Experts: drug amounts in Michael Jackson death probe don't add up

[Oceangirl]

Propofol dosage reported in Michael Jackson case is low, experts say


Dr. Conrad Murray told police he injected 25 milligrams the night the pop star died. Experts say that dose would have little effect on an average patient, and possibly no effect on a regular user.

By Kimi Yoshino

August 27, 2009

If Michael Jackson died from lethal levels of the powerful anesthetic propofol, then he must have been injected with much more of the drug than his personal physician reportedly told police he gave the pop star, medical experts said.

According to court records unsealed in Houston on Monday, Dr. Conrad Murray told police that he had been giving Jackson 50 milligrams of propofol each night over a six-week period. In a three-hour interview with police two days after Jackson's death, Murray said he had been trying to wean the singer off the powerful anesthetic and, on the night of his death, gave him a combination of other sedatives before succumbing to Jackson's repeated demands for propofol.

Murray then gave Jackson 25 milligrams of propofol, according to the documents, which were filed with the court in support of searches of Murray's office and storage unit in Houston. But those amounts -- 25 and 50 milligrams -- are far below the dosage required to anesthetize someone and keep them asleep, several experts said.

"It doesn't make any sense," said Dr. John Dombrowski, a member of the American Society of Anesthesiologists. "I cannot believe that was the number that was given. Such a small amount won't tip anyone over in terms of respiratory depression."

What's more likely, Dombrowski said, is that the numbers in the documents are somehow in error. Murray might not have provided an infusion rate, such as 25 milligrams every few minutes, or police might not have understood the medical terminology, Dombrowski said.

The preliminary toxicology reports cited in the court records said that "lethal levels" of propofol were found in Jackson's blood. Final autopsy and toxicology reports have yet to be released by the Los Angeles County coroner's office.

Murray has said through his attorney that he believes nothing he administered should have led to Jackson's death. His attorney, Ed Chernoff, said Murray answered the detectives' questions truthfully.

In a YouTube video, a direct message from Murray to his supporters, the doctor thanked people for standing by him. "I have done all I could do," Murray said in the video. "I told the truth, and I have faith the truth will prevail."

The medical experts said that if the propofol dosage were higher and combined with other medications, it could have led to an overdose.

Dr. Scott Engwall, vice chair of anesthesiology at UC Irvine's School of Medicine, said that for an average person without a high tolerance to drugs, 50 milligrams of propofol might be enough to make them doze off for five or 10 minutes. But the drug would immediately wear off. Someone like Jackson, who had been using it nightly for as many as six weeks, according to Murray's testimony, might close his eyes briefly -- or it might not work at all, Engwall and other doctors said.

"I think it's not unreasonable that there is some part of this picture we still do not know," Engwall said.

kimi.yoshino@latimes.com

Times reporter Harriet Ryan contributed to this report.
Copyright © 2009, The Los Angeles Times

 

[Oceangirl]

see they are saying not the 25 milligram but also the 50 milligrame does not make any sense , so why would you even believe murray gave those drugs in the first place , he lied about everything , everything , why would yo believe anything at all ?

 

[cryingangel]

That interview was great, though some of the readers were :doh:

Of course nothing adds up when the person giving the timeline is a genuine liar.
As my mother said, with 50 mg, he would wake up after a few minutes and be able to walk around without even feeling dizzy or anything. Who does that idiot think he's fooling? :doh:

 

[TeharaMJ]

at this point I am not buying a word that comes out of Murray.... the guy is a first class quack, I seriously doubt he even attended his medical degree lectures much less specialise in cardiology.

 

[kes1984]

at this point I am not buying a word that comes out of Murray.... the guy is a first class quack, I seriously doubt he even attended his medical degree lectures much less specialise in cardiology.

Quack is right!

Murray is either a liar or a complete imbicile. Either way is not good for him. I mean, to say he gave 50mg when every medical professional is saying this would not be enough to even really sedate a man, much less kill them means he is either lying about the dosage or he just has no idea!

 

[angelofhope]

Murray knows he is in the sh**t and so is just making up numbers to try and cover up his actions. I can't see any jury letting Murray away with this. The more that comes out,the worse it looks for Murray. He's GOIN DOWN!!!

 

[praisemichael]

people seem to be forgetting the 1 Valium tablets 4 mg's of Lorazepam, 4 mg of Midazolam and the 25 mg's Propofol and the drug Dr Conrad Murray gave Michael to try and revive him. So it does add up but it's obvious those drugs aren't important enough to account for, typical!

 

[myfavouritewintercoat]

It's time we stop lionizing a pedophile and a drug addict.

I'd take this article more seriously if they hadn't put that bit in!

 

[LindaC781]

Richmond, Va. can BITE ME!

"a person who was under the care of a physician has died" Exactly. End of.

Yep...that person can bite me too. What a jerk.

Hey! You! RICHMOND VA!!

 

[summer]

About the propofol dose..."Told you so". :cheers:

So the propofol did not kill him but the cocktail of drugs that stupid doctor gave him. I have a friend that works as a pharmist tech and when this happen in the beginning she told me that diprivan is never to be given with other drugs.

How could this man be so stupid and provide diprivan after giving Jackson all these sedatives.

And I do not believe MJ was a drug addict. He only started taking the Propofol as the TII started approching. Which made got more anxious and lost sleep. A drug addict do not contro when he can stop and start taking a drug.

And that question from Richmond about MJ being Pedo was just wrong seeing the man was acquitted.

Actually it's not true that you can't give Propofol (=Diprivan) with other drugs. We give several drugs with it ALL the time. Fentalyl, Midazolam or Lorazepam right before it, a muscle relaxant, pain medication, antibiotics, you name it. And that's why I said that Dr. Murray having given Midazolam and Lorazepam before Propofol was not the problem...problem was that he was giving them in a HOME, ALONE without help there, without the proper equipment. You can combine all kinds of drugs with Propofol and it's safe, WHEN YOU KNOW WHAT YOU ARE DOING and are prepared. We give all kinds of drugs with it, but the patients are carefully monitored and already intubated so they are safe. Something can still always go wrong, but we have staff ready to help, we have all kinds of drugs available, etc. Again, you CAN combine Propofol with other drugs...but the ONLY person doing it should be an ANESTHESIOLOGIST. Also, any kind of drug can have side effects and become dangerous if you don't know how it works and don't use it properly...just as a reminder. A lot of drugs need to be injected slowly and if you do it too fast, you can have side-effects. Even some antibiotics can damage a patient if you give them too fast i.v. Some drugs can make a patient vomit if you inject them too fast...etc. Most drugs are safe, when used properly, in the right setting. Dr. Murray used a drug he was not trained to use...in an enviroment that was not proper.

 

[daphnieas]

It sickens me to read how they repeatedly stated that Murray was innocent until convicted by a jury, but at the same time jump to the statement that Mike was a pedophile, such hypocresy.

 

[elusive moonwalker]

cheers for that summer intresting info

 

[prismsagainst5live]

thank you summer, your input is very helpful. It looka like Murray has more questions to answer.

 

[slimblonde2]

The trouble is, they are basing these questions and answers on a 'leaked' report from a 'trustworthy source'. THERE ARE NO OFFICIAL FINDINGS YET RELEASED.
It's all very interesting in theory, but we don't know if anything in the leaked document was correct, so hypothesising whether this or that was the lethal dosage is a waste of time.

Until we know what was administered and when, FOR REAL we can't really make a judgement.

Even the timings of when MJ was reportedly found unconscious seem to vary, starting at 11:40 and now 12:05.

I still want to know why, if MJ was due to go to a rehearsal that day, was he asking for propofol at 10:40am? Wouldn't he normally be having breakfast at that time? It seems very weird to spend the whole night awake from 1am to 10:40 and then demand propofol. Wouldn't you know by 3am or 5am that you weren't going to sleep at all? I believe something was going on between 10am and noon that we don't know about. Is Murray the fall guy/patsy/scapegoat? Is that why he was being paid $150,000 a week? Is that why he was on the 'phone to his lawyer pretty darn quick? Is that why he was employed in the first place?

 

[rockin2505]

I'm wondering what part of what we're hearing/reading is definitely true. The only part I guess we can trust is that Michael died of a lethal amount of propofol. I don't think Dr. Murray would wait till 10.40 to administer propofol. It must have happenen earlier imo. Also for the dose to be lethal. Maybe they're putting the part of the other drugs in to convince people he was an addict when in fact he wasn't anymore. To aid Dr. Murray's defence. I'm hoping for a quick release of the toxocology report, so we have some definite answers.

 

[Topflux]

No one probably remember my posts about injecting propofol, but thats what I wrote. This doctor really injected it. If you want to keep someone sleeping like that it's very careful and dangerous. And what makes it even more dangerous is that then you have this amount of it in the beginning in your blood. If you drip it, its not that dangerous.

I just dont understand this whole situation. In the first place what was the POINT of giving this propofol in the morning at all!? And after all those other drugs. So unthoughtful... And whatever Michael begged how he could have been mentally ok after all those other drugs. What a doc... I really hate him. Pure hate. 8/

 

[Topflux]

I didnt want Michael to die. It was one of my worst nightmares. If I could help him still.

 

[kasume]

The medical experts said that if the propofol dosage were higher and combined with other medications, it could have led to an overdose.

Dr. Scott Engwall, vice chair of anesthesiology at UC Irvine's School of Medicine, said that for an average person without a high tolerance to drugs, 50 milligrams of propofol might be enough to make them doze off for five or 10 minutes. But the drug would immediately wear off. Someone like Jackson, who had been using it nightly for as many as six weeks, according to Murray's testimony, might close his eyes briefly -- or it might not work at all, Engwall and other doctors said.

"I think it's not unreasonable that there is some part of this picture we still do not know," Engwall said.

http://latimesblogs.latimes.com/lan...th-probe-dont-add-up-medical-experts-say.html

MURDER MURDER MURDER!! Does every single Michael Jackson fan who knows this have to raise up a big sign with the word 'murder' in big red thriller letters in front of national television, lapd buildings, and investigator's buildings??? We do!!

It sickens me to read how they repeatedly stated that Murray was innocent until convicted by a jury, but at the same time jump to the statement that Mike was a pedophile, such hypocresy.

This man mentioned justice for all people in songs and speeches, and yet, he recieves NO JUSTICE in return.

I believe Michael deserves Justice more than ever.......I pray to God that he does.

 

[chantille]

So the propofol did not kill him but the cocktail of drugs that stupid doctor gave him. I have a friend that works as a pharmist tech and when this happen in the beginning she told me that diprivan is never to be given with other drugs.

How could this man be so stupid and provide diprivan after giving Jackson all these sedatives.

And I do not believe MJ was a drug addict. He only started taking the Propofol as the TII started approching. Which made got more anxious and lost sleep. A drug addict do not contro when he can stop and start taking a drug.

And that question from Richmond about MJ being Pedo was just wrong seeing the man was acquitted.

Dr Murray said he was not the first person to administer Propofol and Michael was taking it long before he was employed in other words in would have been long before TII rehearsals.

 

[SUSIE.Q]

I knew it didn't sound right when I heard the dosage given.

In adults, for the initial induction of anaesthesia intravenously, Propofol is typically administered at a rate of 20-40mg over 10 seconds until the patient has gone under. Following loss of consciousness the patient is then given inhalation agents (gases) to maintain this state. This initial dose of propofol is fast acting and lasts for generally 4-7 minutes before the patient begins to come around. It is the agents that keep them under anaesthesia, but additional propofol can be given via an IV infusion of 4-12mg over an hour to maintain unconsciousness. (Total Intravenous Infusion -TIVA).

During induction, the patient is given oxygen to create a reserve for when they stop breathing on their own. They then have to be ventilated artificially until the monitor records their ability to maintain their own CO2 output.

Midazolam and Lorazepam are benzodiazepines to relieve anxiety, administered either prior to being anaesthetised or as a co-induction agent with propofol, both practices are common. The dosages of those administered don't seem excessive, don't forget he also used the local anaesthetic lidocaine to counteract the painful reaction to the induction of propofol. Again, this is common practice.

Murray said after he administered the propofol he left to go to the restroom, which is the most critical time to be monitoring the patient's vital signs to ascertain whether they are breathing unaided and maintain their own CO2 output. Why did he leave at such a critical moment? It doesn't make sense.

 

[CarinaT]

OK, I will NOT let that one pedophile comment ruin my morning.
I will keep calm.
I will keep calm.

 

[Chanya]

Ok, so some "experts" say it was enough to kill a horse, other "experts" say it wasn't enough to tip anyone over the edge. Ok, thank god for expertise.

Business as usual in the MJ world. Contradicting reports, lies, fake friends and media whores looking for attention. When will it ever end?

 

[movingcoolcat]

I knew it didn't sound right when I heard the dosage given.

In adults, for the initial induction of anaesthesia intravenously, Propofol is typically administered at a rate of 20-40mg over 10 seconds until the patient has gone under. Following loss of consciousness the patient is then given inhalation agents (gases) to maintain this state. This initial dose of propofol is fast acting and lasts for generally 4-7 minutes before the patient begins to come around. It is the agents that keep them under anaesthesia, but additional propofol can be given via an IV infusion of 4-12mg over an hour to maintain unconsciousness. (Total Intravenous Infusion -TIVA).

During induction, the patient is given oxygen to create a reserve for when they stop breathing on their own. They then have to be ventilated artificially until the monitor records their ability to maintain their own CO2 output.

Midazolam and Lorazepam are benzodiazepines to relieve anxiety, administered either prior to being anaesthetised or as a co-induction agent with propofol, both practices are common. The dosages of those administered don't seem excessive, don't forget he also used the local anaesthetic lidocaine to counteract the painful reaction to the induction of propofol. Again, this is common practice.

Murray said after he administered the propofol he left to go to the restroom, which is the most critical time to be monitoring the patient's vital signs to ascertain whether they are breathing unaided and maintain their own CO2 output. Why did he leave at such a critical moment? It doesn't make sense.

I just wanted to ask this question to someone with medical expertice:

Some anti anxiety drugs can influence a persons ability to breath, because they influence the nervous system? The muscles that controls breathing, are controlled by the part of the nervous system that are controlled by the same part of the brain as most muscles (unlike the heart)? There are some medical terms that I keep forgetting...parasympatic nervous system or something like that.
So a combination, although normal procedure in a hospital do pose some additional risk if done outside of a hospital environment?

 

[Oceangirl]

I knew it didn't sound right when I heard the dosage given.

In adults, for the initial induction of anaesthesia intravenously, Propofol is typically administered at a rate of 20-40mg over 10 seconds until the patient has gone under. Following loss of consciousness the patient is then given inhalation agents (gases) to maintain this state. This initial dose of propofol is fast acting and lasts for generally 4-7 minutes before the patient begins to come around. It is the agents that keep them under anaesthesia, but additional propofol can be given via an IV infusion of 4-12mg over an hour to maintain unconsciousness. (Total Intravenous Infusion -TIVA).

During induction, the patient is given oxygen to create a reserve for when they stop breathing on their own. They then have to be ventilated artificially until the monitor records their ability to maintain their own CO2 output.

Midazolam and Lorazepam are benzodiazepines to relieve anxiety, administered either prior to being anaesthetised or as a co-induction agent with propofol, both practices are common. The dosages of those administered don't seem excessive, don't forget he also used the local anaesthetic lidocaine to counteract the painful reaction to the induction of propofol. Again, this is common practice.

Murray said after he administered the propofol he left to go to the restroom, which is the most critical time to be monitoring the patient's vital signs to ascertain whether they are breathing unaided and maintain their own CO2 output. Why did he leave at such a critical moment? It doesn't make sense.

ok , but he is saying I was not planning to administer propofol to him , i was trying to wean him off propofol , but from your post one can conclud that was not at all the case and all the meds given were probably given before or with propofol . you don't prepare the patient 10 hourse before you give him propofol , right ? so another evidence that he was not trying to wean mj off propofol at all , and that he administered it during the night way before 10.40 am .

 

[Gaiaschild]

MURDER MURDER MURDER!! Does every single Michael Jackson fan who knows this have to raise up a big sign with the word 'murder' in big red thriller letters in front of national television, lapd buildings, and investigator's buildings??? We do!!



This man mentioned justice for all people in songs and speeches, and yet, he recieves NO JUSTICE in return.

I believe Michael deserves Justice more than ever.......I pray to God that he does.

I agree, and it is just feels so wrong.