MICHAEL JACKSON DIDN'T DRINK PROPOFOL (re: Richard Ruffalo Pretrial Testimony)

JANUARY 10, 2011: Conrad Murray Preliminary Morning Trial

Richard Ruffalo, an anesthesiologist and pharmacologist, stood as the last witness. 

 

Deputy District Attorney, David Walgreen



David Walgreen questioned Richard Ruffalo re: the stomach contents:

Propofol in stomach= 0.13mg

Lidocaine in stomach= 1.6mg

Richard Ruffalo testified that these amounts reflect the total amounts of Propofol and Lidocaine found in stomach. To find Propofol and Lidocaine in stomach PER UNIT,

he divided the above amounts by 70 (70 gram being the total stomach contents).

Concentration of Propofol in stomach= 0.13÷70=0.00186mg/ml

Concentration of Lidocaine in stomach=1.6÷70= 0.0228mg/ml

Richard Ruffalo concluded that these concentration levels are very low and that they weren’t indicative of someone orally taking them. If someone drank Propofol or Lidocaine, their respective concentrations in the stomach would be much higher.

Richard Ruffalo also explained why propofol and lidocaine were found in the stomach:

“It is a phenomenon that we call postmortem redistribution, meaning drugs go from high concentration to low concentration. For example, we have the liver which has a very high concentration of 6.2mg/ml. It is a very high concentration compared to the 0.00186mg/ml found in stomach. That is because the liver is kind of next to the stomach. The heart literally sits about now quiet an inch from the stomach.”

JANUARY 10, 2011: After lunch break

Michael Flanagan

Michael Flanagan cross examined Richard Ruffalo, pointing out to a conversion mistake. Mr. Ruffalo admitted the mistake. Consequently, Mr. Ruffalo stated that Michael may have drank Lidocaine.

In the morning Trial, Mr. Ruffalo had testified

that drug moves from high concentrations to low concentrations, which explained the Propofol and Lidocaine found in stomach. To do so, he compared the Propofol and Lidocaine levels in the stomach to their respective levels in other samples (femoral, heart or hospital bloods).

But Michael Flanagan pointed out that the other samples are measured in micrograms per milliliter, whereas the concentrations that Mr. Ruffalo came up with, before the lunch break, were measured in milligrams per milliliter. All units should be the same for accurate comparison.

Michael Flanagan: So as it stands, you made a mistake here?

Richaerd Ruffalo: I have to agree

Richard Ruffalo converted the milligrams (mg) in the concentrations into micrograms (ug)

1 mg (milligram) =1000ug (microgram)

Concentration of Propofol in stomach= 0.00186mg/ml =1.86ug/ml

Concentration of Lidocaine in stomach=0.0228mg/ml = 22.8ug/ml

Michael Flanagan pointed out that in all other samples, Propofol is higher than Lidocaine.

Propofol in heart blood=3.2ug/ml               Lidocaine in heart blood= 0.68ug/ml

Propofol in hospital blood= 4.1ug/ml           Lidocaine in hospital blood=0.51ug/ml

Propofol in femoral blood =2.6ug/ml           Lidocaine in femoral blood = 0.84ug/ml

Michael Flanagan pointed out that the Lidocaine in stomach (2.28ug/ml) is 40 times higher than Lidocaine in hospital blood (0.5ug/ml). Based on the new calculations, Richard Ruffalo testified that MICHAEL MAY HAVE DRANK LIDOCAINE.

Mr. Ruffalo advised asking the coroner what the numbers for gastric contents on the autopsy report stand for. Are they concentrations or the total amount? 

Now we have more Lidocaine than Propofol in the stomach whilst we have more Propofol than Lidocaine in other blood samples (heart, hospital, femoral or liver etc)
So, Mr. Flanagan concluded, the Lidocaine levels in the stomach can't be explained by postmortem redistribuion, thus, he concluded, Michael must have drank Lidocaine.

PROPOFOL & LIDOCAINE IN STOMACH ARE TOTAL AMOUNTS

Propofol and Lidocaine numbers on the Michael Jackson autopsy report ARE the TOTAL AMOUNTS IN THE STOMACH, NOT concentrations.

I am not sure if the confusion during Richard Ruffalo testimony was an honest mistake
by Michael Flanagan or it was an deliberate defense tactic devised to confuse the expert. Mr. Flanagan knew or should have known that the levels for gastric contents on autopsy report were total amounts because LA Coroner toxicologist Jamie Lintemoot testified so.

Michael Flanagan: The autopsy report says that the stomach contains 70 grams

of dark fluid Did you analyze this dark fluid for Propofol?

Jamie Lintemoot: Yes

Michael Flanagan: In that dark fluid, you determined 0.13ug/ml of Propofol, correct?

Jamie Lintemoot : That is incorrect. It was 0.13mg (milligrams)

Michael Flanagan: 0.13 milligrams. That is not a percentage, is it?

Jamie Lintemoot: No

Michael Flanagan: In the 70 grams of dark fluid in the stomach,

is that the total amount of propofol that was in there?

Jamie Lintemoot: Yes

Michael Flanagan: So you determined it was 0.13mg in the 70 gram that is in the stomach?

Jamie Lintemoot: Yes

Michael Flanagan: I am wondering what this dark fluid consisted of. That is 0.13mg
of Propofol and we have 1.6mg of Lidocaine. We have another 69 grams plus that was something other than Propofol and Lidocaine

Michael Flanagan: 12 parts of Lidocaine to 1 part of Propofol?

Jamie Lintemoot: Yes

Michael Flanagan: In the stomach?

Jamie Lintemoot: Yes

REFUTING MICHAEL FLANAGAN

Both Michael Flanagan and Richard Ruffalo overlooked that the stomach contents are in GRAMS whilst the Propofol and Lidocaine levels in stomach are in MILLIGRAMS

So we need to convert 70 grams into milligrams, divide it by the stomach Propofol and Lidocaine levels on autopsy report then multiply it by 1000 to get concentrations in ug/ml

1 gram =1000mg (milligram)

70 gram = 70,000mg
1 mg =1000ug (microgram)

ACCURATE CONCENTRATION LEVELS IN STOMACH IN MGs

Concentration of Propofol in stomach= 0.13÷70,000=0.00000186mg/ml

Concentration of Lidocaine in stomach=1.6÷70,000=0.0000228mg/ml

Now we have to convert the mg values to ug values so they are compatible in units
to those levels in heart, femoral, hospital etc. To do this, we multiple them by 1000

ACCURATE CONCENTRATION LEVELS IN STOMACH IN UGs
Concentration of Propofol in stomach= 0.00000186mg/ml =0.00186ug/ml

Concentration of Lidocaine in stomach=0.0000228mg/ml = 0.0228ug/ml

We have the same numbers we had before the lunch break, minus the technicality

This renders Michael Flanagan’s argument INVALID

Richard Ruffalo’s following testimony still stands:

David Walgreen: Are those concentration values very low?

Richard Ruffalo: Yes

David Walgreen: Are those concentration levels are consistent with someone orally ingesting Propofol or Lidocaine?

Richard Ruffalo: Not at all

David Walgreen: Why is that?

Richard Ruffalo: If you ingest Lidocaine, you would have a higher concentration
David Walgreen: How about Propofol?

Richard Ruffalo: Same thing