Medical Board Files More Charges Against Conrad Murray in Michael Jackson Death
With Justin Bieber ticketed for dodging paparazzi and Katie Holmes awarded primary custody, the gossip press can be forgiven for missing the latest in the case of the doctor who overdosed Michael Jackson.
Conrad Murray has been slapped with a new round of allegations from the Medical Board of California. The timing may seem odd. Jackson died in June 2009, after taking anesthesia drugs prescribed and administered by Murray. Murray was convicted of involuntary manslaughter and sentenced to four years in prison in November 2011. The medical board filed its first round of charges against Murray in February 2012. This new amended accusation is dated June 27, 2012.
In the accusation against Murray filed in February, there were two causes for action: conviction of a crime and failure to maintain adequate records. As I wrote at the time, the document seemed like fill-in-the-blank boilerplate, with more space devoted to the state code Murray violated than the details of the violations.
The amended accusation still includes the conviction and records violations, but it adds “gross negligence-inappropriate administration of dangerous drugs,” “repeated negligent acts-inappropriate administration of dangerous drugs,” and “incompetence-inappropriate administration of dangerous drugs.”
The new charges are much more detailed and provide a full explanation of just how far Murray strayed outside the standards of practice when administering the anesthetic propofol – and other drugs – to Jackson. It breaks down the “gross negligence” violation into four parts. Here are quotes from each:
Excessive administration of dangerous drugs/sedatives:
Propofol is not indicated for the induction of sleep and/or to treat insomnia. It is strictly indicated for moderate or deep sedation in a monitored hospital setting, or an accredited outpatient facility that meets the requirements set forth in Health and Safety Code sections 1248.1 and 1248.15. … [Murray] used dangerous drugs to sedate patient M.J. at his home for the purpose of inducing sleep. On more than 40 occasions between April 2009 and June 25, 2009, patient M.J. was sedated with a combination of benzodiazepines and propofol.
Inadequate monitoring:
The patient is required to have a continuous oxygen delivery system, continuous cardiac monitoring, a continuous intravenous access line established, continuous pulse oximetry monitoring, and continuous blood pressure monitoring, all with audible alert systems. In addition, the following operable equipment is necessary in the room and must be ready for use: oxygen, suction, oral and nasopharyngeal airways, a crash cart with backboard, appropriate emergency resuscitation drugs, and a defibrillator. … [Murray’s] failure to secure appropriate equipment for patient monitoring and his failure to maintain emergency equipment and medications is an extreme departure from the standard of care. Furthermore, no competent physician or surgeon would sedate a patient without ensuring that the appropriate patient monitoring and equipment is readily available.
Failure to maintain medical records:
When a patient is administered medications for sedation and/or anesthesia the standard of care requires that the physician maintain medical records detailing the care rendered to the patient. Documentation of sedation and anesthesia is required for the provision of good medical care and quality assurance.
The board sums it up this way:
[Murray] failed to appropriately monitor patient M.J. He abandoned his patient by leaving M.J. unattended while he was under the influence of heavy sedatives. In addition, he administered propofol and other dangerous drugs to patient M.J. in a home setting without appropriate medical equipment and staff to monitor the maintenance of patient M.J.’s hemodynamics, and did not continuously monitor the patient’s vital signs.
All of this happened in June 2009. Since that time, Murray has been tried, convicted and sent to prison. Murray’s medical license was suspended in Texas and has been allowed to expire in Nevada and Hawaii. Yet, the California medical board is still months – if not years – away from revoking Murray’s license, assuming it does not end up in some settlement agreement with him. It’s still in the charging phase, while the criminal prosecutors and other state boards have gone all the way through the process and moved on.
In March, after the board made its first accusation against Murray, I asked the board’s Director of Public Affairs, Dan Wood, what took so long. He said that the board was waiting for the criminal proceedings to finish before filing charges. He wrote:
To put it in simple terms, once a door is closed and locked no matter who closed and locked it, to rush to repeat the action is redundant. Basically our action now will be the equivalent of placing a sign on the door saying, “This door is now closed and locked officially.”
I wrote him this week to ask whether the door was now being reopened and, if so, what the board hoped to accomplish. I’ll let you know if he responds.
Photo courtesy of Lwp Kommunikáció via Flickr.