Coroners Report released - GRAPHIC CONTENT (Threads merged)

[Limonali]

There are some videos posted on youtube by persons looking very closely/investigating the accuracy of the "autopsy" report. It is quite interesting how many discrepancies this person is finding. From these videos it seems to me that the autopsy report is not factual, and will:rofl: quite possibly torn apart during questioning in a court room. MJJGIRL20 has the english version of these videos on youtube if you are interested in learning about these discrepancies.

^^Can anyone have post a link to these videos??
It would be helpful if we had the links in this thread.

Please could you post this videos.

I believe those videos are people who dont believe that Michael has really passed away....this thread is for facts from the autopsy...facts that we know are true...facts that came from the original report that is posted on page 1 of this thread.

Agree, xthunderx2.
I think there's a designated part of the forum for those videos (???) but this thread is not meant for it.

 

[ginvid]

^^^You are both correct. Things like this are to be posted in the conspiracy section. Do NOT post them here.
Thanks.

 

[JMie]

I don't know where to ask this... I have a question about lupus. I read online somewhere that during the Grand Jury in 1994 dr Klein and Debbie Row testified that Michael had lupus. Is this information correct? Are there documents to prove this testimony?

 

[elusive moonwalker]

i dont think theres any documents to prove this as a grand jury is supposed to be secret. this info was just reported in the media at the time so was leaked. but its hardly something the media would make up as its pro mj. also klien mentioned it after june 09 about diagnosing him

 

[JMie]

thanks.

 

[kissybissy]

Are the videos the VH1 famous crime scenes? I've watched on line and they have a lookalike to play Michael.

 

[Soundmind]

But Oxman started this 'drug addict' angle the SAME day Michael was pronounced dead. Not days, weeks nor months. THE SAME DAY. With all the frenzy going on that day, there's no way anyone in the family had time to be thinking about a will.

Oxman sued MJ in 2007, he wanted $1.5 millions in legal expensses, his claimes were thrown out by a judge. He did that after MJ filed a lawsuit against Randy's team of accountants and managers. That's how Randy tried to get back at MJ. Oxman was part of the PR machine that worked overtime in the summer of 2007 to prove he was in bad health physically & mentaly due to his severe ALCOHOL and drug addictionS. It's very logical to expect him to say SEE I told u so, we were right, do you believe us now, look he is dead. He had been saying that for two years, it did not actually start on that day.

 

[rainny]

i dont think theres any documents to prove this as a grand jury is supposed to be secret. this info was just reported in the media at the time so was leaked. but its hardly something the media would make up as its pro mj. also klien mentioned it after june 09 about diagnosing him

He did. Deepak Chopra also spoke about MJ having lupus, I think.

 

[MJ~And~Me]

Warning - The report contains graphic details and content, please view at your own risk.

http://www.tmz.com/2010/02/08/micha...fol-cause-of-death-homicide-dr-conrad-murray/

TMZ has just obtained a copy of the full L.A. County Coroner's report in the death of Michael Jackson -- which until now was under seal. The conclusion is clear ... Propofol killed the singer.

According to the report, the manner of death is homicide and the conclusion is based on the following 4 items:

1. Circumstances indicate the Propofol and the benzodiazepines were administered by another.

2. Propofol was administered in a non-hospital setting without any appropriate medical indication.

3. The standard of care for administering Propofol was not met. Recommended equipment for patient monitoring, precision dosing and resuscitation was not present.

4. The circumstances do not support self-administration of Propofol.

The Coroner's report was under wraps until the criminal complaint was filed and it will be a centerpiece in the prosecution of Dr. Conrad Murray on charges of involuntary manslaughter.

exactly :yes:

 

[kasume]

I honestly don't know where to begin. I thank this person for their excellent medical analysis and interpretation.

It makes me believe more that this was a first degree murder.

http://www.facebook.com/pages/Michael-Jackson-Homicide-Investigative-Research/296194732047
Michael Jackson Homicide: Investigative Research

the purpose of this discussion topic is to help provide clarity to the Michael Jackson official autopsy report released to certain media outlets via court order in early 2010. a copy of the official autopsy report was obtained directly from the County of Los Angeles, Department of Coroner [case number: 2009-04415]. this specific document was the subject of detailed medical analysis conducted by medical specialist(s)/professionals, presented here for member viewing.

[side note: posts relating to the official AR and the medical analysis of the document were collected from the MJ H:IR discussion topic: "Medical Notes & Medical Board", in order to allow for more direct access to the subject. Q & A follow the analysis.]

Michael Jackson Homicide: Investigative Research

MJ H:IR would like to express our deepest gratitude for the selfless contributions of all those involved in this complicated project. special thanks to Tima for her medical expertise and for taking on the exhaustive, time-consuming task of converting the information into layman’s terms in order to allow for page members - primarily comprised of MJ’s international fan community - a better understanding of the circumstances behind the passing of a widely beloved individual who has brought us all together through his art and kind spirit.

this endeavor was no small task, and was done so in loving appreciation of Michael.


Michael Jackson Homicide: Investigative Research
[the following introduces content within the AR released by and directly obtained from the County of Los Angeles, Department of Coroner.]

---p. 1---


CASE REPORT


CASE NUMBER: 2009-04415
APPARENT MODE: ACCIDENTAL / NATURAL
SPECIAL CIRCUMSTANCE: Celebrity, Media Interest

LAST, FIRST NAME: JACKSON, MICHAEL JOSEPH
CALIFORNIA DRIVER’S LICENSE (CDL): N8685798

ADDRESS: 100 NORTH CAROLWOOD DRIVE, LOS ANGELES, CA 90077

SEX: MALE / RACE: BLACK / D.O.B.: 8/29/1958 / AGE: 50 /HT: 69 in. / WT: 136 lbs. / EYES: BROWN / HAIR: BROWN / TEETH: ALL NATURAL / CONDITION: FAIR


SYNOPSIS

THE DECEDENT IS A 50-YEAR-OLD BLACK MALE WHO SUFFERED RESPIRATORY ARREST WHILE AT HOME UNDER THE CARE OF HIS PRIMARY PHYSICIAN. ON THE DAY OF HIS DEATH, THE DECEDENT COMPLAINED OF DEHYDRATION AND NOT BEING ABLE TO SLEEP. SEVERAL HOURS LATER, THE DECEDENT STOPPED BREATHING AND COULD NOT BE RESUSITATED. PARAMEDICS TRANSPORTED HIM TO UCLA MEDICAL CENTER, WHERE HE WAS PRONOUNCED DEAD. THE DECEDENT WAS TAKING SEVERAL PRESCRIPTION MEDICATIONS INCLUDING CLONAZEPAN, TRAZODONE, DIAZEPAM, LORAZEPAM AND FLOMAX. IT IS UNKNOWN IF HE WAS COMPLIANT WITH HIS MEDICATIONS. THE DECEDENT SUFFERED FROM VITILIGO AND HAD NO HISTORY OF HEART PROBLEMS.

[signed by Elissa J. Fleak, 6/26/2009, 04:33 – reviewed by (signature not legible) 6/26/09, 07:00]


[*do note that the statement in which was said to have been made by the decedent in regards to complaints of dehydration and not being able to sleep as the reason for the call to the primary care physician could only be verified by the primary care physician, Dr. Conrad R. Murray. (A)]


Michael Jackson Homicide: Investigative Research
---p. 2---


County of Los Angeles, Department of Coroner Investigator’s Narrative

Case Number: 2009-04415
Decedent: Jackson, Michael


Information Sources:

1. Detective W. Porche, LAPD - West Los Angeles Division
2. Detective S. Smith, LAPD – Robbery Homicide Division
3. UCLA Medical Center, medical record #397-5944


Investigation:

On 6/25/09 at 1538 hours [3:38pm], Detective W. Porche from the Los Angeles Police Department (LAPD) reported this case as an accidental vs. natural death investigation to me at 1615 [4:15pm]. I arrived at the UCLA Medical Center at 1720 hours [5:20pm], along with Assistant Chief E. Winter and Forensic Attendant A. Perez. Upon my completion of the body examination at the hospital, the decedent was transported by the Los Angeles Sheriffs Department-Air Bureau to the Coroner’s Forensic Science Center (FSC). Forensic Attendant Perez escorted the decedent’s body during transport.

Assistant Chief E. Winter and I left the hospital and went to the decedent’s residence. We arrived at the residence at 1910 hours [7:10pm] and I performed a scene investigation. We departed the scene 2020 hours [8:20pm] and returned to the FSC.


Location:

Place of death: UCLA Medical Center, 757 Westwood Plaza Drive, Los Angeles, CA 90095


Informant/Witness Statements:

The following information is preliminary and subject to change pending further investigation by the appropriate law enforcement agency. I spoke with Detective S. Smith from the LAPD and he reported that on the early morning of 6/25/09 at approximately 0100 hours [1am], the decedent placed a call to his primary physician, cardiologist, Dr. Conrad Murray. The decedent complained of being dehydrated and not being able to sleep. Dr. Murray went to the decedent’s residence and administered medical care. The details and extent of this medical care are currently unknown; thought he decedent slept for several hours and Dr. Murray was at the bedside. Around 1200 hours [12pm], Dr. Murray found that the decedent was not breathing and he pulled the decedent onto the bedroom floor and began CPR. 911 was called and paramedics responded to the house.

According to the medical record (listed above), the paramedics arrived at the home at 1220 hours [12:20pm] and found the decedent asystolic. Paramedics continued CPR and ACLS protocol including two rounds of epinephrine and atropine. The decedent was then intubated and CPR efforts continued. The decedent remained unresponsive; his pupils were fixed and dilated. Under advisement of Dr. Murray, the decedent was placed in the ambulance and transported to UCLA Medical Center. Throughout the transport, all medical orders were given by Dr. Murray.

The decedent presented asystolic to the hospital. Central lines and an intra-aortic balloon pump were placed but the decedent remained without vital signs. Dr. Cooper pronounced death at 1426 hours [2:26pm] on 6/25/09.

According to Detective S. Smith, the decedent had been undergoing daily strenuous exercise in preparation for an upcoming planned music tour, in which it would have been necessary for the decedent to be in strong physical condition. The decedent did not have a history of heart problems. He was taking several prescription medications including clonazapam, trazodone, diazepam, and Flomax but it is unknown if he was compliant.
[*the last sentence suggests that MJ was prescribed and maybe known to consume the prescription drugs mentioned, but it is UNKNOWN whether or not he was actually taking them as directed. what will be presented in the AR medical analysis (by Tima) to follow is a breakdown/calculation of the prescriptions found which would demonstrate reason to consider that MJ may not have been compliant, that is, not taking all the medication he was being prescribed – activity NOT conducive of an “addict”. (A)]
on Wednesday


Michael Jackson Homicide: Investigative Research
---p. 3---


Scene Description:

The decedent’s residence is a two-story mansion located in Bel-Air on a quiet residential street. The home is clean and well-groomed. I observed the bedroom on the second floor of the home, to the right of the top of the staircase. Reportedly, this is the bedroom where the decedent had been resting and entered cardiac arrest. His usual bedroom was down the hall.

The bedroom to the right of the staircase contained a queen size bed, numerous tables and chairs, a dresser and a television. There was also a large attached walk-in closet. The bedding was disheveled and appeared as though someone had been lying on the left side of the bed. There was a blue plastic pad lined with cotton on the left side of the fitted sheet near the center of the bed. Near the left foot of the bed, there was a string of wooden beads and a tube of toothpaste. Miscellaneous items remained on the right side of the bed including a book, laptop computer and eyeglasses. Also near the foot of the bed, there was a closed bottle of urine atop a chair.

Next to the left side of the bed, there were two tables and a tan colored sofa chair. Reportedly, the decedent’s doctor sat there. A green oxygen tank was also on this side of the bed. The decedent’s prescription medication bottles were seen on the tables with various medical supplies including a box of catheters, disposable needles and alcohol pads. Several empty orange juice bottles, a telephone and lamp were on the tables as well. An ambu-bag and latex gloves lay on the floor next to the bed.


Evidence:

I collected medical evidence from the decedent’s residence on 6/25/09; sec form 3A.


Body Examination:

I performed an external body examination at the hospital on 6/25/09. The decedent was wearing a hospital gown. The body is that of an adult Black male who appears to be approximately 50-years-old. He has brown colored eyes, natural teeth and brown hair. The decedent’s head hair is sparse and is connected to a wig. The decedent’s overall skin has patches of light and dark pigmented areas.

The ambient temperature in the hospital room was 68 degrees F at 1815 hours [6:15pm]. At 1811 hours [6:11pm], rigor mortis was not present throughout the body and lividity blanched with light pressure. Lividity was consistent with a supine position. [supine: lying on the back or with the face upward].

There was a dark black discoloration on the decedent’s upper forehead near his hair line. Dark coloration was present on the decedent’s eyebrows, eyelashes and lips. A small amount of gauze was found on the tip of his nose and an ETT [endotracheal tube], held in place with medical tape, was seen in his mouth. A red discoloration is prominent on the center of his chest.

Gauze covering a puncture wound was taped to his right neck and IV catheters were present in his left neck and bilaterally in the inguinal area [http://hernia.tripod.com/types.gif]. There was also an external urine catheter present. Additional puncture wounds were seen in his right shoulder, both arms and both ankles. There is a bruise on his left inner leg, below his knee and 4 discolored indentations were found on his lower backside.


Identification:

The body was positively identified as Michael Joseph Jackson by visual comparison to his California Driver’s License on 6/25/09.
on Wednesday


Michael Jackson Homicide: Investigative Research
---p. 4---


Next of Kin Notification:

The decedent was not married and his children are under 18 years of age. His mother, is the legal next-of-kin and was notified of the death on 6/25/09.


Tissue Donation:

The hospital record does not indicate if the decedent’s family was approached regarding donation.


Autopsy Notification:

Detectives S. Smith from the LAPD – Robbery Homicide Division requests notification of autopsy. See file for contact information.

[this document is signed by Elissa Fleak, Investigator on 6/26/09, along w/ a “supervisor” (signature not legible). (A)]
on Wednesday


Michael Jackson Homicide: Investigative Research
----------------------

AUTOPSY REPORT

- the autopsy report link provided below was cross-referenced and consistent with the copy received from the County of Los Angeles, Department of Coroner: http://images.eonline.com/static/news/pdf/MichaelJacksonCoronerReport2.8.10.pdf

- a copy of the autopsy report may be ordered from: http://coroner.lacounty.gov/htm/prfdth.htm

- for further reference, see search warrant/affidavit (also included, with notes, under MJ H:IR discussion topic: Conrad R. Murray): http://www.etonline.com/documents/cmurrayaffidavit_et.PDF]

------------------------


Michael Jackson Homicide: Investigative Research
[note: the following medical analysis in its entirety was provided and exclusively conducted by Tima (see topic: “Page Member Updates” for brief description of medical credentials/contact info)]

Legal Notice: The content of this post is original work owned by Tima. If you are interested in sharing this material, you may do so CONDITIONED you do site this page as your original source & duly inform her beforehand.



Autopsy Analysis


Case Report:

Page 1:

Written by the coroner’s investigator, Elissa Fleak, it is meant to provide a summary of the case, the condition the body was found, sources of information & anything else that pertains to coroner’s involvement & investigation of this case.

The first page hasn’t been fully filled out & is quite frankly missing some information that one would expect to see, regardless of whether you're a professional in medic/law enforcement field or just an average Joe. Anyone who has ever seen an autopsy report in their lives would be able to spot the inconsistencies.
For example on the top right hand corner of the form there’s a section that says “Crypt” & “S.C.” this refers to the tag number of the fridge crypt they keep the body in before & during the course of autopsy up to the point the body has been released to the family’s appointed mortuary. This form was completed & signed by the coroner’s investigator Elissa Fleak on 6/26/09 & then reviewed by the supervisor on the same date. It is a fact that the body was transferred to the coroner’s office on 6/25/09 [remember the infamous helicopter scene transferring the body], so by the time this report was written & signed they did have a Crypt number, as they would have put the body in a crypt fridge otherwise it would rot. [You could search the internet & would find dozens of autopsies of other high profile people floating on the internet & they all have the crypt number]

Another interesting thing is that Michael’s California driver’s license was used to identify the body, no finger printing [as far as my research shows this along with a necessary third party identification i.e. next of kin, is necessary to issue a death certificate. They could have easily compared his finger prints to their records as they did have Michael’s finger prints in the system due to the 2005 booking.] Also if you look at the first page of the case report you’ll see the section under “Identified by” is left blank, so no physical ID was done on him.
The interesting part is that it is stated that the patient was not clothes & in the course of the autopsy the medical examiner states that there were no clothing for examination, but the hospital gown. [I was just wondering how did they manage to get a naked Michael to the hospital but in the midst of the all the struggles to save him & get him to the hospital someone remembered to bring his license along to have him identified, I just find it very odd!!!]

Another important piece of information is the case report is the report number which also happens to be missing. This is a number generated automatically when a police report is made & is different than the case number (case number is coroner’s assigned, whereas the report number is assigned by the police, i.e. LAPD) Elissa Fleak, has used the information given to her by detective Smith of LAPD to write this case report, hence there must be a LAPD report number, but that seems to be missing from this report.

The description of the events preceding to the involvement of the coroner’s investigator, Elissa Fleak, is provided to her by LAPD detective S. Smith of the Robbery Homicide Division.


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 2:

Upon the arrival of the paramedics, the victim has been found ASYSTOLIC. Paramedics respond with CPR/ACLS, two rounds of epinephrine & atrophine, incubation & more CPR.

Elaboration: In medicine, asystole aka flat-line is a state of no cardiac electrical activity, hence no cardiac output or blood flow. Asystole is one of the conditions required for a medical practitioner to certify death. When a patient displays asystole, the treatment of choice is an injection of epinephrine and atropine (vasopressin may also be used) and chest compressions. In asystole, the heart will generally not respond to defibrillation because it is already depolarized. Asystole is usually a confirmation of death as opposed to a heart rhythm to be treated, although a small minority of patients are successfully resuscitated if the underlying cause is identified and treated immediately.
While the heart is asystolic, there is no blood flow to the brain unless CPR or internal cardiac massage (when the chest is opened and the heart is manually compressed) is performed. After many emergency treatments have been applied but the heart is still unresponsive, it is time to consider pronouncing the patient dead. Even in the rare case that a rhythm reappears, if asystole has persisted for fifteen minutes or more the brain will have been deprived of oxygen long enough to cause brain death, and a sign of that is fixed and dilated pupils.

It is worth mentioning that a world-renowned surgeon at the UCLA Medical Center has pioneered a way to revive people that most doctors would have long written off, including a woman whose heart had stopped for 2 & a half hours. For more information read this: http://www.msnbc.msn.com/id/31686168/ns/business-msnbc_wire_services/?ocid=twitter


ACLS Protocol: ACLS stands for Advanced Cardiac Life Support and it refers to a protocol for handling patients who are experiencing serious medical emergencies such as cardiac arrest. Here is the summary of protocol:

Step 1: Assess responsiveness (speak loudly, gently shake patient if no trauma - "Annie, Annie, are you OK?"

Step 2: perform ABCD: Airway: open airway, look, listen, & feel for breathing
Breathing: if not breathing, slowing give 2 rescue breathing / Circulation: check pulse, if pulse less begin chest compressions at 100/min, 15:2 ratio. /Defibrillation

Step 3: confirm asystole: check monitor, lead, power and change leads

Step 4: Consider bicarbonate if (hyperkalemia, bicarbonate-responsive acidosis, tricyclic OD, to alkinalize urine for aspirin OD, prolonged arrest, Not for hypercarbia-related (respiratory) acidosis, nor for routine use in cardiac arrest).

During a respiratory arrest inadequate ventilation causes retention of carbon dioxide, producing a small degree of respiratory acidosis [acidosis = abnormally high acidity of blood & body tissues] it is assumed that most patients suffering a cardiac/respiratory arrest will experience acidosis & if so it's important to reverse this effect to prevent the brain from further irreversible damage. this is done by injecting the patient with Bicarb (Bicarbonate Sodium), unless the cardiac arrest is caused by one of the following:
medication / narcotics over dose
someone who is being suffocated due to inhaling of Co2
or someone who has suffered a long arrest (>10 min)

Step 5: Transcutaneous Pacing (TCP) if used must be considered early, routine use is not necessary, it is not to be used in case of asystol

Elaboration: TCP (Transcutaneous Pacing) (also called external pacing) is a temporary means of pacing a patient's heart during a medical emergency. all EMT vehicles have this mini pace maker as part of their standard equipment. it is used when the heart rate is extremely low & it is no longer used in asystol patients. during TCP pads are placed on the patient's chest, either in the anterior/lateral position or the anterior/posterior position. The pads are then attached to a monitor/defibrillator, a heart rate is selected, and current (measured in milliamps) is increased until the an acceptable heart rate is reached & patient is transferred to the hospital. TCP can be painful to patients & it might cause burn to skin.

Step 6: Epinephrine 1 mg IV q3-5 min

Step 7: 1 mg iv q3-5 min up to 0.04mg/kg. Endotracheal tube: Give 2 to 2.5 x IV dose. (Dilute up to 10ml with normal saline). Adverse reactions: CNS toxicity: tremor, delirium. Hypo/hypertension.
Elaboration: This is basically the general dose of Epi & Atr that could be given to a patient who has suffered cardiac arrest.

there's another step that although is not the officially protocol, at some extreme cases of asystol & when the patient is not responsive to anything else is tried by the paramedic/health care professional & that is cutting the chest open & massaging the heart, this is last resort & sometimes can be the miracle in asystol cases.

Step 8: Consider termination. If patient had >10min with adequate resuscitative effort and no treatable causes present, consider cessation - it is, after all, the final rhythm.
Is it mentioned that Michael remained unresponsive to the CPR efforts and his pupils were fixed and dilated. But there’s no indication as to when the paramedics noticed his pupils. I would assume that as part of the ACLS, that’s one of the first things they check for. It is worth mentioning that fixed & dialed pupils in asystol cases is clear indication that brain death has occurred. So we’re missing a crucial timeline here, when did they notice his pupils?

It is stated that under “advisement” of doctor Murray Michael’s body was placed in the ambulance & transferred to UCLA. After looking further into the issue of hierarchy here is what I found. I have included the link to the “Medical Response on the Scene Guideline” for the state of California*, but here is a summary of the section that discusses the presence of physician on the scene:

If a bystander at an emergency scene identifies him/herself as a physician the 911 responder will work in conjunction with the physician until the arrival of paramedics.

Paramedics should give the physician a "Note to Physicians on Involvement with EMT-Is and Paramedics" card. (Available at the EMS Office or on the EMS website.) This is what the document represents:

[After identifying yourself by name as a physician licensed in the Sate of California, and, if requested, showing proof of identity, you may choose one of the following:

1. Offer your assistance with another pair of eyes, hands or suggestions, but let the life support team remain under base hospital control; or,

2. Request to talk to the base station physician and directly offer your medical advice and assistance; or,

3. Take total responsibility for the care given by the life support team and physically accompany the patient until the patient arrives at a hospital and responsibility is assumed by the receiving physician. In addition, you must sign for all instructions given in accordance with local policy and procedures. (Whenever possible, remain in contact with the base station physician)]

After determining the alternative the physician has chosen, here is the next course of action:

ALTERNATIVE #1 - If the physician on scene chooses alternative #1, the physician should assist the paramedic team or offer suggestions but allow the paramedics to provide medical
treatment according to County protocol.

ALTERNATIVE #2 or ALTERNATIVE #3 - If the physician on scene chooses alternative #2 or #3 the paramedics should ask to see the physician's medical license, unless the physician is known to the paramedics. Contact the base physician and have the physician on scene speak directly with the base physician.

*[Retrieved from: http://www.acgov.org/ems/Resource_policy_manual/Medical_personnel_on_scene.pdf]


It was mentioned by the EMT personnel that Murray administered about 2mg of Anexate aka flumazenil.

In the medical evidence listed by the coroner investigator, Elissa, an empty glass vial of flumazenil was found on the scene. Here is a little bit of information about flumazenil:

[anexate is the commercial name of two different drugs: 1-flumazenil (a benzodiazepine antagonist) 2-Mefenorex (a stimulant drug used as appetite suppresser), we know that the anexate used in the case is the 1st one, flumazenil]

Flumazenil: is an antidote for benzodiazepine overdose. Flumazenil is very effective at reversing the Central Nervous System depression (which leads to decreased rate of breathing, decreased heart rate, and loss of consciousness possibly leading to coma or death)

Propofol effects the CNS (central nervous system) & represses respiration & cardiac activity, so although the industry has not produced an antidote specifically targeted for prpofol, there are medication that can reduce the suppressive effect of propofol on CNS & hence assist in restoring normal respiration & cardiac activity.

Although the biochemistry of function of flumazenil & propofol can get very teachincal, I'll try to give you a simplified elaboration:

in the chemical formula of propofol has several of Methyl [CH3] group components (Methylethyles), to reduce it's effect, you'll need to de-Methylate the compound, meaning separate the Methyles from the propofol molecules, & one of the medications available in the market that is able to do that is flumazenil.
So although propofol doesn't have a specific antidote, flumazenil can been considered a proper antagonist for propofol's effects on the CNS.


So here is the controversy about the idea of accepting that Murray administered Anexate aka flumazenil.
Generally speaking when administering Flumazenil is completely (99%) metabolized by human blood plasma* & very little unchanged flumazenil (<1%) is found in the urine.
As mentioned above, flumazenil is metabolized through the plasma in human blood, however when a person dies, the metabolization stops immediately, this means that if flumazenil was administered too late, it would appear in his blood, because it would not have been metabolized.

So it is almost impossible to check if this medication was indeed administered, as it will not appear in blood or urine, due to the fact that the plasma of the blood metabolizes it quickly & almost completely.

so a simple blood test after death would show the unmetabolized the molecules of flumazenil. but in the autopsy report we have there's no sign of flumazenil in blood.

In the autopsy report we have there's also no trace of it in the urine, but there are some fatty acids & methylene components present in the urine that are byproduct of metabolization of flumazenil & certain other medications. But we can't be certain if those components present in his urine is produced by which medication exactly & further analysis is required.

It is mentioned that the victim was still asystolic when arrived to the hospital. It also mentioned that Central Lines & IABP (intra-aortic balloon pump) is placed, although the report is very vague as to when exactly this was done, as time plays a crucial role & these efforts are not as effective if not done soon enough.

CL (Central Line): is an intravenous line that is used for giving the patient fluids and / or medications. It may be used when the patient’s veins in the arms are difficult to access or when certain medications or nutrients need to be given that cannot be administered into the smaller veins found in the arm. It is inserted into one of the larger veins of the body. These are found in the neck (jugular vein), the front of the shoulder (subclavian vein) or the groin (femoral vein). In some patients, a CL may be inserted into the vein of the elbow and advanced into the subclavian vein, this type of catheter is known as a Peripherally Inserted Central Catheter or PICC line.

IABP (intra-aortic balloon pump): It consists of a cylindrical balloon that sits in the aorta and counter pulsates, it is used as an attempt to keep the pressure of a weak heart which is not pulsating harmonically, hence carrying oxygen to vital organs such as brain.

I have sent most of past week studying this device & have read many cardiac related journals, & I am yet to find a single study or case where they have used IABP on an asystol patient. My professors agree that using such method while so many other options are on the table is absolutely uselss & mad. It is simply useless to use IABP on an asystol patient, because the patient’s heart is not pulsating to begin with. Specially in this case where the patient has been asystol for quite a while. There’s absolutely no point in using an IABP, unless at some point they have gotten a pulse on him & tried to strengthen it by using the IABP. We (my professors & I) are all in consensus that they should have used an internal cardiac message method. Which is opening the patient’s chest & massaging the heart & aorta at the same time.

It is stated that detective Porche reported this death as accidental vs. natural, and then coroner assigns an investigator to launch the investigation & from there Elissa along with the assistant chief W. Winter spent 1 hr in the scene & collected evidence before returning to the FSC (Forensic Science Center). It is worth mentioning that contrary to other autopsy reports that I have personally view (for further information you can check out autopsyfiles.org) the report number is missing from page 1. There is a report number for this case, but seems like the investigator either has forgotten to enter it, or is not aware of it. The reason that I insist that there’s a report number, is when the hospital calls for an investigation to the death & someone of the phone or in person takes down the information, they automatically generate a 15 digit report number, which is coded to include the year, the county number & etc.


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 3:

The closed bottle of urine found fond the room. There’s no indication of what type or size of bottle it is. [coroner investigators must be thorough in their descriptions] or the color & texture of the urine, we do not know if this urine has been sent for analysis or not.

b) Green Oxygen tank, also missing the type of size, as there are many different ones with different densities available

c) Hospital room temperature : 20°C =68 F

d) It is stated that rigor mortis was not present throughout the body [so does this mean that it was present in some parts, But not everywhere?] Lividity blanches with light pressure. Lividity was consistent with a supine position (lying down with the face up).

Here is breakdown of events that happen after the heart stops:
Please note that the times given are approximate
1} The heart stops
2} The skin gets tight and grey in color
3} All the muscles relax
4} The bladder and bowels empty
. . . .4a - Men will get an erection.
5} The body's temperature will typically drop 1.5 degrees F. per hour unless outside environment is a factor. The liver is the organ that stays warmest the longest, and this temperature is used to establish time of death if the body is found within that time frame.
After 30 minutes we start seeing:
6} The skin gets purple and waxy
7} The lips, finger- and toe nails fade to a pale color or turn white as the blood leaves.
8} Blood pools at the lowest parts of the body leaving a dark purple-black stain called lividity
9} Hands and feet turn blue
10} Eyes start to sink into the skull
After 4 hours we start seeing:
11} Rigor mortis starts to set in
12} The purpling of the skin and pooling of blood continue
13} Rigor Mortis begins to tighten the muscles for about another 24 hours, then will reverse and the body will return to a limp state.
After 12 hours we start seeing:
14} The body is in full rigor mortis.
After 24 hours we start seeing:
15} The body is now the temperature of the surrounding environment
16} In males, the semen dies
17} The head and neck are now a greenish-blue color
18} The greenish-blue color continues to spread to the rest of the body
19} There is the strong smell of rotting meat
20} The face of the person is essentially no longer recognizable
Rigor mortis: is one of the recognizable signs of death that is caused by a chemical change in the muscles after death, causing the limbs of the corpse to become stiff and difficult to move or manipulate.

Lividity / PM (postmortem) Lividity: settling of the blood in the lower portion of the body, causing a purplish red discoloration of the skin. If the area blanched on pressure, it is said that lividity is not fixed & you could say that it’s more than 2 hours but less than 10 hours after death.

e) Red discoloration on the center of his chest: could be due to external heart massage & CPR

f) In his mouth there’s ETT, held in place with medical tape: Endo-Tracheal Tube is used for airway management, mechanical ventilation and as an alternative route for many drugs if an IV line cannot be established. The tube is inserted into a patient's trachea in order to ensure that the airway is not closed off and that air is able to reach the lungs. The ETT is regarded as the most reliable available method for protecting a patient's airway.

g) Gauze covering a puncture wound was taped to his right neck: this could be the way they tried to get the IABP (Intra Aortic Ballon Pump) to this thoracic aorta. Or it could be the place where Murray administered Propofol.

h) IV catheters were present on his left neck and bilaterally in ingulnar area (close to groin): this is where the Central Line is inserted. It was administered either by the EMT or at the hospital to try to get him the medications.

i) Additional puncture marks on his right shoulder, both arms, both ankles: can’t know for sure what caused them, it could be where he reiceved propofol or IV nutrients.

j) Bruise on his left inner leg, below his knee, & 4 discolored indentation on his lower back: no clue as to what might have caused these!

Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Pages 5-10: Medical Evidence

The medications are listed in alphabetical order, (Dose, Form), [Prescribing Physician], followed by a short description


Amoxicillin (500mg capsules): [Prescribed by: Dwight James/Cherilyn Lee]
Belongs to a class of antibiotics called penicillins & is a moderate antibiotic, used to treat bacterial infections. It does not kill bacteria, but they stop bacteria from multiplying. Common infections that amoxicillin is used for include infections of the middle ear, tonsils, throat, larynx (laryngitis), bronchi (bronchitis), lungs (pneumonia), urinary tract, and skin. It also is used to treat gonorrhea. Amoxicillin is rarely associated with important drug interactions. Side effects due to amoxicillin include diarrhea, dizziness, heartburn, insomnia, nausea, itching, vomiting, confusion, abdominal pain, easy bruising, bleeding, rash, and allergic reactions.

Date of issue: 2/2/09
Directions: 4 times /day = 1 every 6 hrs
Number Issued: 28
Number remaining: 21

The evidence was logged on 7/9/09, which means that Michael took the capsules for only about two days.


Aspirin: on the scene there was found a open bottle of BAYER Aspirin—over the counter purchase


Azithromycin (250mg tablets): [Prescribed by: Dwight James/Cherilyn Lee]
One of the world's best-selling antibiotics, is used to treat certain infections caused by bacteria, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, skin, and throat. It works by stopping the growth of bacteria. It will not work for colds, flu, or other viral infections. It should not be taken at the same time as aluminum- or magnesium- based antacids should not be taken at the same time as aluminum- or magnesium- based antacids. The most common side effects are diarrhea or loose stools, nausea, abdominal pain, and vomiting which may occur in fewer than one in twenty persons who receive azithromycin.

Date of Issue: 3/9/2009
Directions: 2 tables on 1st day, then 1 tablet for 4 days
Number Issued: 6
Number remaining: 2

The evidence was logged on 7/9/09, which means that Michael took the tablets for 3 days only.


Bausch & Lomb eye drops: over the counter purchase.

This evidence was logged in on 6/29/09


Benoquin (20% lotion) [no doctor names]
Benoquin Cream 20% is indicated for final depigmentation in extensive Vitiligo. It is applied topically to permanently depigment normal skin surrounding vitiliginous lesions in patients with disseminated (greater than 50 percent of body surface area) idiopathic vitiligo. It is not recommended in freckling; hyperpigmentation caused by photosensitization following the use of certain perfumes (berlock dermatitis); melasma (chloasma) of pregnancy; or hyperpigmentation resulting from inflammation of the skin. It is not effective for the treatment of cafe-au-lait spots, pigmented nevi, malignant melanoma or pigmentation resulting from pigments other than melanin. It is not a cosmetic skin bleach. Use of Benoquin Cream 20% is contraindicated in any conditions other than disseminated vitiligo.
Possible side effects are mild, transient skin irritation and sensitization. Although those reactions are usually transient, treatment should be discontinued if irritation, a burning sensation, or dermatitis occur. Depigmentation is usually accomplished after one to four months of treatment. If satisfactory results are not obtained after four months of Benoquin Cream 20% treatment, the drug should be discontinued. When the desired degree of depigmentation is obtained, the Cream should be applied only as often as needed to maintain depigmentation (usually only two times weekly).
Application direction is to apply & rub a thin layer of Benoquin Cream 20% into the pigmented area two or three times daily, or as directed by physician. Prolonged exposure to sunlight should be avoided during treatment with Benoquin Cream 20%, or a sunscreen should be used.

This evidence was logged in on 6/26/09


Ultravate Ointment: a small tube was found with no prescription directions or doctor names.
It is a corticosteroid used on the skin to reduce itching and inflammation associated with different skin conditions. It is recognized by the Lupus foundation of American as an effective treatment for Lupus rashes. Side effects (experienced mostly by Lupus sufferers) are: Skin thinning and pigment changes, superficial blood vessel formation.

This evidene was logged in on 7/9/09


Clonazepam (1mg tablets): [Prescribed by: Dr. Metzger]
It is an anti-anxiety medication in the benzodiazepine family, the same family that includes diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), flurazepam (Dalmane), and others. It is generally considered to be among the long-acting benzodiazepines. Clonazepam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits brain activity. It is believed that excessive activity in the brain may lead to anxiety or other psychiatric disorders. Clonazepam also is used to prevent certain types of seizures. It may be prescribed for Epilepsy, anxiety disorders, panic disorders, hyperrekplexia, and many forms of parasomnia.
Side effect include: Drowsiness, Impairment of cognition, judgment, or memory, Irritability and aggression, Psychomotor agitation, Lack of motivation, Loss of libido, Impaired motor function, Impaired coordination, Impaired balance, Dizziness, Diarrhea, Cognitive impairments, Increased sleepwalking (If used in treatment of sleepwalking), Auditory hallucinations, Short-term memory loss, Anterograde amnesia (common with higher doses), Some users report hangover-like symptoms of being drowsy, having a headache, being sluggish, and being irritable after waking up if the medication is taken before sleep. This is likely the result of the medication's long half-life, which continues to affect the user after waking up, as well as its disruption of the REM cycle.

Date of Issue: 4/18/2009
Directions: 1 at bedtime
Number issued: 30
Number remaining: 8

The evidence was logged on 6/26/09, which means that Michael took this medication for 22 nights.


Diazepam (10mg tables): [Prescribed by: Dr. Murray]
It is a benzodiazepine derivative drug & commonly used for treating anxiety, insomnia, seizures, muscle spasms, restless legs syndrome, obsessive compulsive disorder, alcohol withdrawal, benzodiazepine withdrawal, and Ménière's disease. It may also be used before certain medical procedures (such as endoscopies) to reduce tension and anxiety, and in some surgical procedures to induce amnesia. It possesses anxiolytic, anticonvulsant, hypnotic, sedative, skeletal muscle relaxant, and amnestic properties.
Diazepam is a core medicine in the World Health Organization's "Essential Drugs List," which is a list of minimum medical needs for a basic health care system.
Most common side effects are Somnolence, Suppression of REM sleep, Impaired motor function, Impaired coordination, Impaired balance, Dizziness and nausea, Depression, Impaired learning, Anterograde amnesia (especially pronounced in higher doses), Cognitive deficits, Reflex tachycardia. If taken with other medications, particular care should be taken with drugs that enhance the effects of diazepam, such as barbiturates, phenothiazines, narcotics and antidepressants. Diazepam does not alter the metabolism of other compounds. There is no evidence that would suggest diazepam alters its own metabolism with chronic administration. Diazepam increases the central depressive effects of alcohol, other hypnotics/sedatives (e.g., barbiturates), narcotics, and other muscle relaxants.

Date of Issue: 6/20/2009
Directions: ½ to 1 every 6 hrs
Number issued: 60
Number remaining: 57

The evidence was logged on 6/26/09, if we assume that Michael took the highest recommended dose (which is 1 every 6 hrs), then it means that Michael used the medication for 1 day only. If we assume that Michael took the lowest recommended dose (1/2 tablet every 6 hrs) then it means that Michael took this medication for maximum of 2 days (hardly an addiction, wouldn’t you say so?)


ECA Stack (no dose capsules): [no doctor names]
ECA is an acronym for a combination of three difference medications: ephedrine, caffeine and aspirin. The ECA stack is a popular drug combination, which is used as an energy booster and a fat burner to improve athletic performance and increase energy. The ECA stack is a fairly potent central nervous system (CNS) stimulant. The components work together synergistically; in other words, their combined effect is much greater than the effect of the individual components alone. The effects of the stack are: a major decrease in appetite, thermo-genesis (creation of heat), which causes the body to burn more calories; increased fat burning and muscle sparing through the stimulation of beta-receptor sites. The most serious risk factor of the ECA stack is the effect ephedrine can have on a pre-existing heart condition. It has been linked to death in people with valve damage, cardiac hypertrophy, and other heart problems. Stimulants should not be taken by anyone with a heart condition. Some of the side effects of ECA are: Insomnia, dry mouth irritability, stress, headache, dizziness, irregular heartbeat and increased thirst. Ephedrine has been linked to death causing many countries to outlaw or control it. The risk of ephedrine has caused many people to try "ephedrine free" stack formulas. There is no proof that any of these formulas are effective, but a great deal of evidence exists to support the effectiveness of the ECA stack, but with risks.

The evidence was logged on 6/29/09, there’s no indication of recommended dosage, prescribing doctor, or the initial number available in the bottle. The remaining number is however mentioned to be 14.


Flomax (0.4mg Capsules): [Prescribed by: Dr. Murray]
Flomax is the trade name for Tamsulosin. It is used to improve symptoms associated with an enlarged prostate (benign prostatic hypertrophy). It is sometimes used for the passage of kidney stones. It works by relaxing muscles in the bladder and prostate. This may improve urine flow rates and decrease urinary hesitancy/urgency. This medication should not be used to treat high blood pressure. Some of the side effects are: Dizziness, unusual weakness, drowsiness, trouble sleeping, or runny nose.

Date of Issue: 6/3/2009
Directions: 1 per day
Number issued: 30
Number remaining: 24

The evidence was logged on 6/26/09, which means that Michael took this medication for 6 days.


Flumazenil (0.5mg/ml Liquid): [no doctor names]
This medication reverses the sedative effects of certain medications, and counteracts effects of certain anesthetics. It may also be used in the treatment of drug overdose. It is however most effective when used as an antagonist against benzodiazepines. It has been found to be effective in overdoses of non-benzodiazepine sleep enhancers, although the results are mixed. Intravenous flumazenil has been shown to antagonize sedation, impairment of recall, psychomotor impairment and ventilatory depression produced by benzodiazepines. After injection of Flumazenil, the onset of action is rapid and usually effects are seen within one to two minutes, the peak effect is seen at six to ten minutes. Since many benzodiazepines have longer half-lives than flumazenil, repeat doses of flumazenil may be required to prevent recurrent symptoms of overdose.

In the medical evidence log, it is mentioned that the investigators recovered an empty glass vile of Flumazenil on 6/26/09. The investigator has also logged in on 6/29/09 4ml-5ml glass vials of Flumazenil; however there’s no indication of how many of these vials were recovered. It appears that there’s also no indication of the prescribing doctor or patient’s name of the vials.


Hydroquinone (8% Lotion): [ no doctor names]
It is used to decrease the formation of melanin in the skin. Melanin is the pigment in skin that gives it a brown color. It is sometimes used by vitiligo patients as a depigmenting agent. It is most crucial for the patients using this lotion to avoid sun exposure. Recently new lotions have been produced that offer some sun damage protection. Some of the side effects are severe burning, itching, crusting, or swelling of treated areas. Prolonged use of hydroquinone has been associated with the development of exogenous ochronosis (a persistent blue-black pigmentation), especially in African Americans (many of you might have noticed strange smudge like black marks, or very dominant blue veins on Michael’s hands, & if you were wondering what could have caused it, this medication could be a possible cause).

The evidence was logged on 6/26/09 & there’s no indication of how much of the lotion was used.


Lidocane (4% Lotion): [Prescribed by: Dr. Murray]
This cream is an anesthetic used on the skin to prevent pain. It is used before certain procedures such as inserting IV lines, skin grafts or skin laser surgery where numbing of the skin and surrounding area is necessary. Other common used of lidocane are: arthritis, carpel tunnel, joint pain, gout, migraine headaches, sun burns, bone spurs, back pain, insect stings, sore neck, tennis elbow, cold sores, tendonitis & etc. some of the common side effects are: temporary redness, tingling or lightening of the skin.


The evidence was recovered on 6/26/09 & there’s no indication of how much of the lotion was used.

[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Pages 5-10: Medical Evidence Continued

Lidocaine HCI (6-30 ml liquid): [no physician or patient name]
This drug is used in the treatment of life threatening ventricular arrhythmias (abnormal rapid heart rhythms), including those associated with heart attacks. It is also used for anesthesia, either local, regional, or general. Intravenous infusion of lidocaine can provide pain relief to patients suffering from severe internal pain due to tumors or HIV. In recent years many studies have been conducted to use Lidocaine in modern acupuncture for treatment of insomnia. By combining knowledge in modern medicine and traditional Chinese medicine, auricular points were selected for treatment of insomnia. Instead of the placement of needles, injection of small amounts of Lidocaine into these sites was employed. However these studies case are relatively new & their results have not been federally verified. Most important use of Lidocaine injection (for the purpose of this specific case) is to dilute propofol. One of propofol's most frequent side effects is pain on injection, especially in smaller veins. This pain can be mitigated by pretreatment with lidocaine. Lidocaine either mixed with propofol or preceding it as a separate injection causes destabilization of the emulsion and reduces anesthetic potency in humans. Common side effects include: lightheadedness, drowsiness, dizziness, apprehension, euphoria, tinnitus, blurred or double vision, nystagmus, vomiting, sensations of heat, cold or numbness, twitching and tremors, disorientation, confusion, psychosis, nervousness, agitation, nausea, difficulty swallowing, dyspnoea, slurred speech.

This evidence was logged in on 6/29/09.


Lorazepam (2mg tablet): [Prescribed by: Dr. Murray]
Also known as Ativan, is from the same family of benzodiazepines, & as mentioned before benzodiazepines are known for their sedative, anxiety-relieving and muscle-relaxing effects. Its best known indication is the short-term management of severe chronic anxiety. It is fast acting, and useful in treating fast onset panic anxiety. Lorazepam has strong sedative/hypnotic effects, and the duration of clinical effects from a single dose makes it an appropriate choice for the short term treatment of insomnia, particularly in the presence of severe anxiety. Among benzodiazepines, lorazepam has a relatively high addictive potential. Withdrawal symptoms, including rebound insomnia and rebound anxiety, may occur after only 7 days' administration of lorazepam. It is given before a general anaesthetic to reduce the amount of anaesthetic agent required, Oral lorazepam is given 90 to 120 minutes before procedures, and intravenous lorazepam as late as 10 minutes before procedures. The effectiveness of lorazepam in long-term use (more than 4 months), has not been assessed by systematic clinical studies. The physician should periodically reassess the usefulness of the drug for the individual patient. Any of the five intrinsic benzodiazepine effects possessed by lorazepam (sedative/hypnotic, muscle relaxant, anxiolytic, amnesic and anticonvulsant) may be considered as side-effects, if unwanted. Lorazepam's effects are dose-dependent, meaning that the higher the dose the stronger the effects (and side-effects) will be. Using the smallest dose needed to achieve desired effects lessens the risk of adverse effects.


Date of Issue: 4/28/2009
Directions: 1 at bedtime
Number issued: 30
Number remaining: 9

The evidence was logged on 6/26/09, which means Michael took this medication for 21 nights.


Aside from the above mentioned Lorazepam tables, the coroner’s investigator has recovered few injectable vials of Lorazepam from the scene:

Lorazepam (4-5ml liquid): [no physician or patient name]
It is not mentioned how many were recovered

Lorazepam (2-4ml liquid): [no physician or patient name]
It is not mentioned how many were recovered

Midazolam (5-10ml liquid): [no physician or patient name]
It is a short-acting drug in the benzodiazepine class that is used for treatment of acute seizures and for inducing sedation and amnesia before medical procedures. It is mostly used on infants and children to induce sedation. Midazolam has a fast recovery time and is the most commonly used benzodiazepine as a premedication for sedation; less commonly it is used for induction and maintenance of anesthesia. This drug is given slowly by vein (IV) or into a large muscle (IM). Intravenous midazolam has been associated with respiratory depression and respiratory arrest, especially when used for sedation in noncritical care settings. In some cases, where this was not recognized promptly and treated effectively, death or hypoxic encephalopathy has resulted. The patient receiving Midazolam must be closely & continuously monitored. Intravenous midazolam should be used only in hospital or ambulatory care settings, including physicians’ and dental offices, that provide for continuous monitoring of respiratory and cardiac function, i.e., pulse oximetry. Immediate availability of resuscitative drugs and age- and size-appropriate equipment for bag/valve/mask ventilation and intubation, and personnel trained in their use and skilled in airway management should be assured. Common side effects are: Dizziness, headache and pain or redness at the injection site, nausea and vomiting.

This evidence was logged in on 6/29/09


Prednisone (10mg tablet): [Prescribed by: Arnold Klein]
Prednisone is a synthetic hormone commonly referred to as a "cortisteroid." Prednisone is very similar to the hormone cortisone, which the body manufactures. In part, prednisone acts as an immunosuppressant. The immune system protects against foreign bacteria and viruses. It is used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, or breathing disorders. In some illnesses (such as Lupus), the immune system produces antibodies, which become overactive and cause undesirable effects. These illnesses are referred to as "autoimmune diseases". Prednisone is being considered the single most important factor in improving the outlook for lupus patients. It is a very powerful tool in the treatment of lupus, it is usually effective in bringing lupus under control and it saves lives. It specially helps those Lupus patients who are suffering Arthritis as well & is known to be one of the most effective treatments for this specific case. Side effects are: Mood swings, depression, or euphoria, Insomnia (can be lessened by taking the prednisone in the a.m.), Indigestion (can be lessened by taking prednisone with food), Increased appetite and weight gain, Susceptibility to infections, Prednisone slightly decreases resistance to infection, Fluid retention (A salt-restricted/potassium-rich diet may help reduce fluid retention.), Hyperglycemia or diabetes (prednisone elevates blood sugar), Flushing or hot flashes (usually because of an elevated blood sugar), Easy bruising of skin.

Date of Issue: 4/25/2009
Directions: 6 tablets on the issued date, 4 the next day
Number issued: 10
Number remaining: 0

The evidence was logged on 7/9/09, which means Michael did take the medication in full and as directed.


Propofol (3-100ml liquid): [no physician or patient]It is a short-acting, intravenously administered hypnotic agent. Propofol is a drug that reduces anxiety and tension, and promotes relaxation and sleep or loss of consciousness. Propofol provides loss of awareness for short diagnostic tests and surgical procedures, sleep at the beginning of surgery, and supplements other types of general anesthetics. Because it allows easy arousability and recovery shortly after the infusion stops, it is used in intensive care units, emergency rooms and other areas during minor procedures, intubation and artificial ventilation. Strict aseptic technique must always be maintained handling of this medication.
The half life of elimination (i.e. the time that takes a substance to lose half its effect) of propofol has been estimated at between 2 and 24 hours. However, its duration of clinical effect is much shorter, because propofol is rapidly distributed into peripheral tissues. When used for IV sedation, a single dose of propofol typically wears off within minutes.
Propofol is versatile; the drug can be given for short or prolonged sedation as well as for general anesthesia. Propofol is for injection into a vein. It is given by trained anesthesia professionals in a controlled environment. Propofol blood concentrations at steady state are generally proportional to infusion rates, especially in individual patients.
Undesirable effects such as cardio-respiratory depression are likely to occur at higher blood concentrations which result from bolus dosing or rapid increases in the infusion rate. An adequate interval (3 to 5 minutes) must be allowed between dose adjustments to allow for and assess the clinical effects.
When administering Propofol Emulsion by infusion, syringe or volumetric pumps are recommended to provide controlled infusion rates. Infusion rates should always be titrated downward in the absence of clinical signs of light anesthesia until a mild response to surgical stimulation is obtained in order to avoid administration of propofol at rates higher than are clinically necessary.

Later on, I will include a detailed calculation of induction & maintenance rate as introduced by FDA for adult patients less than 55 years of age.

Propofol should be prepared for use just prior to initiation of each individual anesthetic/sedative procedure. The vial syringe rubber stopper should be disinfected using 70% isopropyl alcohol. Propofol should be drawn into sterile syringes immediately after vials are opened. When withdrawing Propofol vials, a sterile vent spike should be used. The syringe(s) should be labeled with appropriate information including the date and time the vial was opened. Administration should commence promptly and be completed within 12 hours after the vials have been opened. Propofol should be prepared for single-patient use only. Any unused portions of Propofol, reservoirs, dedicated administration tubing and/or solutions containing Propofol must be discarded at the end of the anesthetic procedure or at 12 hours, whichever occurs sooner. The IV line should be flushed every 12 hours and at the end of the anesthetic procedure to remove residual Propofol Emulsion.
For general anesthesia or monitored anesthesia care (MAC) sedation Propofol should be administered only by persons trained in the administration of general anesthesia and not involved in the conduct of the surgical/diagnostic procedure. Sedated patients should be continuously monitored, and facilities for maintenance of a patent airway, providing artificial ventilation, administering supplemental oxygen, and instituting cardiovascular resuscitation must be immediately available. Patients should be continuously monitored for early signs of hypotension, apnea, airway obstruction, and/or oxygen desaturation.
These cardiorespiratory effects are more likely to occur following rapid bolus administration, especially in the elderly, debilitated, or adult patients <55 yrs of age.

Attention should be paid to minimize pain on administration of Propofol. Transient local pain can be minimized if the larger veins of the forearm or antecubital fossa are used. Pain during intravenous injection may also be reduced by prior injection of IV lidocaine (1 mL of a 1% solution).

If overdosage occurs, Propofol administration should be discontinued immediately. Overdosage is likely to cause cardiorespiratory depression. Respiratory depression should be treated by artificial ventilation with oxygen. Cardiovascular depression may require repositioning of the patient by raising the patient's legs, increasing the flow rate of intravenous fluids, and administering pressor agents and/or anticholinergic agents.
Most common side effects that occur after the patient is woken from sedation are: difficulty breathing, wheezing, swelling of the throat, fast heartbeat, palpitations, lightheadedness or fainting spells, numbness or tingling in the hands or feet, seizure (convulsion), skin rash, flushing (redness), or itching, swelling or extreme pain at the injection site, uncontrollable muscle spasm.

This evidence was logged in on 6/29/09.


Also the medical evidence log has an entry on 6/26/09 indicating recovery of an empty glass vial of propofol.


Temazepam (30mg capsules): [Prescribed by: Dr. Murray]
It is a benzodiazepine hypnotic. It is considered as a short-term (i.e. 7-10 consecutive days) insomnia therapy. Usage for more than 2-3 consecutive weeks requires complete re-evaluation of the patient. Like all other benzodiazepines, Temazepam can be abused and lead to dependence, therefore their use should be avoided in people in certain particularly high risk groups (i.e. people with a history of alcohol or drug abuse or dependence, emotionally unstable patients, people with severe personality disorders). If temazepam is indeed prescribed to people in these groups, they should generally be monitored very closely for signs of abuse and development of dependence. Some of the side effects are: Dizziness, lethargy, drowsiness, confusion, euphoria, staggering, ataxia, falling as well as infrequent paradoxical reactions (e.g. excitement, stimulation, hyperactivity, hallucinations).
Date of Issue: 12/22/2008
Directions: 1 at bedtime as needed
Number issued: 30
Number remaining: 3

This evidence was logged in on 6/26/09, which means that Michael took this medication for about 27 nights. Now this is a medication that can cause severe dependency. But as you can see Michael didn’t take all the pills & in the interval between the prescription date till the date the evidence was collected ( almost 6 months) Michael may have used this medication for only about 27 nights. Hardly the behavior of the drug addict!!!!


Tizanidine (4mg tablet): [Prescribed by: Dr. Arnold Klein]
Tizanidine also known with its brand name Zanaflex is a muscle relaxant. It is used to treat the spasms, cramping, and tightness of muscles caused by medical problems such as multiple sclerosis, spastic diplegia, back pain, or certain other injuries to the spine or central nervous system. It is also prescribed off-label for migraine headaches, as a sleep aid, and as an anticonvulsant. It is also prescribed for some symptoms of fibromyalgia. Some of the side effects associated with Zanaflex are: drowsiness, extreme tiredness, confusion, slow heartbeat, fainting, dizziness, slow or shallow breathing, loss of consciousness, weakness, nervousness, depression, vomiting, tingling sensation in the arms, legs, hands & feet, dry mouth, constipation, diarrhea, stomach pain, heartburn, rash, sweating. No alcohol should be consumed while taking this medication.

Date of Issue: 6/7/2009
Directions: 1/2 at bedtime
Number issued: 10
Number remaining: 8

This evidence was logged in on 6/26/09, which means Michael took this medication for about 4nights.


A second set of Zanaflex was entered into the evidence log on 7/9/2009, below is the details:

Zanaflex (4mg tablet): [Prescribed by: Dr. Arnold Klein]
Date of Issue: 11/6/2008
Directions: 1/2 at bedtime
Number issued: 4
Number remaining: 0


Trazadone (50mg tablet) : [Prescribed by: Dr. Metzger]
Trazodone is a psychoactive compound with sedative and anti-depressant properties. It is used to treat depressions, an off the label use of the medication is in treatment of insomnia. Some of the side effects of Trazodone are vomiting, diarrhea, nausea and tiredness.

Date of Issue: 4/18/2009
Directions: 2 at bedtime as needed
Number issued: 60
Number remaining: 38

This evidence was logged in on 6/26/09, which means Michael might have taken this medication for about 11 nights.


The following items were logged into the medical evidence data sheet on 6/26/2009:

1- One green Oxygen tank
2- A broken syringe
3- An open box of hypodermic disposable needles
4- An open box of IV catheters
5- UVA Anthelios XL Lotion (one of the best sunscreens in the world produced by LaRoche Posay laboratories)
6- Open bottle of Bayer Aspirin


The following items were logged into the medical evidence data sheet on 6/29/2009:

1- 2 blue plastic/canvas bags
2- 1 square black bag
3- 5 business cards for Dr. Conrad Murray
4- 1 IV side clamp
5- 1 blue rubber strip
6- 1 blood pressure cuff
7- 1 red stained piece of gauze (no indication whether why it’s blood or not!)
8- 1 pulse finger monitor
9- 1 bag of medical supplies including crumpled packaging


[to be continued...]

Michael Jackson Homicide: Investigative Research
Autopsy Analysis

Continued:


Attention:
1- We’re now commencing the anatomical & the actual autopsy summary; I did my best to simplify most of the material in layman’s terms to the best of my abilities.

2- I’m going to avoid repetition of some of the material that have been discussed in the previous section of the report. So if you want to have a better understanding of this current material you must read my previous posts.

3- I also would like to mention that though I have tried to avoid portraying the grueling image that an autopsy report presents, going over this type of information can exert a huge amount of emotional distress & if you think you might not be able to handle some of the very graphic mental images you might get after reading this summary, I highly recommend that you avoid it.

4- I still strongly believe that this autopsy report lack information and is far from complete. There are many regular procedures and explanations missing from this report. There are few instances that they have left substance unidentified. I will bring the controversial points to your attention as we proceed through the report.

Here is California Law on Autopsy:

The remains of deceased persons are brought to the Coroner’s Office because California State Law requires the coroner to investigate deaths of persons dying from criminal violence, by accident, by suicide, sudden unexpected deaths, (without attending physician), any suspicious or unusual manner, or when the decedent is unidentified. Not all cases that are transported to the coroner’s office are autopsied. Cases where no “foul play" is suspected and evidence of natural death is present, the coroner will decide whether an autopsy is required. California Law provides that the coroner does not need permission for an autopsy. The office of the coroner will attempt to comply with the wishes of the next-of-kin, if this does not conflict with the duties of the coroner as charged by California Law.


Pages 11-12: provides an anatomical summary which is later on expanded throughout the report. So we’re going right through the elaboration of each segment which starts from page 13.


Michael Jackson Homicide: Investigative Research
Autopsy Analysis

Continued:


Page 13:

a) External exam & remarks:


1- The body is identified by toe tag (Federal law states that all the deceased be swabbed for DNA analysis & have their information entered into the newly created DNA bank. There’s no indication of any sort of DNA test in this case.
There’s no indication of why they didn’t finger print the deceased, although this is the most common method of IDing a body especially since they had Michael’s finger prints on file. )

2- The body was refrigerated un-embalmed & there’s no indication of future embalmment & whether it is going to be done at the coroner’s or at the mortuary.

** Interesting Observation: The autopsy did not take place till 6/26/09 & as mentioned above the body was refrigerated, however on page 13, the coroner conducting the autopsy mentions presence of ETT (Endo-Tracheal Tube that they inserted in his throat to make sure the airway is open & to give him oxygen, remember the infamous ambulance picture & also look back at my previous posts on the autopsy analysis) It is absolutely BIZARRE to have the body refrigerated with the ETT still in place. because rigor mortis is going to happen & also the cold is going to stiffen the muscles & it will be hard to extract the tube. ALWAYS all the medical extensions must be removed from the body before refrigeratig it & before the rigor mortis sets in, otherwise you're jeopardizing the autopsy & it's accuracy, because you will be damaging the tissues & organs. Also the IABP (intra aortic balloon pump) & CL (central lines including IVs) are said to be still in place at the time of the autopsy. neither myself nor my professor who is a trained coroner has ever seen anything like this. this is either a typo or if they indeed leave this items in his body & refrigerated it they have compromised the accuracy of the autopsy.

3- The body weighs 136 lb = 62 Kg

4- The body’s height is 69 inches = 5.75 ft = 175.26 cm ( Michael’s height according to his driver’s license & passport is 5.9 ft = 179.83 cm )

5- Lower back has 1/4-1/2 inch (0.64-1.27 cm)pre-mortem abrasions which are thought to be caused by some sort of beads found on the deceased’s bed as shown in the scene photographs.

6- A condom catheter is present. Condom catheter sits over the penis & allows a person to empty his bladder without using a urinal, bedpan, or toilet.

7- Gauze pads are seen on the right side of the neck, both left & right antecubital fossa (triangular cavity of elbow joint where they usually draw blood from) and left forearm.

8- The central chest has an irregular abrasion of the following size: 1.1/2 x 1.1/4 inch = 3.81 x 3.18 cm. this abrasion is surrounded by a bruise of the following size: 3 x 3 inch = 7.62 x 7.62 cm (could be caused by CPR)

9- The soft tissue of the left anterior chest (left bosom) shows a 3.1/2 x 2 inch = 8.89 x 5.08 cm bruise (could be caused by CPR)

10- The soft tissue of the right anterior chest (right bosom) shows a 5 x 3.12 inch = 12.7 x 8.89 cm bruise (could be caused by CPR)

11- The sternum ( long thin bone that connect the ribs in the middle of the chest) is fractured at 3rd rib.

[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 14:

a) External exam & remarks: Continued


12- Both right & left 4th & 5th ribs are fractured at the rib junction to the sternum bone.

13- Behind both left & right ears a 3/4 inch = 1.9 cm scar is visible

14- A 3/5 inch = 1.52 cm scar on outer wall of each nostril, both right & left

15- Top of right shoulder bears an irregular scar-like area with a diameter of 4 inches = 10.16 cm

16- On the back side of the neck, right at the base, there are two visible scars, the one on the right side measures about 3 inches = 7.62 cm & the one on the left side measures about 3.3/4 inches = 9.53 cm

17- Both left & right wrist bear a scar measuring to 1/8 inch = 0.32 cm (there’s no indication whether this scar appears on the front or back side of the wrist)

18- The inside of the arm, close to the triangular cavity of the elbow joint bears a scar measuring to 1/4 inch = 0.64 cm

19- There’s a scar measuring to 7/8 inch = 2.22 cm on the muscle on the palm of the hand just beneath the thumb of the right hand.

20- Right lower quadrant (in medicine we refer to this section of human body as RLQ & it bears the following important organs in males: cecum, appendix, ascending colon, right ureter), the RLQ of the deceased bears a 2 inch = 5.08 cm surgical scar (however later on the report we notice that none of the organs in the RLQ are missing & to claim this scar as a surgical scar just seems bizarre & inaccurate.)

21- There’s a 5/8 inch = 1.6 cm scar around the navel

22- The right knee bears a semicircular scar & few other smaller scars are located at a distance from it, measuring 1/2 to 1/4 inch = 1/27 to 0.64 cm

23- The front of right leg has a 5 x 2.1/2 inch = 12.7 x 6.35 cm area of hyper-pigmentation

24- There are dark tattoos on both eyebrows, eyelids (lower & upper) and on the front half of the scalp. There is also a pink tattoo around the lips.

25- Focal de-pigmentation of skin especially over the front of the chest and abdomen, face & arms (this could be due to his vitiliago)

26- Rigor mortis (rigidity of muscles that happens after death) is present in limbs & jaw. Lividity is fixed (meaning the skin color has turned purple due to the pooling of blood after death & even after applying pressure the color stays purple which means the person has been dead for more than 10 hrs.)

27- There are no abnormalities seen on the head & it is partly covered by black hair which is short & tightly curled. The front of head has some balding.


Page 15:

a) External exam & remarks: Continued


28- The eyes are brown and the white part of the eye is free of any abnormal coloration. There’s no purple hemorrhage of the inner side of the eye lids.

29- The passage connecting the nose & the mouth is unobstructed.

30- A bandage is seen on the tip of the nose

31- It is stated that he neck is unremarkable (this is a contradiction to previous statements pointing out all the marks & scars on the neck!!!!)

32- There’s no chest deformity, both outer & inner wall of chest seem normal.

33- Penis is uncircumcised

34- The exterior & surface of the body doesn’t show any swelling or deformation or abnormality

35- It is mentioned that the body was not clothed. This is very ambiguous, as earlier in the report, when the body was in the hospital it was mentioned that the deceased was wearing a hospital gown. It is common to submit all the deceased clothing to the coroner for investigation. I doubt Michael arrived to the hospital naked & I doubt they transferred his body to the coroner’s office naked.

[to be continued...]

Michael Jackson Homicide: Investigative Research
Autopsy Analysis

***WARNING***

SKIP READING THIS POST IF YOU FEEL YOU CAN NOT STAND THINKING ABOUT INCISIONS & BLOOD, AS THIS POST PROVIDES A DESCRIPTION OF DIFFERENT INCISIONS DONE ON THE BODY TO CARRY OUT THE AUTOPSY

***************************************************

Page 15:

b) Incisions:

1- The first cut known as the 'Y' incision is made. The arms of the Y extend from the front of each shoulder to the bottom end of the breastbone. The tail of the Y extends from the sternum to the pubic bone and typically deviates to avoid the navel. The incision is very deep, extending to the rib cage on the chest, and completely through the abdominal wall below that. The skin from this cut is peeled back, with the top flap pulled over the face.

2- The ribs are then sawn off and the front of the chest wall is cut away, to expose the organs underneath. The most common way to remove the organs is known as the Rokitansky method. Organs are removed by cutting off their connections to the body and are usually removed as one.

3- The brain is removed using a transverse incision (in a crosswise direction) through the brainstem, cutting the connection from the base of the brain to the spinal cord. The brain is then either cut fresh or is placed in a 20% solution of formalin to fix it for future analysis.

4- In its fresh state the brain is very difficult to cut, so in order to make it easier for the neuropathologist to examine, the brain will be fixed in a solution of formalin for up to two weeks. Although two weeks is the optimal time to fix the brain, it can be sufficiently fixed in a shorter period in order to facilitate the return of the brain to the body prior to burial in selected cases. Should the pathologist need to retain the whole brain it would typically be discussed with the relatives of the deceased first, prior to the release of the body for the funeral. Once the study of the brain has been completed the brain would either be returned to the body, or in the case where the funeral has already taken place the pathologist will consult with the family to determine the most appropriate manner of disposing of the brain.

5- All removed organs are weighed and studied individually. Most organs are cut up in sections by a scalpel.

6- Intestines are drained in a sink to remove undigested food and feces that remains.

7- Microscopic samples of most organs are taken for further analysis & all major blood vessels are cut open and examined lengthwise.

8- After the autopsy is completed the organs are placed back in the body, and the body will sometimes be filled with a filler material. The head and body are then sewn up. The brain is returned to the body, except in the cases where the brain has been retained for further tests.


c) Neck & throat:

1- All neck & throat organs are removed all as one block along with tongue.

2- Small bruises are seen inside the lips and center of the tongue (could have been cause by CPR & insertion of ETT)

3- The lining of the passage where the nasal canal connect to the throat (that’s the place where he food usually get’s stock by going through the wrong canal) has three slightly raised nodules measuring 0.2 cm in diameter. (this could be caused by forcing the ETT down the throat, or forcing other breathing instruments down the nostrils)

4- Both hyoid bone (is a horseshoe shaped bone situated in the front midline of the neck) & larynx ( voice box) are intact & without fracture

5- All other facial & throat organs are intact & without bruising.


d) Chest & Abdominal Cavities:

1- The cavity surrounding lungs contains minimal fluid & no adhesions. [lack of adhesion means that the body hasn’t started decomposing, but lack of fluids in the cavity means that lungs are health, this is a contradiction to the respiratory & lung analysis that is given later in the report, if lungs weren’t healthy, there would be plenty of fluid in the cavity]

2- The inner lining of the chest wall is intact

3- The lungs are well expanded [this means that they can have a full inhale capacity & maximum intake oxygen, again contradiction to lung & respiratory analysis]

4- Soft tissues of the abdominal & chest wall are in good shape.

5- All the organs in the abdominal cavity are present & have the normal shape.

6- The abdominal cavity has no inflammation and no adhesion [this means that decomposition of the body hasn’t started yet]

[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 16:

e) Cardiovascular System:

1- The arteries are normal; there are no abnormalities or blockage along the aorta.

2- The heart is normal & weighs 290 grams [this is a perfect weight for heart & means that it was in great shape, studies have shown that in men, the weight of the heart increases from its median value which is about 300 grams. So Michael’s hear was in great shape]

3- All the heart chambers & its connecting blood vessels are in perfect shape


f) Respiratory System:

1- Minimal secretions are found in the upper respiratory passages (i.e. nose, oral cavity, chamber below the throat & the voice box) [this means that at the time of death the deceased was not suffering from any infections in his upper respiratory passages]

2- The lining of the area known as the voice box has suffered some bruising & undersurface bleeding. [This might have been cause by the ETT being pushed down the throat.]

3- An abnormal respiratory noise can be heard from the lungs. [the coroner tries inflating & deflating the lungs to see if the deceased was suffering any lung conditions. In this case it seems that the deceased was suffering from a long condition due to the abnormal noise made by the lungs, further analysis is done which will be discussed later]

4- There is congestion is the lungs

5- It is mentioned that the left lung weighs 1060 grams & the right lung weighs 940 grams. [This is one of the most bizarre statements made in this autopsy report. In all humans the right lung weighs more than the left lung, simply due to the position of human heart, in few cases which are very rare, some people have their heart on their right side as opposed to the left side & hence their left lung weighs more than the right one, but that is not the case for Michael. There’s no mention of it on the section anywhere on the autopsy that his heart was on his right side. So I don’t know really how to justify this outrageous statement by the coroner]

6- The thin tissue that covers the lungs looks normal & smooth & its veins are without clotting.


Page 17:

g) Gastrointestinal System:

1- The gullet (food tube) is intact throughout.

2- There is no swelling in the stomach [this is sign that there was no drug abuse, as people who abuse drugs usually suffer from distended stomach syndrome]

3- It is mentioned that the stomach contains 70 grams of dark fluid [alright why this fluid hasn’t been analyzed? What good is an autopsy if they’re going to live substances unknown & unanalyzed?!]

4- There are a few mucous hemorrhages but none of which are identified to be ulcers.

5- No tablet or capsule portions are seen in the stomach contents [very interesting comment, again this can help to establish a timeline, considering the average time each medication’s metabolism takes, but it seems that the coroner is slacking off & couldn’t be bother to look into it. I’ll attach my calculations later on]

6- Both the small intestine & the colon look good & normal inside & out.

7- After cutting open both the small intestine & colon a 2mm polyp (the kind that is attached to the tissue like a skin tag) is seen close to the rectum area. The polyp is pink in color, which means it’s not of a dangerous type.

8- The appendix is present.

9- Everything about the pancreas looks normal


h) Hepatobiliary System

1- Everything about the liver looks normal & it weighs about 1480 grams [This is the normal weight]

2- The gallbladder also looks fine, it doesn’t contain any stones. It contains about 10 grams of bile (adult human gallbladder can store up to 50 grams of bile, the amount of bile produced by liver depends on the amount of fat entering the stomach, the fattier the diet the higher the amount of bile produced)


i) Urinary System:

1- Left kidney weighs 120 grams & right kidney weighs 140 grams. [Although the numbers are well within the normal range, the issue is that in humans the left kidney is slightly bigger & heavier than the right kidney, here again we see a different pattern. Seems like the person who wrote this report had their left & right confused!]

2- The kidneys surface tissue & tract looks normal.

3- A 0.2 cm off white mass encircles the middle of the right kidney. [this kind of mass could be just fat or a renal cyst, no analysis is available here to identify which one it is.]

4- The ureters are normal

5- The bladder contains 550 grams of clear yellow-orange urine [it’s not abnormal, it could be caused by lack of certain vitamins in blood]

6- The bladder seems to be suffering from some obstruction, no further detail is provided.


j) Genital System:

1- The prostate is moderately enlarged but aside from that there are no abnormalities. This moderate enlargement is not dangerous.

2- Both testes look normal


Page 18:

k) Hemolymphatic System:

1- The spleen weighs about 110 grams & it has a normal appearance.

2- The lymph nodes in body are all small & normal [being small is a very good sign; it means that the body didn’t have any autoimmune problem, which is strange as we know Michael was suffering from Lupus. In Lupus the lymph nodes are enlarged because they have become over active.]

3- Both the bone & the bone marrow look normal.

4- There’s a 1.5 cm off white mass encircling the center of the left adrenal gland. [this could be fat or a cyst, in either case, it’s not alarming.]


l) Endocrine System:

1- Thyroid gland looks normal & weighs about 24 grams

2- The tissue from parathyroid is submitted for analysis

3- The adrenals are in perfect shape the cells are alive & haven’t suffered hemorrhage

4- Pituary gland is of normal size

5- The Thymus is not identified. [this report gets bizarre page by page, apparently the coroner was not able to find the thymus, so the dead body is missing his thymus. The thymus is a specialized organ of the immune system. In lupus patients the whole immune system becomes over active attacking the body’s tissues & organs. However in HIV AID patients the thymus will be damaged to the point that it cannot be identified in the body. Another cause for missing the thymus is a very rare birth defect called the Digeorge Syndrome, however people suffering from this syndrome have certain facial features that make that stand out, very much similar to down syndrome. We know Michael didn’t have Digeorge Syndrome, there’s no mention of the deceased body having HIV, so why is the thymus missing? I can’t find a medical explanation for it!!!!
It is worth mentioning that removal of Thymus is highly unconventional & dangerous, the only time that a surgeon might decide to remove a thymus is in infants with sever heart defects that require heart surgery, the thymus is these cases sometimes have to be removed in order to have an unobstructed access to the heart. however this is not the case in older children or adults. another very rare case that requires removal of thymus, which again I insist is very rare & it's a tough choice for a surgeon to make, is if a patient is suffering from Myasthenia gravis. Myasthenia gravis is a neuro-muscular disease leading to severe fluctuation of muscles & weakness &fatiguability. again not all the cases of Myasthenia gravis require removal of thymus. removal of thymus bears sever neurological side effects & it is a contributing factor in death of HIV patients.]

m) Head and Central Nervous System:

1- There is no hemorrhage on the surface or below the surface of the scalp

2- The skull is un-fractured in all parts.

3- All the tissues covering the brain are intact & without hemorrhage [the deceased suffered from cardiac arrest, which means his brain was left without oxygen for a good while, so there must be some hemorrhage on the interior tissue, the tissue closest to the brain, but the coroner indicates that all tissues are spotless!!!!!]

4- The brain weighs 1380 grams


n) Spinal Cord:

1- The spinal cord is not dissected


o) Neuropathology:

1- The brain was placed in formalin at the time of autopsy to be fixed, in order to undergo further examination.

2- Selected areas of the brain is preserved by the neuropathologist on 7/8/09

3- The rest of the brain was released to the mortuary on 7/8/09 [so that whole thing about the delayed burial because they didn’t have his brain is untrue, the mortuary had the brain on July 8, one day after the memorial]


Page 20:

Visual Aid:

1- 17 photographs taken at the hospital on 6/25/09

2- 13 photographs taken at the scene on 6/25/09 showing the bedroom where paramedics treated the decedent

3- 1 photograph taken at the Forensic Science center on 6/25/09

4- 61 photographs taken before & during autopsy on 6/26/09 documenting resuscitative injury & prostate enlargement whiting the urinary bladder [does this mean that they only photographed the mentioned parts & procedures & not the entire course of autopsy?!]

5- 3 photographs of a silver BMW 645 Ci taken on 6/29/09 [what does this photo do at the coroners?! This has nothing to do with the autopsy]

6- 13 photographs taken at the scene on 6/29/09 showing the dressing room with closets where additional medical evidence was collected.

7- 4 photographs of the stokes litter (it’s the kind of stretcher they use in rescue missions) from Sherriff’s Air 5 helicopter used in transporting decedent. [you have all seen the infamous body transfer footage, no body bags used, just wrapped in white sheet, no wonder they had to go back & photograph that…you just don’t transfer a dead body without a body bag! It’s a high risk, you might lose body fluids that could be crucial to the case.]

8- 5 enlarged scene photographs taken by the police are reviewed by Dr. Calmes [dr. who?!], plus some other scene photos taken by the police

9- 16 x-rays

10- Diagrams 20 & 22 [refer to the original autopsy report, I can’t post them here]


***NOTE: the witness to the autopsy is LAPD detective Smith.


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 21:

Coroner’s Final Opinion

Although we don’t have the actual toxicology report attached with this autopsy report, but the coroners have made their final opinion about the cause of death based on mostly the toxicology report. The coroner states, based on the toxicology results, high levels of propofol & benzodiazepines were found in the victim’s blood.

It is mentioned that the autopsy did not show any trauma or natural diseases which could contributed to the death.

It is decided the manner of death is “HOMICIDE”, based on the following:

a) The propofol & benzodiazepines found in victims system was administered by another & there’s no evidence for self-administration of propofol.

b) The propofol was administered outside of a hospital setting & without appropriate medical & monitoring equipment & does not meet the standard of administering the propofol

[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 22 & 23:

Pulmonary (Lungs) Pathology:

Conducted by Dr. Russell P. Sherwin, Professor of Pathology at Keck School of medicine at university of science California. the consult was completed on 7/31/09.

The pulmonary pathology report gives a brief description of the process used to stabilize lungs and preparing them to be examined.

From the examination of different layers of tissue of both lungs & their lobs, the pathologist has noticed various pigmentation & brownish discoloration. These are usually associated with people who are known to be light smokers.

There are few masses on the lower left lobe right at the base of the lung, they are not identified as cancerous but as a result of severe inflammation & hemorrhaging of the tiny blood vessels inside the mentioned lobes.


The deceased seems to have suffered from the following:

1- Diffuse congestion and patchy hemorrhage. In laymen’s terms the victim was suffering from gases & blood & other fluids being trapped in his lungs & this is a serious condition if left untreated can lead to death.

2- Marked respiratory bronchiolitis = a severe form of inflammation of the smaller airways inside the lungs, the term marked means the condition was severe & could be seen with naked eye.

3- Histiocytic desquamation = which means clusteration & separation of tissue cells inside the lungs. This is like shedding skin or having a rash but inside the lung.

4- Multifocal chronic interstitial pneumonitis = this is a long term long disease which associated with the scarring of the lungs. The symptoms of this condition are: progressive shortness of breath, and continues coughing

5- Organizing and recanalizing thromboemboli of two small arteries: what this means is that two small arteries that distribute within the lungs had experienced blockage due to clotting & therefore spontaneously reconstructs itself by forming new canals. People suffering from this condition go through severe coughing periods & sometimes cough blood.

6- Multifocal fibrocollagenous scars with or without congestion and hemorrhage = this is similar to the condition explained in number 4, but it occurs within the passages.

7- Intravascular eosinophilia with occasional interstitial eosinophilic infiltrate = this is a condition that is seen in people with chronic lung diseases and asthma. It means that the concentration of eosinophils which is a byproduct of our immune system, is very high in the area of lungs to the point that it’s causing more damage than helping cure the existing lung condition.

8- Suggestive focal desquamation of reparatory lining cells with squamous metaplasia = this is in reference to conditions 4 & 6. It means that benign (non-cancerous) changes to the lining of the respiratory system


Consultant’s Opinion

Although the consultant makes it clear that the above mentioned conditions did not play a factor in the death of the deceased, it is mentioned that the above conditions are deemed to be chronic & are serious.

I’d like to bring it to your attention that all the above mentioned conditions are very serious & labeling them as chronic means that the deceased was suffering from them for a long time. Someone with the above mentioned conditions would not be able to sing, or sing and dance at the same time & if attempted to do so he would most definitely end up in hospital suffering from serious respiration complications.

Do u think the guy who sang at the top of his lungs & danced at the same time in “This is it” could have pulled it off with all the above mentioned conditions?

It’s my true humble opinion that it’s impossible!!!! Of course you’re entitled to your own opinion.


Page 24:

Dental Consult

Dental consult is performed by Dr. Cathy Law. She mentioned that there’s a routine history of restorative dentistry & doesn’t notice anything out of place or abnormal. Apparently she has dental records from two Las Vegas dentists who performed restorative & surgical treatments. The consult was completed on 7/10/09.


Pages 25 to 27:

Neuropathology Consult

This consult is performed by Dr. John M. Andrews & is completed on 7/30/09.
The consultant uses the preliminary information presented in the first few pages of this autopsy report as his base of information for the circumstances. We have been over the first few pages & it’s no secret that the case report is not the best sources of information as it’s very incomplete & lacks a lot of information.
The consultant consults is as contradictory as the rest of the report, if not more! So please bear with me as I will try to break it down & provide it in layman’s terms.

1- The report mentions that the dura mater (which is the outer layer covering brain) is free of any discoloration or hemorrhage, also the subdural which is the layer below it is said to be clear of any lesions or hemorrhage. [This is very interesting as we thought this patient died due to cardiac arrest which means that his brain was left without Oxygen for a good while so as in all other normal human beings, we expect to see some kind of hemorrhage on any of the three layers surrounding the brain, but here is no evidence of such a thing. How how did this patient die or should I ask who does this brain belong to?]

2- Something in the report regarding the blood vessels leading to the base of the brain misled me to believe that the brain belongs to someone with SI (Situs Inversus is a condition in which a person’s organs are located in the reverse position of a normal human being) however after further investigation & go over a few case studies, I found out that the blood streams leading to the brain do not indicate that this brain belongs to a person with SI. So despite the fact that the lungs & the kidneys are definitely from someone with SI the brain belongs to a normal person.

3- It is said that some calcification are observed in the brain. Calcification can be caused by too much calcium in the blood stream but since there is no information available regarding the decedent’s diet, no formal analysis or diagnosis can be given.

4- Over all the brain looks pretty health & normal. This brain most definitely did not belong to someone with a history of drug addiction or abuse as there are no visible marks or congestion on the brain.

[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Pages 30-31:

Anesthesiology Consult

This consult is done by Dr. Selma Calmes on 8/3/2009. The first page of this consult is nothing but general & relevant information on Propofol and its administration. Please refer to my previous post on the medical evidence on general information about Propofol. On page 31, the doctor answers 3 questions pertaining to this particular case:

1- Was the standard of care for giving propofol met? [duh !!!! LMAO]

In her answer the consultant mentions that it is unknown whether medical personnel were continuously observing the decedent [this consult is dated on 8/3/09 so I think by then the consult could have been enough information about the case to know that no one was monitoring the decedent, not ever Murray LOL]. The consultant concludes that the standard of care for giving propofol was not met based on the evidences collected on the scene & statement given by the Paramedics.

2- Could the decedent have given propofol to himself?

The consultant says that the decedent could not have administered the propofol to himself, due to the position of the IV catheter found in his left leg. The injection port of the IV tubing was 13.5 cm from the tip in catheter, hence the decedent should have bent his knees sharply or sat up to be able to administer the propofol, this is an awkward position, also knowing the fact that propofol is extremely fast acting it is almost impossible for the decedent to have administered it on himself. Someone with medical knowledge or experience was required to administer the propofol otherwise sleep would not be maintained.

3- What is an anesthesiologist’s view point on the toxicology screen results? [please remember that the tox results have not been released to the public]

The consultant mentioned that the propofol levels presented on the tox report are consist with levels found in patients undergoing general anesthesia for a major surgery. A patient with this level of propofol would be intubated and ventilated by an anesthesiologist; hence any cardiac depression would be noted immediately & treated accordingly. Another point that the consults mentions is the fact that there were other long acting benzodiazepines (i.e. Lorazepam) found in the victim’s body, these accentuate & accelerate the respiratory & cardiac effects of propofol.

[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Pages 32, 33:

Radiology Consult

A whole body radiographic survey is conducted by Dr. Donald Boger on 7/2/09. Here’s a breakdown of the findings:


Dental

The skull & face radiology was used to identify any dental work done. Page 24 of the autopsy contains a dental consult carried by Dr. Cathy Law on 7/10/09. Dr. Law mentions in her consult that she has used both the dental record from two Las Vegas dentists who performed dental procedures on the decedent as well as two radiographic photos provided by the coroner. We’re not sure if the radiographic photos used for the dental consult by Dr. Law on 7/10/09 are the same ones taken & analyzed by Dr. Boger on 7/2/09. There are some inconsistencies regarding the location of dental crowns & work done in the two analysis available.[ I tried mapping the teeth using the international teeth numbering system, but I need to confirm my finding with a dentist. So I’m not going to post them yet]


Face

The nasal bones are obscured by overlaying cranial (pertaining to the skull) & facial structures [this means that nasal bones look normal…huh no mention of any changes in nasal bones & their length, so mention of any possible rhinoplasty aka nose job, changing the nasal bone structure!!!!]

It is also mentioned that the rest of the facial structure is unremarkable!!!![What about the famous cleft placed in his chin? That ought to show in the radiography photo, any outside object & implants will show in the x-rays.]

It’s also mentioned that a ETT (Endo-tracheal tube) is in place!!!!
[1st : they fail to mention whether ETT is in place in his throat or nostrils, 2nd: these photos were taken on 7/2/09, so since June 25 it did not cross anyone’s mind to pull out the ETT? Also remember that on page 13 of the autopsy report it is mentioned that ETT is present. So not only the froze the body with ETT in place, they also did the autopsy without removing it & took the radiographic pictures with ETT still in place!!! Could it get any more bizarre!!! The same applies to the IABP (intra-aortic balloon bump]

Chest

it is said that there are no visible abnormalities other than a minimal arthritis of spine at two bones towards the lower chest & above the abdomen line.
It is mentioned that a small right C7 cervical rib is present. All humans have 7 cervical bones, however the 7th bone is not associated with any ribs. Having a 7th rib extended from the 7th cervical bone is an abnormality that is either genetics or developed in a fetus due to abnormal uterus environment. Only %2 of people (1 in 500) will have this abnormality. In some cases the persons with this abnormality have a pair of ribs extending from their 7th cervical bone, but usually being suffering from this abnormality have only one single extra rib usually developed on the side opposite to their heart’s position. People with this abnormality suffer from excess pressure on the blood & never vessels that travel to the arm & neck which in turn causes pain & weakness of muscles around hand & arm & neck, they will also suffer from frequent loss of pulse in the arm which in turn leads to more pain, arm fatigue & impairment of arm’s motion.
The radiologist also mentions that the overlaying soft tissues are unremarkable.
[hmmm what about all the bruising & scars mentioned in previous pages?!]


***IMPORTANT OBSERVATION:
Nowhere in the autopsy when the coroner opened the decedent’s chest there’s a mention of a 7th rib, this is not something that would escape the eye, it’s a very rare condition & easy to spot. Also the doctor conducting the radiographic mentions that everything on the thoracic skeleton is fine, he fails to mention the fracture of the long bone that joins the ribs together (it was mentioned on page 13 that this bone was fractured at the place of the 3rd rib) also there’s no mention of the two broken ribs (it was mention of page 14 of the autopsy report that the 4th & 5th ribs were fractured). I can’t imagine how the radiologist could have missed these fractures; they are bound to show on the X-rays. Unless…..!!!![use your imagination lol]


Abdomen & Pelvis

A mild arthritis of lower back is mentioned. Also presence of the abdominal portion of the IABP (intra aortic balloon pump) as well as IV catheters in the thigh.


Arms, hands, fingers

The right arm, hand & fingers are said to be normal looking, except for the mild arthritis that’s present in the joint of index & long fingers. Some part of the forearm was not covered in the x-ray. [WHAT?!!!!]

The left arm, hand & fingers also look normal except for the moderate arthritis seen in the joint on the little finger.


Legs & feet

The legs & feet seem to be normal looking except on the arteries of both legs a thin yet long layer of calcification is seen. Artery calcification is considered a genetically inherited disease, & it’s known as a major cause of mortality in the west. It usually caused pain & swelling.
[surely someone with calcification of arteries in their legs wouldn’t be able to jump up & down the stage & dance!]
[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 34-36:

Microscopic Description

This consult is done by Dr. Christopher Rogers on 8/19/09. Interestingly enough from his point of view most of the organs are healthy looking even the lungs. In previous pages the autopsy provided a detail description of abnormalities & conditions that the lungs were afflicted with, but here the lungs seem to be healthy looking except for sign of hemorrhage due to resuscitation.
Also in the microscopic analysis of the skin the doctor claims that no scar or suture material is present [what about all the scars listed in the first few pages of the autopsy?!] so at the end of his analysis he seems to find everything is normal except for the enlarged prostate & some polyps of the colon, vitiligo & signs of resuscitation. No mention of the other conditions that were discussed earlier in the report!!!!


Pages 37-40: are graphs & pictures


Pages 41-48:

Forensic Science Laboratory Analysis Summary Report


Blood

a) Femoral (means taken from the artery in thighs) the following are detected:

1- Lidocaine (0.84 µg/ml)

2- Lorazepam (169 ng/ml)

3- Propofol (2.6 µg/ml)


b) Heart (blood extracted from heart chambers) the following are detected:

1- No alcohol was found

2- Lidocaine (0.68 µg/ml)

3- Diazepam (<0.10 µg/ml)

4- Lorazepam (162 ng/ml)

5- Midazolam (4.6 ng/ml)

6- Nordiazepam (< 0.05 µg/ml)

7- Carbon Monoxide (< 10 % saturation)

8- Propofol (3.2 µg/ml)


c) Hospital (this is referring to blood drawn in the hospital on 6/25/09 @ 13:30 hrs, the tube was labeled “Trauma, Gershwin”???)

1- Lidocaine (0.51 µg/ml)

2- Propofol (4.1 µg/ml)


Liver

1- Lidocaine (0.45 µg/ml)


Stomach Contents

1- Lidocaine (1.6 mg) [in the event that Lidocaine cream is rubbed on the stomach it's possible for the tissue to absorb it in. however it's unlikely for it to appear in the stomach contents. it might however be detected in the stomach tissue.]

2- Propofol (0.13 mg)
[unless this person was drinking propofol there's no reason propofol should be detected in the stomach contents specially since it's such a short acting agent. I believe the Forensic Lab scientists are humoring us here)


Urine (this analysis is done on approximately 450 ml of urine found in a bottle on the scene, no analysis was done on the urine extracted from the bladder!!!!!!!):

1- Lidocaine (present, no amount given)

2- Midazolam (6.8 to 25 ng/ml to )

3- Ephedrine (present, no amount given)

4- Propofol (0.15 µg/ml)


Vitreous (from the eyes)

1- Propofol (< 0.40 µg/ml)

[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 49:

Medical Evidence Analyzed by the Forensic Science Laboratory

1- Lidocaine & Propofol were detected in approximately 0.19 g of white fluid from a 10 cc syringe with plunger

2- Propofol, Lidocain, Flumazenil were detected in approximately 0.17 g of white tinted fluid from a 10 cc syringe [why was the same syringe used to administer Flumazenil & Propofol? This could affect Flumazenil’s effectiveness]

3- Propofol, Lidocain, Flumazenil were detected in approximately 0.47 g of yellow tinted fluid from a short section of IV tubing attached to a Y connector
[1st the fact that the fluid is yellow tinted is an indication of presence of a forth agent that is not mentioned here, otherwise the color of this mixture must remain milky white or off white; 2nd if Flumazenil was administered to slow down & reverse the depression of respiratory & cardiac systems, it should have administered separately & not through the same IV tubing, as it would have began interaction with the residue already present in the IV tubing before reaching the blood & it wouldn’t be as effective.]

4- No drugs were detected in approximately 17 g of clear fluid from a long section of IV tubing attached to an IV bag plug
[apparently it didn’t cross anyone’s mind in the Forensic Science Lab to analyze this clear fluid!!!]

5- No drugs were detected in approximately 0.38 of clear fluid from a 1000 cc IV bag [interestingly enough they did not analyze this “clear fluid” to identify it, so we don’t know if it’s water or what!]
[to be continued...]


Michael Jackson Homicide: Investigative Research
Autopsy Analysis


Page 51:

Hair Samples

The coroner criminalist, Jaime Lintemoot reports that on August 6 she was notified that hair sample was required by the Forensic Lab for “potential” toxicology testing.
Interestingly enough although it is mentioned that two autopsies had been carried out on the decedent, it didn’t cross anyone’s mind during the autopsy process to collect hair samples. This is very bizarre and very unlikely as hair sampling is a standard procedure that must happen at the beginning of the autopsy, otherwise due to rigor mortis & initiation of decomposition the results are not deemed to be reliable.
So on August 6, 2009 the criminalist proceeds to collect hair samples from the decedent.
[almost a month and half after death, by this time decomposition must have started & we don’t have any information on a possible embalmment & if the body was embalmed then the hair sample collected is of no use & can’t be used for toxicology testing.]

It is mentioned that an unknown dark residue is present on the natural hair. Noting about a dark residue was mentioned during the autopsy, & the criminalist fails to mention whether she collected a sample of this dark residue to be tested & identified or not.
It is also mentioned that the hair towards the middle of the head was sparse & short (as opposed to the autopsy report that says the hair towards the front of the head is sparse & short) & covered with an unknown clear adhesive material. Once again the criminalist fails to mention whether a sample of this clear material was collected for testing. I would assume that the criminalist is required to do so in order to rule out any traces of these materials from the collected specimen. It is also customary to collect the hair samples from the area close to the crown of the head where as in this case the criminalist has chosen to collect hair from the right & left temporal regions. The criminalist finalized this on 9/9/09.


Michael Jackson Homicide: Investigative Research

Autopsy Summary
For those of you who don’t feel like going over the page to page & detailed analysis that I posted on the released autopsy of Mr. Michael Joseph Jackson, here is a summary.

Disclaimer
Included in the [ ] are my own personal comments. We’re taking all the statements made in this autopsy report as “facts”. I’d like to emphasize that while facts remain the same, each individual is entitled to their own interpretation or opinion as long as they do not tend to manipulate or change the facts. So you don’t have to agree with my interpretation & analysis, but you can’t change what’s stated in the report.

1- Case report:

Written by the coroner’s investigator, Elissa Fleak, it is mean to provide a summary of the case, the condition the body was found, sources of information & anything else that pertains to coroner’s involvement & investigation of this case.
The first page hasn’t been fully filled out & is quite frankly missing some information that one would expect to see, regardless of whether you're a professional in medic/law enforcement field or just an average Joe. Anyone who has ever seen an autopsy report in their lives would be able to spot the inconsistencies.
For example on the top right hand corner of the form there’s a section that says “Crypt” & “S.C.” this refers to the tag number of the fridge crypt they keep the body in before & during the course of autopsy up to the point the body has been released to the family’s appointed mortuary. This form was completed & signed by the coroner’s investigator Elissa Fleak on 6/26/09 & then reviewed by the supervisor on the same date. It is a fact that the body was transferred to the coroner’s office on 6/25/09 [remember the infamous helicopter scene transferring the body], so by the time this report was written & signed they did have a Crypt number, as they would have put the body in a crypt fridge otherwise it would rot. [you could search the internet & would find dozens of autopsies of other high profile people floating on the internet & they all have the crypt number]
Another interesting thing is that Michael’s California driver’s license was used to identify the body, no finger printing [as far as my research shows this along with a necessary third party identification i.e. next of kin, is necessary to issue a death certificate. They could have easily compared his finger prints to their records as they did have Michael’s finger prints in the system due to the 2005 booking. Also if you look at the first page of the case report you’ll see the section under “Identified by” is left blank, so no physical ID was done on him]
The interesting part is that it is stated that the patient was not clothes & in the course of the autopsy the medical examiner states that there were no clothing for examination, but the hospital gown. [I was just wondering how did they manage to get a naked Michael to the hospital but in the midst of the all the struggles to save him & get him to the hospital someone remembered to bring his license along to have him identified, I just find it very odd!!!]

Another important piece of information is the case report is the report number which also happens to be missing. This is a number generated automatically when a police report is made & is different than the case number (case number is coroner’s assigned, whereas the report number is assigned by the police, i.e. LAPD) Elissa Fleak, has used the information given to her by detective Smith of LAPD to write this case report, hence there must be a LAPD report number, but that seems to be missing from this report.

The description of the events precede to the involvement of the coroner’s investigator, Elissa Fleak, is provided to her by LAPD detective S. Smith of the Robbery Homicide Division. It is stated that upon arrival of the paramedics on the scene at 12:26 pm, they found the victim in asystole which means the heart didn’t have any electrical or mechanical movement & is considered one of the 1st signs of death, also his pupils were fixed & dilate which means his brain was without oxygen for over 6 minutes; brain death can occur if the brain doesn’t receive oxygen for more than 10 minutes.
Dr. Murray assumed control of the victim & was issuing all the medical orders. All the CPR efforts & medication given by the paramedics were useless & the victim was not revived, & it was decided to transfer him to the hospital.
[In the light of recent revelations about Murray’s efforts in concealing information from the paramedics regarding administering propofol, I’d like to bring the following important medical fact to your attention: since the paramedics found the victim asystole it wouldn’t have made a difference what kind of medication was given to him. The unfortunate fact is that it was too late, especially with fixed & dilated pupils, there isn’t much anyone can do at this point, as the brain is dead. ]

The victim is pronounced dead at the hospital & that’s when the coroner is called in to investigate. The investigator accompanied by a detective & a forensic lab scientist, make their way to the scene to collect evidence.

2- The Medications:
The medications mostly anti-anxiety & muscle relaxers & also some lupus & vitilgo treatments.
It is worth mentioning that based on the date the medications were issued, the date they were logged into the evidence sheet, the original number issued & the remaining number, it is very obvious that Michael was not very consistent in taking his medications. Even the very addictive medications like Lorazepam were taken by Michael inconsistently, proving that Michael Jackson was most definitely NOT ADDICTED to prescription medication. People with a weakness/addiction to prescription medication, can’t wait to finish the prescribed dose & get their hand on more, sometimes running out of medication sooner than the expected grace period, however from the collected evidence it is proven beyond any doubt that Michael Jackson was not taking the medication found in his house consistently & was not showing behavior consistent with drug addicts.

Based on the Forensic Science Lab findings the medications found in his blood are partly consistent with the list that Conrad Murray gave to the investigators, for example there are no traces of Valium, Clonazepam, Trazodone or Flomax found in Michael Jackson’s blood. This is very important as the media has been trying hard to portray Michael as a drug addict, but this autopsy report is a clear proof that that image is far from the truth & Michael was anything but an addict.
It is also worth mentioning that the Propofol levels found in Michael’s body are consistent with the dosage given to adult individuals who are supposed to undergo a full anesthesia for a major surgery. That does not mean that this was a fatal dose, what has led to the death is the standard of care during administration of propofol rather than the dose given. This is a normal dose for an adult of Michael’s size to receive in order to induce sleep/anesthesia, however this medication is supposed to be administered only in a hospital setting where a patient is intubated & his heart & respiration is closely monitored. Propofol is a very short & fast acting agent, it starts taking effect as soon as it hits the blood & it will wear out quickly & that’s why the patient needs to receive it like an IV in order to maintain the anesthesia. As a result of propofol’s quick effects, cardiac & respiration depressions occur quickly & are supposed to be monitored throughout the entire time the medication is being administered. Clearly these are not the circumstances under which Conrad Murray had administered this to Michael. Also the fact that he had given Michael a few other medications that have the same effect of propofol on respiration & heart activity, is more reason to monitor Michael’s heart & breathing, as those other medications combined with propofol, although might not have formed a fatal, but could have cause rapid depression in respiration & cardiac activity & without proper monitoring device & intubation to provide necessary oxygen to the lungs, there’s no chance the patient would have survived.

3- Internal & external examinations:
A list of scars, marks or anything else that would stand out is provided. Although at times this list appears to be extremely contradictory, we don’t really have anything else to compare it to. Interestingly enough they start with a clean shaven individual & then end up with “a beard & mustache is present”. Also at the beginning of the report it is stated that the bald spot is towards the front of the head, but towards the head it seems that the coroner has changed their mind about that & has moved the bald spot towards the crown of the head!!!! Also almost a month & half after the death the coroner decides to collect hair samples for toxicology. Hair samples must be collected at the beginning of the autopsy, & stored properly as to not be tainted by the environmental effects otherwise they're no good for any sort of test. a month & half after death the body has been cut open, exposed to various chemicals, frozen & defrosted a few times & maybe embalmed so collecting hair sample even a week after the death is compromising the investigation, I can't imagine how a hair sample more than a month after the fact would help the investigation. There is no mention of any scars on, below or anywhere around his chin, we all know that Michael had a surgery & had placed a cleft in his chin. Despite appearance of some surgical scars on his abdomen, no organs are missing.
One of the most shocking revelations is about the weight of the lungs & the kidneys. Majority of humans have their heart on their left side (unless they are suffering from a very rare birth defect called Situs Inversus or in short SI, people with SI have their organs located in the opposite side) although the coroner mentions that everything about the heart looks perfectly normal & there’s no mention of the heart being located on the right side [believe me, this condition is so rare the coroner would never miss mentioning something like this in the report, it’s very important to the investigation as people with SI suffer from other side effects & complications that could have been considered as a contributing death factor. So if this body was body of someone with SI it would have been mentioned in the report]
There’s a no mention of the victim’s heart being placed on the right side rather than the left side, however strangely enough the left lung as well as the left kidney weigh more than the right ones. This could only happen if a person is suffering from SI.
Another very bizarre thing is that the coroner was not able to identify the thymus in the body. The thymus is a specialized organ of the immune system & there are only a few instances where someone would be missing the thymus : 1-birth defect called Digeorge Syndrome: people with such defect have facial features similar to people suffering from down syndrome & are easily identified [we all know Michael’s facial features didn’t indicate down or Digoerge syndromes.] 2-HIV sufferers [if this body belonged to a person with HIV, it would have been mentioned in the report as it would have effects on different organs] 3-removal of the thymus during infancy due to a necessary heart surgery. In the rare cases that an infant is suffering from a fatal heart condition, a surgeon might decide to remove the thymus in order to reach the heart; however this leaves the infant with certain neurological side effects & can lead to muscle weakness [I highly doubt that Michael had his thymus removed during infancy, that would leave him incapable of pulling off all those dance moves that made his career]

The most bizarre thing in this report however is the respiratory system analysis. It portrays the victim as someone with very weak & ill lungs. At point one might consider that these lungs belonged to a light smoker. Although it is mentioned that the condition of the lungs is not a contributing factor to the death, it is safe to say that those lungs did not belong to a person who could not only sing, but dance at the same time. The lungs are in such a condition that if this person would try to sing he would end up coughing for hours & might have needed medical attention to get rid of the cough. Singing & dancing around the stage is definitely out of question for this person [we all know that this descriptions doesn’t fit Michael Jackson, he was singing at the top of his lungs & dancing at the same time, leaving his backup dancers in awe]

Other bizarre things in this report are: presence of a 7th rib (which is an abnormality that only 1 in 500 people can have & seemed to have miraculously escaped the coroner’s eyes but the radiologist sees it! Having a 7th can cause extra pressure on the nerves of arm & neck giving it limited mobility. [We all know Michael could really use those hands, don’t we?!]
Also the fact that his brain didn’t show the tell tale signs of being deprived of oxygen, i.e. the signs & hemorrhages that a person who has died of cardiac arrest would have had are not seen on his brain.
Amazingly enough there’s propofol in his stomach, unless he was drinking that stuff there’s no explanation on how propofol would have been found in the stomach contents. Propofol is a short acting agent & it exits the body quickly so it is almost impossible for it to appear in the stomach contents!
While it is mentioned that the body belongs to someone who has vitiligo, the body doesn’t bear any of the symptoms of Lupus, the disease that we all know Michael was suffering from. The coroner states that the lymph nodes in the body are normal looking & small. Lupus sufferers have enlarged lymph nodes due to the fact that in Lupus the immune system become so over active that it starts attacking the body’s organs & tissue. We don’t see any of these symptoms in this body! [I’ll be posting a Lupus 101 to bring to light this rare but painful condition]

[Above is just a glimpse of you can see in the 51 pages of the autopsy. For more details please refer to my previous posts that addresses the autopsy page by page & in great detail. It is my personal belief that this autopsy is not the real deal. The medical contradictions are numerous & bizarre. I think this is a patch job, put together from autopsy of at least two different people, none of which was suffering from Lupus.]


Michael Jackson Homicide: Investigative Research
Lupus

Before getting into defining what Lupus is, I thought I should offer you some statistics to help you understand the different scopes of this illness & people suffering from it.

[The information for these statistics were gathered by LFA: Lupus Foundation of America]

• Approximately 1.5 million Americans have a form of lupus

• Of individuals diagnosed with lupus, 90% are women

• 80% develop lupus between the ages of 15 to 45

• Lupus is 2 to 3 times more common among people of color

• A survey from the LFA discovered that over 50% of respondents suffered for more than four years before their lupus was properly diagnosed; For most (in the same survey), it took trips to at least three doctors to get the correct diagnosis and nearly half were rightly diagnosed by a rheumatologist

• While the number of deaths attributed to lupus have been on the rise in the last 20 years, it is not known whether this represent an actual increase in mortality or just better identification and reporting of the illness.

• The survey participants cited pain (65%), lifestyle changes (61%), and emotional problems associated with lupus (50%) as the most difficult factors for coping with lupus.

• Four of ten lupus patients are treated by three or more doctors, and take six or more medications to treat symptoms of the disease

• About 5 percent of the children born to individuals with lupus will develop the illness

• 20 percent of people with lupus will have a parent or sibling who already has lupus or may develop lupus


What is Lupus?

Lupus is a chronic, autoimmune disease that can damage any part of the body (skin, joints, and/or organs inside the body). Chronic means that the signs and symptoms tend to last longer than six weeks and often for many years and in most cases for the rest of a patients’ life. In lupus, something goes wrong with your immune system, which is the part of the body that fights off viruses, bacteria, and germs ("foreign invaders," like the flu).
Normally our immune system produces proteins called antibodies that protect the body from these invaders. Autoimmune means your immune system cannot tell the difference between these foreign invaders and your body’s healthy tissues ("auto" means "self") and creates auto-antibodies that attack and destroy healthy tissue. These auto-antibodies cause inflammation, pain, and damage in various parts of the body.
Lupus is also a disease of flares (the symptoms worsen and you feel ill) and remissions (the symptoms improve and you feel better). Lupus can range from mild to life-threatening and should always be treated by a doctor. With good medical care, most people with lupus can lead a full life.
Lupus is not contagious, not even through sexual contact. You cannot "catch" lupus from someone or "give" lupus to someone.
Lupus is not like or related to cancer. Cancer is a condition of malignant, abnormal tissues that grow rapidly and spread into surrounding tissues. Lupus is an autoimmune disease, as described above.
Lupus is not like or related to HIV (Human Immune Deficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome). In HIV or AIDS the immune system is underactive; in lupus, the immune system is overactive.


What different forms of Lupus are there?

Systemic Lupus Erythematosus

Systemic lupus is the most common form of lupus, and is what most people mean when they refer to "lupus." Systemic lupus can be mild or severe. Some of the more serious complications involving major organ systems are:

• inflammation of the kidneys (lupus nephritis), which can affect the body’s ability to filter waste from the blood and can be so damaging that dialysis or kidney transplant may be needed

• an increase in blood pressure in the lungs (pulmonary hypertension)

• inflammation of the nervous system and brain, which can cause memory problems, confusion, headaches, and strokes

• inflammation in the brain’s blood vessels, which can cause high fevers, seizures, behavioral changes,

• hardening of the arteries (coronary artery disease), which is a buildup of deposits on coronary artery walls that can lead to a heart attack


Cutaneous Lupus Erythematosus

Cutaneous refers to the skin, and this form of lupus is limited to the skin also known as discoid lupus. Although there are many types of rashes and lesions (sores) caused by cutaneous lupus, the most common rash is raised, scaly and red, but not itchy. It is commonly known as a discoid rash, because the areas of rash are shaped like disks, or circles. Another common example of cutaneous lupus is a rash over the cheeks and across the bridge of the nose, known as the butterfly rash. Other rashes or sores may appear on the face, neck, or scalp (areas of the skin that are exposed to sunlight or fluorescent light), or in the mouth, nose, or vagina. Hair loss and changes in the pigment, or color, of the skin are also symptoms of cutaneous lupus.

Not everyone one who has cutaneous lupus will develop systemic lupus, only about 10 percent of people who have cutaneous lupus will develop systemic lupus. However, it is likely that these people already had systemic lupus, with the skin rash as their main symptom.

*******
It is widely known that Michael Jackson was suffering from Discoid Lupus, so I will be focusing more on this category of Lupus. Another famous person suffering from Discoid Lupus is Seal, the singer. You might have noticed the scars on his face (cheeks) those are due to his Lupus.
******


Drug-induced Lupus Erythematosus

Drug-induced lupus is a lupus-like disease caused by certain prescription drugs. The symptoms of drug-induced lupus are similar to those of systemic lupus, but only rarely will any major organs be affected.
The drugs most commonly connected with drug-induced lupus are hydralazine (used to treat high blood pressure or hypertension), procainamide (used to treat irregular heart rhythms), and isoniazid (used to treat tuberculosis). Drug-induced lupus is more common in men because they are given these drugs more often; however, not everyone who takes these drugs will develop drug-induced lupus. The lupus-like symptoms usually disappear within six months after these medications are stopped.


Neonatal Lupus

Neonatal lupus is a rare condition that affects infants of women who have lupus and is caused by antibodies from the mother acting upon the infant in the womb. At birth, the infant may have a skin rash, liver problems, or low blood cell counts, but these symptoms disappear completely after several months with no lasting effects. Some infants with neonatal lupus can also have a serious heart defect. With proper testing, physicians can now identify most at-risk mothers, and the infant can be treated at or before birth. Most infants of mothers with lupus are entirely healthy.


What causes Lupus?

Genes

No gene or group of genes has been proven to cause lupus. Lupus does, however, appear in certain families, and when one of two identical twins has lupus, there is an increased chance that the other twin will also develop the disease. These findings, as well as others, strongly suggest that genes are involved in the development of lupus. Although lupus can develop in people with no family history of lupus, there are likely to be other autoimmune diseases in some family members. Certain ethnic groups (people of African, Asian, Hispanic/Latino, Native American, Native Hawaiian, or Pacific Island descent) have a greater risk of developing lupus, which may be related to genes they have in common.


Environment

While a person’s genes may increase the chance that he or she will develop lupus, it takes some kind of environmental trigger to set off the illness or to bring on a flare. Examples include:
• ultraviolet rays from the sun
• ultraviolet rays from fluorescent light bulbs
• sulfa drugs, which make a person more sensitive to the sun
• sun-sensitizing tetracycline drugs
• penicillin or other antibiotic drugs such as: amoxicillin ; ampicillin
• an infection
• a cold or a viral illness
• exhaustion
• an injury
• emotional stress, such as a divorce, illness, death in the family, or other life complications
• anything that causes stress to the body, such as surgery, physical harm, pregnancy, or giving birth

However, many people cannot remember or identify any specific factor that occurred before they were diagnosed with lupus.


Hormones
Hormones are the body’s messengers and they regulate many of the body’s functions. In particular, the sex hormone estrogen plays a role in lupus. Men and women both produce estrogen, but estrogen production is much greater in females. Many women have more lupus symptoms before menstrual periods and/or during pregnancy, when estrogen production is high. This may indicate that estrogen somehow regulates the severity of lupus. However, it does not mean that estrogen, or any other hormone for that matter, causes lupus.


*******
We don't know Michael Jackson's full medical history & that of his family, so it's almost impossible to guess how he could have developed this illness. It could be a mixture of genes & environmental factors. We all know about his childhood & the trauma & stress he had to deal with starting at the tender age of 5; that kind of trauma & stress is known to cause many different physical complications such as juvenile diabetes & Lupus.
*******

Diagnosing Lupus

Unlike other chronic illnesses, trying to reach a diagnosis of lupus isn’t always easy. Because many symptoms of Systemic Lupus Erythematosus (SLE) mimic those of other illnesses, Lupus can be a difficult disease to diagnose. The diagnosis of Lupus is based off of a combination of physical symptoms and laboratory results and for most people is not a one time diagnosis. More often than not it is a diagnosis that evolves over time either towards more certainty that a person does or does not meet the criteria for a diagnosis of Lupus.


*******

We do know that Michael was diagnosed with Lupus around 1984, after he had the burn incident during the filming of the Pepsi commercial and by then his Vitiligo (change in pigmentation) had started to show. As mentioned in my previous post, loss of pigment is one of the side effects that could affect people who are suffering from Lupus. The de-pigmentation (aka Vitiligo) in men usually starts in upper portions of hands and groin. Vitiligo associated with Lupus is extremely aggressive and tends to affect more than 50% of the body.

I also would like to clarify that the drug-induced Lupus has nothing to do with drug abuse/addiction. Drug-induced Lupus is a direct result of an existing genetic complication that once combined with certain drugs leads to hyperactivity of the body’s immune system and Lupus. Therefore, for one to assume that Michael Jackson’s Lupus was caused by drug abuse is incorrect. Michael was diagnosed with Lupus while undergoing constructive surgery on his scalp. At that time Michael didn’t have any problems with prescription drugs and had already started developing some of the signs of Lupus, namely Vitiligo.

*******

How Lupus affects the body

Since we’re looking into Lupus in relation to Michael Jackson, I am going to concentrate on the effect of Cutaneous Lupus on body. One important thing to keep in mind while looking into Lupus is that, people suffering from Systemic Lupus will at some point in their life develop symptoms of Discoid/Cutaneous Lupus, however, the reverse is not the case. If a person with Discoid/Cutaneous Lupus develops symptoms of Systemic Lupus, then it is concluded that they had Systemic Lupus all along and the original diagnosis was wrong.

Throughout the years it has been implied by different individuals that Michael Jackson was indeed suffering from Discoid/Cutaneous Lupus. The proof of that is his signature umbrella to protect him against sun rays, his Vitiligo, and many more other minor things that I will be pointing out throughout my posts.

So here is a look at how Discoid/Cutaneous Lupus affects body:

a) The Eyes:

• Blood vessel changes in the retina -- the light-sensitive lining inside the eye
• Changes in the skin around the eyelids
• Dry eyes
• The skin lesion is well-defined, slightly raised, scaly, and malformed
• Scarring may result in deformities along the edge of the eyelids

*******

So many speculations have been made throughout the years as to why Michael Jackson was so fond of his sunglasses - it could be a fashion statement, a way to hide away from the stalking crowd, or due to the hypersensitivity of his eyes to light as a result of Lupus, or all of the above. Can you imagine working hard under those strong stage lights? It could have had a painful effect on his eyes.

Also, many of you might remember the creditor’s claim that Dr. Klein made against Michael’s estate that included a long list of procedures Michael had done, amongst which were numerous Restylane, Botox, i.m. injections. These could very well be just cosmetic procedures (let’s face it, if we had the money & resources we would have loved to get rid of our aging lines too) but it may also seem more like a treatment measure taken to deal with the side effects of Discoid Lupus. As mentioned above, this type of Lupus causes lesions and deformities around the eyes, so injecting Restylane/Botox (which is a type of filler) is very common amongst Lupus patients who can afford it. Restylane and Botox injections are usually preceded by i.m. injection (i.e. Demerol) to reduce the pain of the procedures. It is understandable for someone in Michael’s position who is constantly in front of the cameras (whether he likes it or not) to be extremely self conscious and want to correct the skin deformities that could have been very well caused by Lupus. Throughout the years, the tabloids/media have worked hard on portraying everything related to Michael Jackson as bizarre and flamboyant. I hope after reading this post, you will be able to form your own opinion and distinguish the sensationalism caused by the media from the facts that could be very well related to a painful illness called Lupus.

*******

The Skin:

Skin disease in Lupus can cause rashes or sores (lesions), most of which will appear on sun-exposed areas such as your face, ears, neck, arms, and legs. It is worth mentioning that most of these skin conditions are chronic and need to be treated by a professional dermatologist. People with Discoid Lupus usually have disk-shaped, round lesions. The sores usually appear on your scalp and face, but sometimes they will occur on other parts of body as well. The color & texture of these lesions depend on the race and skin color of the sufferer. Usually they do not hurt or itch, but over time these lesions can produce scarring and skin discoloration (darkly colored and/or lightly colored areas depending on the patient’s original skin color). Many of you might know the singer Seal - he is famous for the scars on his cheek bones. Seal is also a Lupus sufferer, whose scars are caused by Discoid Lupus.

Another effect that could be associated with Lupus, but is also recognized as a separate condition is Vitiligo induced by Lupus. Vitiligo is mostly considered a genetic illness, however, it is very common for people with Lupus to suffer from skin discoloration named Vitiligo. It is worth mentioning that if a person has the genetic defect that causes Vitiligo as well as Lupus, their Vitilgo tends to be aggressive and it will affect more than 50% of their body, usually starting from hands and groin. You can imagine that for a person like Michael Jackson who is always in the public eye, it is a big challenge dealing with the Lupus lesions and Vitiligo, especially since his Vitiligo was aggressive. So once the lesions had spread to his face and neck, the best course of action for him would be to lighten the unaffected areas in order to blend his skin color, hence the change from black to a very pale white. Many Vitiligo and Lupus sufferers indicate that if they had the financial resources, they too would use the same technique to achieve a uni-tone skin color. So although many tried to say that Michael Jackson was not proud of his race and attempted to change his color, he was simply trying to look normal despite the illness that had plagued him and his appearance.
The scars are hard to get rid of and might be managed by plastic surgery, although since Lupus is an autoimmune disease, it means that recovery from the scar tissue of such surgeries is a long and difficult ordeal.

Many might recall that whenever asked about the number of plastic surgeries done on his nose, Michael Jackson would say not more than two, and many people would think it’s an understatement since his nose had changed remarkably throughout the years. But there’s a simple explanation for it: Michael could have had only two plastic surgeries done on his nose, but due to his Lupus, the scarring from the surgery is worsened by the Lupus. So not only does his body have to deal with healing the surgery scar tissues, but also the Lupus lesions. This means that he needed to get corrective surgery to get rid of the scarring. Corrective surgery means removal of the scarred tissue and this process goes on like a chain. So while he might have had only two nose jobs, he had to go through few corrective surgeries to deal with the scarred tissue and remove them; that means that he’s losing tissue hence the shrinkage of the nose.

Discoid lesions that occur on the scalp may cause hair fall, sometime this hair loss could be permanent. This could answer the speculation of Michael Jackson using wigs/hair extensions in recent years. Discoid Lupus is not life threatening and can be managed with proper treatment. The most important thing for people with Discoid Lupus is to avoid sun exposure, and while indoors, avoid prolonged exposure to fluorescent lights. That is the main reason Michael Jackson would carry an umbrella whenever he was outdoors.


Treating Lupus

Unfortunately, Lupus doesn’t have a cure. Health professionals continue to search for better ways to care for and treat people with Lupus. For most people with Lupus, proper treatment can minimize symptoms, reduce inflammation and pain, and stop the development of serious organ damage.
Some of the common medications used to treat Discoid Lupus, its side effects, and the pain associated with them are:
• Common painkillers such as Aspirin, Tylenol, etc.
• Steroid in forms of pills and creams (Discoid cases usually use creams). In the list of medication found in Michael Jackson’s home were Prednison tablets and Ultravate Ointment - both very commonly prescribed to Lupus patients. [for detailed information refer to my previous post on the medication found on the scene]


Michael Jackson Homicide: Investigative Research
Propofol Dose Calculation:

Based on the autopsy report & the anesthesiologist consult ordered by the coroner’s office, the amount of Propofol found in Michael Jackson’s body is consistent with the amount present in patients undergoing general anesthesia for a general/major surgery. Below you can find a detailed dosage calculation as instructed by FDA. This is the exact method anesthesiologists use to calculate the amount of Propofol required to put a patient under anesthesia. It is worth mentioning that besides the patient’s medical history, his/her weight & age are deciding factors on how much anesthetic a patient might require.

a) Induction of General Anesthesia:

General anesthesia by Propofol is induced through IV injection & it usually takes a little less than a minute to achieve total unconsciousness. Patients under 55 years of age require 2 to 2.5 mg/kg of Propofol injectable emulsion whether unpremedicated or premedicated using oral benzodiazepines (i.e. Lorazepam etc). For induction, Propofol injectable emulsion should be titrated (approximately 40 mg/10 seconds) based on the patient’s response until signs of anesthesia are observed. The existence of other benzodiazepines does not affect the induction rate of Propofol, it rather affects the rate at which respiratory or cardiac depression can happen.

[This means that the combination of drugs given to Michael was not fatal, as a matter of fact it is often customary to give a patient some oral benzodiazepines (depending on their heart condition) before administering Propofol to ease anxiety & pain!!!]


b) Maintenance of General Anesthesia:

Once again in patients under 55 years of age once the anesthesia is induced, it can be maintained by administering Propofol injectable emulsion by continuous infusion or intermittent IV bolus injection (this means irregular injection of Propofol is single large doses, but this is usually not recommended as the patient could wake up in between the injections.)

[Since the goal was to achieve sleep, infusion is the way to go.]

Maintenance by infusion of Propofol injectable emulsion should immediately follow the induction dose in order to provide continuous anesthesia. During the initial period following the induction dose, higher rates of infusion are generally required (150-200 mcg/kg/min) for the first 10-15 minutes. Infusion rates should subsequently be decreased 30%-50% during the first half hour of maintenance. Generally a rate of 50-100 mcg/kg/min should be achieved in adults under 55 during maintenance.

Once again it is worth mentioning that presence of other drugs that cause CNS (central nervous system) depression & lead to respiratory depression can increase the effect Propofol has on CNS. They are not fatal together, they just cause faster depression & that’s why this anesthetic is supposed to be administered in a controlled setting where the patient can be monitored every second he/she is under anesthesia.
Let’s calculated how much Propofol needed to be administered to a man of Michael’s age & weight to keep him under continuous anesthesia:

Age: 50 yrs
Weight: 61.7 Kg

To induce anesthesia we need 2-2.5 mg/kg, so for a 61.7 kg patient we need at least 123.4 mg = 12.34 ml & at most 154.25 mg = 15.43 ml, to be safe let’s say an average of these two amounts, namely 138.83 mg = 13.88 ml of Propofol to induce anesthesia.

In order to maintain the anesthesia we need 50-100 mcg/kg/min. Although we need a higher does in the first 10-15 minutes of the maintenance process, for the purpose of simplifying our calculation & to avoid use of non-layman methods, let’s use 75 mcg/kg/min as the middle marker between the maximum & minimum doses, in order to get an average dose that is not too high or too low.

To calculate the amount needed to maintain anesthesia using the minimum dosage required:

75 mcg x 61.7 kg (weight of patient) = 4627.5

We know that (1000 mcg = 1mg ) therefore : 4627.5 / 1000 ~ 4.63

Also (1hr = 60 min) therefore: 4.63 x 60 = 277.8 mg/hr 27.78 ml/hr is the average dose required to maintain at least one hour of anesthesia.

*Note: if you were wondering how the conversion between mg & ml is done here is the explanation:
[According to FDA each vial of Propofol injectable emulsion, regardless of size, gives 10 mg of Propofol per 1 ml. Using the below formula which is used to calculate ml/hr rate for anesthesia maintenance:

Dose ordered / dose available x volume available : 277.8 / 10 x 1 = 27.78 ml / hr is required to maintain anesthesia. ]

Let’s say Michael wanted to get at least 6 hrs of sleep every night, let’s calculate how much Propofol that would require:

He’d need an average of 138.83 mg = 13.88 ml to induce anesthesia & an average of 277.8 mg/hr = 27.78 ml to maintain the anesthesia, for 6 hrs of sleep we need 1805.63 mg = 180.56 ml of Propofol for just one night!

If Michael was using Propofol as they allegedly said for 6 week prior to June 25 every night, they would need a total of 75836.46 mg = 7583.65 ml = 7.58 liters of Propofol!!!!

Miraculously the unsealed affidavit only contains information on a purchase made by Murray on May 12 for a total of 5 Propofol injectable emulsion vials, 4 of which were 100 ml & 1 was 20 ml. Based on this information we have no way of knowing whether Murray did manage to get this huge amount of Propofol or was this yet another rumor to convince the masses that the king of pop was a junkie!!! Propofol is not a controlled substance, but it’s not like gum that you could go to the store & pick up a carton full of it & not raise any suspicion; somewhere someone should have picked on the fact that this Dr. is buying way too much Propofol!

It is my personal opinion that Michael Jackson simply could not have received such huge amount of Propofol during course of 6 weeks without showing some side effects during his waking hours; he simply would not be able to do any sort of physical activity yet alone go through rigorous rehearsals & deliver. Medically speaking that is just not possible!

According to the released affidavit that lists the items found in the scene during the visits made by LAPD & the coroner’s investigators a total of 11 vials of Propofol was recovered, from which 3 were 100 ml & 8 were 20 ml, this gives us a total of 460 ml = 4600 mg of Propofol to start with.

In the warrant it is mentioned that 1 vial of the 20 ml vials as well as 1 of the 100 ml vials were empty & then 1 vial of the 20 ml was 3/4 empty; meaning that a total of 135 ml = 1350 mg of Propofol was consumed by the time the evidence was recovered.

Considering the time line given by the LAPD, the time at which Murray says he administered Propofol is marked at 10:40 am. 911 was called at 12:21 pm & they arrived at the scene at 12:26 pm.

If we assume that Murray disconnected the Propofol IV right before calling 911, that means that Michael had received Propofol for at least about 100 minutes. Using the same steps I described above it is easy to calculate that 100 minutes of anesthesia requires approximately 601.83 mg = 60.183 ml of Propofol.
Yet the empty bottles point the marker at 1350 mg =135 ml of Propofol?!

Keep in mind that the toxicology findings confirms that the amount of Propofol found in Michael’s body was equivalent to the amount required for general anesthesia, that means that there wasn’t excessive amount of Propofol in his body, therefore we can trust that our calculation are accurate. Having said that are we to believe that Murray did not get rid of the empty vials that are obviously not used on that date, as he’s supposed to, especially considering that there are minor children in the house (& we know how sensitive Michael was on shielding the kids) or are we to believe that the empty vials were left there to make this about drugs & addiction?!!!!
Also the partial Forensic lab finding that are attached to the autopsy report, as well as the anesthesiologist both point out the fact that the Propofol level were consistent with that of general anesthesia, but amazingly enough the cause of death has been said to be “acute Propofol intoxication”, how could someone have died of acute Propofol intoxication if the Propofol found in their body are within the normal levels of general anesthesia?! If they had to choose anything as cause of death, it should have been Central Nervous System failure (which controls respiration & cardiac activity) & not Propofol intoxication!


Michael Jackson Homicide: Investigative Research
the analysis below coincides with with Tima's analysis, also concluding that MJ was not an addict (see follow up comments in the link provided).

***

Was Michael an addict?

Written by Nikki Evans-Taylor and Meghan Keeler

The capacity to become physically addicted to propofol has not been firmly established by any literature. Propofol is not structurally or pharmacologically related in any way to other common anesthetics such as opioids (narcotic pain killers), barbiturates (such as phenobarbital) or benzodiazepines. Propofol has no attraction to receptors that the above drugs commonly interact within the brain--meaning that potential for abuse and/or addiction should be limited. It is actually chemically similar to vitamin E and aspirin.

A case report titled Lethal Self-Administration of Propofol (Diprivan): A Case Report and Review of the Literature states, regarding dependency "there is no evidence of tolerance", which refers to the need to increase the amount of drug to maintain a given response. An article authored by Zacny, et al. discusses the possibility that propofol might be psychologically addictive at sub-therapeutic levels in healthy volunteers. However, Dr. J. Robert Sneyd blasted this study for its use of volunteers with a history of alcohol, soft and hard drug use. Sneyd also discussed the biased reporting of the statistics. Furthermore, Jackson was well into therapeutic range and was not using sub-therapeutic doses for recreational use. Jackson was also not self-administering propofol.

Valium (diazepam) is a long-acting benzodiazepine. Ativan (lorazepam) is an intermediate-acting benzodiazepine. Versed (midazolam) is a short-acting benzodiazepine. All the benzodiazepines administered to Jackson are acceptable for the treatment of insomnia. However, other kinds benzodiazepines are typically used for insomnia, such as Restoril (temazepam) which was found among Jackson's medications though this particular medication was not taken June 25th. Concerning insomnia, even though benzodiazepines may be used, IV benzodiazepines should not have been used to treat Jackson since he could take oral medications. There was no need for IV benzodiazepines for Jackson.

There have been rumors that Jackson had an addiction to various benzodiazepines. Rumors are simply that--rumors--and there is no current proof of such an addiction thus far. Jackson had one oral benzodiazepine prescribed to him by Dr. Metzger for insomnia. Jackson had three oral benzodiazepines prescribed to him by Murray, two for insomnia and one, written days before his death, was prescribed to take throughout the day. Information from Table 3A in the autopsy report shows that Jackson did not appear to be a compliant patient--he rarely finished or took his medications as prescribed, including antibiotics which should be finished in most situations. He underutilized almost every medication he had in his possession. For those medication bottles found empty, based on the date the medications were filled at the pharmacy, it is appropriate to have found them completely used. The amount of benzodiazepines remaining and the length of time since being filled/written do not correlate with an addiction. However, Murray's benzodiazepine-prescribing was more encouraging of establishing a tolerance in his patient (with no apparent tolerance) rather than trying to prevent one from occurring.

Even though benzodiazepines do pose a physical risk of tolerance and dependence, it is not common. An excellent article to read is "Benzodiazepine Use, Abuse and Dependence" by Charles P. O'Brien M.D. Ph.D. A link to this article can be found here:

http://www.psychiatrist.com/supplenet/v66s02/v66s0205.pdf

This article highlights the differences between tolerance, dependence and abuse. This article states that benzodiazepines are rarely a primary drug of abuse and that the actual percentage of people who abuse these drugs is very low. There is a major different between someone who intentionally chooses to abuse a drug and someone who accidentally becomes tolerant or dependent from regular use. Jackson did not appear to suffer from tolerance or dependence when he died though Murray was writing prescriptions which could have easily led to a tolerance or dependence to benzodiazepines. Physicians should be at the forefront of preventing tolerance and/or dependence from occurring. Physicians should be monitoring their patients regularly for signs or symptoms of tolerance or overuse and limiting the amount of medications they prescribe to their patients. Also, Murray never mentioned a fear of Jackson becoming addicted to benzodiazepines--Murray said he feared an addiction to propofol only. Jackson reportedly slept the entire night with the use of midazolam and lorazepam and without propofol on June 23rd. This notion could also indicate Jackson had no tolerance or addiction to benzodiazepines (nor a dependence on propofol as previously discussed).

Jackson did not have any organ damage that would indicate long-term drug abuse. For example, hearing loss from chronic narcotic analgesic (ex. Oxycontin) abuse is common. Liver damage is also a common find among drug abusers since the liver is responsible for metabolizing almost all medications. It appears that chronic propofol abusers (abuse over years) may develop hepatic steatosis or a "fatty liver", possibly from the triglyceride content of propofol. Valvular heart damage from bacterial infections and/or certain kinds of skin damage/demarcations may be seen if someone injects medications regularly with needles. Jackson had none of these theoretical or common signs of abuse. It is known that Jackson used narcotic pain relievers at times. Narcotic analgesics are known to cause accidental dependence and tolerance in many patients. Even if Jackson had a tolerance issue in the past, it is important to remember that no narcotic pain relievers were found in the residence or in Jackson's body. Every medication found in Jackson's system were administered to him by Murray, under his own admittance. Even if some dependency issues arose from the treatment of pain, as Jackson admitted to a pain medication dependency in 1993, this dependency seems to have been treated appropriately as all of his organ systems were in excellent condition other than some lung issues that were minimal and not due to any form of drug abuse. Jackson was determined to have had bronchiolitis and chronic interstitial pneumonitis along with scarring in his lungs. These were likely from autoimmunity issues.

Please realize that all of the information above concludes that Jackson was not the "drug addict" the media has painted him out to be--he ended up being a victim of someone else's actions, not from personal misuse of medications. Everyone in their lifetime has at some point misused a medication, perhaps shared a medication they should not, taken a medication that may not have been necessary for an ailment, etc. That does not mean someone is an addict. In fact, Jackson was at intermittent times on very high doses of prednisone, presumably to treat his discoid lupus. This steroid critical in the treatment of immune diseases could have caused him to have appeared unusually euphoric or "high" at times. Individuals without a substantial medical background may not be aware of such effects with a medication like prednisone. Many people do not understand the basis behind drug addiction, what may lead to it, how the physical components of a drug may actually induce addiction/tolerance/dependence or how many find themselves relying on a medication just to have some sort of livelihood. By far, many who take medications in excess usually do so either from accidental tolerance/dependence formation or from inappropriate self-medication of an ailment. Perhaps they are depressed or suffering from an ailment such as fibromyalgia which then is treated with inappropriate medications or substances. Many people who find themselves using drugs and/or alcohol do so from something a physician cannot see--emotional pain. People in general should be more sympathetic to others who may or may not have a drug problem instead of seeing them as below one's self. Jackson may or may not have had some issues in the past, but it is important to remember he, too, was human. He does not appear to have any long-term damage from any sort of abuse of medications and certainly did not have any issues when he died--other than Murray being in his life.

http://www.facebook.com/note.php?note_id=389722846305&id=100000552847746

(A) thanks Inge - and, of course, Nikki Evans-Taylor and Meghan Keeler

Michael Jackson Homicide: Investigative Research

In light of the recent developments in the case of People vs Conrad Murray for the manslaughter charge, I'd like to mentions a few key points:

1- By LAW it is the defense's RIGHT to have access to all the evidence & witnesses that the prosecution is going to bring to court. The defense must be given the opportunity to cross examine the evidences & witnesses once the prosecution has determined what or who they are.

2- The cross examination of the witnesses & evidence by the defense team can be done either directly or indirectly, which leads to 3 different scenarios:

A) the defense hired experts will be able to directly examine the evidence & samples collected in testing environment different from the one used by the prosecution

B) if there's limitation in regards to amount or stability of the samples available (i.e. blood, fluid, tissue, etc.) the prosecutors & the defense will reach an agreement to have a third neutral party to carry out the tests while an expert representative of both sides, presides over the procedures.

C) If the evidence or samples are deemed government property or are of a national security nature, the tests can be carried out in a government lab, by government experts & an expert representative of the defense will preside over the proceedings.

Although to us MJ is a national (or better yet a global) treasure, but legally speaking, the samples & evidence collected in this case are not government property & don't have a national security nature, hence the defense must be allowed to have access to them & examine them in a non-bias third party facility.

3- it is PROTOCOL for the coroner's office to preserve all the collected samples & evidences in a manner that will survive the test of time. This means preserving all the chemical, tissue, fluid, etc samples in a fashion that would prevent crystallization & solidification, deterioration of the samples. The coroner's doesn't need a court order for that, because it is THE PROTOCOL in EVIDENCE COLLECTION. THEY MUST PRESERVE the samples in a way that if the case needs to be reopened they can go back & re-test the evidence! & believe it or not, we actually DO HAVE the technology to keep these sort of samples for years without anything happening to them!

As mentioned in my autopsy analysis, the coroner has done a sloppy job in collecting & testing the samples & now we're seeing the prosecution & the defense going back & forth on an issue that shouldn't even be an issue to begin with! Had they had done their job properly to begin with, we wouldn't be having this conversation & they hearing would be on its way!
I know that most of us are angry at Murray, but if we've learned anything from Mr. Michael Jackson, is that we must not let anger overshadow our best judgement & fairness & in all fairness Murray, like any other human being, deserves a fair trial, not just for his sake, but also for Mr. Michael Jackson's sake & our sake. Mr. Jackson deserves better than this, his case must be presented in a fair manner & so far the defense hasn't been given their rightful access to the evidence. We deserve to hear the truth from both sides, prosecution & defense!

RE: TIMA's CREDENTIALS (brief)

I have been contributing mostly to the "Medical notes & Medical board" discussion topic of our page & I thought I should provide you with my credentials as to give you the confidence that the information provided is well researched & has academic & professional basis.
The information and detailed analysis that I contribute is provided for the purpose of raising awareness while offering clarity and accuracy where supposition or theory exists regarding Michael Jackson's publicly known medical history and autopsy findings. Below are some of my academic/professional credentials:

Specialized Honors Bsc Biotechnology & Medical Sciences

Specialized Honors Bsc Space Engineering & Life Sciences

Research assistant with the Lupus Foundation of America

Research assistant with the Princess Margaret Cancer Center, University Health Center, Toronto West Hospital

Volunteer worker & research assistant at the Sick Kids Hospital, Toronto

Published works for various student magazines

I encourage all of you to read through my posts & I'd be more than happy to answer any questions /comments /criticism that you might have.

http://www.facebook.com/pages/Michael-Jackson-Homicide-Investigative-Research/296194732047

 

[MJ~And~Me]

Re: MJ H Investigative Research

im not reading all of that sorry :lol:can you tell me what its about in a little way :lol:

 

[kasume]

Okay, this is still kind of long, even with some points left out. But if I cut out so much, many avoidable questions are bound to arise

Basically the coroner did a sloppy job with the autopsy, and Michael was far from a drug addict. Also, there are inconsistencies in this that really NEED to be checked out. And overall, something is fishy about this report....It even contradicts that he died from cardiac arrest.

First, I will quote this from the author of the analysis, Tima. Her medical credentials are listed at the very end of the first post in this thread, and she mentions of others whom have helped her with this analysis, one being a trained coroner.

It is my personal belief that this autopsy is not the real deal. The medical contradictions are numerous & bizarre. I think this is a patch job, put together from autopsy of at least two different people, none of which was suffering from Lupus

1)

The first page hasn&#8217;t been fully filled out & is quite frankly missing some information that one would expect to see, regardless of whether you're a professional in medic/law enforcement field or just an average Joe. Anyone who has ever seen an autopsy report in their lives would be able to spot the inconsistencies.

2) Was Michael transported to the hospital naked or not?

The interesting part is that it is stated that the patient was not clothes & in the course of the autopsy the medical examiner states that there were no clothing for examination, but the hospital gown.

3) We know that Michael was asystolic. NOTHING had worked on him.

at some extreme cases of asystol & when the patient is not responsive to anything else is tried by the paramedic/health care professional & that is cutting the chest open & massaging the heart, this is last resort & sometimes can be the miracle in asystol cases.

Why did they not try that?

4)

Is it mentioned that Michael remained unresponsive to the CPR efforts and his pupils were fixed and dilated. But there&#8217;s no indication as to when the paramedics noticed his pupils. I would assume that as part of the ACLS, that&#8217;s one of the first things they check for. It is worth mentioning that fixed & dialed pupils in asystol cases is clear indication that brain death has occurred. So we&#8217;re missing a crucial timeline here, when did they notice his pupils?

5) The emergency medical technicians said Murray gave Michael 2mg of flumazenil

flumazenil can been considered a proper antagonist for propofol's effects on the CNS.

So here is the controversy about the idea of accepting that Murray administered Anexate aka flumazenil.
Generally speaking when administering Flumazenil is completely (99%) metabolized by human blood plasma* & very little unchanged flumazenil (<1%) is found in the urine.
As mentioned above, flumazenil is metabolized through the plasma in human blood, however when a person dies, the metabolization stops immediately, this means that if flumazenil was administered too late, it would appear in his blood, because it would not have been metabolized.

So it is almost impossible to check if this medication was indeed administered, as it will not appear in blood or urine, due to the fact that the plasma of the blood metabolizes it quickly & almost completely.

so a simple blood test after death would show the unmetabolized the molecules of flumazenil. but in the autopsy report we have there's no sign of flumazenil in blood.

In the autopsy report we have there's also no trace of it in the urine, but there are some fatty acids & methylene components present in the urine that are byproduct of metabolization of flumazenil & certain other medications. But we can't be certain if those components present in his urine is produced by which medication exactly & further analysis is required.

6) The way Murray administered Flumazenil would make it not so effective, also Murray is not mentioning a fourth substance that he gave.

[why was the same syringe used to administer Flumazenil & Propofol? This could affect Flumazenil&#8217;s effectiveness]

3- Propofol, Lidocain, Flumazenil were detected in approximately 0.47 g of yellow tinted fluid from a short section of IV tubing attached to a Y connector
[1st the fact that the fluid is yellow tinted is an indication of presence of a forth agent that is not mentioned here, otherwise the color of this mixture must remain milky white or off white; 2nd if Flumazenil was administered to slow down & reverse the depression of respiratory & cardiac systems, it should have administered separately & not through the same IV tubing, as it would have began interaction with the residue already present in the IV tubing before reaching the blood & it wouldn&#8217;t be as effective.]

6) Use of balloon pump useless and mad

It is mentioned that the victim was still asystolic when arrived to the hospital. It also mentioned that Central Lines & IABP (intra-aortic balloon pump) is placed, although the report is very vague as to when exactly this was done, as time plays a crucial role & these efforts are not as effective if not done soon enough.

I have sent most of past week studying this device & have read many cardiac related journals, & I am yet to find a single study or case where they have used IABP on an asystol patient. My professors agree that using such method while so many other options are on the table is absolutely uselss & mad.

We (my professors & I) are all in consensus that they should have used an internal cardiac message method. Which is opening the patient&#8217;s chest & massaging the heart & aorta at the same time.

7) Report number is not entered

There is a report number for this case, but seems like the investigator either has forgotten to enter it, or is not aware of it. The reason that I insist that there&#8217;s a report number, is when the hospital calls for an investigation to the death & someone of the phone or in person takes down the information, they automatically generate a 15 digit report number, which is coded to include the year, the county number & etc.

8) Descriptions are not thorough, substances were not tested that SHOULD have been, inconsistencies

The closed bottle of urine found fond the room. There&#8217;s no indication of what type or size of bottle it is. [coroner investigators must be thorough in their descriptions] or the color & texture of the urine, we do not know if this urine has been sent for analysis or not.

Green Oxygen tank, also missing the type of size, as there are many different ones with different densities available

3- It is mentioned that the stomach contains 70 grams of dark fluid [alright why this fluid hasn&#8217;t been analyzed? What good is an autopsy if they&#8217;re going to live substances unknown & unanalyzed?!]

31- It is stated that he neck is unremarkable (this is a contradiction to previous statements pointing out all the marks & scars on the neck!!!!)

35- It is mentioned that the body was not clothed. This is very ambiguous, as earlier in the report, when the body was in the hospital it was mentioned that the deceased was wearing a hospital gown. It is common to submit all the deceased clothing to the coroner for investigation. I doubt Michael arrived to the hospital naked & I doubt they transferred his body to the coroner&#8217;s office naked.

5- No tablet or capsule portions are seen in the stomach contents [very interesting comment, again this can help to establish a timeline, considering the average time each medication&#8217;s metabolism takes, but it seems that the coroner is slacking off & couldn&#8217;t be bother to look into it. I&#8217;ll attach my calculations later on]

4- No drugs were detected in approximately 17 g of clear fluid from a long section of IV tubing attached to an IV bag plug
[apparently it didn&#8217;t cross anyone&#8217;s mind in the Forensic Science Lab to analyze this clear fluid!!!]

5- No drugs were detected in approximately 0.38 of clear fluid from a 1000 cc IV bag [interestingly enough they did not analyze this &#8220;clear fluid&#8221; to identify it, so we don&#8217;t know if it&#8217;s water or what!]

9) Michael was NOT an addict. Period.

2- The heart is normal & weighs 290 grams [this is a perfect weight for heart & means that it was in great shape, studies have shown that in men, the weight of the heart increases from its median value which is about 300 grams. So Michael&#8217;s hear was in great shape]

2- There is no swelling in the stomach [this is sign that there was no drug abuse, as people who abuse drugs usually suffer from distended stomach syndrome]

4- Over all the brain looks pretty health & normal. This brain most definitely did not belong to someone with a history of drug addiction or abuse as there are no visible marks or congestion on the brain.

It is worth mentioning that based on the date the medications were issued, the date they were logged into the evidence sheet, the original number issued & the remaining number, it is very obvious that Michael was not very consistent in taking his medications. Even the very addictive medications like Lorazepam were taken by Michael inconsistently, proving that Michael Jackson was most definitely NOT ADDICTED to prescription medication. People with a weakness/addiction to prescription medication, can&#8217;t wait to finish the prescribed dose & get their hand on more, sometimes running out of medication sooner than the expected grace period, however from the collected evidence it is proven beyond any doubt that Michael Jackson was not taking the medication found in his house consistently & was not showing behavior consistent with drug addicts.

Based on the Forensic Science Lab findings the medications found in his blood are partly consistent with the list that Conrad Murray gave to the investigators, for example there are no traces of Valium, Clonazepam, Trazodone or Flomax found in Michael Jackson&#8217;s blood. This is very important as the media has been trying hard to portray Michael as a drug addict, but this autopsy report is a clear proof that that image is far from the truth & Michael was anything but an addict.

An article authored by Zacny, et al. discusses the possibility that propofol might be psychologically addictive at sub-therapeutic levels in healthy volunteers. However, Dr. J. Robert Sneyd blasted this study for its use of volunteers with a history of alcohol, soft and hard drug use.

Jackson had one oral benzodiazepine prescribed to him by Dr. Metzger for insomnia. Jackson had three oral benzodiazepines prescribed to him by Murray, two for insomnia and one, written days before his death, was prescribed to take throughout the day. Information from Table 3A in the autopsy report shows that Jackson did not appear to be a compliant patient--he rarely finished or took his medications as prescribed, including antibiotics which should be finished in most situations. He underutilized almost every medication he had in his possession. For those medication bottles found empty, based on the date the medications were filled at the pharmacy, it is appropriate to have found them completely used. The amount of benzodiazepines remaining and the length of time since being filled/written do not correlate with an addiction. However, Murray's benzodiazepine-prescribing was more encouraging of establishing a tolerance in his patient (with no apparent tolerance) rather than trying to prevent one from occurring.

Jackson did not appear to suffer from tolerance or dependence when he died though Murray was writing prescriptions which could have easily led to a tolerance or dependence to benzodiazepines.

Also, Murray never mentioned a fear of Jackson becoming addicted to benzodiazepines--Murray said he feared an addiction to propofol only. Jackson reportedly slept the entire night with the use of midazolam and lorazepam and without propofol on June 23rd. This notion could also indicate Jackson had no tolerance or addiction to benzodiazepines (nor a dependence on propofol as previously discussed).

Jackson did not have any organ damage that would indicate long-term drug abuse.

Info on Narcotic Pain Relievers taken in past

It is known that Jackson used narcotic pain relievers at times. Narcotic analgesics are known to cause accidental dependence and tolerance in many patients. Even if Jackson had a tolerance issue in the past, it is important to remember that no narcotic pain relievers were found in the residence or in Jackson's body. Every medication found in Jackson's system were administered to him by Murray, under his own admittance. Even if some dependency issues arose from the treatment of pain, as Jackson admitted to a pain medication dependency in 1993, this dependency seems to have been treated appropriately as all of his organ systems were in excellent condition other than some lung issues that were minimal and not due to any form of drug abuse. Jackson was determined to have had bronchiolitis and chronic interstitial pneumonitis along with scarring in his lungs.

He does not appear to have any long-term damage from any sort of abuse of medications and certainly did not have any issues when he died--other than Murray being in his life.

Attention:
From the point on, the medical analyst stated if you want to have a better understanding of this current material you must read her previous posts.

She also states, &#8220;I have tried to avoid portraying the grueling image that an autopsy report presents, going over this type of information can exert a huge amount of emotional distress & if you think you might not be able to handle some of the very graphic mental images you might get after reading this summary, I highly recommend that you avoid it.

I still strongly believe that this autopsy report lack information and is far from complete. There are many regular procedures and explanations missing from this report. There are few instances that they have left substance unidentified. I will bring the controversial points to your attention as we proceed through the report.

10) The body was refridgerated with the ETT {Endo-Tracheal Tube that they inserted in his throat to make sure the airway is open & to give him oxygen) and IABP (intra aortic balloon pump).

ALWAYS all the medical extensions must be removed from the body before refrigeratig it & before the rigor mortis sets in, otherwise you're jeopardizing the autopsy & it's accuracy, because you will be damaging the tissues & organs.

neither myself nor my professor who is a trained coroner has ever seen anything like this. this is either a typo or if they indeed leave this items in his body & refrigerated it they have compromised the accuracy of the autopsy.

[1st : they fail to mention whether ETT is in place in his throat or nostrils, 2nd: these photos were taken on 7/2/09, so since June 25 it did not cross anyone&#8217;s mind to pull out the ETT? Also remember that on page 13 of the autopsy report it is mentioned that ETT is present. So not only the froze the body with ETT in place, they also did the autopsy without removing it & took the radiographic pictures with ETT still in place!!! Could it get any more bizarre!!! The same applies to the IABP (intra-aortic balloon bump]

***WARNING***

SKIP READING THIS POST IF YOU FEEL YOU CAN NOT STAND THINKING ABOUT INCISIONS & BLOOD, AS THIS POST PROVIDES A DESCRIPTION OF DIFFERENT INCISIONS DONE ON THE BODY TO CARRY OUT THE AUTOPSY

***************************************************

11) Contradiction of respiratory and lung analysis

1- The cavity surrounding lungs contains minimal fluid & no adhesions. [lack of adhesion means that the body hasn&#8217;t started decomposing, but lack of fluids in the cavity means that lungs are health, this is a contradiction to the respiratory & lung analysis that is given later in the report, if lungs weren&#8217;t healthy, there would be plenty of fluid in the cavity]

3- The lungs are well expanded [this means that they can have a full inhale capacity & maximum intake oxygen, again contradiction to lung & respiratory analysis]

12)

3- An abnormal respiratory noise can be heard from the lungs. [the coroner tries inflating & deflating the lungs to see if the deceased was suffering any lung conditions. In this case it seems that the deceased was suffering from a long condition due to the abnormal noise made by the lungs, further analysis is done which will be discussed later]

12) Lupus contradiction

2- The lymph nodes in body are all small & normal [being small is a very good sign; it means that the body didn&#8217;t have any autoimmune problem, which is strange as we know Michael was suffering from Lupus. In Lupus the lymph nodes are enlarged because they have become over active.]

13) Thymus was not identified???

[this report gets bizarre page by page, apparently the coroner was not able to find the thymus, so the dead body is missing his thymus. The thymus is a specialized organ of the immune system. In lupus patients the whole immune system becomes over active attacking the body&#8217;s tissues & organs. However in HIV AID patients the thymus will be damaged to the point that it cannot be identified in the body. Another cause for missing the thymus is a very rare birth defect called the Digeorge Syndrome, however people suffering from this syndrome have certain facial features that make that stand out, very much similar to down syndrome. We know Michael didn&#8217;t have Digeorge Syndrome, there&#8217;s no mention of the deceased body having HIV, so why is the thymus missing? I can&#8217;t find a medical explanation for it!!!!
It is worth mentioning that removal of Thymus is highly unconventional & dangerous, the only time that a surgeon might decide to remove a thymus is in infants with sever heart defects that require heart surgery, the thymus is these cases sometimes have to be removed in order to have an unobstructed access to the heart. however this is not the case in older children or adults. another very rare case that requires removal of thymus, which again I insist is very rare & it's a tough choice for a surgeon to make, is if a patient is suffering from Myasthenia gravis. Myasthenia gravis is a neuro-muscular disease leading to severe fluctuation of muscles & weakness &fatiguability. again not all the cases of Myasthenia gravis require removal of thymus. removal of thymus bears sever neurological side effects & it is a contributing factor in death of HIV patients.]

14) Cardiac arrest contradiction

3- All the tissues covering the brain are intact & without hemorrhage [the deceased suffered from cardiac arrest, which means his brain was left without oxygen for a good while, so there must be some hemorrhage on the interior tissue, the tissue closest to the brain, but the coroner indicates that all tissues are spotless!!!!!]

The report mentions that the dura mater (which is the outer layer covering brain) is free of any discoloration or hemorrhage, also the subdural which is the layer below it is said to be clear of any lesions or hemorrhage. [This is very interesting as we thought this patient died due to cardiac arrest which means that his brain was left without Oxygen for a good while so as in all other normal human beings, we expect to see some kind of hemorrhage on any of the three layers surrounding the brain, but here is no evidence of such a thing. How how did this patient die or should I ask who does this brain belong to?]

15) Photographs

4- 61 photographs taken before & during autopsy on 6/26/09 documenting resuscitative injury & prostate enlargement whiting the urinary bladder [does this mean that they only photographed the mentioned parts & procedures & not the entire course of autopsy?!]

5- 3 photographs of a silver BMW 645 Ci taken on 6/29/09 [what does this photo do at the coroners?! This has nothing to do with the autopsy]

16)

The deceased seems to have suffered from the following:

1- Diffuse congestion and patchy hemorrhage. In laymen&#8217;s terms the victim was suffering from gases & blood & other fluids being trapped in his lungs & this is a serious condition if left untreated can lead to death.

2- Marked respiratory bronchiolitis = a severe form of inflammation of the smaller airways inside the lungs, the term marked means the condition was severe & could be seen with naked eye.

3- Histiocytic desquamation = which means clusteration & separation of tissue cells inside the lungs. This is like shedding skin or having a rash but inside the lung.

4- Multifocal chronic interstitial pneumonitis = this is a long term long disease which associated with the scarring of the lungs. The symptoms of this condition are: progressive shortness of breath, and continues coughing

5- Organizing and recanalizing thromboemboli of two small arteries: what this means is that two small arteries that distribute within the lungs had experienced blockage due to clotting & therefore spontaneously reconstructs itself by forming new canals. People suffering from this condition go through severe coughing periods & sometimes cough blood.

6- Multifocal fibrocollagenous scars with or without congestion and hemorrhage = this is similar to the condition explained in number 4, but it occurs within the passages.

7- Intravascular eosinophilia with occasional interstitial eosinophilic infiltrate = this is a condition that is seen in people with chronic lung diseases and asthma. It means that the concentration of eosinophils which is a byproduct of our immune system, is very high in the area of lungs to the point that it&#8217;s causing more damage than helping cure the existing lung condition.

8- Suggestive focal desquamation of reparatory lining cells with squamous metaplasia = this is in reference to conditions 4 & 6. It means that benign (non-cancerous) changes to the lining of the respiratory system

17) Consultant&#8217;s opinion &#8211; Michael would not be able to sing and dance.

Although the consultant makes it clear that the above mentioned conditions did not play a factor in the death of the deceased, it is mentioned that the above conditions are deemed to be chronic & are serious.

I&#8217;d like to bring it to your attention that all the above mentioned conditions are very serious & labeling them as chronic means that the deceased was suffering from them for a long time. Someone with the above mentioned conditions would not be able to sing, or sing and dance at the same time & if attempted to do so he would most definitely end up in hospital suffering from serious respiration complications.

18) 7th rib

***IMPORTANT OBSERVATION:
Nowhere in the autopsy when the coroner opened the decedent&#8217;s chest there&#8217;s a mention of a 7th rib, this is not something that would escape the eye, it&#8217;s a very rare condition & easy to spot. Also the doctor conducting the radiographic mentions that everything on the thoracic skeleton is fine, he fails to mention the fracture of the long bone that joins the ribs together (it was mentioned on page 13 that this bone was fractured at the place of the 3rd rib) also there&#8217;s no mention of the two broken ribs (it was mention of page 14 of the autopsy report that the 4th & 5th ribs were fractured). I can&#8217;t imagine how the radiologist could have missed these fractures; they are bound to show on the X-rays.

19) Michael couldn&#8217;t be able to dance due to artery calcification.

The legs & feet seem to be normal looking except on the arteries of both legs a thin yet long layer of calcification is seen. Artery calcification is considered a genetically inherited disease, & it&#8217;s known as a major cause of mortality in the west. It usually caused pain & swelling.
[surely someone with calcification of arteries in their legs wouldn&#8217;t be able to jump up & down the stage & dance!]

20) Contradiction in Microsopic Description - No mention of the other conditions that were discussed earlier in the report.

Also in the microscopic analysis of the skin the doctor claims that no scar or suture material is present [what about all the scars listed in the first few pages of the autopsy?!] so at the end of his analysis he seems to find everything is normal except for the enlarged prostate & some polyps of the colon, vitiligo & signs of resuscitation. No mention of the other conditions that were discussed earlier in the report!!!!

21) Hair samples not reliable

The coroner criminalist, Jaime Lintemoot reports that on August 6 she was notified that hair sample was required by the Forensic Lab for &#8220;potential&#8221; toxicology testing.
Interestingly enough although it is mentioned that two autopsies had been carried out on the decedent, it didn&#8217;t cross anyone&#8217;s mind during the autopsy process to collect hair samples. This is very bizarre and very unlikely as hair sampling is a standard procedure that must happen at the beginning of the autopsy, otherwise due to rigor mortis & initiation of decomposition the results are not deemed to be reliable.
So on August 6, 2009 the criminalist proceeds to collect hair samples from the decedent.
[almost a month and half after death, by this time decomposition must have started & we don&#8217;t have any information on a possible embalmment & if the body was embalmed then the hair sample collected is of no use & can&#8217;t be used for toxicology testing.]

Hair samples must be collected at the beginning of the autopsy, & stored properly as to not be tainted by the environmental effects otherwise they're no good for any sort of test. a month & half after death the body has been cut open, exposed to various chemicals, frozen & defrosted a few times & maybe embalmed so collecting hair sample even a week after the death is compromising the investigation, I can't imagine how a hair sample more than a month after the fact would help the investigation.

22) there&#8217;s no chance the patient would have survived

..Also the fact that he had given Michael a few other medications that have the same effect of propofol on respiration & heart activity, is more reason to monitor Michael&#8217;s heart & breathing, as those other medications combined with propofol, although might not have formed a fatal, but could have cause rapid depression in respiration & cardiac activity & without proper monitoring device & intubation to provide necessary oxygen to the lungs

23) Propofol needed

Let&#8217;s calculated how much Propofol needed to be administered to a man of Michael&#8217;s age & weight to keep him under continuous anesthesia:

Age: 50 yrs
Weight: 61.7 Kg

To induce anesthesia we need 2-2.5 mg/kg, so for a 61.7 kg patient we need at least 123.4 mg = 12.34 ml & at most 154.25 mg = 15.43 ml, to be safe let&#8217;s say an average of these two amounts, namely 138.83 mg = 13.88 ml of Propofol to induce anesthesia.

To calculate the amount needed to maintain anesthesia using the minimum dosage required:

75 mcg x 61.7 kg (weight of patient) = 4627.5

We know that (1000 mcg = 1mg ) therefore : 4627.5 / 1000 ~ 4.63

Also (1hr = 60 min) therefore: 4.63 x 60 = 277.8 mg/hr 27.78 ml/hr is the average dose required to maintain at least one hour of anesthesia.]

He&#8217;d need an average of 138.83 mg = 13.88 ml to induce anesthesia & an average of 277.8 mg/hr = 27.78 ml to maintain the anesthesia, for 6 hrs of sleep we need 1805.63 mg = 180.56 ml of Propofol for just one night!

If Michael was using Propofol as they allegedly said for 6 week prior to June 25 every night, they would need a total of 75836.46 mg = 7583.65 ml = 7.58 liters of Propofol!!!!

24) Propfol for six weeks not possible with Michael

It is my personal opinion that Michael Jackson simply could not have received such huge amount of Propofol during course of 6 weeks without showing some side effects during his waking hours; he simply would not be able to do any sort of physical activity yet alone go through rigorous rehearsals & deliver. Medically speaking that is just not possible!

25) Cause of Death should not be propofol intoxication

Also the partial Forensic lab finding that are attached to the autopsy report, as well as the anesthesiologist both point out the fact that the Propofol level were consistent with that of general anesthesia, but amazingly enough the cause of death has been said to be &#8220;acute Propofol intoxication&#8221;, how could someone have died of acute Propofol intoxication if the Propofol found in their body are within the normal levels of general anesthesia?! If they had to choose anything as cause of death, it should have been Central Nervous System failure (which controls respiration & cardiac activity) & not Propofol intoxication!

26) No need for IV benzodiazepines for Michael

Concerning insomnia, even though benzodiazepines may be used, IV benzodiazepines should not have been used to treat Jackson since he could take oral medications. There was no need for IV benzodiazepines for Jackson.

 

[artik]

Re: MJ H Autopsy Analysis

Very informative reading, thank you.

 

[kasume]

Re: MJ H Autopsy Analysis

the author of this did a very excellent job breaking everything down for all of us to understand.

 

[LindavG]

Re: MJ H Autopsy Analysis

I read everything and I'm even more confused now lol. I really don't know what to think anymore. Also, it says his hair was brown? His hair was black :mello:

 

[8701girl]

Re: MJ H Autopsy Analysis

I read everything and I'm even more confused now lol. I really don't know what to think anymore. Also, it says his hair was brown? His hair was black :mello:

I think mikes hair was naturally dark brown.

 

[xthunderx2]

Re: MJ H Autopsy Analysis

I also read that whole thing..I too am more confused...however we have been saying all along that the coroners report could of been tweaked ...I believe it was. This is my opinion. Thank you Kasume for posting this..

 

[kasume]

The question is WHY??

Why tweak something? Is this the reason for no report #? I'll have to ask the author if leaving out the report # would mean the autopsy can be tweaked....

There is a report number for this case, but seems like the investigator either has forgotten to enter it, or is not aware of it. The reason that I insist that there&#8217;s a report number, is when the hospital calls for an investigation to the death & someone of the phone or in person takes down the information, they automatically generate a 15 digit report number, which is coded to include the year, the county number & etc.

And even if this report was changed or taken from other individuals, what would be the purpose?????

The entire autopsy shows no sign of drug addiction, of an unhealthy Michael.... in order to help that docs defense

So what would be the purpose of having something changed or fake??? If helping Murray was the reason for changing something, they could have changed the condition of his organs or something...And I don't see any other reason why they would do something to the report.

Or maybe they were afraid of the doctors of the autopsy coming out to contradict them....still, there would be no sense of changing it if so. I'll have to think about this a little more.

But why the doctors would refridgerate the body with those medical items that could damage the organs and cause inaccuracy.....Or were they in on this and trying to damage Michael's organs on purpose?? Or were they just that reckless and didn't care about Michael and his autopsy?

 

[Angel]

Well I read everything and most all of it struck me from the very first time when reading the coroner's report. Very fishy.
One thing I don't agree with though is this paragraph:

"Another very bizarre thing is that the coroner was not able to identify the thymus in the body. The thymus is a specialized organ of the immune system & there are only a few instances where someone would be missing the thymus : 1-birth defect called Digeorge Syndrome: people with such defect have facial features similar to people suffering from down syndrome & are easily identified [we all know Michael’s facial features didn’t indicate down or Digoerge syndromes.] 2-HIV sufferers [if this body belonged to a person with HIV, it would have been mentioned in the report as it would have effects on different organs] 3-removal of the thymus during infancy due to a necessary heart surgery. In the rare cases that an infant is suffering from a fatal heart condition, a surgeon might decide to remove the thymus in order to reach the heart; however this leaves the infant with certain neurological side effects & can lead to muscle weakness [I highly doubt that Michael had his thymus removed during infancy, that would leave him incapable of pulling off all those dance moves that made his career]"

Actually the thymus is very active during infancy and childhood but ad the body goes through puberty it atrophies and disappears, it does not exist or have any function in adults. They teach this in high school biology.

Other than this the poster seems to have quite a good list of inconsistencies. Oh and another one I remember from back when i read the report was about his teeth. They said all his teeth were natural in the beginning but later they changed their minds saying he had major restorative work. Guess this one's understandable though, the work might have been so good that to the non-trained eye or during a quick check-up , it might not stand out.

Either way, this does make you wonder but at the same time, could all this help the defense's case??

 

[kasume]

Re: MJ H Autopsy Analysis

Now that you mention it, I remember hearing that about the thymus too. I just looked it up and read it can shrivel up within 24 hours after death. funny how some get the simple things mixed up instead. like the right and the left getting mixed up in the report.

All I can say is I hope investigators have looked into this. They have their own medical experts. They must know about this. It'll be interseting to see what comes of this in the future, or whether the prosecution will just ignore it....

 

[MooringTide]

Re: MJ H Autopsy Analysis

Too long for me to read.

 

[djbaby]

Re: MJ H Autopsy Analysis

HI. This was an interesting read. I have to say though regarding what happens after you die - men do not typically get an erection. As far as my reading tells me this is a phenomenon that is associated with death by hanging.