October 20, 2011

CONRAD MURRAY MURDER WEAPON

Denying any Propofol use to medical personnel and investigators indicates that Murray knew, with malice aforethought, that Propofol use was dangerous, inappropriate and unprecedented for treating insomnia.  A killing caused by dangerous conduct and offender’s obvious lack of concern for human life’ defines second-degree murder. 

When Murray decided to invent a dangerous insomnia machine, setting up an anesthesia operatory in Jackson’s bedroom without proper training, experience or certification, he committed second-degree murder. 

Whether Murray intended to kill Jackson or not, has nothing to do with second-degree murder.  His reckless medical practices caused Jackson’s death” ~DR JOHN CURTIS


Crime Scene



Broken needle

Following is pretrial testimony by LA Coroner Investigator, Elissa Fleak who collected medical evidence from the crime scene

Q. Investigator Fleak, you see two separate tables next to the bed? 

Elissa Fleak: Yes

Q. You have one directly adjacent to the bed [nightstand] then there is a second table
      just to the side of that [brass trolley] Is that right?

Elissa Fleak: Yes

Q. Looking at People’s 30, which would be the table adjacent to the nightstand 
     [brass trolley], did you recover a syringe?

Elissa Fleak: A syringe on the table and a needle on the ground to the left of the bed



Q. When you say syringe, what are you referring to?

Elissa Fleak: The plunger and the top part of the syringe, the plastic

Q. To which you would attach a needle?

Elissa Fleak: Correct. I did describe it as a broken syringe because the two pieces were separated. The needle was separate from the plunger. It is NOT broken. I should have described them as not connected















Conrad Murray hiding incriminating evidence

While Michael Jackson wrestled death, instead of calling 911 or trying to save his patient, his high priced doctor, Conrad Murray opted to clean up crime scene. 

Alberto Alvarez: He instructed me to remove the IV bag from the IV stand

Q. To be clear, 911 had not been called yet?

Alberto Alvarez: That’s true, sir

Q.  In regard to the IV bag removal, describe what Dr. Murray said

Alberto Alvarez: He pointed to the IV stand and he said
                             “remove that bag and put it in the blue bag”

Q. Did you notice anything about the IV bag that caught your attention?

Alberto Alvarez: I noticed there was a bottle inside the bag and then I noticed that
at the bottom of the bag, there was milk-like substance

Q. Separate from the bottle, you are talking about a liquid?

Alberto Alvarez: Yes it was at the bottom of the bag, sir

Q. You  saw a bottle literally inside of the bag?

Alberto Alvarez: Yes, it was inside of the bag

Q. Where was that bottle? Was it at the bottom of the bag? Was it sitting in the middle
of the bag? Was it floating in liquid?

Alberto Alvarez: It was towards the bottom of the bag



On June 29, 2009, Elissa Fleak returned to the crime scene to recover more evidence hidden in a closet, including a slit saline bag which held a 100ml Propofol bottle.

Q. Did you find a saline bag that had been apparently cut open?

Elissa Fleak: Yes

Q. Did you find anything in that saline bag?

Elissa Fleak: Yes, there was a bottle of 100ML vial of Propofol in the cut-open IV bag

Q. If I zoom in on the picture, does this depict the cut within that saline bag going from top to bottom if the IV bag had been hanging on an IV stand?

Michael Flanagan: Objection

Court: Sustained

Q. I ask you to describe this area that I’m pointing

Elissa Fleak: There is a slit in the bag

Q. That is the Propofol bottle contained within the IV bag?

Elissa Fleak: It was inside the bag, yes



Second IV Bag

Q. Was there still ANOTHER IV bag hanging from the IV stand?

Alberto Alvarez: Yes

Q. Did Doctor Murray instruct you to remove that bag?

Alberto Alvarez: No

The second IV bag was filled 1/2 to 1/3 with normal saline fluid. Long tubing and the
IV bag did NOT have any drugs in them. There was syringe stuck and depressed at the Y connector. The syringe tested positive for Lidocaine, Propofol and Flumanezil. Short tubing also tested positive for Lidocaine, Propofol, and Flumanezil.

Long tubing = tube from saline bag to Y conenctor
Short connector = tube from Y connector to IV catheter hooked to patient



Why 2 IV set?

Murray told the police that for 6 weeks, he injected Michael with Propofol bolus to put him to “sleep” then followed up with Propofol IV infusion to keep Michael “asleep”

“On the early morning of 6/25/2009 at approximately 1:00 hours the decedent placed a call to Conrad Murray and complained of being dehydrated and and not being able to sleep" ~The Autopsy Report, Page 2

Detective Orlando Martinez:  Dr. Murray indicated that he arrived around 1:00AM

Q. What happened at that point, according to Dr. Murray?

Orlando Martinez: Dr Murray said Mr Jackson came upstairs, they had a brief conversation, then Mr Jackson showered and changed

Q. What happened next?

Orlando Martinez: Dr Murray rubbed Mr Jackson’s feet and rubbed some skin lotion
                                                                   on Mr Jackson’s back

Q. Did he indicate that was for dermatological condition?

Orlando Martinez: Yes

Q. Following that, according to Dr. Murray, did he begin using an IV?

Orlando Martinez: Yes

Q.  For what purpose, according to Dr. Murray?

Orlando Martinez: Dr Murray said he put an IV for hydration
Conrad Murray also told paramedic Richard Senneff and UCLA ER Doctor Richelle Cooper that he was treating Michael Jackson for dehydration that night.

Orlando Martinez: Dr. Murray gave Mr. Jackson 2mg Lorazepam diluted with saline

Orlando Martinez: Dr Murray introduced 2mg Midazolam via the same method

Conrad Murray needed a system where he can dehydrate Michael (with saline), inject drugs boluses (via Y connector) and provide a continuous Propofol IV infusion (by spiking a Propofol vial to the IV system). This cannot be done by using only one IV set.
It requires the use of TWO IV bags, piggy-backed.

Piggyback





An IV piggyback is a way to administer medication
through a previously inserted intravenous line

If a patient is receiving continous IV fluid (saline for dehydration) and in addition, he must receive a second kind of intermittent infusion (Propofol) then we will need 2 sets of IVs and we will need them connected.

This system enables Conrad Murray to hydrate, inject drug boluses and provide continous Propofol infusion



Review of Conrad Murray orders from Applied Pharmacy of Las Vegas reveals that Conrad Murray is being less than truthful about how much Propofol he was administering to Mr. Jackson every night. He was most definitely administering MORE that 50mg per night that he alleges. This amount is LESS than the standard induction dosage and would NOT have put Mr. Jackson to “sleep” especially if he built a tolerance to Propofol as the defense team claims. The induction dosage (enough to anesthetize someone) is 2.5mg/kg. Michael Jackson was 62 kg so the induction dosage from him would be at least 155mg

Review of the sizes of the Propofol vials and number of saline bags Conrad Murray ordered suggest (1) from the onset, Conrad Murray planned on using the Propofol contraption that we will cover in awhile. He ordered 100ml vials for continuous drip and smaller 20ml vials for bolus injections (2) He did NOT order the saline bags for the sole purpose of hydrating Michael Jackson. The intended use for the bags was different 

Conrad Murray ordered only 9 saline bags on April 6, 2009. His next order of 12 saline bags was on June 15, 2009 so he used only 9 saline bags in 2 months. Had Murray been ordering saline bags for hydrating Mr. Jackson, he would have ordered MORE.

CONRAD MURRAY’S PROPOFOL MACHINE

Disclaimer: The following is a speculation based on limited publically available information. It aims to make sense of the “broken needle” and the contraption (slit saline bag with 100ML propofol vial inside) found in the closet.  The veracity of this conjecture requires affirmation that: (1) Murray was using a non-vented IV tubing (2) there is a needle stuck in the 100ML propofol vial which was in the slit saline bag recovered from the closet.

Conrad Murray didn’t just invent a new medical treatment for insomnia. He also invented a “medical equipment” to accompany his so-called medical treatment. This arts and craft project which dripped an anesthetic into his patient’s vein without an infusion pump was incriminating evidence, testament to the substandard care Murray provided to his patient.
The milky white substance you see in a Propofol bottle is NOT all drug. Regardless of
the size of the Propofol bottle (25ml, 50ml or 100ml), only %1 of the mixture is active Propofol. Propofol has high fat content due to oil and egg yolk. Because of its high lipid content, Propofol is susceptible to bacterial growth. To deter contamination, Propofol comes in vacuum vials, topped with rubber stoppers.


50ML and 100ml Propofol vials come with a hang so they can be hung to IV stand for continous infusion.   


Withdrawing drug out of a vacuum vial is tricky. To equalize the pressure, you must push an equivalent amount of air into the drug vial for the amount of fluid that is to be withdrawn. For instance, if you would like to draw 10ML Propofol, you would pull back the plunger of your syringe to10ML to draw air into the syringe, push the needle into the rubber lid of the vial, turn the vial upside down and then inject the air into the vial.


Merely spiking a vial to the IV line won’t work, Propofol won't drip


Vented Tubing vs Non-vented Tubing


Non vented tubing                                       Vented tubing






Vented tubing allows air to enter into the IV set so you don't have to keep injecting air into the vial











When Propofol is used as a continuous IV infusion, anesthesiologists use vented tubing that allows air into
the vial and an infusion pump to regulate Propofol flow.

Conrad Murray wasn't using an infusion pump.

Making an educated inference based on the arts and crafts contraption found in the closet (saline bag with Propofol vial inside) Murray wasn't using vented tubing either.








CONRAD MURRAY IS LYING ABOUT LORAZEPAM & MIDAZOLAM

Murray told the detectives that he was becoming concerned that Michael was becoming addicted to Propofol. On June 22, 2009 Murray allegedly “INTRODUCED” Lorazepam and Midazolam as part of his “weaning” process.

A quick look at Conrad Murray orders disproves his allegation that these 2 drugs entered into the treatment for “weaning” purposes. They were very much part of his “treatment”.
Conrad Murray’s first order of Lorazepam and Midazolam was on April 30, 2009
1 tray of 10ml Lorazepam (10 vials)
2 trays of 2ml Midazolam (20 vials)

On May 15, he ordered:
2 trays of 2ml Midazolam (20 vials)

On June 15, 2009, he ordered:
1 tray of 10ml Lorazepam (10 vials)
2 trays of 2 ml Midazolam (20 vials)




Conrad Murray needed a contraption where he can administer boluses of drugs via Y connector, saline to hydrate/dilute drugs
and Propofol continous infusion so he piggy-backed 2 IV lines mentioned in Alberto Alvarez testimony (one with 1/2 to 1/3 full saline that Conrad Murray did NOT instruct Alberto Alvarez to remove, the other with empty saline bag with 100ML Propofol vial)


Assuming he only had non-vented tubing and he can't just spike a Propofol vial to the IV line, Murray had to find a way to ventilate the Propofol IV line so the drug could drip.

Conrad Murray needed a continuous air flow into the 100ml Propofol vial.
ENTER ‘BROKEN SYRINGE’ 


"When non vented tubing is all that was available and vented tubing was needed
we inserted a sterile needle into the stopper of the bottle to act as the air vent" (source)

Conrad Murray detaches the needle from the syringe. Needle hub would provide flow of air into the vial, sparing him from injecting air into the vial continuously. But there is one problem he needs to overcome. Propofol is leaking from the needle hub.




Murray needs something to hold the leaked Propofol bits from the needle hub 
ENTER SLIT SALINE BAG

Conrad Murray cuts a vertical hole on one layer of an empty saline bag so he can stick Propofol bottle into the bag. This way, leaked Propofol from the needle hub would be held by saline bag. He places the Propofol vial into the bag and spikes the vial to the IV 

Alberto Alvarez: I noticed there was a bottle inside the bag and then I noticed that
at the bottom of the bag, there was milk-like substance


"Focusing on the milligram dosage that killed Jackson diverts attention away from Murray’s gross negligence. What killed Jackson was an arrogant physician playing with anesthesia without proper training & experience"
                                               ~DR JOHN CURTIS


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3 comments:

  1. Thank you very much for the clear explanation you have provided related to the key medical evidences
    Murray was so adamant in hiding instead of giving a proper CPR or calling Emergencies straight away.

    However, the plastic top part of the separated syringe contained propofol and lidocaine as well.
    Many times I have thought that it was Murray the one who put both substances into that syringe so as to later blame the victim and use that separated syringe as the "instrument" for his crazy theory... (hence their lawyers asking for re-testing syringes for amounts).

    What is your point of view regarding the content of that "broken" syringe?

    Thank you very much

    ReplyDelete
  2. @Smoothluger Yes, the syringe barrel did have Propofol and Lidocaine. Murray told police that he first does a bolus injection to put Michael to sleep then continuous IV drip to keep him asleep. The syringe was likely used for a bolus injection, THEN it was detached from the needle for the purpose of ventilating a non-vented tubing for the Propofol infusion IV.

    At this point, the type of tubing Murray used (vented or non-vented) isn't publically available info but it's a vital piece of the puzzle. It will come out in the trial. In above speculation, I did assume that only non-vented tubing was available. Or else, the arts and crafts project found in the closet (saline bag with 100ML Propofol vial) and why he had to detach syringe don't make sense. IF Murray had a vented tubing, all he had to do was to spike the Propofol vial to the IV line

    Thank you for commenting

    ReplyDelete
  3. I received some information last night and today I was doing searches to confirm when I ran across your blog. Can you contact me? I'd like to know how you received your information. Everything you have here I received as well. Also, I'd like to know if you are the one involved with the children's hospital.

    Thank you for all of this. It's overwhelmingly amazing!

    ReplyDelete