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Conrad Murray trial: Propofol dosing requires care, expert says

October 13, 2011 |  2:05 pm

Dr. Steven Shafer
Jurors in the trial of Michael Jackson’s doctor began hearing Thursday from a top expert on propofol, the surgical anesthetic that led to the singer’s death.

Dr. Steven Shafer, a professor of anesthesiology at Columbia University, told jurors that when the drug was first introduced in the early 1990s for sedation, he conducted the research that established the dosing guidelines that are still currently in use.

Shafer said in his analysis, he discovered that propofol had to be used carefully because if the doctor is “off by just a little,” a dose could result in a patient taking hours rather than minutes to wake up from sedation.

FULL COVERAGE: The trial of Conrad Murray

Dr. Conrad Murray is accused of involuntary manslaughter for Jackson’s June 25, 2009, death from the effects of the drug, which he said he gave the singer nightly over two months to get him to sleep.

Responding to a prosecutor’s questions, Shafer also corrected what a defense attorney had earlier told jurors - -that he was a student of the defense’s main medical expert, Dr. Paul White.

Shafer said while the two experts are longtime friends and colleagues, he was never a student of White.

An attorney for Murray told jurors during opening statements last month that White was known among his peers as “the father of propofol.”

Shafer was only on the stand long enough to detail his lengthy qualifications before court adjourned for the day for scheduling reasons.

Earlier Thursday, a defense attorney asked a sleep doctor who reviewed Murray’s care for the California Medical Board if Murray was culpable even if Jackson gave himself the drugs that killed him.

“Is it your position that even if Michael Jackson self-medicated with excessive amounts of lorazepam ... pushed 25 milligrams of propofol, Dr. Murray is still responsible for his death?” attorney Michael Flanagan asked.

“Absolutely,” Dr. Nader Kamangar responded.

Flanagan then asked whether a doctor who prescribed 30 Ambien sleeping pills to a patient who takes them all at once to commit suicide would be responsible for the patient’s death.

A prosecutor objected to the question, and the judge did not allow it.

Under additional questioning by a prosecutor, Kamangar said “knowing when to say no” when a patient asks for something that could be harmful is one of the fundamental elements of a physician-patient relationship.

“No matter how much the patient may complain, no matter how much the patient may beg, you as the doctor should say no?” Deputy Dist. Atty. David Walgren asked.

“That’s correct,” Kamangar replied.

Walgren also later asked whether it was Murray’s actions that resulted in Jackson’s death.

“In this case, Conrad Murray was grossly negligent in multiple instances and that gross negligence directly caused the death of Michael Jackson, is that correct?” he asked.

“That’s correct,” Kamangar said.

RELATED:

Jackson would be alive if not for Conrad Murray, expert says

Conrad Murray’s care of Jackson gross negligence, witness says

Sleep doctor: Treating Michael Jackson with propofol 'inconceivable'

-- Victoria Kim at Los Angeles County Superior Court

Photo: Dr. Steven Shafer in court Thursday. Credit: Robyn Beck / Los Angeles Times

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