Conrad Murray trial -Day eleven.

Today should be interesting, as there is some question whether Dr. Richard Ruffalo, Anesthesiologist and clinical pharmacologist will testify for the Pros. During the prelim, there was a controversy over the testimony of Dr. Ruffalo. The defense opined that the Pros may not even call their own expert. That may be, but IMO that would be a mistake. I think the defense will call him, if the Pros don't. Better to get him on the stand first, before the defense gets him. Here is an article from April about this.

http://articles.cnn.com/2011-04-29/...timony-defense-theory-ed-chernoff?_s=PM:CRIME

And this reference on vindicatemj and sprocket

Dr. Richard Ruffalo, the anesthesiologist who testified during the hearings, unfortunately drew a parallel between a person heavily deprived of sleep with a heroine addict who reaches for a syringe when nobody sees him. The comparison is incorrect as insomniacs don’t take medicine to get themselves high – they need medication to fall asleep, and they need sleep for sustaining their lives!

Even absolutely healthy people deprived of sleep for several days running are risking their lives – so we should never compare insomniacs with addicts who take hard drugs for recreation purposes and undulging themselves!

The anesthesiologist speaks of Dr. Murray leaving a dangerous drug in the presence of his patient:

“That would be then another extreme departure, because the patient is a known addict, and the doctor then allowed that much like a known heroin addict, and leaving a syringe of drugs available. It’s an extreme departure. And making sure the patient can’t have self access to drugs. That’s an extreme departure.

Dr. Ruffalo also admitted he had made a mistake when calculating the amount of propofol in Michael’s stomach but said Dr. Murray’s guilt was still there as “either way, it doesn’t matter,” he testified. “He abandoned his patient and didn’t resuscitate appropriately.”

I made an interpretation mistake. I thought it was micrograms and it’s really milligrams.
So, we’re back to it being orally? Well, we’ll have to talk to the coroner.

It’s a big difference isnt’ it? I totally agree.




45x what it is in the hospital blood.
Yes, I made a mistake

http://vindicatemj.wordpress.com/2011/01/12/dr-conrad-murrays-preliminary-hearings-concluded/
 
Today should be interesting, as there is some question whether Dr. Richard Ruffalo, Anesthesiologist and clinical pharmacologist will testify for the Pros. During the prelim, there was a controversy over the testimony of Dr. Ruffalo. The defense opined that the Pros may not even call their own expert. That may be, but IMO that would be a mistake. I think the defense will call him, if the Pros don't. Better to get him on the stand first, before the defense gets him. Here is an article from April about this.

http://articles.cnn.com/2011-04-29/...timony-defense-theory-ed-chernoff?_s=PM:CRIME

And this reference on vindicatemj and sprocket

Dr. Richard Ruffalo, the anesthesiologist who testified during the hearings, unfortunately drew a parallel between a person heavily deprived of sleep with a heroine addict who reaches for a syringe when nobody sees him. The comparison is incorrect as insomniacs don’t take medicine to get themselves high – they need medication to fall asleep, and they need sleep for sustaining their lives!

Even absolutely healthy people deprived of sleep for several days running are risking their lives – so we should never compare insomniacs with addicts who take hard drugs for recreation purposes and undulging themselves!

The anesthesiologist speaks of Dr. Murray leaving a dangerous drug in the presence of his patient:

“That would be then another extreme departure, because the patient is a known addict, and the doctor then allowed that much like a known heroin addict, and leaving a syringe of drugs available. It’s an extreme departure. And making sure the patient can’t have self access to drugs. That’s an extreme departure.

Dr. Ruffalo also admitted he had made a mistake when calculating the amount of propofol in Michael’s stomach but said Dr. Murray’s guilt was still there as “either way, it doesn’t matter,” he testified. “He abandoned his patient and didn’t resuscitate appropriately.”

I made an interpretation mistake. I thought it was micrograms and it’s really milligrams.
So, we’re back to it being orally? Well, we’ll have to talk to the coroner.

It’s a big difference isnt’ it? I totally agree.




45x what it is in the hospital blood.
Yes, I made a mistake

http://vindicatemj.wordpress.com/2011/01/12/dr-conrad-murrays-preliminary-hearings-concluded/



In a word: :eek:

Thanks, goaliemom. Yeah, they gotta call him. Period.
 
witness is going through a detailed explanation to the jury about what it is a cardiologist does (so far I've heard him say nothing about treating insomnia)
 
p: as an expert cardiologist you're not an expert in yada yada yada (all the things Dr. Murray was doing to MJ)
witness: no
 
still going over witness's credentials...he has quite a long list of them.

witness testified that he reviewed Dr. Murray's qualifications and Dr. Murray was not board certified cardiologist on June 25, 2009
 
witness has worked as an expert reviewer for the California Medical Board when complaints are filed to see if the dr in question has acted within the standard of care established
 
Anyone else hear that sizzle? This good-looking cardiologist had turned on the stove, and is selecting the pan in which he will fry Dr. Murray.
icon10.gif
 
witness explaining to jury the different levels of judging a dr's standard of care protocol

p: did you conduct an expert review through the Cal Med Board on this case as it relates to Dr. Murray
w: yes
p: how many expert reviews have you done on other drs
w: 8
p: and did you find extreme deviations on standard of care on the other doctors
w: no, this is the first review I've ever determined extreme deviations (also called it gross negligence)

p: are there procedures where cardiologists use propofol
w: yes, there is. when most of our procedures we do, (naming a few of them - he's speaking fast and explaining some of the procedures)
Cardiologists in general, we are experts at mild or moderate sedation.
(explaining the difference between the two and now saying neither is deep sedation and explaining deep sedation. deep sedation is the only time i see cardiologists using propofol)

p: so in your practice of cardiologist, you usually use mild or moderate
w: yes

witness said that in those procedures propofol is not used, benzodiazopenes are used
deep sedation is when propofol is used and an anthesiologist is always who does it, not the cardiologist
 
Ouch, ouch, ouch, ouch, ouch!!!!!

Talk about a "jury" of your peers!!!

I think the good doctor Murray is gonna need some propofol to get through this witness's testimony.
 
Prosecution talking about informed consent. Wonder if MJ signed that? Cause it didn't look like he had signed Murray's contract. This witness should just have a big flashing sign on his chest saying Murray is not one of us.
 
Witness is explaining different monitoring machines needed for using propofol. Witness is good, but seems almost gleeful when mentioning Murray's name. Witness has a cute little grin but I am not sure it will work the way prosecution wants it to.
 
Witness is still explaining what all a Dr. needs for typical standard of care while giving propofol. That list is really long, and witness is pointing out what Murray did and did not do that is standard of care.
 
Witness is still explaining what all a Dr. needs for typical standard of care while giving propofol. That list is really long, and witness is pointing out what Murray did and did not do that is standard of care.

BBM

No objection by defense for witness making such bold statements?!
 
BBM

No objection by defense for witness making such bold statements?!

There was one objection, when prosecutor did not say for sure that they were talking about propofol, other than that witness has just been going. The judge mentioned to the witness he needed to give yes or no answers and then go from there.
 
Witness is now explaining what Murray did and did not do during respiratory arrest. Explaining that this was a respiratory arrest and not a cardiac arrest.

Now explaining why Murray's CPR was wrong, using one hand, on a soft bed.
 
witness found 6 extreme deviations from standard of care all amounting to gross negligence (he relied solely on Dr. Murray's statement to do his review)


1. Propofol was not medically indicated (being used for sleep and not for a diagnostic procedure. before you do a procedure or sedation the patient should sign an informed consent and this was not done either) Prior to this case never heard of propofol being used for treating sleep problems
2. Using propofol in home setting without proper equipment, staffing, constant monitoring, proper medications on hand to counter medications emergencies that may come up during the sedation (going over each one individually now and said that while he grouped these all together as 1 extreme deviation amounting to gross negligence, they are all actually individually extreme deviations that are all each gross negligence on their own as well) says most important error was no backup or way of calling for help quickly (note from me: I've seen what looks to me like Dr.Murray rolling his eyes slightly through some of this testimony)
3. No preparedness to handle emergency situation (gave quite a few examples)
4. Improper care during the arrest (in this case MJ's breathing stopped) when trying to resuscitate, Dr.M didn't follow proper protocol (explaining difference between cardiac arrest and then explaining the respiratory arrest that happened to MJ) explaining what Dr. Murray should have done as soon as he walked in the room and found MJ in the condition he says he found him in. The first thing he said is call 911, then went into what Dr. M should have done after. (note by me: a lot of what this dr. is saying is very, very damaging to Dr. M IMO)
5. Failure to immediately summon emergency help (lots of discussion about this and why that would have made a difference - camera panned to Dr. Murray and he looks very arrogant right now - to me that is)
6. Failure to maintain proper medical records (going into why this is so important - insurance wants it, litigation but most important reason is to take better care of the patient)
 
witness: Dr. Murray did not document a single thing and could not give any information to emergency physicians that he should have had if he had document medical notes
 
BBM

No objection by defense for witness making such bold statements?!

Nope, other than objecting that the type of sedation not being specific when the witness started explaining something. The question was reasked to specify propofol and testimony continued.
 

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