Conrad Murray trial: As case goes to jury, a pressing question

How did a fatal level of the anesthetic propofol end up in Michael Jackson's blood? That's a key question as the jury in the trial of Dr. Conrad Murray begins deliberations Friday.

To reach a verdict, jurors deliberating in the trial of Michael Jackson’s physician must confront a question that cannot be answered with scientific certainty. How did a fatal level of the anesthetic propofol end up in the King of Pop’s blood?

Two people know the correct answer to that question. One is dead. The other, Dr. Conrad Murray, offered police an explanation that prosecutors find implausible.

On Friday at the Los Angeles County Courthouse, a jury of seven men and five women are set to begin their deliberations after a five-week trial that featured 49 witnesses and 330 pieces of evidence.

How the jury answers that single question about drug levels in Jackson’s blood could go a long way toward determining whether Dr. Murray is found guilty or is acquitted of involuntary manslaughter in Jackson’s death in June 2009.

The medical examiner found that Jackson died of acute propofol intoxication in combination with other sedatives. But what experts were unable to determine conclusively was how the lethal combination of drugs entered the pop star’s system.

Prosecutors have offered the theory that Murray set up an open-ended intravenous drip that allowed a significant quantity of propofol to continue to flow into Jackson’s body until he was so sedated that he was no longer able to breath.

Defense lawyers have presented a competing theory that at some point Jackson self-administered a syringe-full of propofol in a fast push of anesthetic which, in combination with other drugs, killed him almost instantly.

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In closing arguments on Thursday, Deputy District Attorney David Walgren told the jurors that Murray’s decision to treat Jackson’s chronic insomnia with nightly propofol infusions in the bedroom of Jackson’s rented mansion was far outside any recognized medical standards of care.

“This type of care has never been seen,” he said. “This was a pharmaceutical experiment in a bedroom.”

In a recorded statement to police two days after Jackson’s death, Murray told investigators that for nearly two months he had administered nightly intravenous drip infusions of propofol to help Jackson sleep.

Mr. Walgren seized on the admission and told jurors to recall how much propofol was being ordered – and reordered – by Murray during that period of time. Investigators discovered the doctor had received more than four gallons of the powerful anesthetic – enough to administer enormous doses of 2,000 milligrams each night.

In his recorded statement to police, Murray said he administered only a 25-milligram dose of propofol by injection, an amount of anesthetic likely to cause sedation for five to 10 minutes.  

Murray’s defense counsel, Edward Chernoff, urged the jurors to accept that Murray was telling the truth when he told police that he administered only a relatively small 25-milligram dose of propofol to Jackson roughly 1 hour and 10 minutes before Jackson was found unresponsive in his bed.

This issue is critical to the defense because propofol is both fast-acting and quickly depleted. If Murray injected only 25 milligrams into Jackson, that amount of the drug would be out of Jackson’s system in minutes, and the heightened risks to Jackson would have disappeared long before Murray found Jackson lifeless.

“If that is what Dr. Murray did, then no matter what, there was no danger, no chance of harm to Michael Jackson based on what Dr. Murray knew he gave to Michael Jackson,” Mr. Chernoff said. “That is absolutely indisputable.”

The 25-milligram injection – if true – would explain why Murray was not at Jackson’s bedside at the time Jackson stopped breathing. He assumed Jackson was simply asleep. And it might somewhat undercut phone records and testimony showing that Murray was making phone calls and returning e-mails and text messages rather than closely monitoring his patient at bedside when the emergency arose.

Most important, it raises a bigger question. How did the extremely high levels of propofol discovered by toxicologists enter Jackson’s system if Murray injected only 25 milligrams?

Chernoff told the jury Jackson must have given it to himself in a desperate attempt to get some much-needed rest. He must have done it when Murray was distracted or out of the room.

“What they are really asking you to do,” he told the jury, “is convict Dr. Murray for the actions of Michael Jackson.”

Chernoff suggested that prosecutors and some of their witnesses engaged in a “conspiracy” to suggest that Jackson died during a continuous intravenous drip of propofol.

“It is clear what the prosecution is attempting to do is create a drip that never existed,” Chernoff told the jury. “They refuse to accept the most obvious and reasonable explanation for all of this, that Dr. Murray gave Michael Jackson exactly what he said he did.”

“This isn’t some conspiracy,” Walgren told the jury. “This is what Conrad Murray was doing every night, a drip is what he called it,” the prosecutor said. “It explains the blood levels. It is consistent with the phone records.”

In his rebuttal closing argument, Walgren made a candid admission. “The people cannot prove exactly what happened behind those closed doors. Michael Jackson could give answers, but he is dead. But you know what was happening every night. You know the volume of propofol that was being shipped. You know what was found, and you know that Michael Jackson died of propofol intoxication.”

Walgren did not stake his entire case on the jury finding that a continuous drip of propofol killed Jackson. He offered the jury a second way to convict Murray.

Murray could be found guilty of involuntary manslaughter, he said, if the jury unanimously agreed that Jackson’s death was directly caused by Murray’s administration of propofol in a bedroom without proper monitoring equipment and proper resuscitation equipment, and without constant vigilance to closely monitor his patient.

“No one had ever heard of propofol being administered in a bedroom – ever – until Conrad Murray did it to Michael Jackson,” Walgren said. “The setting is a direct cause of his death. This is criminal gross negligence.”

Chernoff told the jury that the only reason his client is on trial is because the dead patient was pop superstar Michael Jackson.

“I can’t disagree that giving propofol in a home is a proper thing to do. And he did that for 60 days,” Chernoff said. But Murray was not giving Jackson drugs to fuel an addiction; he was trying to help a patient sleep normally.

“They want to paint a perfect villain and a perfect victim as if we’re in a television show and we want to feel good when it ends,” the defense lawyer said. “There’s no perfect villain. And there’s no perfect victim.”