Court records Show Jackson's Doctor Acting More Like a Dealer

Let's assume that Dr. Conrad Murray did not kill Michael Jackson.

The Los Angeles County Coroner's preliminary assessment was released Monday as part of the Los Angeles Police Department search warrant and affidavit. It indicates that Jackson was killed by drugs Murray gave him, including the anesthetic propofol, but we are likely to see a drawn-out court case before we can say with certainty that Murray was at fault.

Regardless of criminal liability, Murray and the doctors Jackson hired over the past few years still failed their patient. Jackson had fallen into the sad pattern of a prescription drug addict, police records show, and his doctors fed his addiction rather than treating him.

Murray said that by the time he was hired by Jackson to join the singer on his comeback tour, other doctors already had given Jackson propofol so frequently to help him sleep that he referred to the white liquid drug as his "milk," according to the search warrant. The list of medical professionals who had contact with Jackson in recent years includes at least six doctors and a nurse practitioner, according to the search warrant. Investigators found drugs in Jackson's bedroom that had been prescribed by Dr. Allan Metzger, a Los Angeles rheumatologist, and Dr. Arnold Klein, a Beverly Hills dermatologist.

Metzger was reprimanded in 2000 by the Medical Board of California for engaging in "fraudulent medical practice based on prescriptions written for an international entertainer, using a false/fictitious name." The entertainer, according to numerous news accounts, was Michael Jackson's sister, Janet.

In July, Metzger's lawyer told CNN that Metzger had refused in April to write Michael Jackson a prescription for propofol.

"Inasmuch that it cannot be determined whether the cause of death is due to the actions of a single night and/or a single doctor, or the grossly negligent treatment of several doctors over an extended period of time, your affiant believes these medical records are germane to the ongoing death investigation," wrote Detective Orlando Martinez of the Los Angeles Police Department.

The fact that Jackson had secured dangerous prescription drugs from other doctors should have been Murray's first sign to steer Jackson away from those drug. Addicts will doctor shop, until the doctors close their doors.

As I detailed in an earlier post, propofol is not a sleep aid. The American Society of Anesthesiologists has made it clear, repeatedly, that propofol is a surgical aid, and it should be used with constant monitoring by someone trained in anesthesia, not a cardiologist who has not bothered to keep up his board certification.

Dr. John Dombrowksi, an anesthesiologist who sits on some of the society's committees, told Antidote for an earlier post that Murray was using propofol well outside the norm.

"It's only used in a controlled setting. A doctor's office and a hospital for a procedure," Dombrowski said. "That's like me recommending chemo for someone because they are tired of shaving their head."

In his final hours, as described in this heartbreaking story in the Los Angeles Times, Jackson begged repeatedly for the drug. Murray, defending his decisions that day, told police he had been trying to wean Jackson off propofol. At that point, it was too late.

CNN provided a timeline that shows how Murray was essentially catering to Jackson's addiction, not following a logical prescription pattern.

At about 1:30 a.m., Murray gave Jackson 10 mg of Valium.

At about 2 a.m., he injected Jackson with 2 mg of the anti-anxiety drug Ativan.

At about 3 a.m., Murray then administered 2 mg of the sedative Versed.

At about 5 a.m., he administered another 2 mg of Ativan.

At about 7:30 a.m., Murray gave Jackson yet another 2 mg of Versed while monitoring him with a device that measured the oxygen saturation of his blood.

At about 10:40 a.m., "after repeated demands/requests from Jackson," Murray administered 25 mg of propofol, the document said.

"Jackson finally went to sleep and Murray stated that he remained monitoring him. After approximately 10 minutes, Murray stated he left Jackson's side to go to the restroom and relieve himself. Murray stated he was out of the room for about two minutes maximum. Upon his return, Murray noticed that Jackson was no longer breathing," the affidavit said.

What patient outside of a hospital receives a new drug every hour or two?

A patient who has been failed by doctor after doctor after doctor.

Murray had one last chance to act like a doctor instead of a dealer. He told investigators that he found Jackson unconscious at 11 a.m., according to the records. Between 11:18 a.m. and 12:05 p.m., Murray made three separate calls, but he did not call 9-1-1.

Murray's attorney, Edward Chernoff, wrote in a prepared statement that the timeline in the affidavit was wrong.

"Much of what was in the search warrant affidavit is factual. However, unfortunately, much is police theory. Most egregiously, the timeline reported by law enforcement was not obtained through interviews with Dr. Murray, as was implied by the affidavit," Chernoff wrote. "Dr. Murray simply never told investigators that he found Michael Jackson at 11:00 a.m. not breathing. He also never said that he waited a mere 10 minutes before leaving to make several phone calls. In fact, Dr. Murray never said that he left Michael Jackson's room to make phone calls at all."

There's a good case to be made that Jackson was simply looking for a doctor to do his bidding. He reportedly agreed to pay Murray more than $1.5 million for his services.

Even if Murray can prove in court that he wasn't at fault, he will have a hard time proving that he acted in the best interest of his patient.

Related Posts:

To see Michael Jackson doctor’s alleged slipup, look at the label

Q&A with Dr. John Dombrowski Part 1: Michael Jackson's bungled pain management may have killed him

Q&A with Dr. John Dombrowski, Part 2: Anesthetizing Michael Jackson "indefensible"