January 6th, 2011
RICHELLE COOPER, M.D--Dr. Cooper is an emergency medicine physician at UCLA. She did her training at UCLA and became an attending physician for UCLA in 1998. She supervises residents as faculty for UCLA as well as caring for patients who come to the ER.
DIRECT EXAMINATION: BY MR. WALGREN
Cooper confirms she was working in the ER at UCLA on June 25th, 2009. She recalls being contacted via the base station radio nurse regarding the events concerning this case. She states the medical intensive care nurse who answers the radio calls is located in a separate room in the ER next to the treatment rooms. The nurse radios back and forth with the paramedics in the field regarding appropriate protocols and care to be given to patients. She confirms she is consulted as needed when the nurse needs assistance for a call.
Cooper confirms she was consulted by the radio nurse regarding Michael Jackson.
Walgren: FROM THE TOTAL OF YOUR INVOLVEMENT WITH THE RADIO NURSE AND THE COMMUNICATIONS WITH THE PARAMEDICS, WHAT WAS YOUR UNDERSTANDING OF THE PHYSICAL CONDITION OF THE PATIENT PRIOR TO HIS ARRIVAL AT UCLA?
Cooper: THE SUMMARY OF THE REPORT I HAD WAS A RADIO CALL, I BELIEVE, AROUND 12:18 THAT THERE WAS A PATIENT WHO WAS UNRESPONSIVE, ASYSTOLIC, WITHOUT PULSES, NOT BREATHING. THAT THE PARAMEDICS HAD INSTITUTED PROTOCOL TO RESUSCITATE THE PATIENT, INTUBATED THE PATIENT, PLACED AN I.V. AND STARTED PROTOCOL DRUGS. THERE WAS NO RESPONSE AND NO SPONTANEOUS CIRCULATION.
Cooper states she was aware paramedics responded to a 911 call. She states she has briefly seen the run sheet from that particular 911 call but has not seen any dictated report or transcript of the call. Cooper clarifies that a run sheet is hospital form or document the radio nurse creates for each call. Cooper state she saw that sheet and signed it at the time she was called to give advice.
Cooper states she cannot say for sure the exact time of the 911 call.
Cooper: I CAN'T SAY FOR SURE THE EXACT TIME OF THE 911 CALL. I DID REVIEW MY RECORDS, AND MY UNDERSTANDING WAS THE ARREST WAS AROUND 12:18.
Walgren asks if the arrest occurring at 12:18 p.m. was her understanding and she agrees. Cooper states if she could look over her report she could indicate a time as she recalls transcribing one.
Cooper is able to examine the base hospital form (run sheet). It states cardiac arrest was at 12:18. She states that is the estimated time of cardiac arrest, not the time of the 911 call.
Cooper confirms this time of cardiac arrest could have come from Conrad Murray. However, she confirms she does not have any first-hand knowledge as to the source of cardiac arrest time.
Cooper confirms she continued doing other tasks and was consulted on an as-needed basis. Cooper confirms she was contacted for a pronouncement as resuscitations efforts appeared to have not been producing any response.
Walgren: WHAT DO YOU MEAN BY PRONOUNCEMENT?
Cooper: BASED ON L.A. COUNTY E.M.S. PROTOCOLS, A PATIENT FOUND WITHOUT PULSE, NOT BREATHING, PUPILS FIXED AND DILATED, ATTEMPTED RESUSCITATION, NO RESPONSE TO RESUSCITATION, AND RESUSCITATION EFFORTS MORE THAN 20 MINUTES, THEY MAKE PROTOCOL TO BE ANNOUNCED IN THE FIELD.
Cooper states she gave authorization for a pronouncement of death at 12:57 p.m. for the patient whom at the time she did not know was Michael Jackson.
Cooper confirms she was then made aware there was a personal physician at the scene who wanted other treatments given, including sodium bicarbonate. Cooper remarked if the physician had a valid California license, the paramedics could give sodium bicarbonate but the physician would need to accompany the patient to the nearest hospital. She also instructed that the personal physician would need to assume care of the patient. To the best of her knowledge, her instructions were followed by Murray, et. al.
Cooper confirms she was present in the ER at 1:13 p.m. when the ambulance arrived. She states everyone was prepared for arrival of the patient and everyone knew their roles.
Cooper: AS THE PATIENT ROLLED PAST, I WAS INTRODUCED TO DR. MURRAY. AND AS THE PATIENT WAS BEING PUT ON THE MONITOR AND EVERYONE WAS STARTING THEIR WORK, I ASKED, "WHAT HAPPENED?"
Cooper identifies Murray in court for the record. Walgren asks Cooper what Murray told Cooper, if anything.
Cooper: DR. MURRAY REPORTED THE PATIENT HAD BEEN IN HIS USUAL STATE OF HEALTH, NOT ILL, BUT HAD BEEN WORKING VERY HARD AND HE THOUGHT HE MAY BE DEHYDRATED. HE HAD BEEN HAVING TROUBLE SLEEPING, AND HE HAD GIVEN HIM TWO MILLIGRAMS OF LORAZEPAM THROUGH AN I.V.
Cooper confirms Murray stated the patient had not been ill, had been working long hours, had had trouble sleeping and was dehydrated.
Walgren: DID YOU ASK ABOUT ANY NARCOTICS DR. MURRAY HAD GIVEN THE PATIENT?
Cooper: I ASKED EVERYTHING. WHAT MEDICATIONS THE PATIENT WAS ON AND WHAT HAD BEEN ADMINISTERED.
Cooper states Murray reported to her he had given 2 mg of lorazepam at some point in the morning and later on given another 2 mg of lorazepam and then witnessed the patient arrest. Cooper confirms Murray never mentioned any other medications, narcotics or drugs he had administered to the patient at that time. She confirms the only medication mentioned was the total dose of 4 mg of lorazepam and he did claim to have witnessed the actual arrest.
Walgren: WHAT DOES THAT (arrest) MEAN?
Cooper: I TOOK IT TO MEAN HE GAVE THE MEDICINE, THEN THE PATIENT'S HEART STOPPED OR HE HAD STOPPED BREATHING, AND THEN HE INSTITUTED CPR.
Walgren: AS A DOCTOR, WHAT IF SOMEONE SAYS, "I WITNESSED THE ARREST." WHAT DOES THAT MEAN, "I WITNESSED THE ARREST"?
Cooper: IT MEANS YOU ARE IN THE ROOM AND YOU HAVE SEEN THE EVENT WHERE THE PATIENT HAS DIED IN FRONT OF YOU.
Cooper is asked if she specifically asked Murray about any other drug use or history of drug use. She states at that point she was managing the patient's care but did have several conversations with Murray where more questions were asked as she was trying to determine what exactly had happened. She did ask about purported past drug use or any drug that he may have been taking in addition to the purported Vailum and Flomax.
Cooper: IT WAS REPORTED NO OTHER DRUG USE, NO PAST MEDICAL HISTORY, NO SEIZURE ACTIVITY BEFORE THE ARREST, AND PATIENT NOT COMPLAINING OF CHEST PAIN OR ANYTHING BEFORE THE ARREST.
Cooper confirms the lorazepam was mentioned in the initial conversation with him. Subsequent questioning was directed to Murray in which she was able to retrieve additional information from him.
Cooper confirms Murray told her there was no seizure activity by the patient preceding the arrest and no reported trauma. She confirms she asked Murray if the patient took any additional information to which Murray mentioned the patient was taking Flomax and Valium. Cooper states Valium (diazepam) is a benzodiazepine, a sedative, as is lorazepm. She states Flomax is usually used for urinary problems, in someone who has an enlarged prostate. She states Flomax assists those who "go to the bathroom a lot" as it relaxes the urinary muscle.
Cooper again confirms Murray stated there had been no reports of chest pain or anything of that nature.
Cooper confirms the patient was deceased as he had no signs of life upon arrival. She confirms she and her team did everything possible to attempt to revive the patient. She states they started with a full assessment: endotracheal tube was correctly placed and ventilation was positive.
Cooper: WE THEN PUT AN ULTRASOUND ON THE PATIENT'S HEART TO SEE IF THERE WAS ANY (cardiac) MOTION AND THERE WAS SOME MOVEMENT OF THE HEART AND MOVEMENT OF THE VALVE BUT NOT WHAT I WOULD SAY IS GOOD HEART FUNCTION IN TERMS OF A HEART THAT WAS PUMPING. THERE WAS NO PALPABLE PULSE. THERE WERE NO OTHER SIGNS OF TRAUMA.
(On a side note, this heart movement could have been being caused by the medications being administered. A dying heart muscle may move, too.)
Cooper states they proceeded to resume CPR and administered more medications including initial IV fluids (based on the reported dehydration) and did obtain further IV access to administer the medications.
Cooper confirms the patient was continuing to be ventilated and chest compressions were being done. She also confirms there is continuous cardiac monitoring taking place. Walgren asks if CPR chest compressions can artificially create a detectable pulse from time to time. Cooper states that "is the goal". She confirms Walgren's statement that is important to stop compressions from time to time to check and see if the body is spontaneously creating the pulse. Cooper confirms she did not note, observe or feel a pulse independent from CPR and compressions.
Walgren asks Cooper if at 1:21 in the afternoon a weak femoral pulse was noted by someone. She confirms yes and continues to elaborate.
Walgren: DO YOU KNOW WHO INDICATED THAT?
Cooper: I DON'T. THE NURSE SCRIBE SHEET IS AN AMALGAMATION OF WHAT IS BEING CALLED OUT BY THE DOCTORS, THE NURSES, THE TECHS. SOMEONE REPORTED FEELING A PULSE, BUT I DO NOT RECALL WHAT IT WAS.
Cooper confirms Murray was in the room during that time.
Walgren asks about what medications were given in the ER.
Cooper: THE PATIENT RECEIVED, I BELIEVE, ANOTHER EPINEPHRINE, RECEIVED SODIUM BICARBONATE, RECEIVED VASOPRESSIN. A DOPAMINE DRIP WAS STARTED, AND LATER EPINEPHRINE AND BICARB DRIP WAS STARTED.
Cooper states this medications mentioned above did not lead to a return in spontaneous circulation.
She states care continued until the pronouncement of death at 2:46 p.m.
Walgren confirms care was administered in the ER for approximately 1 hour and 13 minutes. Cooper confirms she was the one who made the pronouncement of death. Cooper then confirms from the time of her initial pronouncement at 12:57 p.m. through the paramedics until the pronouncement time at the ER at 2:46 p.m. there was no notable changes in the patient's condition, as in no return of spontaneous circulation.
Cooper agrees that blood was drawn at the hospital for necessary testing.
Walgren asks if a particular labeling system was used for Michael. Cooper states that for any critically ill patient there are registration packs created that have all the information they will need, including labels. Those particular labels were used to label blood initially. Cooper clarifies that the name "Gershwin" is similar to that of a "John Doe" situation. However, "John Doe" cannot be used every time so there is a generated list of names to be used, including Gershwin, which is used for the registration packet. This method is used to prevent a delay of care from the inability to label items. There is a particular medical record number that is unique to the patient, regardless of the name.
Cooper, Walgren and Flanagan begin to review the handwritten report written by Cooper. They are referencing the unique medical record number which is "Trauma WM0241, Gershwin". Cooper confirms this was the one affixed for the records of Michael Jackson. She confirms the medical record number as well.
Cooper begins to discuss the use of condom catheters. She states it is a urinary catheter used to collect urine that is used externally rather than internally via the urethra. She states it is typically used for someone with issues with incontinence or sedated in an operating room.
(Side note, I have never heard of use of a condom catheter in the OR--I have only heard of internal or Foley catheters used in the OR with condom catheters being used for incontinence only.)
Cooper confirms a condom catheter was visible upon the patient's arrival to the trauma room.
Cooper confirms that from the first encounter with Murray until the last he never mentioned administering propofol to Michael. She confirms Murray only mentioned the use of lorazepam and Valium concerning the use of benzodiazepines.
Cooper confirms in her experience as a medical doctor she has never been involved in, witnessed or been present for a situation where an MD administered propofol in a home setting.
Cooper confirms she uses propofol in the ER. She uses it for procedural sedation.
Walgren: WHAT DO YOU MEAN BY PROCEDURAL SEDATION?
Cooper: WE USE IT IF WE ARE PERFORMING A PAINFUL PROCEDURE AND THE PATIENT NEEDS TO BE SEDATED DEEPLY, WE WILL OFTEN ADMINISTER THE MEDICATION TO, SAY, REDUCE A BROKEN BONE, A DISLOCATED JOINT, SOME SORT OF PROCEDURE THAT YOU WANT THE PATIENT TO BE COMFORTABLE FOR AND WE ALSO USE IT SOMETIMES WHEN WE HAVE PATIENTS WHO ARE INTUBATED. GENERALLY, HEAD TRAUMA PATIENTS WE WANT TO BE ABLE TO WAKE UP AND REEVALUATE THE NEUROLOGIC STATUS.
Walgren: IN YOUR EXPERIENCE THEN, OTHER THAN IN A PROCEDURAL SEDATION WHERE YOU WANT TO PUT THE PATIENT UNDER, OR IN, FOR EXAMPLE, A HEAD TRAUMA PATIENT, HAVE YOU EVER SEEN PROPOFOL USED IN YOUR EXPERIENCE IN ANY OTHER SETTING?
Cooper: OUT-PATIENT SURGERY SETTINGS, O.R. SETTINGS, BUT I'VE NEVER SEEN IT USED OR HEARD OF IT USED IN A HOME SETTING, IF THAT IS THE QUESTION.
Cooper again states she has never seen or heard of propofol used in a home setting.
Walgren completes his direct examination.
CROSS-EXAMINATION: MR. FLANAGAN
Flanagan: DO YOU YOURSELF USE PROPOFOL?
Cooper: PERSONALLY, I DON'T. I HAVE ADMINISTERED IT TO PATIENTS, IF THAT IS THE QUESTION YOU HAVE.
Cooper is asked if she is an anesthesiologist. She states she is not, she is a board-certified emergency medical physician with privileges for procedural sedation at UCLA.
Cooper is asked if one must be an anesthesiologist to give a medication. Cooper states any doctor can use any medication.
(Side note, this is partially true, though if a doctor does not practice within their scope there can be legal ramifications for doing so and a doctor should not attempt to practice out of their scope, either.)
Flanagan asks if it was 30 minutes from time of the initial pronouncement of death until the arrival at the hospital. Cooper clarifies it was less than 30 minutes considering an initial pronouncement time of 12:57 p.m. and an arrival time of 1:13 p.m. She agrees it was approximately 10-20 minutes.
Flanagan: BUT NEVERTHELESS, YOU UNDERTOOK TO TRY TO RESUSCITATE?
Cooper: THERE WAS A REPORT BY DR. MURRAY THAT HE HAD FELT A FAINT PULSE SEPARATE, WHICH CONFLICTED WITH THE REPORT OF THE PARAMEDICS THAT THERE WASN'T A PULSE. WHEN THE PATIENT ARRIVED, I MADE DECISION WE WILL ATTEMPT TO RESUSCITATE TO CONFIRM.
Flanagan asks if having a faint pulse justifies the resumption of resuscitation. Cooper states if there is a pulse, resuscitation could be resumed. Flanagan asks if a pulse was felt later on that morning. Cooper states there was one person who said they felt a pulse but she could not confirm such nor did she feel the pulse. She could not recall who called out they felt a pulse as it was not recorded. Cooper is asked if she has a copy of the medical record with her. She does not. A copy is made available to her. She confirms after receiving the records she did not write the name of the person who stated they felt a pulse.
Cooper looks over a nurse scribe note.
Flanagan: DOES THE NURSE REPORT WHO REPORTED THE PULSE?
Cooper: NO. IT SAYS, "13:21, WEAK FEMORAL PULSE PALPATED WITHOUT CPR," THEN THE PERSON WHO WROTE THE NOTE INITIALS IT.
Flanagan: AND THEN 13:22?
Cooper: WHEN SOMEONE REPORTED THEY FELT A PULSE, AND I LOOKED AT THE MONITOR AND SAW THE SLOW WIDE RHYTHM, I WENT AND PUT THE ULTRASOUND ON THE HEART, SAW THE SAME CARDIAC ACTIVITY AND ATTEMPTED TO FEEL A PULSE AND DIDN'T. I ORDERED CPR TO BE CONTINUED AT 13:22.
Cooper confirms again Murray was in the room at that time.
Flanagan: YOU ARE NOT MAKING A CLAIM THAT HE IS THE ONE THAT WAS FEELING FOR THE PULSE?
Cooper: I DO NOT KNOW WHO REPORTED THE PULSE. DR. MURRAY WAS IN THE ROOM AND INITIALLY DID HAVE GLOVES ON, MAKING ATTEMPTS TO FEEL A PULSE. WHEN WE STARTED TO PERFORM LINES, I ASKED HIM. I SAID HE IS NOT ALLOWED TO PROVIDE MEDICAL CARE, ALTHOUGH HE WAS IN DISCUSSION WITH ME.
Cooper confirms Murray initially was hands-on with Michael in the trauma room. However, Cooper cannot recall if he was still hands-on at 1: 21 p.m.
Flanagan: DO YOU THINK THAT THE PULSE THAT WAS REPORTED IN THIS RECORD IS NOT FACTUAL?
Cooper: I THINK IT IS FREQUENT IN A RESUSCITATION WHEN YOU ATTEMPT TO FEEL A PULSE, PEOPLE MAY SAY THEY FEEL A PULSE. IT MAY BE THEIR OWN PULSE THEY ARE FEELING. IT CAN BE VERY DIFFICULT. AT TIMES, PULSES ARE RECORDED THAT AREN'T THERE. I WAS NEVER ABLE TO INDEPENDENTLY CONFIRM A PULSE WITHOUT CPR.
Cooper asks if she was working hands-on at that time by Flanagan.
Cooper: AT THAT TIME SOMEONE REPORTED A PULSE, THEN I WENT AND I ATTEMPTED TO FEEL A PULSE, DID NOT FEEL A PULSE, AND ORDERED CPR BE RESTARTED.
Flanagan asks when Cooper had a conversation with Murray regarding his medical history. Cooper states she took a brief history initially. As drugs were being administered and circulating she asked Murray more questions.
Cooper states she began questioning Murray as soon as he came in the door because he was the one who initially gave report of what had happened to the patient. Cooper agrees it was reported to her by Murray he was there to witness when the patient stopped breathing. Cooper states she did not ask for a specific time, however.
Cooper: HE BASICALLY TOLD YOU THAT HE WAS THERE TO SEE WHEN THE PATIENT STOPPED BREATHING?
Flanagan: WHEN YOU USE THE TERM WITNESSED, A WITNESSED ARREST, WHAT IS IT THAT YOU SEE THAT CAUSES YOU TO THINK YOU ARE WITNESSING AN ARREST?
Cooper: I INTERPRETED THAT TO MEAN HE WITNESSED THE PATIENT STOP BREATHING AND THEN STOPPED TO HAVE A PULSE, AND RESUMED CPR AND RESUSCITATION.
Flanagan asks a couple questions which are objected to by Walgren. The Court sustains the objections. Flanagan asks if the term "witnessed arrest" is a term of art/medical term.
Cooper: IF I WAS IN A ROOM WITH A PATIENT AND THE PATIENT'S EYES ROLLED BACK, HE STOPPED BREATHING, AND DIDN'T FEEL A PULSE, I WOULD REPORT THAT WHILE I WAS IN THE ROOM I WITNESSED AN ARREST. I'M NOT SURE IF YOU WOULD CALL THAT ART OF MEDICINE. THAT IS WHAT I WOULD TAKE AS WITNESSING THE ARRESTING IN THE ROOM AT THE TIME.
Flanagan and Cooper continue the discussion of what would constitute "witnessing arrest". Cooper agrees that part of witnessing an arrest is witnessing someone go from conscious to unconscious-- so long as one visibly observes such.
(Not every loss of consciousness is an arrest of some sort.)
Flanagan asks Cooper if Murray said he witnessed the arrest. Cooper states her recollection of what was told to her by Murray did include him saying he witnessed the arrest. She states she did not ask for further details.
There is some discussion between Flanagan and Cooper as to whether or not all physicians agree as to what the term "witness arrest" means.
Cooper: I CAN'T SPEAK FOR ALL MEDICAL PEOPLE. THE PARAMEDICS, AND EMERGENCY PHYSICIANS, AND CARDIOLOGISTS DO RESUSCITATIVE WORK. THERE IS STANDARD TERMINOLOGY USED WHEN WE TALK ABOUT CARDIAC ARREST, WITNESSED PHYSICAL BYSTANDER CPR. THESE ARE GENERAL PHRASES THAT WE USE THAT I WOULD ASSUME FOR ALL PHYSICIANS WHO DO THIS TYPE OF WORK WOULD SAY WITNESSED ARREST IS YOU OBSERVED THE DEATH OCCUR.
Cooper is asked if she explored this further with Murray and states no, she did not as she was trying to resuscitate the patient. She agrees she had other things to do.
Flanagan: AND YOU ASKED HIM IF MICHAEL JACKSON WAS AN ABUSER OF RECREATIONAL DRUGS?
Cooper: I DON'T BELIEVE I SAID WAS HE AN ABUSER OF RECREATIONAL DRUGS. I ASKED WAS THERE ANY DRUG USE IN THE PAST OR CURRENTLY.
Cooper states Murray's reply to her was "no".
Flanagan: YOU ALSO ASKED IF HE WAS TAKING ANY DRUGS ON A REGULAR BASIS; IS THAT CORRECT?
Cooper agrees.
Flanagan: WHY DID YOU ASK THAT?
Cooper: I HAD A 50-YEAR-OLD MALE WHO WAS DEAD. I DIDN'T KNOW WHY. I WAS TRYING TO THINK OF REASONS FOR SOMETHING I MAY BE MISSING OR SOMETHING RELATED TO THE EVENT THAT WOULD EXPLAIN, AND IT IS A COMMON QUESTION WHEN YOU ARE TAKING HISTORY IS WHAT IS THE PAST MEDICAL HISTORY AND WHAT OTHER DRUGS MAY BE USED.
Cooper agrees this information was to be used in the treatment of Michael and her medical decision making.
Cooper confirms Murray stated he gave 2 mg of lorazepam earlier in the day. She states she cannot recall asking for a specific time. Cooper then confirms Murray told her she gave Michael another 2 mg of lorazepam. Cooper is asked if she asked when the last dose was given. She states no, she did not.
Flanagan: WOULDN'T THE TIME BE OF SIGNIFICANCE TO YOU?
Cooper: I ASSUMED I WAS RECEIVING A CLEAR TESTIMONY. "I WAS AT THE PATIENT'S BED. I GAVE TWO MILLIGRAMS OF LORAZEPAM. I WITNESSED ARREST. I INSTITUTED CPR. 911 WAS CALLED." MY ASSUMPTION IS THIS WAS ALL PROXIMATE TO THE PARAMEDICS ARRIVING AND THE PATIENT ARRIVING TO ME.
Flanagan asks if she assumed the patient arrested on the induction of the 2 mg of lorazepam.
Cooper: I WAS TOLD BY DR. MURRAY THAT THE PATIENT WAS GIVEN TWO MILLIGRAMS OF LORAZEPAM AND SUBSEQUENTLY ARRESTED.
Cooper again confirms she was not given a time sequence and she did not ask for one.
Flanagan asks if lorazepam contributes to an arrest, is there something she would do from a treatment standpoint. Cooper replies the circumstances of the arrest were not clear as 2 mg of lorazepam would not typically cause an arrest in an adult male. She states it would typically cause respiratory depression and would expect the doctor to say the patient is not breathing well. Flanagan asks what she would expect Murray to do and she replies she would expect him to first stimulate/wake the person as generally people will breathe better on their own with a little bit of sedation.
(There onset of action and peak drug concentrations differ for the oral vs. intramuscular vs. intravenous administration of lorazepam. Two milligrams taken as a tablet is different than two milligrams given intravenously.)
Cooper is against asked if Murray had told her about Michael being given Valium. Walgren objects and the question is restated. Cooper agrees to a Valium being included in the medical history.
Flanagan asks if she asks when and she states no.
Flanagan: YOU DIDN'T CARE?
The Court: WAIT. IS THAT A QUESTION?
Flanagan: WELL, YEAH, THAT IS A QUESTION. DID YOU CARE WHEN?
Cooper: I ASKED WHAT MEDICATIONS HAD BEEN GIVEN AND WHAT WAS GIVEN PRECEDING WHAT HAPPENED WITH THE ARREST. I DID NOT ASK SPECIFICALLY WHAT THE LAST DOSE OF HIS REGULAR MEDICATIONS WERE.
Flanagan asks if the timing is of the dose is not important. Cooper states it could be important if she were to be administering more sedatives.
Cooper reaffirms she is familiar with propofol.
Flanagan: DO YOU USE IT FOR ANESTHETIC PURPOSES OR JUST SEDATION PURPOSES?
Cooper: THE VAST MAJORITY OF THE TIME, WE USE IT FOR PROCEDURAL SEDATION. I DO NOT WORK IN THE OPERATING ROOM. AT TIMES, WE DO USE IT ON PATIENTS WHO ARE INTUBATED AND BEING VENTILATED. THAT IS MOST COMMONLY IN THE SHORT-TERM AND THE PATIENT HAS A HEAD INJURY, A TRAUMA PATIENT.
Flanagan asks Cooper if she has been trained to give a certain amount of propofol for procedural sedation and she confirms he has been trained on such. She states she typically starts with a dose of 1 mg/kg and that dose is usually sufficient. She agrees for someone weighing 136 lbs (about 60 kg) 60 mg would be the amount for 1 mg/kg. She states that dose would be sufficient for most patients and it is a conservative amount for procedural sedation.
Flanagan: WHEN YOU SEDATE A PATIENT WITH ONE MILLIGRAM PER KILOGRAM, ARE WE TALKING ABOUT UNCONSCIOUS OR JUST IN KIND OF A--
Cooper: OUR GOAL IS TO NOT SEDATE SOMEONE TO BE COMPLETELY UNCONSCIOUS.
Cooper is asked if she would expect unconsciousness in Michael if he was given 60 mg of propofol. She states it could produce deep sedation, unconsciousness as some patients respond differently.
Flanagan: AND 25 MILLIGRAMS DEFINITELY WOULD HAVE PRODUCED UNCONSCIOUSNESS, WOULDN'T IT?
Cooper states she would not expect unconsciousness.
Cooper is asked if propofol lasts for a short period of time and agrees.
Cooper states hypothetically she would expect for 60 mg in Michael to lasts about 10-20 minutes. Flanagan then asks if 25 mg would last about 5-10 minutes.
Cooper: IN A DOSE THAT IS LOW, I DON'T KNOW HOW MUCH SEDATION YOU WOULD HAVE. THE MEDICATION, HOW LONG THE MEDICATION IS AROUND TO METABOLIZE MAY NOT CHANGE. I WOULDN'T EXPECT DEEP SEDATION.
Flanagan: YOU WOULDN'T EXPECT SEDATION TO LAST MORE THAN FIVE OR TEN MINUTES ON 25 MILLIGRAMS. YOU WOULDN'T EXPECT MORE THAN FIVE, TEN MINUTES OF SEDATION, WOULD YOU?
Cooper: I DON'T KNOW HOW LONG IT WOULD LAST. THE TYPICAL DOSE THAT I GIVE WHEN I GIVE A DOSE OF SEDATION, AND THE HALF-LIFE AND THE METABOLISM OF THE DRUG IS DIFFERENT IN EVERY PATIENT. A DOSE USUALLY TAKES TEN TO 20 MINUTES TO COMPLETELY WEAR OFF. SOMETIMES LESS IN SOME PATIENTS.
Cooper agrees she does not always know how patients are going to respond. She agrees there are certain guidelines that she begins with when dosing propofol.
Cooper agrees she would likely start with 60 mg of propofol for procedural sedation for a painful procedure in Michael given a weight of 60 kg. Again, she would expect it to wear off in 10-20 minutes.
Flanagan: SO NOW IF DR. MURRAY WERE TO GIVE THE PATIENT 25 MILLIGRAMS OF PROPOFOL BETWEEN 10:40 AND 10:50 IN THE MORNING, YOU WOULDN'T EXPECT THAT TO PRODUCE BREATHING PROBLEMS AT 12:00 O'CLOCK, WOULD YOU?
Cooper: I WOULDN'T KNOW WHY ONE WOULD BE USING A MEDICINE THAT IS USED TO PRODUCE DEEP SEDATION AND NOT GIVE A DOSE THAT IS SEDATING. TWENTY-FIVE MILLIGRAMS, I WOULDN'T EXPECT TO HAVE THAT EFFECT. I WOULD NOT EXPECT 40 MINUTES LATER, IF THERE WAS NO ADVERSE EVENT, THAT THE MEDICINE WOULD STILL BE HAVING AN EFFECT.
Flanagan: SO HYPOTHETICALLY, IF YOU HAD AN INJECTION OR INFUSION, A SLOW INFUSION OF PROPOFOL BETWEEN 10:40 TO 10:50 AND YOU SEE A PERSON STOP BREATHING AT ABOUT 12:00 NOON, YOU WOULDN'T THINK IT WAS THE PROPOFOL, WOULD YOU?
Cooper states when she administers propofol it is given as a bolus, a single bolus dose. She states the only time the medication is given as a continuous drip is when the patient is intubated and being artificially ventilated.
Cooper: SO YOU ARE TALKING ABOUT A SLOW INFUSION OVER SOME PERIOD OF TIME. IF YOU COULD CLARIFY WHAT YOU ARE STATING.
Flanagan states he is talking about the infusion of 25 mg over 3-5 minutes at around 10:40 a.m. or 10:50 a.m.
Flanagan: YOU WOULDN'T EXPECT THAT TO HAVE ANY EFFECT ON THE PATIENT AT 12:00 O'CLOCK, WOULD YOU?
Cooper: IF NO OTHER -- IF THE PATIENT HAD NOT STOPPED BREATHING OR HAD ANY OTHER EVENT AND WAS OKAY AFTER THAT, I WILL NOT EXPECT THAT WOULD BE A PROBLEM LATER.
Flanagan: SO WHAT I'M SAYING IS THAT IF, ALL OF A SUDDEN, IF THIS IS WHAT YOU HAVE DONE BETWEEN 10:40 AND 10:50 AND ALL OF A SUDDEN YOU SEE A PATIENT THAT IS NOT BREATHING AT 12:00 O'CLOCK, YOU ARE NOT GOING TO THINK IT IS THE PROPOFOL, ARE YOU?
Cooper: IF I ADMINISTERED MEDICATION THAT PRODUCED SEDATION AND A PATIENT STOPPED BREATHING, I WOULD BE CONCERNED THE MEDICATIONS I GAVE OR MEDICATIONS THAT THE PATIENT HAD INGESTED IN ADDITION TO WHAT I GAVE, OR THAT HAD PRODUCED SEDATION, HAD PRODUCED RESPIRATORY ARREST, IF THAT IS WHAT OCCURRED.
Flanagan: BUT NOW IF DR. MURRAY HAD TOLD YOU THAT EARLIER IN THE MORNING, LIKE AT 10:40, THERE HAD BEEN ADMINISTRATION OF 25 MILLIGRAMS OF PROPOFOL, WOULD THIS HAVE ALTERED YOUR TREATMENT?
Cooper states at the time she was going to standard resuscitation for a patient in cardiac arrest thus no, it would not have changed what she was doing at the time.
Cooper states when she has given propofol, on a 1 mg/kg basis, she usually sees an onset of action usually within 1 minute.
Flanagan: AND THE ELIMINATION, IF YOU ARE NOT GIVING A DRIP, IS ALSO VERY QUICK?
Cooper: IF YOU ARE NOT GIVING REPEAT DOSE, THE ELIMINATION IS GENERALLY TEN TO 20 MINUTES THE PATIENT IS RECOVERED.
Cooper affirms when giving a 1 mg/kg bolus typically the onset of action within a minute and she does expect them fully awake within 20 minutes. She states the patient is able to awake early in relation to the duration of action of the medication, as in it wears off fast.
Flanagan: NOW, FROM A MEDICAL STANDPOINT, AS A DOCTOR, IN THE EVENT THAT THERE IS A 25 MILLIGRAM DOSE OF PROPOFOL BETWEEN 10:40 AND 10:50 THAT WAS ADMINISTERED TO A 60-KILOGRAM WEIGHING PATIENT, WHEN THAT PATIENT SUFFERS A CARDIAC ARREST AT 12:00 O'CLOCK, WOULD YOU LINK THOSE TWO?
Cooper: I WOULD -- I WOULD BE CONCERNED PARTICULARLY IF THERE WERE OTHER MEDICATIONS THAT WERE GIVEN, THAT IT WOULD PRODUCE AN ARREST WHICH WOULD LEAD TO CARDIAC ARREST.
Flanagan asks if Cooper would think propofol was the cause of cardiac arrest at noon.
Cooper: IF THE PATIENT WAS AWAKE AND COMPLETELY NORMAL AND NOT SEDATED AFTER THE MEDICATION, AND THEN HAD A SUBSEQUENT PROBLEM WITH NO OTHER MEDICATIONS GIVEN, I WOULD NOT THINK IT WAS RELATED.
Cooper states she does not know anything about propofol blood levels. She would not know how to calculate a particular level in a particular organ or the blood.
Cooper is asked if lorazepam is different than propofol. She states yes, it is. She agrees lorazepam lasts longer than propofol.
Flanagan: YOU CAN GIVE LORAZEPAM, SAY, THREE HOURS AND IT WOULD STILL BE HAVING AN EFFECT IF IT IS A TOTAL OF FOUR MILLIGRAMS?
Cooper states yes, it would.
Flanagan: BUT PROPOFOL WOULDN'T HAVE AN EFFECT THAT LONG, WOULD IT?
Cooper states no, but propofol in combination with another sedative could have an additive effect.
Flanagan: BUT THE ADDITIVE EFFECT WOULD ONLY HAVE AN EFFECT AS LONG AS THE PROPOFOL WAS ADMINISTERED?
Cooper agrees.
Flanagan: YOU WOULDN'T EXPECT ANY EFFECT AFTER AN HOUR, WOULD YOU?
Cooper: IF A SINGLE DOSE OF PROPOFOL WAS GIVEN IN A ONE-TIME DOSE, I WOULD NOT EXPECT THE PATIENT WITH NORMAL HUMAN FUNCTION AND NORMAL HEALTH, THAT WOULD STILL HAVE ANY EFFECT ON SEDATION IN AN HOUR, NO.
Flanagan states he has nothing further.
REDIRECT EXAMINATION: MR. WALGREN
Walgren: MR. FLANAGAN'S HYPOTHETICAL CENTERED AROUND A PARTICULAR FACT PATTERN, BEING THAT HE WANTED YOU TO ASSUME DR. MURRAY GAVE ABOUT 25 MILLIGRAMS OF PROPOFOL AROUND 10:40 AND 10:50. DO YOU RECALL THAT?
Cooper state she recalls him giving her times and doses.
Walgren asks Cooper if Flanagan was asking her to assume Murray have 25 mg of propofol sometime between 10:40 a.m. and 10:50 p.m. She agrees. Walgren asks if when answering the question about what kind of effect that would have had at noon, she assumed the former statement of Murray's to be true. Cooper agrees.
Walgren: OBVIOUSLY, IF THAT WAS NOT A TRUTHFUL STATEMENT, YOUR ANSWER MIGHT VARY CONSIDERABLY?
Cooper states that is correct.
Walgren asks what is meant by the additive effects of narcotics.
Cooper: IF YOU GIVE PROPOFOL AND YOU GIVE AN ADDITIONAL MEDICINE THAT PRODUCES SEDATION, A BENZODIAZEPINE, OR IF YOU ARE GIVING NARCOTIC MEDICATIONAS SOMETIMES WE DO WHEN WE ARE DOING PROCEDURAL SEDATION, WE COMMONLY DO THAT. YOU CAN HAVE DEEPER LEVELS OF SEDATION THAN YOU ANTICIPATE.
Walgren: SO IF SOMEONE HAD BEEN GIVEN AN I.V. OF LORAZEPAM, FOLLOWED LATER BY AN I.V. OF MIDAZOLAM, FOLLOWED LATER BY ANOTHER I.V. OF LORAZEPAM, FOLLOWED LATER BY ANOTHER I.V. OF MIDAZOLAM, THOSE WOULD HAVE ALL A CONTRIBUTORY EFFECT IF, SUBSEQUENT TO THAT, THE PERSON WAS THEN GIVEN PROPOFOL?
Cooper states yes it could. Walgren asks if that could certainly have an additive effect that could result in respiratory and cardiac arrest. Cooper states yes, it could. Cooper agrees as an ER doctor she would want to know that whole medical history and have all that information available to her. She agrees she was not given any such history by Murray on June 25th, 2009.
Cooper agrees with Walgren that people can respond differently to propofol.
Walgren: AND BECAUSE PEOPLE RESPOND DIFFERENTLY TO PROPOFOL, THAT IS WHY IN YOUR EXPERIENCE IT IS ONLY GIVEN IN A HOSPITAL SETTING; IS THAT TRUE?
Cooper: FOR CLARIFICATION, IT IS A MEDICINE THAT CAN PRODUCE DEEP SEDATION. AND WHEN IT IS BEING ADMINISTERED, APPROPRIATE MONITORING EQUIPMENT NEEDS TO BE AVAILABLE BECAUSE YOU CAN'T ANTICIPATE HOW SEDATED SOMEONE WILL BE. SO OUR PROTOCOLS IN THE HOSPITAL FOR USE REQUIRE SPECIFIC MONITORING AND PERSONNEL AVAILABLE.
Cooper states the type of personnel and monitoring equipment required include oxygen and typically carbon monoxide monitoring devices, equipment available to manage the airway (as in the equipment needed to intubate someone) as well as someone capable of ventilating the patient and someone whose sole responsibility is to monitor the sedation. She states a heart monitor is also used. She agrees this protocol is to prevent any respiratory and/or cardiac arrest, by having all the equipment needed and the people responsible for their sole tasks. She affirms this is to make sure the patient does not die.
Walgren completes his redirect examination of Cooper.
RECROSS-EXAMINATION: MR. FLANAGAN
Cooper agrees when she is taking a history of a patient it is for the purposes of treatment. She is looking for a relevant history.
Flanagan: THE FACT THAT MICHAEL JACKSON HAD BEEN TAKING, SAY, A HUNDRED MILLIGRAMS OF DEMEROL IN THE PAST, YOU WOULDN'T NEED TO KNOW THAT FOR THIS PURPOSE, WOULD YOU?
Cooper: WHEN I ASKED THE QUESTION ABOUT PRIOR DRUG USE, ONE OF THE CONSIDERATIONS WAS IS THIS SOMEONE WHO HAD OTHER MEDICATIONS IN ADDITION TO THE LORAZEPAM THAT WAS PROVIDED THAT WOULD PROVIDE AN EXPLANATION FOR WHY THE PATIENT WAS NOT ALIVE.
Cooper agrees she is asking for relevant drug use.
Flanagan: AND IF THE DRUG IS GIVEN AT A POINT IN TIME WHERE IT COULD NOT BE PERTINENT TO THE PATIENT'S CURRENT CONDITION, THAT INFORMATION WOULDN'T BE OF ANY USE TO YOU, WOULD IT?
Walgren objects but the objection is overruled.
Cooper: FREQUENTLY, WHEN WE TAKE A HISTORY, I WILL ASK ABOUT ALL HOSPITALIZATIONS, ALL SURGERIES, ALL MEDICATIONS. I WON'T NECESSARILY ASK EVERY MEDICATION THE PATIENT HAS TAKEN IN THEIR LIFE. I NEED TO KNOW RELEVANT INFORMATION CONCERNING THE EVENT.
Flanagan: BY MR. FLANAGAN: YOU WEREN'T TAKING AHISTORY THIS NIGHT TO DETERMINE ALL PAST SURGERIES, PAST CONDITIONS AND STUFF, WERE YOU?
Cooper states she was trying to do so. Cooper agrees she wanted information that would be relevant at that point in time for the purposes of treating Michael that particular day. Cooper agrees if Murray had told her he had been administering propofol in the past to Michael that would not have changed the resuscitative efforts made on that particular day.
Flanagan completes his re-cross examination.
FURTHER REDIRECT EXAMINATION: MR. WALGREN
Cooper agrees she wanted to obtain as much information as possible related to the medical and narcotic history of the patient.
Walgren: AND AS YOU MENTIONED PREVIOUSLY, THE HISTORY OF BENZODIAZEPINE THAT HE LISTED OFF, IF THAT INFORMATION WAS GIVEN TO YOU, THAT WOULD HAVE BEEN HELPFUL AS IT RELATED TO THE ADDITIVE EFFECT YOU MENTIONED?
Cooper states yes, it would have been.
Cooper is asked if she wanted to know about any other benzodiazepine that had been given to the patient. She states she would want to know about any medication that was given to the patient, including benzodiazepines and the propofol.
Cooper agrees had she known about the benzodiazepines and propofol, and knowing the additive effect she was aware of, that would have given her a fairly clear explanation of what had occurred.
Cooper agrees she assumed, as a doctor speaking to another doctor, that she was being told the truth by Murray.
Walgren completes his examination.
Flanagan declines the chance to further re-cross examine Cooper. Cooper is excused.
Sunday, August 28, 2011
Monday, August 22, 2011
Thao Nguyen's Hearing Testimony--01/06/11
January 6th, 2011
THAO NGUYEN, M.D.--Cardiology Fellow at UCLA in Los Angeles. A Cardiology Fellow is a physician-in-training; Nguyen states she is to finish her "residency in internal medicine, then take a fellowship in cardiology". She states she is "4th year cardiology" and doing post-doctoral research as she is an M.D/PH.D, also known as a physician scientist. On 6/25/2009 she was the cardiology fellow responsible for cardiac intensive care at UCLA. At the time of her testimony (January 2011) she had been a cardiology fellow three and a half years--in June of this year she would have completed her cardiology fellowship and post-graduate doctoral research fellowships. She states she will stay on with UCLA as a clinical instructor.
DIRECT EXAMINATION: MR. WALGREN
Nguyen recalls on June 25th, 2009 she was a fellow and responsible for the cardiac care unit. She recalls being summoned to the ER by Dr. Richelle Cooper. Nguyen states Cooper is the attending physician for the ER. Nguyen recalls being introduced to Conrad Murray by Cooper in the ER.
Nguyen recalls approaching Murray for the purpose of asking about the situation and the patient. Murray told Nguyen he was the physician for Michael Jackson. He told her Michael was preparing for a concert tour in England, had been tired and had some difficulty in sleeping and required some medications for sleep. Nguyen states she had follow-up questions for Murray which included asking what Murray gave to Michael. Murray told Nguyen he gave 4 mg of Ativan (lorazepam), IV.
Nguyen is asked if she knew the condition of the patient. She confirms she knew. Based on the condition of the patient, Nguyen asked more questions. She asked Murray if he'd given any other medications besides Ativan, any other sedatives or narcotics. Nguyen states Murray's reply was, "no".
Nguyen asked Murray if he tried to reverse the effects of the Ativan. Murray's reply was "no".
(On a side note, Murray did apparently use flumazenil at some point which is the reversal agent for Ativan. Flumazenil was found in a syringe and in the terminal-end short tubing found at the residence. Whether any reached Michael's bloodstream or whether it was given when Michael was still alive is unknown.)
Nguyen then asked Murray what happened after he gave Michael the medication (Ativan). Nguyen states Murray told her he "later found the patient not breathing". Nguyen asked Murray when he found the patient not breathing and his reply was "he did not know the time". Nguyen asked Murray for an estimate of time as to when he found Michael in relation to when he had called 911 (correction, Murray did not call 911, Alberto Alvarez made the call to 911). Murray stated he "had no concept of time". Nguyen confirms those were in fact Murray's words in relation to the questions he was asked and not her opinions of Murray.
Walgren: SO HE WAS NOT ABLE TO GIVE YOU A TIME ESTIMATE?
Nguyen: ...AND HE DID NOT HAVE A WATCH AND DID NOT HAVE ANY CONCEPT OF TIME.
Nguyen confirms the statement above to Walgren.
(On a side note, Murray appears to have been wearing a watch when he arrived at UCLA that afternoon:
Nguyen again confirms Murray was unable to give her any estimate of time between when the drug was injected intravenously, to the time when he was found not breathing, or to the time in which 911 was called.
Nguyen recalls Murray asking her not to give up easily and to try her best to save the patient.
Nguyen states that is what was done on her behalf. Nguyen again confirms that Murray never mentioned any other medications other than Ativan (lorazepam). Nguyen states he did not mention anything about propofol or any other benzodiazpines (ex. midazolam or diazepam which Murray later admitted to administering during the night).
Nguyen states her team placed an intra-aortic balloon pump. She states a balloon pump is used for certain indications, such as in this particular case, for drug-induced cardiovascular failure, in order to decrease the work required of the heart and to increase the oxygen supplied directly to the heart. Nguyen adds it is a "last ditch effort". Nguyen states she did not have an optimistic view of the balloon pump working based on the observations and readings she had available to her. However, Nguyen states the balloon pump was utilized at the request of Murray to not give up easily. Nguyen states, BUT BEFORE INSERTING THE BALLOON PUMP, THERE WAS AN UNDERSTANDING THAT WAS MADE WITH DR. MURRAY THAT IF THIS METHOD OR MEASURE SHOULD FAIL TO REVIVE THE PATIENT, RESUSCITATE THE PATIENT SUCCESSFULLY, WE WILL CALL IT QUITS."
Nguyen states the balloon pump was inserted successfully but failed to revive the patient. Death was pronounced as a result of the failure to revive the patient.
Nguyen recalled glancing at her pager when she was questioning Murray about what had happened and what the time frame was concerning key events--the time was 1:35 p.m.
Walgren completes his direct examination. Recess was taken.
CROSS-EXAMINATION: MR. FLANAGAN
Nguyen is asked if she uses lorazepam in her practice (recall, she is a cardiology fellow and Murray is a cardiologist). She responds she does. Flanagan asks how long 4 mg of Ativan would keep at 136 lb. patient asleep and if it would cause him/her to sleep at all.
Nguyen states Ativan is a short or intermediate acting medication. She states it would take about 15 minutes or so (to sedate or taken an effect in the patient). The Court states he does not know what Flanagan means in terms of what type of effect the drug creates. Flanagan proceeds to ask more questions about Ativan (lorazepam).
Nguyen states it is a benzodiazepine. It is an anxiolytic or anti-anxiety drug. Nguyen confirms it is also used to induce sleep and can be used for insomnia.
Flanagan again asks how long this medication would work in a 136 lb. patient (Michael's estimated weight at the time of his death). Nguyen states the half-life of the drug is 14 hours but it is hard for her to give a duration of action as every patient is different--not just factoring in weight. Nguyen states someone who is used to receiving Ativan would likely respond differently than someone who is naive to the drug (someone who rarely takes or does not take the drug).
Nguyen clarifies that the half-life of a drug is the time it takes for the drug to drop to half of its initial concentration.
(On a side note, the half-life does not correlate to the duration of action for a drug).
Flanagan against attempts to get information from Nguyen about the effects Ativan would have on a patient of certain criteria (weight, sex, age, etc.). Nguyen asks Flanagan questions in an attempt to establish what kind of patient Flanagan is inquiring about during his cross-examination. Nguyen states she would want to know whether or not a person has been exposed to a benzodiazepine as it would not be her first drug of choice. She states there are other options besides benzodiazepines, especially for naive patients. She states benzodiazepines are known to have a high addictive (tolerance) potential so she would not want to create a larger issue (of tolerance) if the patient is not naive.
Flanagan asks Nguyen to assume she is to give Ativan to a patient for insomnia who weighs 136 lbs. but has no medical history (nothing else is known about the patient). Nguyen states she would start very low, with 1 or 2 mg orally. She states she would not use IV administration of the drug. She would wait to see if the patient received any benefits from the medication and if not she would advance to"a little bit more". She states she would not start off with 4 mg of Ativan IV.
Flanagan lets it be known that Murray states he gave 2 mg at one point and another 2 mg of Ativan at another point in time--not a total of 4 mg at one time.
Walgren objects--the Court states Flanagan may ask what was and was not told to her. Nguyen states she has not reviewed Dr. Cooper's report for this particular case.
Nguyen again states she would start out with 1 or 2 mg of Ativan in a 136 lb. patient (recall she would use oral administration and not IV). She is asked how long she would expect that amount of Ativan to induce sleep. She states again, it depends on the patient and the history, but would expect it to last a couple hours. She is asked what would occur if she used 4 mg. She states again she would expect it to work a couple hours, depending on the background history of the patient. She states if the patient is not naive to the medication and the same medication is used, one would need to reach a higher concentration to achieve the same effect.
Flanagan asks about blood concentrations of lorazepam. She states depending on the liver and the excretion, certain levels would be attained. She states she is not aware of the blood level in this patient.
Flanagan attempts to ask if Michael's blood level of 169 ng/mL would produce sleep. Walgren objects and the objection is sustained. Nguyen states they (physicians) do not typically order blood levels for Ativan. She reiterates this notion again with Flanagan's subsequent questions. She states in practice it is common to monitor for a clinical effect (what you physically see occurring to the patient) rather than using lab values to determine dosing. She further states that the same scenario exists for propofol use--a clinical effect is monitored rather than a lab value to determine how much of the medication should be given for the desired effect.
Flanagan asks about the term "no concept of time". Nguyen states this was not her wording but rather her recollection of Murray's words. She states again it was not her conclusion he had no concept of time but rather her recollection of Murray stating he had no concept of time.
Flanagan asks how Murray appeared at UCLA, as in terms of his emotional state. Nguyen said he appeared "devastated" based on his facial expressions. She states his voice was normal--she further states his voice appeared "calm" and she was able to have a "calm" conversation with Murray.
Nguyen states he appeared devastated simply based on his facial expressions. She is asked to compare how Murray looked at the hospital to how he looks in court. She states he is not talking in court, thus she cannot tell. She states there was no emotion on his face, she could not tell--she saw the emotion only when he was talking. She states it was his body language and verbal expression that led her to believe he was devastated.
Flanagan begins asking some of the same questions Walgren asked during the direct examination regarding what drugs were administered, what time they were given (to which Murray did not know what time he gave Ativan and could not estimate a time, either), the interval between when he gave Ativan and observed Michael not breathing (to which he could not give an estimate for, either). Flanagan asks Nguyen if she asked Murray if he could estimate within a scope of a couple hours to when anything occurred to which Nguyen replied "his answer was negative, he could not".
Nguyen recalled this conversation occurring at 1:35 p.m. via her pager. She recalls she was in the room with Michael, attempting to revive him. Flanagan asks how many doctors were in the room--she states she recognized Cooper but there could have been other unknown doctors in the room. Flanagan asks if there was a lot of confusion in the room to which Nguyen states there was no confusion in the room. Nguyen states there was "orderly activity" going on for the purpose of running the code (Code Blue). Nguyen recalls there maybe being 5 or 6 people in the room, at least, all having a role in the code.
Nguyen confirms her questioning of Murray took place in the same room in which Michael was in and being attended to by hospital staff. She states Murray was in close proximity to what was occurring in the room to Michael.
Flanagan asks if Nguyen thinks Murray had full concentration at the time he was being questioned by her. Her reply is, "YES. HE WAS NOT WATCHING THE PATIENT WHILE HE TALKED TO ME. HE ESTABLISHED EYE CONTACT WITH ME...THROUGHOUT THE CONVERSATION." She states the conversation took place over a "couple of minutes". She states the room was small and Murray was standing by the left leg of the bed right by Michael. Murray's back was to Michael. Nguyen was facing Michael.
Nguyen states her team member Dr. Cruz came to assist with the balloon pump. She states it was Cruz's idea to insert the balloon pump with her approval. Nguyen confirms there is no indication for a balloon pump to be used if the patient is without a pulse. She confirms they used the balloon pump though there was no pulse. She states they used the balloon pump "per request of Murray not to give up easily and the code was already ran and there was nothing else that could be tried except for that (the balloon pump)".
Flanagan: WOULD IT BE ACCURATE TO STATE THAT DR. MURRAY WAS ADAMANT. HE DID NOT WANT TO GIVE UP ON MICHAEL JACKSON?
Nguyen: HE DID NOT WANT US TO GIVE UP.
Nguyen states no drugs were used to reverse the Ativan by UCLA. Nguyen states, "BEFORE DECIDING NOT TO USE IT, I TURNED TO DR. COOPER AND ASKED HER, "HAS LORAZEPAM BEEN REVERSED?" SHE SAID, "NO." AT THAT TIME, BASED ON OUR ESTIMATE, THE WINDOW OF TIME THAT THE REVERSAL OF LORAZEPAM BY INJECTION OF FLUMAZENIL WAS ALREADY LOST."
Flanagan asks what that window of time is.
Nguyen: AS SOON AS THE PATIENT WAS FOUND DOWN, AT EARLIEST SIGN THAT THE PATIENT WAS IN DISTRESS. NOT WHEN THE PATIENT WAS ALREADY DEAD.
Flanagan asks if it was Nguyen's opinion that Murray did not give any flumazenil to Michael. She states it was her opinion, it was his answer to her (as well).
Nguyen states she has not read the autopsy report in this case. She also confirms Murray did not give the order for the balloon pump and he was not in charge at UCLA. Nguyen states it was not Murray's advice to put in a balloon pump--it was her (and Cruz's) decision. She confirms the indication could have been drug-induced cardiovascular failure, as in there was an indication in this case.
Flanagan tries to ask why Nguyen did not give flumazenil--Walgren objects. The Court states the evidence is being misstated and Nguyen has already indicated the patient was deceased and that is the answer as to why it was not given.
Flanagan attempts to state the balloon pump was to reverse the drug-induced cardiovascular failure. Nguyen states he is incorrect--she did not say that but rather she stated it could help in situations of drug-induced heart failure. She states it does not reverse the drugs-it only helps the heart.
Nguyen again states the reason reversal medications were not given is because the window of time had already elapsed. Nguyen states there was a window of time for the balloon pump, when there is still a pulse. However, she confirms there was no pulse.
(On a side note, it is accurate that balloon pumps are not used when there is no pulse. They do not make the heart beat but rather allow a beating heart to work less which gives it some sort of "break" with the heart continuing to beat the entire time. It appears the only reason a balloon pump was used in this instance was to pacify Murray's request for the team at UCLA "not to give up easily". Otherwise, there was really no indication for the balloon pump since Michael was without a pulse and in fact deceased on arrival.)
REDIRECT EXAMINATION: MR. WALGREN
Walgren asks for clarification on one of the answers Nguyen gave while being questioned about her hypothetical dosing of Ativan for a 136 lb. patient. He clarifies with her that "P.O." means to be taken orally. She confirms she would give the medication orally because it would be safer than giving it intravenously. Nguyen states there is no confusion as to what Murray told her in relation to what was discussed in court. She confirms she has a recollection of what Murray told her on June 25th, 2009. She confirms she was able to hear him clearly.
Walgren completes the redirect examination. Flanagan declines to re-cross examine Nguyen. She is excused.
THAO NGUYEN, M.D.--Cardiology Fellow at UCLA in Los Angeles. A Cardiology Fellow is a physician-in-training; Nguyen states she is to finish her "residency in internal medicine, then take a fellowship in cardiology". She states she is "4th year cardiology" and doing post-doctoral research as she is an M.D/PH.D, also known as a physician scientist. On 6/25/2009 she was the cardiology fellow responsible for cardiac intensive care at UCLA. At the time of her testimony (January 2011) she had been a cardiology fellow three and a half years--in June of this year she would have completed her cardiology fellowship and post-graduate doctoral research fellowships. She states she will stay on with UCLA as a clinical instructor.
DIRECT EXAMINATION: MR. WALGREN
Nguyen recalls on June 25th, 2009 she was a fellow and responsible for the cardiac care unit. She recalls being summoned to the ER by Dr. Richelle Cooper. Nguyen states Cooper is the attending physician for the ER. Nguyen recalls being introduced to Conrad Murray by Cooper in the ER.
Nguyen recalls approaching Murray for the purpose of asking about the situation and the patient. Murray told Nguyen he was the physician for Michael Jackson. He told her Michael was preparing for a concert tour in England, had been tired and had some difficulty in sleeping and required some medications for sleep. Nguyen states she had follow-up questions for Murray which included asking what Murray gave to Michael. Murray told Nguyen he gave 4 mg of Ativan (lorazepam), IV.
Nguyen is asked if she knew the condition of the patient. She confirms she knew. Based on the condition of the patient, Nguyen asked more questions. She asked Murray if he'd given any other medications besides Ativan, any other sedatives or narcotics. Nguyen states Murray's reply was, "no".
Nguyen asked Murray if he tried to reverse the effects of the Ativan. Murray's reply was "no".
(On a side note, Murray did apparently use flumazenil at some point which is the reversal agent for Ativan. Flumazenil was found in a syringe and in the terminal-end short tubing found at the residence. Whether any reached Michael's bloodstream or whether it was given when Michael was still alive is unknown.)
Nguyen then asked Murray what happened after he gave Michael the medication (Ativan). Nguyen states Murray told her he "later found the patient not breathing". Nguyen asked Murray when he found the patient not breathing and his reply was "he did not know the time". Nguyen asked Murray for an estimate of time as to when he found Michael in relation to when he had called 911 (correction, Murray did not call 911, Alberto Alvarez made the call to 911). Murray stated he "had no concept of time". Nguyen confirms those were in fact Murray's words in relation to the questions he was asked and not her opinions of Murray.
Walgren: SO HE WAS NOT ABLE TO GIVE YOU A TIME ESTIMATE?
Nguyen: ...AND HE DID NOT HAVE A WATCH AND DID NOT HAVE ANY CONCEPT OF TIME.
Nguyen confirms the statement above to Walgren.
(On a side note, Murray appears to have been wearing a watch when he arrived at UCLA that afternoon:
Nguyen again confirms Murray was unable to give her any estimate of time between when the drug was injected intravenously, to the time when he was found not breathing, or to the time in which 911 was called.
Nguyen recalls Murray asking her not to give up easily and to try her best to save the patient.
Nguyen states that is what was done on her behalf. Nguyen again confirms that Murray never mentioned any other medications other than Ativan (lorazepam). Nguyen states he did not mention anything about propofol or any other benzodiazpines (ex. midazolam or diazepam which Murray later admitted to administering during the night).
Nguyen states her team placed an intra-aortic balloon pump. She states a balloon pump is used for certain indications, such as in this particular case, for drug-induced cardiovascular failure, in order to decrease the work required of the heart and to increase the oxygen supplied directly to the heart. Nguyen adds it is a "last ditch effort". Nguyen states she did not have an optimistic view of the balloon pump working based on the observations and readings she had available to her. However, Nguyen states the balloon pump was utilized at the request of Murray to not give up easily. Nguyen states, BUT BEFORE INSERTING THE BALLOON PUMP, THERE WAS AN UNDERSTANDING THAT WAS MADE WITH DR. MURRAY THAT IF THIS METHOD OR MEASURE SHOULD FAIL TO REVIVE THE PATIENT, RESUSCITATE THE PATIENT SUCCESSFULLY, WE WILL CALL IT QUITS."
Nguyen states the balloon pump was inserted successfully but failed to revive the patient. Death was pronounced as a result of the failure to revive the patient.
Nguyen recalled glancing at her pager when she was questioning Murray about what had happened and what the time frame was concerning key events--the time was 1:35 p.m.
Walgren completes his direct examination. Recess was taken.
CROSS-EXAMINATION: MR. FLANAGAN
Nguyen is asked if she uses lorazepam in her practice (recall, she is a cardiology fellow and Murray is a cardiologist). She responds she does. Flanagan asks how long 4 mg of Ativan would keep at 136 lb. patient asleep and if it would cause him/her to sleep at all.
Nguyen states Ativan is a short or intermediate acting medication. She states it would take about 15 minutes or so (to sedate or taken an effect in the patient). The Court states he does not know what Flanagan means in terms of what type of effect the drug creates. Flanagan proceeds to ask more questions about Ativan (lorazepam).
Nguyen states it is a benzodiazepine. It is an anxiolytic or anti-anxiety drug. Nguyen confirms it is also used to induce sleep and can be used for insomnia.
Flanagan again asks how long this medication would work in a 136 lb. patient (Michael's estimated weight at the time of his death). Nguyen states the half-life of the drug is 14 hours but it is hard for her to give a duration of action as every patient is different--not just factoring in weight. Nguyen states someone who is used to receiving Ativan would likely respond differently than someone who is naive to the drug (someone who rarely takes or does not take the drug).
Nguyen clarifies that the half-life of a drug is the time it takes for the drug to drop to half of its initial concentration.
(On a side note, the half-life does not correlate to the duration of action for a drug).
Flanagan against attempts to get information from Nguyen about the effects Ativan would have on a patient of certain criteria (weight, sex, age, etc.). Nguyen asks Flanagan questions in an attempt to establish what kind of patient Flanagan is inquiring about during his cross-examination. Nguyen states she would want to know whether or not a person has been exposed to a benzodiazepine as it would not be her first drug of choice. She states there are other options besides benzodiazepines, especially for naive patients. She states benzodiazepines are known to have a high addictive (tolerance) potential so she would not want to create a larger issue (of tolerance) if the patient is not naive.
Flanagan asks Nguyen to assume she is to give Ativan to a patient for insomnia who weighs 136 lbs. but has no medical history (nothing else is known about the patient). Nguyen states she would start very low, with 1 or 2 mg orally. She states she would not use IV administration of the drug. She would wait to see if the patient received any benefits from the medication and if not she would advance to"a little bit more". She states she would not start off with 4 mg of Ativan IV.
Flanagan lets it be known that Murray states he gave 2 mg at one point and another 2 mg of Ativan at another point in time--not a total of 4 mg at one time.
Walgren objects--the Court states Flanagan may ask what was and was not told to her. Nguyen states she has not reviewed Dr. Cooper's report for this particular case.
Nguyen again states she would start out with 1 or 2 mg of Ativan in a 136 lb. patient (recall she would use oral administration and not IV). She is asked how long she would expect that amount of Ativan to induce sleep. She states again, it depends on the patient and the history, but would expect it to last a couple hours. She is asked what would occur if she used 4 mg. She states again she would expect it to work a couple hours, depending on the background history of the patient. She states if the patient is not naive to the medication and the same medication is used, one would need to reach a higher concentration to achieve the same effect.
Flanagan asks about blood concentrations of lorazepam. She states depending on the liver and the excretion, certain levels would be attained. She states she is not aware of the blood level in this patient.
Flanagan attempts to ask if Michael's blood level of 169 ng/mL would produce sleep. Walgren objects and the objection is sustained. Nguyen states they (physicians) do not typically order blood levels for Ativan. She reiterates this notion again with Flanagan's subsequent questions. She states in practice it is common to monitor for a clinical effect (what you physically see occurring to the patient) rather than using lab values to determine dosing. She further states that the same scenario exists for propofol use--a clinical effect is monitored rather than a lab value to determine how much of the medication should be given for the desired effect.
Flanagan asks about the term "no concept of time". Nguyen states this was not her wording but rather her recollection of Murray's words. She states again it was not her conclusion he had no concept of time but rather her recollection of Murray stating he had no concept of time.
Flanagan asks how Murray appeared at UCLA, as in terms of his emotional state. Nguyen said he appeared "devastated" based on his facial expressions. She states his voice was normal--she further states his voice appeared "calm" and she was able to have a "calm" conversation with Murray.
Nguyen states he appeared devastated simply based on his facial expressions. She is asked to compare how Murray looked at the hospital to how he looks in court. She states he is not talking in court, thus she cannot tell. She states there was no emotion on his face, she could not tell--she saw the emotion only when he was talking. She states it was his body language and verbal expression that led her to believe he was devastated.
Flanagan begins asking some of the same questions Walgren asked during the direct examination regarding what drugs were administered, what time they were given (to which Murray did not know what time he gave Ativan and could not estimate a time, either), the interval between when he gave Ativan and observed Michael not breathing (to which he could not give an estimate for, either). Flanagan asks Nguyen if she asked Murray if he could estimate within a scope of a couple hours to when anything occurred to which Nguyen replied "his answer was negative, he could not".
Nguyen recalled this conversation occurring at 1:35 p.m. via her pager. She recalls she was in the room with Michael, attempting to revive him. Flanagan asks how many doctors were in the room--she states she recognized Cooper but there could have been other unknown doctors in the room. Flanagan asks if there was a lot of confusion in the room to which Nguyen states there was no confusion in the room. Nguyen states there was "orderly activity" going on for the purpose of running the code (Code Blue). Nguyen recalls there maybe being 5 or 6 people in the room, at least, all having a role in the code.
Nguyen confirms her questioning of Murray took place in the same room in which Michael was in and being attended to by hospital staff. She states Murray was in close proximity to what was occurring in the room to Michael.
Flanagan asks if Nguyen thinks Murray had full concentration at the time he was being questioned by her. Her reply is, "YES. HE WAS NOT WATCHING THE PATIENT WHILE HE TALKED TO ME. HE ESTABLISHED EYE CONTACT WITH ME...THROUGHOUT THE CONVERSATION." She states the conversation took place over a "couple of minutes". She states the room was small and Murray was standing by the left leg of the bed right by Michael. Murray's back was to Michael. Nguyen was facing Michael.
Nguyen states her team member Dr. Cruz came to assist with the balloon pump. She states it was Cruz's idea to insert the balloon pump with her approval. Nguyen confirms there is no indication for a balloon pump to be used if the patient is without a pulse. She confirms they used the balloon pump though there was no pulse. She states they used the balloon pump "per request of Murray not to give up easily and the code was already ran and there was nothing else that could be tried except for that (the balloon pump)".
Flanagan: WOULD IT BE ACCURATE TO STATE THAT DR. MURRAY WAS ADAMANT. HE DID NOT WANT TO GIVE UP ON MICHAEL JACKSON?
Nguyen: HE DID NOT WANT US TO GIVE UP.
Nguyen states no drugs were used to reverse the Ativan by UCLA. Nguyen states, "BEFORE DECIDING NOT TO USE IT, I TURNED TO DR. COOPER AND ASKED HER, "HAS LORAZEPAM BEEN REVERSED?" SHE SAID, "NO." AT THAT TIME, BASED ON OUR ESTIMATE, THE WINDOW OF TIME THAT THE REVERSAL OF LORAZEPAM BY INJECTION OF FLUMAZENIL WAS ALREADY LOST."
Flanagan asks what that window of time is.
Nguyen: AS SOON AS THE PATIENT WAS FOUND DOWN, AT EARLIEST SIGN THAT THE PATIENT WAS IN DISTRESS. NOT WHEN THE PATIENT WAS ALREADY DEAD.
Flanagan asks if it was Nguyen's opinion that Murray did not give any flumazenil to Michael. She states it was her opinion, it was his answer to her (as well).
Nguyen states she has not read the autopsy report in this case. She also confirms Murray did not give the order for the balloon pump and he was not in charge at UCLA. Nguyen states it was not Murray's advice to put in a balloon pump--it was her (and Cruz's) decision. She confirms the indication could have been drug-induced cardiovascular failure, as in there was an indication in this case.
Flanagan tries to ask why Nguyen did not give flumazenil--Walgren objects. The Court states the evidence is being misstated and Nguyen has already indicated the patient was deceased and that is the answer as to why it was not given.
Flanagan attempts to state the balloon pump was to reverse the drug-induced cardiovascular failure. Nguyen states he is incorrect--she did not say that but rather she stated it could help in situations of drug-induced heart failure. She states it does not reverse the drugs-it only helps the heart.
Nguyen again states the reason reversal medications were not given is because the window of time had already elapsed. Nguyen states there was a window of time for the balloon pump, when there is still a pulse. However, she confirms there was no pulse.
(On a side note, it is accurate that balloon pumps are not used when there is no pulse. They do not make the heart beat but rather allow a beating heart to work less which gives it some sort of "break" with the heart continuing to beat the entire time. It appears the only reason a balloon pump was used in this instance was to pacify Murray's request for the team at UCLA "not to give up easily". Otherwise, there was really no indication for the balloon pump since Michael was without a pulse and in fact deceased on arrival.)
REDIRECT EXAMINATION: MR. WALGREN
Walgren asks for clarification on one of the answers Nguyen gave while being questioned about her hypothetical dosing of Ativan for a 136 lb. patient. He clarifies with her that "P.O." means to be taken orally. She confirms she would give the medication orally because it would be safer than giving it intravenously. Nguyen states there is no confusion as to what Murray told her in relation to what was discussed in court. She confirms she has a recollection of what Murray told her on June 25th, 2009. She confirms she was able to hear him clearly.
Walgren completes the redirect examination. Flanagan declines to re-cross examine Nguyen. She is excused.
Tuesday, August 9, 2011
Rebuttal to Jason Pfeffier's Claims in His Lawsuit Against Arnold Klein
I am literally tired of seeing this article reproduced everywhere. At the same time, I am tired of trying to reply to it everywhere, too. Thus, a blog is required to try and once again repair damage inflicted upon Michael's name:
The following is the article posted via various tabloid websites:
First I will say I could not care less about the spat between Pfeiffer and Klein. They seem to have some issues with one another that go well beyond that of a professional relationship. Sadly, they have stuffed Michael in between them without jusification.
Pfeiffer claims Klein was overmedicating Michael yet apparently has no medical training or authority to base such claims. Klein admits to using Demerol or (not and) oral Percocet to help with pain relief and sedation while performing facial procedures on Michael. Klein did in fact perform facial procedures as there was a very visible change in Michael's appearance over the last few months of his life, as he was gearing up for "This Is It". Klein has stated Michael was "needle-phobic", as others have stated this before, too. Someone needle-phobic would need to be sedated while having injections placed into their face and scalp. The face and scalp are sensitive areas of the body and are the only areas of the body that if tattooed require sedation. If Michael was not sedated enough he could have jerked and a needle could have broken off into his skin--that would be a huge problem for both Michael and Klein.
Both Klein and Pfeiffer have claimed that Michael appeared fine until the last 2 weeks of his life. They both have stated they saw no injection marks on Michael's body, especially his arms. Michael had injections on his arms and neck when he died but these were created by paramedics desperately trying to put an IV line in someone deceased. There were no injections between Michael's toes or track marks anywhere. There was nothing though tabloid articles and so-called experts keep inventing something.
Pfeiffer claims Michael would be so heavily sedated he could not walk. I was not there so I never observed Michael leaving Klein's office but I have seen numerous photos of Michael leaving Klein's office and he appears to have been able to walk just fine without support. He may have been under the influence to some degree (think of when you go the dental office) but thus far I see no evidence to substantiate Pfeiffer's claims that he was unable to walk. Just trying to brave through mobs of people and continuous camera flashes would be enough to cause me to stumble or need assistance walking out of a doctor's office, though.
There is no evidence Klein was writing or giving pain medications to Michael for out-of-office use (AKA home use). There were no pain narcotics found in Michael's home from any source. Thus, there is no evidence that Klein was supplying Michael with narcotics or muscle relaxants, either. Klein wrote two prescriptions for a muscle relaxant called Zanaflex. Zanaflex has NO abuse potential and it is not a narcotic. The autopsy report lists medications written for Michael by Klein that were found in the residence. Klein first wrote for Zanaflex on November 6th, 2008. He wrote a prescription for FOUR tablets. There were no remaining tablets. Klein wrote another prescription for Zanaflex on June 7th, 2009. He wrote for 10 tablets--8 tablets remained in the bottle. This information does NOT support any form of addiction to or abuse of muscle relaxants. If anything it shows Michael was non-compliant, as in, he failed to take his medications as directed by simply not taking them at all. It appears the latter prescription was written under Michael's well-known alias--Omar Arnold. Though it may be illegal I can understand why celebrities seek to have prescriptions filled under alias names. This does not always equate with abuse or addiction as was certainly not the case with Michael. There is no such thing as genuine privacy for celebrities. Everyone deserves to have their healthcare information private, including celebrities, and sometimes using aliases seems to be the best way at providing that to them. I am not saying this is right--but I can simply understand why it is done. There is not always a sinister reason for this action. Lastly, there were no prescriptions found at the residence that had Pfeiffer's name on them.
I have no idea why Pfeiffer mentioned the faked staph infection in order for Michael to get out of court. So what?! There is no way to prove now whether or not Michael did actually have a staph infection. Staph is a very common bacteria, typically found on the skin. Because Michael had to take high doses of prednisone at times he was actually at a higher risk of getting infections like staph infections of the skin because prednisone suppresses the immune system's ability to fight off infection.
Hopefully for the last time--the "51 injections" listed--those were NOT listed as Demerol injections nor does a charge for an injection mean an injection even occurred though Michael was receiving injections of Botox and Restylane (a cosmetic filler). Michael may have even received steroidal injections at times, too. There is no way to know what those injections were if they even occurred. However, in my opinion Klein was a wee bit "invoice-happy" if you get my drift. Judge for yourself.
http://www.scribd.com/doc/48714326/Dr-Arnold-Klein-s-Invoice-Creditor-s-Claim-towards-the-Estate-of-Michael-Jackson
Klein billed for an injection 3 days before Michael passed yet Michael's toxicology report said he was negative for opioids, including Demerol, Percocet, hydrocodone and moprhine. Demerol and its metabolites are typically still present in the body for about a week after the last administration of the drug. The math tells us it is very unlikely Michael was given Demerol within a week of his death, if not longer. That, too, is inconsistent with someone who is supposedly addicted to the substance or abusing it. As Deborah Brazil stated in court--there is no evidence that Michael was withdrawing from Demerol when he died. Now I state there is no evidence Michael was ever abusing or addicted to it, either.
It is so upsetting to continuously see this kind of rubbish out there. It is too bad that rubbish seems to be what the masses hear rather than hearing the truth from an unbiased perspective.
The following is the article posted via various tabloid websites:
A lawsuit has been filed against another one of Michael Jackson's doctors, this time against his dermatologist, Dr. Arnold Klein.
Klein's former assistant Jason Pfeiffer filed the lawsuit, which accuses Klein of fueling the singer's addiction by providing him with muscle relaxers and narcotics and getting him "too drugged up and disoriented to stand on his own," according to the legal papers obtained by *****.
Pfeiffer said that he and Klein's own nurses were concerned that Jackson was being "overmedicated" by Klein and when he voiced his opinion, was told to "keep his mouth shut."
Pfeiffer stated in the legal documents that Michael Jackson asked for a doctor's note to "get out of a court appearance" in October 2008 and Klein issued a note claiming that the singer suffered from a Staph infection and fabricated a test.
There was also a claim made that Klein tried to give Jackson prescription muscle relaxers in 2009 by writing a prescription in Pfeiffer's name. The documents state that this was a common practice and Klein wrote prescriptions for amyl nitrate, Percocet, Cialis, Phentermine and Levitra in Pfeiffer's name, for his own consumption as well as for other patients.
Pfeiffer is suing the dermatologist for wrongful termination, hour and wage violations, sexual harassment and creating a hostile work environment, among other things.
The legal documents mention that Klein required Pfeiffer to help him find sexual partners and to prepare for sexual encounters with "masseurs, paid escorts and prostitutes" and "required that Pfeiffer wash Klein's groin." Pfeiffer also recounted an instance where he was asked to obtain homeless men for his former employer to have sex with.
Pfeiffer said he suffers from emotional problems as a result from Klein's alleged abuse and is suing him for unspecified damages.
Klein is considered the father of modern cosmetic dermatology and developed modern injection techniques for Botox, Collagen and Restylane.
Jackson died at age 50 on June 25, 2009 in his Los Angeles home from an overdose of the anesthetic propofol and two other sedatives that were prescribed by Dr. Conrad Murray. His death was classified as a homicide.
The trial for Murray, the doctor charged with involuntary manslaughter in Michael Jackson's death, was recently delayed until September. Murray has pleaded not guilty and faces up to four years in prison if convicted.
In his own legal documents, Murray accused Klein of getting Jackson addicted to Demerol, a narcotic which he reportedly gave the singer 51 injections in the three months before Jackson's death.
Klein admitted on CNN's "Larry King Live" in July 2009 that he had prescribed the singer Demerol, but denied that Jackson was "riddled with needle marks." On the talk show, Klein also dodged questions about his donated sperm and whether he was the biological father of Jackson's kids.
Klein's attorney, Mira Hashmall, denied the claims.
"Jason Pfeiffer's allegations are scurrilous and false. His claims lack merit and will be proven baseless in court," Hashmall said in a statement.
There was no immediate comment from the Jackson family.
First I will say I could not care less about the spat between Pfeiffer and Klein. They seem to have some issues with one another that go well beyond that of a professional relationship. Sadly, they have stuffed Michael in between them without jusification.
Pfeiffer claims Klein was overmedicating Michael yet apparently has no medical training or authority to base such claims. Klein admits to using Demerol or (not and) oral Percocet to help with pain relief and sedation while performing facial procedures on Michael. Klein did in fact perform facial procedures as there was a very visible change in Michael's appearance over the last few months of his life, as he was gearing up for "This Is It". Klein has stated Michael was "needle-phobic", as others have stated this before, too. Someone needle-phobic would need to be sedated while having injections placed into their face and scalp. The face and scalp are sensitive areas of the body and are the only areas of the body that if tattooed require sedation. If Michael was not sedated enough he could have jerked and a needle could have broken off into his skin--that would be a huge problem for both Michael and Klein.
Both Klein and Pfeiffer have claimed that Michael appeared fine until the last 2 weeks of his life. They both have stated they saw no injection marks on Michael's body, especially his arms. Michael had injections on his arms and neck when he died but these were created by paramedics desperately trying to put an IV line in someone deceased. There were no injections between Michael's toes or track marks anywhere. There was nothing though tabloid articles and so-called experts keep inventing something.
Pfeiffer claims Michael would be so heavily sedated he could not walk. I was not there so I never observed Michael leaving Klein's office but I have seen numerous photos of Michael leaving Klein's office and he appears to have been able to walk just fine without support. He may have been under the influence to some degree (think of when you go the dental office) but thus far I see no evidence to substantiate Pfeiffer's claims that he was unable to walk. Just trying to brave through mobs of people and continuous camera flashes would be enough to cause me to stumble or need assistance walking out of a doctor's office, though.
There is no evidence Klein was writing or giving pain medications to Michael for out-of-office use (AKA home use). There were no pain narcotics found in Michael's home from any source. Thus, there is no evidence that Klein was supplying Michael with narcotics or muscle relaxants, either. Klein wrote two prescriptions for a muscle relaxant called Zanaflex. Zanaflex has NO abuse potential and it is not a narcotic. The autopsy report lists medications written for Michael by Klein that were found in the residence. Klein first wrote for Zanaflex on November 6th, 2008. He wrote a prescription for FOUR tablets. There were no remaining tablets. Klein wrote another prescription for Zanaflex on June 7th, 2009. He wrote for 10 tablets--8 tablets remained in the bottle. This information does NOT support any form of addiction to or abuse of muscle relaxants. If anything it shows Michael was non-compliant, as in, he failed to take his medications as directed by simply not taking them at all. It appears the latter prescription was written under Michael's well-known alias--Omar Arnold. Though it may be illegal I can understand why celebrities seek to have prescriptions filled under alias names. This does not always equate with abuse or addiction as was certainly not the case with Michael. There is no such thing as genuine privacy for celebrities. Everyone deserves to have their healthcare information private, including celebrities, and sometimes using aliases seems to be the best way at providing that to them. I am not saying this is right--but I can simply understand why it is done. There is not always a sinister reason for this action. Lastly, there were no prescriptions found at the residence that had Pfeiffer's name on them.
I have no idea why Pfeiffer mentioned the faked staph infection in order for Michael to get out of court. So what?! There is no way to prove now whether or not Michael did actually have a staph infection. Staph is a very common bacteria, typically found on the skin. Because Michael had to take high doses of prednisone at times he was actually at a higher risk of getting infections like staph infections of the skin because prednisone suppresses the immune system's ability to fight off infection.
Hopefully for the last time--the "51 injections" listed--those were NOT listed as Demerol injections nor does a charge for an injection mean an injection even occurred though Michael was receiving injections of Botox and Restylane (a cosmetic filler). Michael may have even received steroidal injections at times, too. There is no way to know what those injections were if they even occurred. However, in my opinion Klein was a wee bit "invoice-happy" if you get my drift. Judge for yourself.
http://www.scribd.com/doc/48714326/Dr-Arnold-Klein-s-Invoice-Creditor-s-Claim-towards-the-Estate-of-Michael-Jackson
Klein billed for an injection 3 days before Michael passed yet Michael's toxicology report said he was negative for opioids, including Demerol, Percocet, hydrocodone and moprhine. Demerol and its metabolites are typically still present in the body for about a week after the last administration of the drug. The math tells us it is very unlikely Michael was given Demerol within a week of his death, if not longer. That, too, is inconsistent with someone who is supposedly addicted to the substance or abusing it. As Deborah Brazil stated in court--there is no evidence that Michael was withdrawing from Demerol when he died. Now I state there is no evidence Michael was ever abusing or addicted to it, either.
It is so upsetting to continuously see this kind of rubbish out there. It is too bad that rubbish seems to be what the masses hear rather than hearing the truth from an unbiased perspective.
Friday, August 5, 2011
Nicole Alvarez's Hearing Testimony--01/07/11
January 7th, 2011
NICOLE ALVAREZ
(Discussions begin at the sidebar.)
Flanagan asks if they may approach the bench. Flanagan, Chernoff, Brazil and Walgren are present--Low is not. Flanagan states this witness has certain "delicate issues" like that of the previous witness (Bridgette Morgan). He states Alvarez is the mother of one of Murray's children. He states it is known Murray and Alvarez have a social relationship--apparent by them having a child together--but says he does not feel the origin of the relationship should be discussed. He states they had a social relationship in June 2009. He states regarding the 2 minute phone call placed in the ambulance to Alvarez, nothing further should be examined except they lived together, unless the prosecution is going to cover the evidence regarding packages received.
Walgren states issues of credibility are important. He states the fact they have a current social relationship and they have a child together is obviously relevant to her credibility, as well as where they met. He states this witness is entirely different than Morgan. He states Alvarez is the woman who was receiving propofol shipments to her house. He further states she is an uncooperative witness who has refused to cooperate with police, including refusing to open the door for police and she has reached out to Murray's attorneys. Walgren states he feels the phone call is the least of what Brazil wishes to get into--she wishes to examine the nature of the relationship which Walgren feels is much more important. He states when Murray comes to L.A.--he stays with Alvarez.
Chernoff states there is clearly more relevance to this witness . He says he agrees with Walgren. He feels Flanagan is referring to where and how they met as being irrelevant.
Brazil disagrees and says the inception of the relationship, how it progressed, is relevant.
The Court states this witness is dramatically different than Morgan because of the delivery of propofol to Alvarez. Brazil agrees. The Court states he will allow the parties to explore the relationship.
Flanagan interjects--the Court interrupts him. Flanagan states the prosecution can establish the nature of the relationship in June, that they lived together, that when he was not with the patient he was with her and she is the mother of his child. He asks what else has to go into the nature of their relationship.
The Court states that under the preliminary guidelines he is going to allow the nature of the relationship to be explored.
Proceedings begin in open court. Mr. Victor Guinne is serving as counsel for Nicole Alvarez.
DIRECT EXAMINATION: MS. BRAZIL
Alvarez states she is 29 years old. She states she recognizes Murray in the court room as other witnesses have done in the past.
Brazil asks when Alvarez first met Murray. She states she cannot recall, perhaps 2005. She states she met him at a gentleman's club in Las Vegas. Alvarez was employed by the club. She states Murray was a guest at the club. Brazil asks if Alvarez introduced herself to Murray or if there was some other way they were introduced. Alvarez says she cannot recall how they initially spoke. Throughout questioning the defense is objecting to the questions--some objections are sustained and some are overruled.
Alvarez states she maintained contact with Murray either on the telephone or in person. She states she cannot recall if she gave Murray her telephone number when they first met in 2005. She states that at the time they met, to her knowledge Murray was living in Las Vegas at the time. She states she was living in Los Angeles at the time. Brazil asks if Alvarez commuted from Los Angeles to Las Vegas for her job. She states she did commute.
Alvarez agrees that at some point after meeting Murray they developed a personal or intimate relationship. She states she cannot recall when that occurred. Brazil begins to delve further into when the relationship became personal or intimate--the defense objects. The Court sustains the objections. Alvarez states quite some time had passed--it was something that developed over time.
Alvares states that during the development of their relationship, she would see him at times in person but not at all times. She states she would see him in person in Las Vegas and at times in Los Angeles.
Alvarez states it is accurate that she was in a personal relationship with Murray in 2008 but she is not sure if it was personal in 2007. Brazil asks Alvarez if Murray informed her he was still married. She states she does not recall. Brazil's questions about Alvarez knowing about Murray being married are overruled.
Brazil: DURING THE MONTHS OF APRIL, MAY, JUNE OF WAS DOCTOR MURRAY LIVING AT YOUR RESIDENCE?
Alvarez asks for a clarification.
Brazil: DURING THE MONTHS -- LET'S START WITH JUST THE MONTH OF APRIL 2009 WAS CONRAD MURRAY LIVING AT YOUR RESIDENCE?
Alvarez: I AM TRYING TO ANSWER ACCURATELY, AND I DON'T THINK IT'S FAIR TO SAY THAT HE WAS LIVING AT MY RESIDENCE PERMANENTLY OR WOULD YOU DESCRIBE IT AS A TEMPORARY?
Brazil: HOW WOULD YOU DESCRIBE IT?
Alvarez: I WOULDN'T DESCRIBE IT AS A PERMANENT DWELLING FOR MR. MURRAY, NO.
Brazil asks where Alvarez considered Murray's permanent dwelling to be as of April 2009. She states she assumed it to be in Las Vegas with his wife.
Brazil: BUT YOU ARE NOT CERTAIN WHERE IT WAS THAT HE WAS HAVING HIS PERMANENT RESIDENCE IN APRIL OF 2009?
Alvarez: HOW CAN I BE CERTAIN OF THAT? NO, MA'AM.
Brazil asks if she ever asked him about his permanent residence. Alvarez states no.
Alvarez states she has a son with Murray. Her son was born in March of 2009.
Brazil: IN APRIL OF 2009, HOW MUCH TIME WAS CONRAD MURRAY SPENDING AT YOUR RESIDENCE IN LOS ANGELES?
Alvarez: I DON'T RECALL EXACTLY HOW MUCH TIME HE WAS SPENDING THERE. BUT I WOULD -- I DON'T RECALL EXACTLY HOW MUCH TIME.
Brazil asks if he would spend the night there one night during the month? Alvarez states no, that it was quite frequent. Brazil asks if he stayed a week, 2 weeks at a time. Alvarez states "perhaps". Brazil asks if he stayed 3 weeks. Alvarez states she is not going to commit to 3 weeks because "she cannot do that". Brazil asks if she is comfortable with 2 weeks for certain. Alvarez states "at times".
Brazil: SO GIVE ME AN EXAMPLE OF WHAT HIS TYPICAL SCHEDULE WOULD BE WHEN HE WOULD STAY AT YOUR RESIDENCE IN LOS ANGELES?
Alvarez wants to know what times Brazil is referring to in her questioning.
Brazil states they are still focusing on April 2009, after Alvarez had given birth to her son.
Alvarez asks if Brazil is wanting her to give her an example of his schedule. Brazil states she is wanting an example of how frequently Murray was staying overnight at her residence. Alvarez states she thinks it is fair to say 2 weeks out of the month. Alvarez states she does not know where he was the other 2 weeks out of the month.
Brazil: HE WOULD LEAVE YOUR RESIDENCE, AND YOU WOULDN'T HAVE ANY IDEA WHERE HE WOULD GO?
Alvarez: I WOULDN'T LEAVE WITH HIM.
Brazil: WOULD HE LEAVE YOUR RESIDENCE, AND YOU WOULD HAVE NO IDEA WHERE HE WAS GOING?
Alvarez: AN IDEA IS DIFFERENT THAN KNOWING, AND I JUST WANT TO MAKE SURE THAT I AM ANSWERING ACCURATELY BECAUSE I CAN'T CLAIM TO KNOW SOMETHING THAT -- MY ASSUMPTION OR MY BELIEF WOULD BE THAT HE WOULD RETURN.
Alvarez states she her residence is an apartment. Brazil asks again that Murray stayed 2 weeks at a time in April 2009. Alvarez states "at times".
Brazil: WE ARE FOCUSING JUST ON APRIL AND I BELIEVE YOU SAID THAT IT WAS TWO WEEKS IN APRIL THAT YOU FELT COMFORTABLE SAYING THAT HE STAYED. DO I HAVE THAT RIGHT?
Alvarez: I CAN'T RECALL EXACTLY, BUT, IF YOU KNOW -- THAT SOUNDS ABOUT RIGHT, YES.
Brazil: OKAY. SO YOU WOULD SEE HIM, DOCTOR MURRAY, EVERYDAY IN APRIL OF 2009 DURING THE TIME PERIOD THAT HE WAS STAYING WITH YOU, CORRECT?
Alvarez asks if she means every day in April or during the 2 weeks. Brazil states during the 2 weeks.
Alvarez: WELL, WHEN I, WHEN I MENTIONED TWO WEEKS, I DON'T MEAN TWO CONSECUTIVE WEEKS. I WANT TO MAKE SURE THAT'S CLEAR. PERHAPS IT WAS 3 OR 4 DAYS IN BETWEEN. SO IT'S NOT 2 CONSECUTIVE WEEKS. SO I CANNOT SAY THAT I SAW HIM EVERYDAY 2 WEEKS CONSECUTIVELY IN APRIL OF 2009.
Brazil asks if Murray's pattern was to spend a few days with Alvarez, then leave, then return, then leave, etc. Alvarez asks for the question to be repeated.
Brazil: IS IT YOUR TESTIMONY THAT DURING THE MONTH OF APRIL 2009 DOCTOR MURRAY WOULD STAY OVERNIGHT AND BE WITH YOU AND YOUR SON FOR 2, 3, 4 DAYS AT A TIME? THEN HE WOULD LEAVE YOUR RESIDENCE, GO SOMEPLACE ELSE. YOU ARE NOT SURE WHERE, AND THEN HE WOULD RETURN TO YOU RESIDENCE AND STAY FOR A FEW DAYS AND THEN LEAVE AGAIN?
Alvarez states that sounds correct. She states maybe "the 2 or 3 days" and Brazil may want to make it "3 or 4 days", but that correct.
Brazil: DID YOU EXPECT HIM TO COME HOME THAT NEXT DAY, OR DID HE TELL YOU "I WON'T BE BACK FOR A FEW DAYS?"
Alvarez: WELL, TO BEGIN WITH, I DON'T HAVE EXPECTATIONS ON DOCTOR MURRAY. SO I WOULDN'T EXPECT ANYTHING. THAT'S FAIR TO SAY. THAT'S JUST A RULE THAT I LIVE BY.
Brazil asks Alvarez if she would like to re-ask the question--Alvarez states she may do so.
Brazil: WHEN DOCTOR MURRAY WOULD SPEND 2 OR 3 NIGHTS WITH YOU AND THEN HE WOULD LEAVE AND HE WAS NOT RETURNING THAT SAME DAY, WOULD HE LET YOU KNOW THAT HE WAS GOING TO BE AWAY FROM YOU AND YOUR SON FOR A PERIOD OF TIME?
Chernoff objects and the court sustains the objection. Brazil asks if she may be heard. The Court says no, to move onto another subject.
Brazil asks Alvarez if she did not know when Murray was going to be at her residence or some other place. Alvarez asks her to repeat her question twice. The Court remarks that "we've got to pay attention". Brazil asks Alvarez if during April 2009, when Murray would come and go, if she had any idea during the month when he was to be at her residence or when he was going to be away and not returning for several days. Alvarez states no. Brazil asks if such a statement would be inaccurate or accurate and Alvarez states she would "not have an idea".
Alvarez states it is fair to say Murray had the same type of schedule in May 2009 which including him being at the residence for periods of time then leaving. Alvarez agrees Murray likely spent about the same amount of time with her--2 weeks--in May 2009. Brazil asks about June 2009--if Murray maintained the same type of schedule where he would arrive and depart, arrive then depart. Alvarez states "he would always--that's fair to say, yes".
Alvarez confirms that Murray would not tell her when he would be returning when he left in both May and June 2009. Alvarez states when Murray would leave she would be in telephone contact with him. Brazil asks if he would let her know where he was--Alvarez states "at times, I mean, yes, at times".
Brazil: AT TIMES, WOULD HE FAIL TO LET YOU KNOW WHERE HE WAS?
Alvarez: IT JUST WASN'T AN ISSUE. IT WOULD NEVER COME UP. EITHER I HAD AN ASSUMPTION THAT HE WAS IN VEGAS OR HOUSTON. THERE WAS NO NEED TO DISCUSS HIS WHEREABOUTS.
Brazil ask if she spoke with her every day. Alvarez states she would not say everyday and never made such a claim. Alvarez agrees that she was not worried about where Murray was because she was still in touch with him.
Alvarez agrees she always knew that Murray would be returning to her residence at some point even though he was away for a few days at a time.
Brazil asks what month in 2009 Murray began spending the most amount of time with her in Los Angeles. Alvarez says perhaps June. Brazil asks if he spent consistently more time with her in June than in May. Alvarez states with the birth of their child "it was frequent, becoming more frequent anyway". She states he was helping with the baby.
Brazil: I UNDERSTAND. SO NOT JUNE RATHER. IT WAS MARCH OF 2009 THAT HE WAS SPENDING MORE TIME WITH MORE REGULARITY AT YOUR RESIDENCE IN LOS ANGELES; IS THAT ACCURATE?
Alvarez agrees.
Alvarez is asked if Murray was paying her rent. She states yes he was paying her rent. Brazil asks how much the rent was but she cannot recall the exact figure. Brazil asks if it was more or less than $2000 a month. She states it was about but more than $2000 a month. She says perhaps it was around $2500.
Brazil: HOW LONG HAD HE BEEN PAYING YOUR RENT BEFORE YOUR SON WAS BORN?
Alvarez: HE WASN'T RESPONSIBLE FOR MY RENT. EVERYTHING IS IN MY NAME. I AM RESPONSIBLE FOR MY RENT. IF HE CHOSE TO HELP ME AT TIMES, THAT WAS UP TO HIM. THAT WAS SOMETHING THAT WASN'T EXPECTED, OR THAT'S NOT SOMETHING THAT I WAS DEPENDENT UPON HIM TO DO.
Brazil asks if he was paying her rent or helping her during her pregnancy. Alvarez states at times but she also continued to work during her pregnancy. Alvarez states she is an actress. She states she was shooting various projects while pregnant. Alvarez states while she was pregnant she was actually working "more than ever".
Alvarez states she cannot recall if Murray was Michael's personal physician in March 2009 nor can she recall when she became aware of it, either. She claims she was not pregnant when she learned about Murray working as Michael's personal physician.
Alvarez states she knew of Murray's employment before she became pregnant. Brazil asks when she became pregnant. She states she actually learned this information well before she was pregnant. Brazil asks for an earlier date but Alvarez cannot give her a date. Brazil asks for a year she knew the information. Alvarez states "perhaps it was in 2000--well, let's see". The Court asks her what she said and Alvarez states she thinking and cannot give a year.
Brazil asks again when Alvarez became pregnant after Alvarez states to Brazil to go "nine months back". Alvarez now states she was pregnant June of 2008. Brazil asks as of June 2008, when did Alvarez learn that Murray was working for Michael. Alvarez states she cannot recall. Brazil asks if Murray was spending time with her in Los Angeles in June 2008, including time at her apartment. She states yes. However, at that time she still cannot recall if Murray was working for Michael. Alvarez agrees that at some point Murray did tell her he was working for Michael, that she was "made aware of that through Doctor Murray, yes". She believes she was at Los Angeles when he told her he was working for Michael.
Brazil: WHEN YOU WERE IN LOS ANGELES AND DOCTOR MURRAY WOULD STAY WITH YOU, WERE YOU AWARE THAT HE WAS PROVIDING CARE FOR MICHAEL JACKSON AT MICHAEL JACKSON'S RESIDENCE ON CAROLWOOD DRIVE?
Alvarez states no.
Brazil: DID CONRAD MURRAY EVER TELL YOU THAT HE IS PROVIDING CARE TO MICHAEL JACKSON HERE IN LOS ANGELES?
Alvarez states yes. Brazil leads her on with an "and...".
Alvarez: WELL, THAT WAS MY ASSUMPTION.
Alvarez states that was her assumption because she knew Murray was working with Michael but not in what capacity. She further states that her assumption would be if he was here in Los Angeles then he was working with Michael.
Brazil: DID CONRAD MURRAY EVER TELL YOU "I'M MICHAEL JACKSON'S PHYSICIAN," OR DID YOU JUST NOT HAVE ANY IDEA IN WHAT CAPACITY HE WAS WORKING WITH MR. JACKSON?
Alvarez: NO. I KNEW THAT HE WAS HIS PERSONAL PHYSICIAN.
Brazil: AND WHAT DID DOCTOR MURRAY TELL YOU, IF ANYTHING, ABOUT HIS DUTIES RELATED TO MICHAEL JACKSON?
Alvarez: ABSOLUTELY NOTHING.
Alvarez states she was interested but she absolutely did not ask him what he was doing for Michael.
Alvarez: DOCTOR MURRAY AND I WERE ON A NEED-TO-KNOW BASIS. HE'S A PROFESSIONAL MAN. AND I JUST KNOW MY PLACE AND MY POSITION IN HIS LIFE, AND THAT IS NOT MY DUTY TO KNOW THE DETAILS OF HIS BUSINESS. THAT WASN'T A COMMON PRACTICE THAT HE DID, DISCUSS HIS PATIENTS, HIS WHEREABOUTS, OR ANYTHING OF THAT SORT.
Brazil: WHEN DOCTOR MURRAY WAS LIVING WITH YOU IN LOS ANGELES, YOU WERE AWARE THAT HE WAS TREATING MICHAEL JACKSON, CORRECT?
Alvarez: I WAS AWARE THAT WHEN DOCTOR MURRAY WAS IN LOS ANGELES, HE WAS AT TIMES, TO MY BELIEF, WITH MICHAEL. AS TO WHAT CAPACITY, THAT IS NOT SOMETHING THAT I WAS PRIVY TO. SO.
Alvarez states again she was aware that Murray was Michael's personal physician. She states she does not know if he was treating any other individuals in Los Angeles other than Michael.
Alvarez states to her knowledge Murray did not have a medical office in Los Angeles.
Brazil: DESCRIBE FOR ME DOCTOR MURRAY'S SCHEDULE DURING THE TIME THAT HE WAS LIVING WITH YOU IN APRIL? DURING THE TIME THAT HE WAS STAYING WITH YOU, WOULD HE GO TO WORK DURING THE DAY TO PROVIDE CARE FOR MICHAEL JACKSON? WOULD IT BE DURING THE NIGHTTIME? DESCRIBE FOR ME HIS ACTIVITIES, PLEASE.
Alvarez: FROM THE BEST OF MY RECOLLECTION, I BELIEVE THAT IT WOULD BE PRIMARILY IN THE NIGHTTIME. THAT'S FAIR TO SAY.
Brazil: SO DOCTOR MURRAY WOULD BE AT YOUR RESIDENCE DURING THE DAY AND YOU, OF COURSE, WERE HOME WITH A NEWBORN BABY AT THAT POINT, RIGHT?
Alvarez: YES.
Alvarez agrees he was with her during the day and then sometimes in the evenings he would leave. She states he left at approximately 9:00 p.m. given that was the time she put her newborn infant son to bed. She states further that he would leave around 9:00 p.m., sometimes 10:00 p.m. She states it was never at the same time. She states he would return the next day at different times, it was never the same. She states he would return in the morning, "anytime between 7:00 and 7:00 a.m., 8:00, 9:00, 10:00".
Brazil asks what he typically did once he returned in the morning.
Alvarez: TYPICALLY, I WOULD SAY THAT HE WOULD JUST RELAX NORMALLY, SOMETIMES MAYBE GO TO THE GYM, DEPENDING ON THE TIME THAT HE WOULD RETURN. IF IT WAS EARLY, THEN HE WOULD GO TO THE GYM, MAYBE HAVE SOMETHING TO EAT AND SLEEP.
She states in most cases he would sleep a large majority of the day. At times they had dinner and then he would depart again.
Brazil asks if Alvarez was aware that Murray was to accompany Michael to London. She states "absolutely". She states she planned on accompanying him on that trip. She states she cannot recall when he told her she would be accompanying him and that he did not thoroughly discuss the trip with her. She states she was "definitely, definitely" excited about going to London.
Alvarez states she did not know how long she would be gone. She recalled she would be gone maybe 2-3 months then there was to be a Christmas break. She remembered plans to be home for the holidays. Brazil asks if she planned on keeping her apartment or not. Alvarez states she had made no plans since no plans were concrete and she was unsure if she was actually going since she had a baby. She states she was still working things out and there was not a clear decision made on what she was going to do with her apartment. Alvarez again states she was not sure she was going to London with Murray. She was invited to go and hoped to go but she was unsure if she would go because of the baby. She said the baby would have prevented her from going because of exposure to germs, childcare, etc. Again Alvarez confirms that Murray wanted her to go but she did not know if it was in the best interest of her child.
Alvarez confirms that Murray instructed her that he was having packages delivered to her apartment in April, May and June 2009. She states that he did not really say anything other than he had something coming to the apartment. She states that he did not really ask her to do anything with the packages other than to make sure if she got the package before him that she make sure she bring it inside for him rather than it be left outside the door or downstairs in the lobby.
Alvarez states she was given no details as to what the packages were. He did not tell her they were important packages. He did not tell her she had to sign for them.
Alvarez: HE JUST WOULD LET ME KNOW, I THINK, OUT OF RESPECT FOR ME AND MY HOME THAT THERE WAS A DELIVERY COMING. AND I SAID, "OKAY. ALL RIGHT."
Brazil asks for Alvarez to describe her apartment complex based on her statement above that seemed to indicate her apartment may have difficulty receiving packages.
Alvarez: I DIDN'T SAY IT WOULD BE DIFFICULT FOR SOMEONE TO GET IN. I SAID SOMETIMES THEY WOULD LEAVE THEM DOWNSTAIRS IN THE LOBBY, OR THEY WOULD LEAVE THEM OUTSIDE OF MY UNIT DOOR.
Alvarez confirms "they" are shippers like FedEx and UPS. She confirms she received packages in Murray's name. She states she does not recall packages being delivered on a regular basis. From her recollection she believes it was only a few times. She states she believes items were shipped to her apartment for Murray before her son was born but she does not know what those items were. She emphatically denies she ever opened the packages.
Alvarez states she recalled once or twice when packages were left in the lobby. She recalls picking them up and taking them upstairs to her apartment. She recalls the items being boxes. She agrees that Murray received mail inside her mailbox at her residence. She states she has a locked mailbox but that packages are left out in an open area that is not locked. She recalls only a few times that the shipments were left in the common area of the lobby. She recalls some packages were left on her doorstep. Alvarez also recalls signing for some of the packages. Alvarez states he always informed her if there was something coming, from her recollection. She states he did not tell her what the packages were or what they contained and she says she never asked him what they were for or what they contained.
Brazil begins to show Alvarez some documents including receipts from the packages delivered.
Alvarez is asked to confirm her address as the address listed on the first receipt. She does confirm it as her address during April, May and June 2009. Alvarez is asked if she recognizes the signature. She does. She is asked if that is her signature. She states the signature could be hers as it looks like her signature.
Brazil: DO YOU SEE WHERE IT SAYS "RECIPIENT, CARE OF NICOLE ALVAREY AND CONRAD MURRAY, M.D," AND THEN IT HAS YOUR ADDRESS, CORRECT?
Alvarez agrees.
Brazil: DO YOU SEE ON THE RIGHT-HAND SIDE WHERE IT SAYS "SHIPPER, MELISSA ELIAS, APPLIED PHARMACY SERVICES," AND AN ADDRESS IN LAS VEGAS?
Alvarez agrees.
Alvarez is asked if she recalled looking at the shipper listed on the receipt
Alvarez: NO. I MEAN, YOU HAVE TO THINK OF THE BIG PICTURE HERE. I HAVE BABY ON MY HIP, SOMETHING'S COMING. THERE'S A LOT OF THINGS GOING ON. I'M NOT -- I AM SIGNING FOR IT. I AM PUTTING IT DOWN TO THE DETAILS OF WHAT I SIGNED FOR AND WHO IT WAS, I MAY HAVE GLANCED AT IT, YES. THAT'S FAIR TO SAY BUT TO READ A PAPER IN DETAIL, I WAS, UNDERSTOODTHAT THIS PACKAGE WAS NOT FOR ME. SO THERE WOULD BE NO REASON FOR ME TO REALLY THOROUGHLY READ IT IN DETAIL.
Alvarez states she would just confirm whether it belonged to her or Murray
Brazil: MISS ALVAREZ, PLEASE DIRECT YOUR ATTENTION TO EXHIBIT NUMBER 23, ALSO, A FEDEX RECEIPT DATED APRIL 29, 2009, DELIVERY LOCATION, IS THAT ALSO YOUR APARTMENT?
Alvarez agrees.
Brazil: THIS WAS A PACKAGE DELIVERED AND SIGNED FOR BY A P. MARIA. DO YOU SEE THAT?
Alvarez agrees.
Brazil: DO YOU KNOW A P. MARIA RESIDING AT YOUR RESIDENCE WHO WOULD HAVE SIGNED FOR THIS PACKAGE?
Alvarez: I AM -- NOT TO MY KNOWLEDGE, NO. I AM THE ONLY ONE THAT RESIDES AT MY RESIDENCE.
Alvarez states she does not know anyone named P. Maria who would have signed for this package. Alvarez again confirms her address at the time of the package's arrival.
Alvarez confirms her name was misspelled correctly as "Alvarey".
Exhibit 24 is another FedEx receipt dated May 1st, 2009 with delivery again to Alvarez's apartment in care of Alvarez, to Murray from Applied Pharmacy Services.
Exhibit 25 is another FedEx receipt dated May 13th, 2009 with delivery again to Alvarez's apartment.
Brazil: DO YOU RECOGNIZE THE SIGNATURE IN THE GRA BOX AREA IN THE MIDDLE OF THE DOCUMENT, MISS ALVAREZ?
Alvarez states she does not.
Brazil asks again if the signature looks familiar at all to her and she says it does not even though the recipient is listed as Nicole Alvarez and Conrad Murray, with the same apartment address, with the shipping address again from Applied Pharmacy Services.
Alvarez states there is no doorman at the residence to sign for packages nor a doorman.
Brazil: IN MAY OF 2009, WHO BESIDES YOURSELF AND YOUR SON AND CONRAD MURRAY WAS LIVING OR STAYING AT YOUR APARTMENT?
Alvarez: NO ONE WAS LIVING OR STAYING WITH ME WITHIN THOSE MONTHS, NO.
Brazil asks if Alvarez's mother or anyone else came to help with the infant.
Alvarez: ABSOLUTELY. THERE'S PLENTY OF VISITORS WITH THE NEW BABY, PLENTY OF PEOPLE IN AND OUT. BUT STAYING AND LIVING, JUST MYSELF AND MY SON.
Alvarez states it is possible people at her residence helping with the infant could have answered the door but states she was not informed that any of those individuals received a package for her that was shipped to Murray.
Brazil shows another exhibit that includes a receipt from FedEx dated May 15th, 2009. Again, the recipient is Alvarez/Murray from Applied Pharmacy Services. Alvarez confirms she does not see a signature on the receipt. Brazil asks if she recalls having boxes left at her doorstep at times other than the times they were picked up at the mailbox area. Alvarez says it is possible.
Brazil shows another exhibit, a receipt dated June 11th,.2009. The details are the same as previously stated. Alvarez states she recognizes the signature as perhaps her own.
Another exhibit is shown from June 16th, 2009. It is a receipt with the same details as previously stated. Alvarez confirms the address as her apartment address.
Alvarez confirms Murray is currently staying at her apartment (January 2011). She is asked if she recognizes Chernoff seated in court and she states yes.
Brazil: DID YOU CONTACT ED CHERNOFF FOR LEGAL ADVICE AFTER MICHAEL JACKSON DIED?
Alvarez: NO. THERE WOULD BE NO REASON FOR ME TO CONTACT ED CHERNOFF FOR PERSONAL LEGAL ADVICE.
Brazil: WELL, YOU DID CONTACT ED CHERNOFF BACK IN SEPTEMBER OF 2009, DIDN'T YOU?
Alvarez states she contacted him after a subpoena was issued. She is asked why she contacted him after she received a subpoena.
Alvarez: I THINK IT'S A REASONABLE THING TO DO TO INQUIRE.
Brazil asks why she believes such to be a reasonable thing to do.
Alvarez: IF YOU ARE SUBPOENAED TO GO TO COURT, I BELIEVE IT'S A REASONABLE THING THAT ANY THINKING HUMAN BEING WOULD DO.
Alvarez confirms she had questions about her subpoena and thus contacted Chernoff.
Brazil asks who put Alvarez in contact with Chernoff.
Alvarez: OF COURSE, I WOULD ASK CONRAD CAN I SPEAK TO ED (Chernoff).
Brazil: SO CONRAD MURRAY GAVE YOU THE INFORMATION TO CONTACT ED CHERNOFF AFTER YOU WERE SERVED A SUBPOENA; IS THAT CORRECT?
Alvarez: I DON'T RECALL EXACTLY HOW THAT EXCHANGED. PERHAPS I SAID, "YOU KNOW, I WANT AN ATTORNEY. COULD YOU HAVE ED CALL ME," OR PERHAPS I CALLED ED. I DON'T RECALL EXACTLY HOW THAT EXCHANGE WAS MADE BUT THE MUTUAL PERSON THAT INTER -- OF COURSE, I MET ED THROUGH DOCTOR MURRAY.
Alvarez agrees it was a natural act to reach out to Murray's attorney when she received the subpoena.
Alvarez states she "believes" she spoke with Chernoff. She agrees it would be important that she speak to him.
Brazil: AND YOU WANTED SOME LEGAL ADVICE. SO YOU REACHED OUT TO MR. CHERNOFF, CORRECT?
Alvarez: YEAH. I JUST WANTED TO KNOW WHAT WAS IT.
Alvarez states she believes Chernoff explained the subpoena to her but does not think he said too much to her referred her to Joseph Low. Alvarez confirms Low is seated in court. Alvarez agrees that Chernoff gave her Low's phone number. Alvarez states she called Low.
Brazil asks if Alvarez came to court as requested per the subpoena which took place in September 2009. Alvarez confirms Low accompanied her.
Brazil asks if Alvarez reached out to an attorney in December 2010 when she was served with a subpoena. Alvarez remarks yes, the event just occurred last month. She states she believes that attorney was Charlie Windon. A gentleman by the name of Pena is seated in court. Brazil asks Alvarez if she spoke to him as well. She states perhaps she did but she does not recall exactly but does not think she did then recalls she did in fact speak to him via telephone.
Brazil asks Alvarez if she was aware Murray had 6 other children when she began an intimate and personal relationship with him. Chernoff objects and Walgren asks to approach.
Present at the sidebar are Chernoff, Flanagan, Brazil and Walgren. Low is not present. Walgren states the prosecution offers the evidence because it relates to financial obligation and makes note the prosecution intends through other witnesses to elicit some financial evidence as it " relates to, for example, his mortgage default at the time between 2009 pending a lawsuit judgment in June of 2009, child support obligations pending against him in June 2009 and this relates to our case in regard to his financial state of affairs at the time and part of his motive for very likely cutting corner in his care of Michael Jackson during the same time period". Walgren further states the prosecution wishes to offer her knowledge of the other 6 children, as she testified knowing about at the grand jury, as it relates to his financial obligations. The Court asks what she knows about his financial obligations. Walgren states she knows the number of his children. Flanagan states his financial obligations have no relevance in this case and that his children have no relationship to his financial obligations. Flanagan asks to have an offer of proof as to why his financial obligations or number of children is relevant in this case. The Court states that the issue will not have to be dealt with currently as he is sustaining the objection.
Proceedings begin again in open court.
Brazil states she has one more question. She asks Alvarez if Murray is the father of her son. Alvarez states "absolutely". Brazil attempts to ask if Murray is the individual she had a relationship with since meeting him prior to 2007 but Chernoff objects and the objection is sustained. Brazil then concludes her direct examination.
Flanagan does not cross-examine the witness.
The witness is excused.
The transcripts used to create these summaries were lawfully obtained from www.teammichaeljackson.com.
NICOLE ALVAREZ
(Discussions begin at the sidebar.)
Flanagan asks if they may approach the bench. Flanagan, Chernoff, Brazil and Walgren are present--Low is not. Flanagan states this witness has certain "delicate issues" like that of the previous witness (Bridgette Morgan). He states Alvarez is the mother of one of Murray's children. He states it is known Murray and Alvarez have a social relationship--apparent by them having a child together--but says he does not feel the origin of the relationship should be discussed. He states they had a social relationship in June 2009. He states regarding the 2 minute phone call placed in the ambulance to Alvarez, nothing further should be examined except they lived together, unless the prosecution is going to cover the evidence regarding packages received.
Walgren states issues of credibility are important. He states the fact they have a current social relationship and they have a child together is obviously relevant to her credibility, as well as where they met. He states this witness is entirely different than Morgan. He states Alvarez is the woman who was receiving propofol shipments to her house. He further states she is an uncooperative witness who has refused to cooperate with police, including refusing to open the door for police and she has reached out to Murray's attorneys. Walgren states he feels the phone call is the least of what Brazil wishes to get into--she wishes to examine the nature of the relationship which Walgren feels is much more important. He states when Murray comes to L.A.--he stays with Alvarez.
Chernoff states there is clearly more relevance to this witness . He says he agrees with Walgren. He feels Flanagan is referring to where and how they met as being irrelevant.
Brazil disagrees and says the inception of the relationship, how it progressed, is relevant.
The Court states this witness is dramatically different than Morgan because of the delivery of propofol to Alvarez. Brazil agrees. The Court states he will allow the parties to explore the relationship.
Flanagan interjects--the Court interrupts him. Flanagan states the prosecution can establish the nature of the relationship in June, that they lived together, that when he was not with the patient he was with her and she is the mother of his child. He asks what else has to go into the nature of their relationship.
The Court states that under the preliminary guidelines he is going to allow the nature of the relationship to be explored.
Proceedings begin in open court. Mr. Victor Guinne is serving as counsel for Nicole Alvarez.
DIRECT EXAMINATION: MS. BRAZIL
Alvarez states she is 29 years old. She states she recognizes Murray in the court room as other witnesses have done in the past.
Brazil asks when Alvarez first met Murray. She states she cannot recall, perhaps 2005. She states she met him at a gentleman's club in Las Vegas. Alvarez was employed by the club. She states Murray was a guest at the club. Brazil asks if Alvarez introduced herself to Murray or if there was some other way they were introduced. Alvarez says she cannot recall how they initially spoke. Throughout questioning the defense is objecting to the questions--some objections are sustained and some are overruled.
Alvarez states she maintained contact with Murray either on the telephone or in person. She states she cannot recall if she gave Murray her telephone number when they first met in 2005. She states that at the time they met, to her knowledge Murray was living in Las Vegas at the time. She states she was living in Los Angeles at the time. Brazil asks if Alvarez commuted from Los Angeles to Las Vegas for her job. She states she did commute.
Alvarez agrees that at some point after meeting Murray they developed a personal or intimate relationship. She states she cannot recall when that occurred. Brazil begins to delve further into when the relationship became personal or intimate--the defense objects. The Court sustains the objections. Alvarez states quite some time had passed--it was something that developed over time.
Alvares states that during the development of their relationship, she would see him at times in person but not at all times. She states she would see him in person in Las Vegas and at times in Los Angeles.
Alvarez states it is accurate that she was in a personal relationship with Murray in 2008 but she is not sure if it was personal in 2007. Brazil asks Alvarez if Murray informed her he was still married. She states she does not recall. Brazil's questions about Alvarez knowing about Murray being married are overruled.
Brazil: DURING THE MONTHS OF APRIL, MAY, JUNE OF WAS DOCTOR MURRAY LIVING AT YOUR RESIDENCE?
Alvarez asks for a clarification.
Brazil: DURING THE MONTHS -- LET'S START WITH JUST THE MONTH OF APRIL 2009 WAS CONRAD MURRAY LIVING AT YOUR RESIDENCE?
Alvarez: I AM TRYING TO ANSWER ACCURATELY, AND I DON'T THINK IT'S FAIR TO SAY THAT HE WAS LIVING AT MY RESIDENCE PERMANENTLY OR WOULD YOU DESCRIBE IT AS A TEMPORARY?
Brazil: HOW WOULD YOU DESCRIBE IT?
Alvarez: I WOULDN'T DESCRIBE IT AS A PERMANENT DWELLING FOR MR. MURRAY, NO.
Brazil asks where Alvarez considered Murray's permanent dwelling to be as of April 2009. She states she assumed it to be in Las Vegas with his wife.
Brazil: BUT YOU ARE NOT CERTAIN WHERE IT WAS THAT HE WAS HAVING HIS PERMANENT RESIDENCE IN APRIL OF 2009?
Alvarez: HOW CAN I BE CERTAIN OF THAT? NO, MA'AM.
Brazil asks if she ever asked him about his permanent residence. Alvarez states no.
Alvarez states she has a son with Murray. Her son was born in March of 2009.
Brazil: IN APRIL OF 2009, HOW MUCH TIME WAS CONRAD MURRAY SPENDING AT YOUR RESIDENCE IN LOS ANGELES?
Alvarez: I DON'T RECALL EXACTLY HOW MUCH TIME HE WAS SPENDING THERE. BUT I WOULD -- I DON'T RECALL EXACTLY HOW MUCH TIME.
Brazil asks if he would spend the night there one night during the month? Alvarez states no, that it was quite frequent. Brazil asks if he stayed a week, 2 weeks at a time. Alvarez states "perhaps". Brazil asks if he stayed 3 weeks. Alvarez states she is not going to commit to 3 weeks because "she cannot do that". Brazil asks if she is comfortable with 2 weeks for certain. Alvarez states "at times".
Brazil: SO GIVE ME AN EXAMPLE OF WHAT HIS TYPICAL SCHEDULE WOULD BE WHEN HE WOULD STAY AT YOUR RESIDENCE IN LOS ANGELES?
Alvarez wants to know what times Brazil is referring to in her questioning.
Brazil states they are still focusing on April 2009, after Alvarez had given birth to her son.
Alvarez asks if Brazil is wanting her to give her an example of his schedule. Brazil states she is wanting an example of how frequently Murray was staying overnight at her residence. Alvarez states she thinks it is fair to say 2 weeks out of the month. Alvarez states she does not know where he was the other 2 weeks out of the month.
Brazil: HE WOULD LEAVE YOUR RESIDENCE, AND YOU WOULDN'T HAVE ANY IDEA WHERE HE WOULD GO?
Alvarez: I WOULDN'T LEAVE WITH HIM.
Brazil: WOULD HE LEAVE YOUR RESIDENCE, AND YOU WOULD HAVE NO IDEA WHERE HE WAS GOING?
Alvarez: AN IDEA IS DIFFERENT THAN KNOWING, AND I JUST WANT TO MAKE SURE THAT I AM ANSWERING ACCURATELY BECAUSE I CAN'T CLAIM TO KNOW SOMETHING THAT -- MY ASSUMPTION OR MY BELIEF WOULD BE THAT HE WOULD RETURN.
Alvarez states she her residence is an apartment. Brazil asks again that Murray stayed 2 weeks at a time in April 2009. Alvarez states "at times".
Brazil: WE ARE FOCUSING JUST ON APRIL AND I BELIEVE YOU SAID THAT IT WAS TWO WEEKS IN APRIL THAT YOU FELT COMFORTABLE SAYING THAT HE STAYED. DO I HAVE THAT RIGHT?
Alvarez: I CAN'T RECALL EXACTLY, BUT, IF YOU KNOW -- THAT SOUNDS ABOUT RIGHT, YES.
Brazil: OKAY. SO YOU WOULD SEE HIM, DOCTOR MURRAY, EVERYDAY IN APRIL OF 2009 DURING THE TIME PERIOD THAT HE WAS STAYING WITH YOU, CORRECT?
Alvarez asks if she means every day in April or during the 2 weeks. Brazil states during the 2 weeks.
Alvarez: WELL, WHEN I, WHEN I MENTIONED TWO WEEKS, I DON'T MEAN TWO CONSECUTIVE WEEKS. I WANT TO MAKE SURE THAT'S CLEAR. PERHAPS IT WAS 3 OR 4 DAYS IN BETWEEN. SO IT'S NOT 2 CONSECUTIVE WEEKS. SO I CANNOT SAY THAT I SAW HIM EVERYDAY 2 WEEKS CONSECUTIVELY IN APRIL OF 2009.
Brazil asks if Murray's pattern was to spend a few days with Alvarez, then leave, then return, then leave, etc. Alvarez asks for the question to be repeated.
Brazil: IS IT YOUR TESTIMONY THAT DURING THE MONTH OF APRIL 2009 DOCTOR MURRAY WOULD STAY OVERNIGHT AND BE WITH YOU AND YOUR SON FOR 2, 3, 4 DAYS AT A TIME? THEN HE WOULD LEAVE YOUR RESIDENCE, GO SOMEPLACE ELSE. YOU ARE NOT SURE WHERE, AND THEN HE WOULD RETURN TO YOU RESIDENCE AND STAY FOR A FEW DAYS AND THEN LEAVE AGAIN?
Alvarez states that sounds correct. She states maybe "the 2 or 3 days" and Brazil may want to make it "3 or 4 days", but that correct.
Brazil: DID YOU EXPECT HIM TO COME HOME THAT NEXT DAY, OR DID HE TELL YOU "I WON'T BE BACK FOR A FEW DAYS?"
Alvarez: WELL, TO BEGIN WITH, I DON'T HAVE EXPECTATIONS ON DOCTOR MURRAY. SO I WOULDN'T EXPECT ANYTHING. THAT'S FAIR TO SAY. THAT'S JUST A RULE THAT I LIVE BY.
Brazil asks Alvarez if she would like to re-ask the question--Alvarez states she may do so.
Brazil: WHEN DOCTOR MURRAY WOULD SPEND 2 OR 3 NIGHTS WITH YOU AND THEN HE WOULD LEAVE AND HE WAS NOT RETURNING THAT SAME DAY, WOULD HE LET YOU KNOW THAT HE WAS GOING TO BE AWAY FROM YOU AND YOUR SON FOR A PERIOD OF TIME?
Chernoff objects and the court sustains the objection. Brazil asks if she may be heard. The Court says no, to move onto another subject.
Brazil asks Alvarez if she did not know when Murray was going to be at her residence or some other place. Alvarez asks her to repeat her question twice. The Court remarks that "we've got to pay attention". Brazil asks Alvarez if during April 2009, when Murray would come and go, if she had any idea during the month when he was to be at her residence or when he was going to be away and not returning for several days. Alvarez states no. Brazil asks if such a statement would be inaccurate or accurate and Alvarez states she would "not have an idea".
Alvarez states it is fair to say Murray had the same type of schedule in May 2009 which including him being at the residence for periods of time then leaving. Alvarez agrees Murray likely spent about the same amount of time with her--2 weeks--in May 2009. Brazil asks about June 2009--if Murray maintained the same type of schedule where he would arrive and depart, arrive then depart. Alvarez states "he would always--that's fair to say, yes".
Alvarez confirms that Murray would not tell her when he would be returning when he left in both May and June 2009. Alvarez states when Murray would leave she would be in telephone contact with him. Brazil asks if he would let her know where he was--Alvarez states "at times, I mean, yes, at times".
Brazil: AT TIMES, WOULD HE FAIL TO LET YOU KNOW WHERE HE WAS?
Alvarez: IT JUST WASN'T AN ISSUE. IT WOULD NEVER COME UP. EITHER I HAD AN ASSUMPTION THAT HE WAS IN VEGAS OR HOUSTON. THERE WAS NO NEED TO DISCUSS HIS WHEREABOUTS.
Brazil ask if she spoke with her every day. Alvarez states she would not say everyday and never made such a claim. Alvarez agrees that she was not worried about where Murray was because she was still in touch with him.
Alvarez agrees she always knew that Murray would be returning to her residence at some point even though he was away for a few days at a time.
Brazil asks what month in 2009 Murray began spending the most amount of time with her in Los Angeles. Alvarez says perhaps June. Brazil asks if he spent consistently more time with her in June than in May. Alvarez states with the birth of their child "it was frequent, becoming more frequent anyway". She states he was helping with the baby.
Brazil: I UNDERSTAND. SO NOT JUNE RATHER. IT WAS MARCH OF 2009 THAT HE WAS SPENDING MORE TIME WITH MORE REGULARITY AT YOUR RESIDENCE IN LOS ANGELES; IS THAT ACCURATE?
Alvarez agrees.
Alvarez is asked if Murray was paying her rent. She states yes he was paying her rent. Brazil asks how much the rent was but she cannot recall the exact figure. Brazil asks if it was more or less than $2000 a month. She states it was about but more than $2000 a month. She says perhaps it was around $2500.
Brazil: HOW LONG HAD HE BEEN PAYING YOUR RENT BEFORE YOUR SON WAS BORN?
Alvarez: HE WASN'T RESPONSIBLE FOR MY RENT. EVERYTHING IS IN MY NAME. I AM RESPONSIBLE FOR MY RENT. IF HE CHOSE TO HELP ME AT TIMES, THAT WAS UP TO HIM. THAT WAS SOMETHING THAT WASN'T EXPECTED, OR THAT'S NOT SOMETHING THAT I WAS DEPENDENT UPON HIM TO DO.
Brazil asks if he was paying her rent or helping her during her pregnancy. Alvarez states at times but she also continued to work during her pregnancy. Alvarez states she is an actress. She states she was shooting various projects while pregnant. Alvarez states while she was pregnant she was actually working "more than ever".
Alvarez states she cannot recall if Murray was Michael's personal physician in March 2009 nor can she recall when she became aware of it, either. She claims she was not pregnant when she learned about Murray working as Michael's personal physician.
Alvarez states she knew of Murray's employment before she became pregnant. Brazil asks when she became pregnant. She states she actually learned this information well before she was pregnant. Brazil asks for an earlier date but Alvarez cannot give her a date. Brazil asks for a year she knew the information. Alvarez states "perhaps it was in 2000--well, let's see". The Court asks her what she said and Alvarez states she thinking and cannot give a year.
Brazil asks again when Alvarez became pregnant after Alvarez states to Brazil to go "nine months back". Alvarez now states she was pregnant June of 2008. Brazil asks as of June 2008, when did Alvarez learn that Murray was working for Michael. Alvarez states she cannot recall. Brazil asks if Murray was spending time with her in Los Angeles in June 2008, including time at her apartment. She states yes. However, at that time she still cannot recall if Murray was working for Michael. Alvarez agrees that at some point Murray did tell her he was working for Michael, that she was "made aware of that through Doctor Murray, yes". She believes she was at Los Angeles when he told her he was working for Michael.
Brazil: WHEN YOU WERE IN LOS ANGELES AND DOCTOR MURRAY WOULD STAY WITH YOU, WERE YOU AWARE THAT HE WAS PROVIDING CARE FOR MICHAEL JACKSON AT MICHAEL JACKSON'S RESIDENCE ON CAROLWOOD DRIVE?
Alvarez states no.
Brazil: DID CONRAD MURRAY EVER TELL YOU THAT HE IS PROVIDING CARE TO MICHAEL JACKSON HERE IN LOS ANGELES?
Alvarez states yes. Brazil leads her on with an "and...".
Alvarez: WELL, THAT WAS MY ASSUMPTION.
Alvarez states that was her assumption because she knew Murray was working with Michael but not in what capacity. She further states that her assumption would be if he was here in Los Angeles then he was working with Michael.
Brazil: DID CONRAD MURRAY EVER TELL YOU "I'M MICHAEL JACKSON'S PHYSICIAN," OR DID YOU JUST NOT HAVE ANY IDEA IN WHAT CAPACITY HE WAS WORKING WITH MR. JACKSON?
Alvarez: NO. I KNEW THAT HE WAS HIS PERSONAL PHYSICIAN.
Brazil: AND WHAT DID DOCTOR MURRAY TELL YOU, IF ANYTHING, ABOUT HIS DUTIES RELATED TO MICHAEL JACKSON?
Alvarez: ABSOLUTELY NOTHING.
Alvarez states she was interested but she absolutely did not ask him what he was doing for Michael.
Alvarez: DOCTOR MURRAY AND I WERE ON A NEED-TO-KNOW BASIS. HE'S A PROFESSIONAL MAN. AND I JUST KNOW MY PLACE AND MY POSITION IN HIS LIFE, AND THAT IS NOT MY DUTY TO KNOW THE DETAILS OF HIS BUSINESS. THAT WASN'T A COMMON PRACTICE THAT HE DID, DISCUSS HIS PATIENTS, HIS WHEREABOUTS, OR ANYTHING OF THAT SORT.
Brazil: WHEN DOCTOR MURRAY WAS LIVING WITH YOU IN LOS ANGELES, YOU WERE AWARE THAT HE WAS TREATING MICHAEL JACKSON, CORRECT?
Alvarez: I WAS AWARE THAT WHEN DOCTOR MURRAY WAS IN LOS ANGELES, HE WAS AT TIMES, TO MY BELIEF, WITH MICHAEL. AS TO WHAT CAPACITY, THAT IS NOT SOMETHING THAT I WAS PRIVY TO. SO.
Alvarez states again she was aware that Murray was Michael's personal physician. She states she does not know if he was treating any other individuals in Los Angeles other than Michael.
Alvarez states to her knowledge Murray did not have a medical office in Los Angeles.
Brazil: DESCRIBE FOR ME DOCTOR MURRAY'S SCHEDULE DURING THE TIME THAT HE WAS LIVING WITH YOU IN APRIL? DURING THE TIME THAT HE WAS STAYING WITH YOU, WOULD HE GO TO WORK DURING THE DAY TO PROVIDE CARE FOR MICHAEL JACKSON? WOULD IT BE DURING THE NIGHTTIME? DESCRIBE FOR ME HIS ACTIVITIES, PLEASE.
Alvarez: FROM THE BEST OF MY RECOLLECTION, I BELIEVE THAT IT WOULD BE PRIMARILY IN THE NIGHTTIME. THAT'S FAIR TO SAY.
Brazil: SO DOCTOR MURRAY WOULD BE AT YOUR RESIDENCE DURING THE DAY AND YOU, OF COURSE, WERE HOME WITH A NEWBORN BABY AT THAT POINT, RIGHT?
Alvarez: YES.
Alvarez agrees he was with her during the day and then sometimes in the evenings he would leave. She states he left at approximately 9:00 p.m. given that was the time she put her newborn infant son to bed. She states further that he would leave around 9:00 p.m., sometimes 10:00 p.m. She states it was never at the same time. She states he would return the next day at different times, it was never the same. She states he would return in the morning, "anytime between 7:00 and 7:00 a.m., 8:00, 9:00, 10:00".
Brazil asks what he typically did once he returned in the morning.
Alvarez: TYPICALLY, I WOULD SAY THAT HE WOULD JUST RELAX NORMALLY, SOMETIMES MAYBE GO TO THE GYM, DEPENDING ON THE TIME THAT HE WOULD RETURN. IF IT WAS EARLY, THEN HE WOULD GO TO THE GYM, MAYBE HAVE SOMETHING TO EAT AND SLEEP.
She states in most cases he would sleep a large majority of the day. At times they had dinner and then he would depart again.
Brazil asks if Alvarez was aware that Murray was to accompany Michael to London. She states "absolutely". She states she planned on accompanying him on that trip. She states she cannot recall when he told her she would be accompanying him and that he did not thoroughly discuss the trip with her. She states she was "definitely, definitely" excited about going to London.
Alvarez states she did not know how long she would be gone. She recalled she would be gone maybe 2-3 months then there was to be a Christmas break. She remembered plans to be home for the holidays. Brazil asks if she planned on keeping her apartment or not. Alvarez states she had made no plans since no plans were concrete and she was unsure if she was actually going since she had a baby. She states she was still working things out and there was not a clear decision made on what she was going to do with her apartment. Alvarez again states she was not sure she was going to London with Murray. She was invited to go and hoped to go but she was unsure if she would go because of the baby. She said the baby would have prevented her from going because of exposure to germs, childcare, etc. Again Alvarez confirms that Murray wanted her to go but she did not know if it was in the best interest of her child.
Alvarez confirms that Murray instructed her that he was having packages delivered to her apartment in April, May and June 2009. She states that he did not really say anything other than he had something coming to the apartment. She states that he did not really ask her to do anything with the packages other than to make sure if she got the package before him that she make sure she bring it inside for him rather than it be left outside the door or downstairs in the lobby.
Alvarez states she was given no details as to what the packages were. He did not tell her they were important packages. He did not tell her she had to sign for them.
Alvarez: HE JUST WOULD LET ME KNOW, I THINK, OUT OF RESPECT FOR ME AND MY HOME THAT THERE WAS A DELIVERY COMING. AND I SAID, "OKAY. ALL RIGHT."
Brazil asks for Alvarez to describe her apartment complex based on her statement above that seemed to indicate her apartment may have difficulty receiving packages.
Alvarez: I DIDN'T SAY IT WOULD BE DIFFICULT FOR SOMEONE TO GET IN. I SAID SOMETIMES THEY WOULD LEAVE THEM DOWNSTAIRS IN THE LOBBY, OR THEY WOULD LEAVE THEM OUTSIDE OF MY UNIT DOOR.
Alvarez confirms "they" are shippers like FedEx and UPS. She confirms she received packages in Murray's name. She states she does not recall packages being delivered on a regular basis. From her recollection she believes it was only a few times. She states she believes items were shipped to her apartment for Murray before her son was born but she does not know what those items were. She emphatically denies she ever opened the packages.
Alvarez states she recalled once or twice when packages were left in the lobby. She recalls picking them up and taking them upstairs to her apartment. She recalls the items being boxes. She agrees that Murray received mail inside her mailbox at her residence. She states she has a locked mailbox but that packages are left out in an open area that is not locked. She recalls only a few times that the shipments were left in the common area of the lobby. She recalls some packages were left on her doorstep. Alvarez also recalls signing for some of the packages. Alvarez states he always informed her if there was something coming, from her recollection. She states he did not tell her what the packages were or what they contained and she says she never asked him what they were for or what they contained.
Brazil begins to show Alvarez some documents including receipts from the packages delivered.
Alvarez is asked to confirm her address as the address listed on the first receipt. She does confirm it as her address during April, May and June 2009. Alvarez is asked if she recognizes the signature. She does. She is asked if that is her signature. She states the signature could be hers as it looks like her signature.
Brazil: DO YOU SEE WHERE IT SAYS "RECIPIENT, CARE OF NICOLE ALVAREY AND CONRAD MURRAY, M.D," AND THEN IT HAS YOUR ADDRESS, CORRECT?
Alvarez agrees.
Brazil: DO YOU SEE ON THE RIGHT-HAND SIDE WHERE IT SAYS "SHIPPER, MELISSA ELIAS, APPLIED PHARMACY SERVICES," AND AN ADDRESS IN LAS VEGAS?
Alvarez agrees.
Alvarez is asked if she recalled looking at the shipper listed on the receipt
Alvarez: NO. I MEAN, YOU HAVE TO THINK OF THE BIG PICTURE HERE. I HAVE BABY ON MY HIP, SOMETHING'S COMING. THERE'S A LOT OF THINGS GOING ON. I'M NOT -- I AM SIGNING FOR IT. I AM PUTTING IT DOWN TO THE DETAILS OF WHAT I SIGNED FOR AND WHO IT WAS, I MAY HAVE GLANCED AT IT, YES. THAT'S FAIR TO SAY BUT TO READ A PAPER IN DETAIL, I WAS, UNDERSTOODTHAT THIS PACKAGE WAS NOT FOR ME. SO THERE WOULD BE NO REASON FOR ME TO REALLY THOROUGHLY READ IT IN DETAIL.
Alvarez states she would just confirm whether it belonged to her or Murray
Brazil: MISS ALVAREZ, PLEASE DIRECT YOUR ATTENTION TO EXHIBIT NUMBER 23, ALSO, A FEDEX RECEIPT DATED APRIL 29, 2009, DELIVERY LOCATION, IS THAT ALSO YOUR APARTMENT?
Alvarez agrees.
Brazil: THIS WAS A PACKAGE DELIVERED AND SIGNED FOR BY A P. MARIA. DO YOU SEE THAT?
Alvarez agrees.
Brazil: DO YOU KNOW A P. MARIA RESIDING AT YOUR RESIDENCE WHO WOULD HAVE SIGNED FOR THIS PACKAGE?
Alvarez: I AM -- NOT TO MY KNOWLEDGE, NO. I AM THE ONLY ONE THAT RESIDES AT MY RESIDENCE.
Alvarez states she does not know anyone named P. Maria who would have signed for this package. Alvarez again confirms her address at the time of the package's arrival.
Alvarez confirms her name was misspelled correctly as "Alvarey".
Exhibit 24 is another FedEx receipt dated May 1st, 2009 with delivery again to Alvarez's apartment in care of Alvarez, to Murray from Applied Pharmacy Services.
Exhibit 25 is another FedEx receipt dated May 13th, 2009 with delivery again to Alvarez's apartment.
Brazil: DO YOU RECOGNIZE THE SIGNATURE IN THE GRA BOX AREA IN THE MIDDLE OF THE DOCUMENT, MISS ALVAREZ?
Alvarez states she does not.
Brazil asks again if the signature looks familiar at all to her and she says it does not even though the recipient is listed as Nicole Alvarez and Conrad Murray, with the same apartment address, with the shipping address again from Applied Pharmacy Services.
Alvarez states there is no doorman at the residence to sign for packages nor a doorman.
Brazil: IN MAY OF 2009, WHO BESIDES YOURSELF AND YOUR SON AND CONRAD MURRAY WAS LIVING OR STAYING AT YOUR APARTMENT?
Alvarez: NO ONE WAS LIVING OR STAYING WITH ME WITHIN THOSE MONTHS, NO.
Brazil asks if Alvarez's mother or anyone else came to help with the infant.
Alvarez: ABSOLUTELY. THERE'S PLENTY OF VISITORS WITH THE NEW BABY, PLENTY OF PEOPLE IN AND OUT. BUT STAYING AND LIVING, JUST MYSELF AND MY SON.
Alvarez states it is possible people at her residence helping with the infant could have answered the door but states she was not informed that any of those individuals received a package for her that was shipped to Murray.
Brazil shows another exhibit that includes a receipt from FedEx dated May 15th, 2009. Again, the recipient is Alvarez/Murray from Applied Pharmacy Services. Alvarez confirms she does not see a signature on the receipt. Brazil asks if she recalls having boxes left at her doorstep at times other than the times they were picked up at the mailbox area. Alvarez says it is possible.
Brazil shows another exhibit, a receipt dated June 11th,.2009. The details are the same as previously stated. Alvarez states she recognizes the signature as perhaps her own.
Another exhibit is shown from June 16th, 2009. It is a receipt with the same details as previously stated. Alvarez confirms the address as her apartment address.
Alvarez confirms Murray is currently staying at her apartment (January 2011). She is asked if she recognizes Chernoff seated in court and she states yes.
Brazil: DID YOU CONTACT ED CHERNOFF FOR LEGAL ADVICE AFTER MICHAEL JACKSON DIED?
Alvarez: NO. THERE WOULD BE NO REASON FOR ME TO CONTACT ED CHERNOFF FOR PERSONAL LEGAL ADVICE.
Brazil: WELL, YOU DID CONTACT ED CHERNOFF BACK IN SEPTEMBER OF 2009, DIDN'T YOU?
Alvarez states she contacted him after a subpoena was issued. She is asked why she contacted him after she received a subpoena.
Alvarez: I THINK IT'S A REASONABLE THING TO DO TO INQUIRE.
Brazil asks why she believes such to be a reasonable thing to do.
Alvarez: IF YOU ARE SUBPOENAED TO GO TO COURT, I BELIEVE IT'S A REASONABLE THING THAT ANY THINKING HUMAN BEING WOULD DO.
Alvarez confirms she had questions about her subpoena and thus contacted Chernoff.
Brazil asks who put Alvarez in contact with Chernoff.
Alvarez: OF COURSE, I WOULD ASK CONRAD CAN I SPEAK TO ED (Chernoff).
Brazil: SO CONRAD MURRAY GAVE YOU THE INFORMATION TO CONTACT ED CHERNOFF AFTER YOU WERE SERVED A SUBPOENA; IS THAT CORRECT?
Alvarez: I DON'T RECALL EXACTLY HOW THAT EXCHANGED. PERHAPS I SAID, "YOU KNOW, I WANT AN ATTORNEY. COULD YOU HAVE ED CALL ME," OR PERHAPS I CALLED ED. I DON'T RECALL EXACTLY HOW THAT EXCHANGE WAS MADE BUT THE MUTUAL PERSON THAT INTER -- OF COURSE, I MET ED THROUGH DOCTOR MURRAY.
Alvarez agrees it was a natural act to reach out to Murray's attorney when she received the subpoena.
Alvarez states she "believes" she spoke with Chernoff. She agrees it would be important that she speak to him.
Brazil: AND YOU WANTED SOME LEGAL ADVICE. SO YOU REACHED OUT TO MR. CHERNOFF, CORRECT?
Alvarez: YEAH. I JUST WANTED TO KNOW WHAT WAS IT.
Alvarez states she believes Chernoff explained the subpoena to her but does not think he said too much to her referred her to Joseph Low. Alvarez confirms Low is seated in court. Alvarez agrees that Chernoff gave her Low's phone number. Alvarez states she called Low.
Brazil asks if Alvarez came to court as requested per the subpoena which took place in September 2009. Alvarez confirms Low accompanied her.
Brazil asks if Alvarez reached out to an attorney in December 2010 when she was served with a subpoena. Alvarez remarks yes, the event just occurred last month. She states she believes that attorney was Charlie Windon. A gentleman by the name of Pena is seated in court. Brazil asks Alvarez if she spoke to him as well. She states perhaps she did but she does not recall exactly but does not think she did then recalls she did in fact speak to him via telephone.
Brazil asks Alvarez if she was aware Murray had 6 other children when she began an intimate and personal relationship with him. Chernoff objects and Walgren asks to approach.
Present at the sidebar are Chernoff, Flanagan, Brazil and Walgren. Low is not present. Walgren states the prosecution offers the evidence because it relates to financial obligation and makes note the prosecution intends through other witnesses to elicit some financial evidence as it " relates to, for example, his mortgage default at the time between 2009 pending a lawsuit judgment in June of 2009, child support obligations pending against him in June 2009 and this relates to our case in regard to his financial state of affairs at the time and part of his motive for very likely cutting corner in his care of Michael Jackson during the same time period". Walgren further states the prosecution wishes to offer her knowledge of the other 6 children, as she testified knowing about at the grand jury, as it relates to his financial obligations. The Court asks what she knows about his financial obligations. Walgren states she knows the number of his children. Flanagan states his financial obligations have no relevance in this case and that his children have no relationship to his financial obligations. Flanagan asks to have an offer of proof as to why his financial obligations or number of children is relevant in this case. The Court states that the issue will not have to be dealt with currently as he is sustaining the objection.
Proceedings begin again in open court.
Brazil states she has one more question. She asks Alvarez if Murray is the father of her son. Alvarez states "absolutely". Brazil attempts to ask if Murray is the individual she had a relationship with since meeting him prior to 2007 but Chernoff objects and the objection is sustained. Brazil then concludes her direct examination.
Flanagan does not cross-examine the witness.
The witness is excused.
The transcripts used to create these summaries were lawfully obtained from www.teammichaeljackson.com.
Thursday, August 4, 2011
Bridgette Morgan's Hearing Testimony--01/07/11
January 7th, 2011
BRIDGETTE MORGAN
Before Morgan is called to the stand the Court, Walgren, Brazil, Chernoff, Low and Flanagan are in chambers discussing a motion in limine concerning Morgan and her testimony. The defense has various objections to the relevance of her testimony. Walgren states that the purpose of placing Morgan on the stand is to attempt to establish the timeline of phone calls (there was a 7 second call from Morgan to Murray at 11:26 a.m. on June 25th, 2009) and preserve relevant testimony as it relates to some of the individuals who either placed calls or received calls from Murray on June 25th, 2009. Walgren continues that the prosecution wishes to briefly establish the nature and purpose of the phone call from Morgan to Murray and to determine whether it was professional or personal. Walgren states he wants Morgan under oath to confirm whether or not she was able to make contact with Murray. Walgren states that regarding the character evidence he does not understand the objection by the defense. He states the phone calls are relevant in the prosecution's theory and show a distinct pattern by Murray to carry on personal social business when his attention should be on his patient.
Low begins his arguments for the motion in limine. He states there are two sources, one being the police report done on Feburary 2nd, 2010 when Morgan was interviewed and a tape recorded interview. Low is concerned that Morgan and Murray's relationship will be revealed as personal and not professional contact. He is also concerned about how Murray and Morgan's relationship began and Morgan's history as an exotic dancer in Las Vegas 6 years prior to 2009.
Brazil states the prosecution does not intend to ask Morgan about her occupation. However, they do intend on asking how Morgan and Murray met, as was done with Sade Anding. They wish to establish their relationship as social. Chernoff pipes in the prosecution knows they met at a topless club and it is prejudicial. Low begins to argue about why it cannot be stated they met "out of town" or "in public" rather than a club. Low also comments that Morgan is studying to become a nurse and she herself does not want this information out because of her business working in a hospital.
Low continues on saying police promised if she told him the truth he would not let out her history of being an exotic dancer. Low states Morgan was lied to and it the situation is not fair.
Brazil disagrees with Low on his characterization of what has occurred regarding Morgan.
The Court states he does not need to know she was working at a club or the nature of the club for the purposes of the preliminary hearing.
Walgren states the prosecution will limit their relationship to beginning at a club and establishing it was a social relationship.
Flanagan states the prosecution knows the call from Morgan to Murray was not completed. He states the fact someone made a call to someone else on the phone who does not answer has no relevance, nor does her state of mind have relevance, either.
Walgren states as the defense has indicated she is not necessarily cooperative. He again states that under oath they want her testifying whether or not the call was completed and whether she left a voicemail or not. He states she has told police that it went to voicemail but she has not said that under oath or in the hearing. The prosecution wishes to preserve her testimony as a social relationship, the nature of the call and that the call was made at the particular time listed.
Chernoff states that the prosecution wants to preserve Morgan's evidence in front of the press and they could have had it preserved via the grand jury as was done with Nicole Alvarez.
The Court states testimony cannot be preserved at a grand jury because there is no confrontation right. He continues on stating he is aware of the issues and the scope of the preliminary hearing. He states the testimony is relevant under certain guidelines set forth for the preliminary hearing and the defense's motion in limine is overruled. However, the Court states this will be a tailored process and he does not want character issues inflaming the court.
Walgren asks if Brazil can be given leeway to lead so Morgan does not blurt out "something else". Chernoff states Brazil has shown an ability to lead into objectionable territory thus he objects to Walgren's request. Walgren states they will ask open-ended questions. Low states he trusts Brazil to be given some leeway without abusing the right to such.
The Court states he does not want to be in situation where the defense are embarrassed because Low has one theory/tactic and his team members (Chernoff, Flanagan) disagree with him.
Low states Chernoff will tell him if he is wrong.
The proceedings end and open court resumes.
DIRECT EXAMINATION: MS. BRAZIL
As with some previous witnesses, Morgan identifies Murray in court.
Morgan states she met Murray in 2003 at a club. She states after meeting Murray she developed a social relationship with him. Morgan confirms her cell phone number in 2009 was (310) ***-9566.
Morgan agrees she called Murray on June 25th, 2009. She states they were following up on a conversation they had had.
Brazil has no more questions but then corrects herself. She asks Morgan if she actually spoke to Murray. She states no. She is asked if she left a voicemail. She states she cannot remember. Brazil states she has nothing further.
Low declines the opportunity to cross examine the witness. Morgan is excused from the stand.
The transcripts used to create these summaries were lawfully obtained from www.teammichaeljackson.com.
BRIDGETTE MORGAN
Before Morgan is called to the stand the Court, Walgren, Brazil, Chernoff, Low and Flanagan are in chambers discussing a motion in limine concerning Morgan and her testimony. The defense has various objections to the relevance of her testimony. Walgren states that the purpose of placing Morgan on the stand is to attempt to establish the timeline of phone calls (there was a 7 second call from Morgan to Murray at 11:26 a.m. on June 25th, 2009) and preserve relevant testimony as it relates to some of the individuals who either placed calls or received calls from Murray on June 25th, 2009. Walgren continues that the prosecution wishes to briefly establish the nature and purpose of the phone call from Morgan to Murray and to determine whether it was professional or personal. Walgren states he wants Morgan under oath to confirm whether or not she was able to make contact with Murray. Walgren states that regarding the character evidence he does not understand the objection by the defense. He states the phone calls are relevant in the prosecution's theory and show a distinct pattern by Murray to carry on personal social business when his attention should be on his patient.
Low begins his arguments for the motion in limine. He states there are two sources, one being the police report done on Feburary 2nd, 2010 when Morgan was interviewed and a tape recorded interview. Low is concerned that Morgan and Murray's relationship will be revealed as personal and not professional contact. He is also concerned about how Murray and Morgan's relationship began and Morgan's history as an exotic dancer in Las Vegas 6 years prior to 2009.
Brazil states the prosecution does not intend to ask Morgan about her occupation. However, they do intend on asking how Morgan and Murray met, as was done with Sade Anding. They wish to establish their relationship as social. Chernoff pipes in the prosecution knows they met at a topless club and it is prejudicial. Low begins to argue about why it cannot be stated they met "out of town" or "in public" rather than a club. Low also comments that Morgan is studying to become a nurse and she herself does not want this information out because of her business working in a hospital.
Low continues on saying police promised if she told him the truth he would not let out her history of being an exotic dancer. Low states Morgan was lied to and it the situation is not fair.
Brazil disagrees with Low on his characterization of what has occurred regarding Morgan.
The Court states he does not need to know she was working at a club or the nature of the club for the purposes of the preliminary hearing.
Walgren states the prosecution will limit their relationship to beginning at a club and establishing it was a social relationship.
Flanagan states the prosecution knows the call from Morgan to Murray was not completed. He states the fact someone made a call to someone else on the phone who does not answer has no relevance, nor does her state of mind have relevance, either.
Walgren states as the defense has indicated she is not necessarily cooperative. He again states that under oath they want her testifying whether or not the call was completed and whether she left a voicemail or not. He states she has told police that it went to voicemail but she has not said that under oath or in the hearing. The prosecution wishes to preserve her testimony as a social relationship, the nature of the call and that the call was made at the particular time listed.
Chernoff states that the prosecution wants to preserve Morgan's evidence in front of the press and they could have had it preserved via the grand jury as was done with Nicole Alvarez.
The Court states testimony cannot be preserved at a grand jury because there is no confrontation right. He continues on stating he is aware of the issues and the scope of the preliminary hearing. He states the testimony is relevant under certain guidelines set forth for the preliminary hearing and the defense's motion in limine is overruled. However, the Court states this will be a tailored process and he does not want character issues inflaming the court.
Walgren asks if Brazil can be given leeway to lead so Morgan does not blurt out "something else". Chernoff states Brazil has shown an ability to lead into objectionable territory thus he objects to Walgren's request. Walgren states they will ask open-ended questions. Low states he trusts Brazil to be given some leeway without abusing the right to such.
The Court states he does not want to be in situation where the defense are embarrassed because Low has one theory/tactic and his team members (Chernoff, Flanagan) disagree with him.
Low states Chernoff will tell him if he is wrong.
The proceedings end and open court resumes.
DIRECT EXAMINATION: MS. BRAZIL
As with some previous witnesses, Morgan identifies Murray in court.
Morgan states she met Murray in 2003 at a club. She states after meeting Murray she developed a social relationship with him. Morgan confirms her cell phone number in 2009 was (310) ***-9566.
Morgan agrees she called Murray on June 25th, 2009. She states they were following up on a conversation they had had.
Brazil has no more questions but then corrects herself. She asks Morgan if she actually spoke to Murray. She states no. She is asked if she left a voicemail. She states she cannot remember. Brazil states she has nothing further.
Low declines the opportunity to cross examine the witness. Morgan is excused from the stand.
The transcripts used to create these summaries were lawfully obtained from www.teammichaeljackson.com.
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