Sunday, June 12, 2011

(No So) Newsworthy News of the World--Cocaine Claim Down the Drain Part II

This is the continuation from the blog here:

The following is my best attempt at gathering and compiling all the medication information contained in the photos listed on TMZ's site:

First prescription:

Rite Aid # 05462-770707
Date Filled: 05/25/2002
Dr. Arnold Klein
Patient: Frank Tyson
Take 1 tablet at bedtime
Alprazolam (Xanax) 1 mg
Quantity: 20
No refills

Second Prescription:

Mickey Fine Pharmacy #414642
Date: 05/28/2002
Dr. Gerard Labiner
Patient: Michael Armstrong
Take 1 tablet by mouth every four to six hours as needed for pain
Percocet 7.5/325 mg
Quantity: 75/100
Discard by: 10/01/2003

Third Prescription:

Mickey Fine Pharmacy #993995
Date: 09/21/2002 (2002 or 2003?)
Dr. Klein? (initials A.W. visible)
Patient: Peter Midani
Take 2
Prednisone ? mg
Discard by 01/01/200?
Quantity: 100
No refills left

Fourth Prescription:

RX #2
Dr. Cary P Logan (Las Vegas, Venetian Hotel)
Date Filled: 06/05/2002
Patient: M, M
Take 1 tablet by mouth three times a day *with food*
Ery-Tab 333 mg tablet EC
Quantity: 30

Date Collected: 11-18-2003

Notice though most items were collected late in 2003 most were from 2002.

-vial (one)--unlabeled
-outpatient detoxification sheet from Dr. Farschian, dated
-Manuel Rivera--#331897--01/29/2002--#100?--Dr. William Vanvalin--Xanax 1 mg--Star Drug
-Frank Tyson--#132928--03/26/2002--#?--Dr. William Vanvalin--Alprazolam 2 mg--Star Drug
-Manuel Rivera--#1007394--06/19/2002--#50--Dr. William Vanvalin--Xanax 1 mg--Longs Drugs
-Ery-tabs (large, yellow)
-Prednisone tablets (unknown mg, white)

The following Xanax prescriptions were filled for anyone on the following dates with the amount of tablets following in parenthesis: 01/29/2002(#100?), 03/26/2002(#?), 05/25/2002(#20), 06/19/2002(#50)--this is not consistent with someone taking 30-40 tablets a night as was stated by Chris Carter who will be looked at further momentarily.

As for the prescription for Xanax written for Frank Tyson by Klein--Klein stated the Xanax was actually Tyson's prescription, not Michael's. Whether it was or not the photos posted on TMZ from the raid at Neverland are not consistent with someone taking 40 Xanax a night. Furthermore , if a medication like Xanax is taken for an intended medical purpose (ex. anxiety) there is nothing wrong with that so long as it is taken as prescribed. I do not think Xanax should be used for insomnia (it seems that is what Klein wrote it for since he wrote to take it at bedtime) because it is a very short-acting benzodiazepine. I suppose if someone is taking it for insomnia it may be used to help them fall asleep rather than to stay asleep. Plus, benzodiazepines are not the best medications to take for insomnia, certainly not long-term, since inadvertent dependence can occur.

When oxycodone is mixed with acetaminophen aka Tylenol (also known as paracetamol in the UK), as Percocet is, it for moderate to severe pain. This medication could be prescribed to someone who has pain due to chronic pain from injuries or for a disease like systemic lupus which causes bodily inflammation and pain. Notice the medication is written to take "as needed" which likely mean the pain was not chronic though people with lupus may have long bouts of pain with flare-ups. When someone suffers from chronic pain (like that of a permanent injury) then typically the medication is written to take regularly (ex. 4 times a day, excluding "as needed") to prevent pain from manifesting and then becoming uncontrollable.

The acetaminophen content in Percocet is fairly low but if used excessively it can cause liver damage, especially if more than 12 tablets a day are taken. That amount would exceed the FDA's recommendation of no more than 4000 mg of acetaminophen a day. If you include any supposed alcoholism and prednisone use Michael should have had some degree of liver damage as all of these substances can cause liver damage even when used alone.

Something important to note here is the leftover prednisone tablets. These were likely written for systemic lupus even though Klein is the prescribing physician (he claims to also be an internal medicine doctor though I personally believe another doctor such as Metzger who specializes in lupus should have been treating Michael's lupus). The prednisone could have helped with pain and inflammation brought on by a lupus exacerbation but prednisone itself has many side effects. Because Michael had been given a prescription for prednisone, that could have deterred doctors from writing for pain medications known as NSAIDS (ex. iburprofen, naproxen). This is because these drugs put the patient at risk for bleeding, especially from stomach ulceration. These medications combined with something like prednisone would dramatically increase the chance of an ulceration occurring. It seems Michael was not compliant (not taking his prednisone on a regular basis) which means he would have been suffering from the ill-effects of lupus with the main complaint of many lupus sufferers being pain. Had he been taking the prednisone as he should have he may not have been in so much pain. But, since he did not take them as he should that probably made him seek pain relief solely from medications like Percocet.

I want to re-emphasize that though Michael's cause of death is attributed to medications you cannot compare his death from propofol to that of a death from abuse to pain narcotics. He did not die from the disease of addiction or pain narcotics. An examination of his body did not reveal the tell-tale signs of being a drug-addict, such as scarring of the skin or evidence of an infection like endocarditis. The puncture wounds on his body were recent, not old. In January during the hearing, paramedics admitted to making most of the puncture wounds, desperately trying to start an IV line on him but this was almost impossible because he had already passed which causes collapsing of the veins--not because of drug abuse as morons like Harvey Levin have stated.

NOTW states:

"Murray’s lawyers plan to call dozens of medics who treated Jacko over the last decade when the trial starts on May 9. His team have also filed paperwork that the King of Pop upped his drug intake during his final days as he rehearsed for the "This Is It" concerts in London. He even DRANK, mixed with orange juice, the powerful intravenous sedative propofol – the drug which eventually killed him. The source explained: “Jackson drinking propofol sounds wild, but it is part of Murray’s strategy to depict how Michael was an extraordinary addict. He says that bottles of the milk – as Michael referred to it – went missing during his treatment and he suspects that Michael would tip the fluid into his drinks to try and get high. The doctor claims that Michael took the measure after he refused to hook him up to an IV to administer it.”

Wow--so NOTW even knows the inner-workings of the defense to know they also filed paperwork stating he upped his drug intake during his final days? Oh, here we go again with Michael "drank" propofol. Here is my commentary on the accusation which is false:

Here is Dr. Shafer's expert analysis regarding the oral ingestion of propofol:

First, it is common medical slang to call propofol "milk". That is not a special pet name that Michael gave to propofol.

The autopsy report lists the propofol amount in the stomach as 0.13 mg which is equal to 0.013 mL--slightly more than a hundreth of a millimeter. We swallow more spit than that with one swallow.

Given the propofol stomach contents was recorded as 0.13 mg (and not mg/mL) that indicates that that amount was based out of the 70 g (70,000 mg) of stomach contents. Had the autopsy report stated 0.13 mg/mL that would have signified concentration of the drug per mL of fluid in the stomach. Had the report said 0.13 mg/mL, the mL concentration from the stomach contents would have had to have been calculated from via the content's specific gravity. Then, once the 70 g amount was known in mL, one would multiply 0.13 mg/mL times the mL stomach content amount to get the number which would have probably been roughly 9.1 mg (assuming the specific gravity was 1) which is still about 1 mL of propofol--not an amount that would likely be drank, either.

One would not by any means get "high" from drinking propofol. They would almost certainly not even be sedated. Based on the blood concentrations stated in the autopsy report, he could not have drank propofol, or at least IV drug administration had to have occurred. Even if he had drank it, which I doubt and can almost say is 100% false, then it would have not rendered an effect, certainly not that of sedation or death.

It seems the author of this trash thinks that a) all drugs can induce a high and b) all drugs can give a high by taking them orally. Wrong. Most highs are achieved only through the intravenous route and most drugs do not induce highs, either. Though some people have commented on feeling "good" after coming to after receiving propofol they are in the minority and Michael's reported use of this drug does not correspond to him wishing to use it for euphoric or recreational reasons.

It sounds like Murray's team paid to have this rubbish published.

NOTW states:

"Murray’s team hope the jury will decide Jacko may have jabbed himself with propofol or overdosed on prescription pills prompting his cardiac arrest in June 2009. Defence lawyers want Sergeant Steve Robel, who led the Neverland investigation, to discuss his findings."

"Jabbed" himself with propofol? Why would he do that when Murray put a IV catheter in his calf and he supposedly drank it, too!? As stated in the following blogs it is almost certain Michael was in fact fully sedated when he was given propofol by Murray.

Whooaaa--"overdosed on prescription pills"? I guess NOTW staff failed to read the autopsy report. The autopsy shows there were no pills in his stomach--the only medications found in the toxicology report in oral form were a) diazepam (Valium) and b) ephedrine--both supplied by Murray. The diazepam was in such low concentration it was rendering no physical effects. The ephedrine was by no means at a toxic level. Recall that all medications written by all other doctors found at the house (via Table 3A) were fine--the only problem medications came from Dr. Conrad Murray who not only purchased them but directly administered them, too. Michael had a legitimate medical problem (insomnia) that he wanted to have treated which is only natural, as anyone would want a good night's rest especially when your life's possessions and millions of dollars are at stake--Murray had the free will and power to do what he did to Michael and knew better than anyone else that evey component of what he did was wrong in the worst ways possible. Had Michael bought propofol online and administered it to himself with no one around--this would be a completely different story. However, the media is almost promoting the latter scenario when absolutely nothing, and I mean nothing like that happened.

I wonder whose idea it was to ask Steve Robel to testify, perhaps it was Nareg Gourjian who has jumped fences and is now representing Conrad Murray, the "alleged" killer of his one-time firm's client? Nareg Gourjian can say all he wants, that he did not directly deal with the 2005 case but he had access to crucial information that the public did not during that time. He has no business representing Murray--it is unsettling and unethical and should have not been allowed and fiercely fought by the Michael Jackson Estate.

Last excerpt of trash (thank goodness) from the NOTW states:

"Excerpts from his report say Michael Laperruque, Jacko’s former bodyguard, revealed the star was self-injecting when doctors were trying to get him off Demerol. He was also popping up to 40 Xanax pills a night, would be driven by his bouncer to medics to get his hits, was smoking marijuana and a heavy drinker. Beverly Hills pharmacist Dr Raj Kumar said: “Jackson was a serial drug addict. There was no way for Murray to control this patient. He could easily argue he had no idea he was taking such large volumes of drugs.” Prosecutors want the judge to ban claims of Jacko’s drug dependency. But last night our source said: “It creates an element of doubt as to Murray’s guilt."

Let me say there is NO DOUBT to Murray's responsibility and guilt in Michael's death whether one believes this to be cold-blooded murder or a horrible accident.

Though Mike Leperruque may be a good person it is hard to take what he says as "golden" (or what he supposedly said by the tabloids) given he once worked for the Santa Barbara police department--the same department that raided Neverland Ranch, the same department that housed Tom Sneddon. Many people who knew Michael, including Mark Lester, Patrick Treacy and Arnold Klein have said there is no way that Michael would have been able to self-inject himself with intravenous medications. There is no physical evidence per the autopsy report of Michael being an intravenous drug abuser, either. Michael did suffer from one infection on his leg in the early 2000s but vitiligo, lupus and use of immunosuppressants like prednisone put him at a much greater risk of skin infection than the rest of the population. Even normal, healthy people can contract something like MRSA.

Though I have yet to see any mention of this--Demerol is available in tablet form. I have never heard any claims of Michael taking Demerol orally, the tablets are rarely used as they are not very potent but they are still available. There is also no evidence Michael was a heavy drinker--Michael's liver, pancreas and esophagus, which can all be damaged with drinking, were in perfect condition and though the liver can repair itself to some extent it is still unlikely to fathom a full return to normalcy if Michael was really a heavy drinker on top of abusing medications, including those that contained acetaminophen.

Now to Chris Carter--we must account for this person who is the actual source of the "40 Xanax a night", "heavy drinking", "pot smoking" and "doctor-shopping". Chris Carter--aka the felon Chris Carter-- is not only a serial armed robber but he has also been convicted of kidnapping and in 2000 he was found guilty of drug possession with the intent to distribute--this was before Michael hired him. Should we trust a felon with a violent history? I think not.

Here are some useful links about Chris Carter who was a key figure in the 2005 trial not only by being the one who came up with some of the most ludicrous allegations involving alcohol (which were unfounded as everything else was) but he is also pivotal in the drug debacle that since followed as he is the main one who supplemented much of the drug abuse claims: (Newsflash--anti-depressants are not a known drug of abuse. I am unaware of any anti-depressants that are being used recreationally. It takes 2-4 weeks of chronic use before they would even render an anti-depressive effect.) (Laperruque mentioned most medications picked up were in Chris Carter's name--could Carter have been getting those medications and then illegally distributing them for cash as he had just a few years prior? No bottles accounted for on TMZ's site are in Chris Carter's name. I believe it is a strong possibility Carter was using his position as security with Michael and selling narcotics while working for Michael though I do not have the evidence to prove such as of current. Placebos are not used to wean people off pain medication, either.)

As for pharmacist Raj Kumar--I had trouble finding their name on the California Board of Pharmacy's web site--do they even exist? Is it possible for a "serial addict" to die with a liver to envy and skin only damaged by his own immune system? If he (assuming they exist) was filling Michael's prescriptions and knew he was an drug addict then he was breaking some serious regulations and could have his license revoked, at minimum. He is completely wrong with Murray not being able to "control his patient". In fact, it was Murray who was completely in control. Going further, can anyone name an instance where as supposed healthy "drug addict" actually died at hands and control of their own doctor who not only administer the medications but was there in the damn house?! The drugs in Michael's toxicology report were all put there by...(drum roll)...Conrad Murray per his own testimony. Michael did not die from a "large volume" of drugs--his cause of death was from propofol but the propofol combined with the large (but not toxic) level of lorazepam worked together to stop Michael from breathing. Who bought those drugs? Who administered those drugs? Conrad Murray. Who refused to do anything when Michael stopped breathing? Conrad Murray. What was he supposedly doing while Michael lay there dying? I do not know but it is apparent that Michael nor Michael's life was any sort of top priority for Murray. Why not? Being Michael's doctor was like winning the lottery--how could Murray be so careless, or moreover why would Murray supposedly be so careless with such a valuable life?

The prosecution's request to ban the claims of drug dependency should be granted--any such claims have NOTHING to do with his death. It is not relevant. The defense is trying to make it relevant only because they are desperate as their client has no defense. The defense's cases is built not just on one lie but multiple lies, hell, even two of Murray's new witnesses were told different things by him. There is no doubt to Murray's guilt--the cause of death says it all--"homicide--via injection by another". Murray has yet to try and implicate anyone else besides the victim who could not self-inject and cannot defend himself against such heinous accusations. Case closed.

All of this information above ties closely into other evidence found in the Neverland raid I hope to discuss soon regarding notes from Dr. Farschian. I have briefly touched on the notes from Farschian before in a previous blog but want to go more in-depth at some point. However, what I hope to do next is to review the court transcripts and give my commentary on them as the trial will be starting in 3 months.

The Vindicate MJ team also covered the cocaine topic in January of this year:

and then covered it again here after the release of the NOTW article:

Some other semi-related Vindicate MJ blogs can be read here:

1 comment:

  1. It is small comfort that News Of The World has been forced to shut down after over 100 years of publication due to it's irresponsible and what appears to be criminal actions in the phone hacking scandal. A story that as of today is still unfolding from both sides of the Atlantic. Shame on them and their ilk and good riddance to the lot of them!!!!