Jackson was responsible for his own health and well being. With a patient who lies, it's impossible for any one of his dozens of doctors to know exactly what drugs he was taking.

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goodgulf (8 friends, send message) wrote: 9m ago

Rich junkies, like Elvis or Michael, have doctors for pushers. Poor junkies have gangsters for pushers. Having a medical degree doesn't make a man any less of a drug dealer.

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spacedust (0 friends, send message) wrote: 10m ago

its prolly ruled a homicide so people can collect insurance money. somebody paid somebody off. maybe insurance didn't cover suicide. which this clearly is, he's addicted to prescription meds. and thats what nobody wants to hear. everybody should just let him rest in peace. instead everyone around him are still trying to milk him for every dime they can. what a bunch of bottom feeding parasites. its sad.

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SunnyCalGal (0 friends, send message) wrote: 10m ago

We support vindication of MJ by mainstream media. MJ was exonerated by a jury of his peers. Not good enough. For his children’s sake, mainstream media must become more responsible. We discuss how truth can compel mainstream media to publicly admit it wrongly accused MJ of despicable crimes. Many people still believe MJ was guilty. They were influenced to believe the allegations by a biased mainstream media. No links allowed here so search at Yahoo Groups for "vindication better than tributes."

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TexasFreeman (32 friends, send message) wrote: 11m ago

The chimp did it with help of the ghost of the elephant man, now can we move on???

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opinions_r_funny (10 friends, send message) wrote: 14m ago

We got rid of John and Kate and the Octomom, why can't we let the coverage of Wacko Jacko go too???

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Bluestar (7 friends, send message) wrote: 23m ago

Good now we know what caused Chester the Molester's death. How about discontinuing the news coverage? There are more important stories to report.

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HomerSentional (34 friends, send message) wrote: 36m ago

Homicide? Doesn't that have to be intentional?

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JeffNW (0 friends, send message) wrote: 37m ago

Looks more like pill popping and better life through pharmacology by a pedophile who could not sleep because of what he has done to countless children than a homicide.

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PublicVOICE (0 friends, send message) wrote: 37m ago

If Dr. Murray was an ethical physician, he would have said "NO" to Jackson's demands for Propofol. Jackson probably would have fired him, but at least the doctor wouldn't be facing homicide or manslaughter charges.