Conrad Murray's Mistakes, Part 6: Bad choices in Michael Jackson’s death led to rare homicide finding

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March 4, 2010

The doctor did it. In the bedroom. With an anesthetic.

The Los Angeles County Coroner spent 51 pages of minute calculations and detailed examinations to come to that simple conclusion on Aug. 24, 2009. Jackson had died from a lethal dose of propofol and other drugs and the death was a homicide.

This was perhaps the most surprising thing about the Michael Jackson case, because coroners are so reluctant to say a physician killed someone.

Coroners review most unusual deaths in hospitals and others, like the Murray case, where foul play was suspected. They usually don't declare a death anything but accidental or natural.

Look at the case of Dr. Andrew Rutland. The same coroner's office investigated the death of a patient from an overdose of anesthesia administered by a doctor, but the bottom line was different: "The manner of death is an accident."

The Murray investigation also started with a premise of "accidental." On June 25, 2009, LAPD Detective W. Porche reported Jackson's death to the coroner's office as "accidental vs. natural death." But, after two months of investigating and consulting with experts, the coroner noted numerous reasons why Murray's behavior was reckless. As I have detailed in previous posts, there were at least four factors at play:

  1. Murray lacked the proper training in pain medicine. "The standard of care for administering propofol was not met," wrote Dr. Selma Calmes in the anesthesiology portion of the coroner's report. Calmes, unlike Murray, is a board certified anesthesiologist.
  2. He was using a drug meant for hospitals in an unsafe setting. The coroner cited this as one of four specific reasons for calling the death a homicide. "The propofol was administered in a non-hospital setting without any appropriate medical indication," he wrote.
  3. Murray was unable to control the story.
  4. There was no peer review process to protect him.

Even when a medical case does go criminal, prosecutors have to prove intent. The coroner can call it a homicide, but the Los Angeles County District Attorney has to pick a charge: first-degree murder, second-degree murder, voluntary manslaughter or involuntary manslaughter. By calling the crime involuntary manslaughter instead of murder, the district attorney picked the lightest of the possible felonies. It would be difficult to prove that Murray wanted to kill Jackson. The singer, after all, was his meal ticket in a very big way.

Also, Murray and his attorney will have facts to marshal of their own, including numerous reports of Jackson's extensive drug use. They also may try to use the coroner's report to their advantage.

The report makes mention that Jackson had lung problems, specifically that his lungs were not at full capacity. "It should be noted that the above lung injury with reserve loss is not considered to be a direct or contributing cause of death," wrote Dr. Russell Sherwin, a professor of pathology at the University of Southern California. "However, such an individual would be especially susceptible to adverse health effects."

Can't you hear the defense attorney?

"If only Dr. Murray had known about this severe and undiagnosed lung ailment and Jackson's secret painkiller addiction, he would have never attempted to treat Mr. Jackson's sleep disorder with the types of medications he was using. Unfortunately, good people of the jury, to all appearances, Mr. Jackson was healthier at 50 than many of us were in our 20s. The man thrilled millions with his moonwalk and gravity defying dance move. This was simply an unavoidable tragedy."

Related posts:

Conrad Murray's Mistakes: Why does Michael Jackson's doctor face criminal charges when others don't?

Conrad Murray's Mistakes 2: Lack of training fueled criminal case in Michael Jackson death

Conrad Murray's Mistakes 3: Using a hospital-only drug in Michael Jackson' bedroom

Conrad Murray's Mistakes, Part 4: When Michael Jackson collapsed, story spun out of doc's control

Conrad Murray's Mistakes, Part 5: Isolated from his peers, Michael Jackson's doctor had no cover

Wrong doctor or wrong patient? Michael Jackson's physician has some explaining to do

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

Court records show Jackson's doctor acting more like a dealer

Doctors Behaving Badly: Michael Jackson's doctor can add "deadbeat dad" to his resume

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

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

Making Hepatitis History Part 1: Michael Jackson's deadly drug strikes again

Q&A with Dr. Doris K. Cope: Michael Jackson was just a symptom of a pain medicine problem