Jackson Trial: Doctor Was 'Grossly Negligent'

A witness has told Dr Conrad Murray's manslaughter trial that he was "grossly negligent" to give propofol to Michael Jackson - as his defence team drop the claim the singer self-administered the powerful drug.

Dr Elon Steinberg said of Murray: "He should not have given him propofol for sleep."

Dr Steinberg told the court that he was commissioned to do an expert review by the California medical board.

He confirmed that Murray was not "board certified" as a cardiologist in 2009.

He criticised the singer's physician for not keeping adequate documentation on his patient.

Dr Steinberg said: "If he would have remembered exactly what he had given he could have communicated that to the emergency room doctors.

"It may not be a causation of death but it was a deviation of care."

Dr Steinberg said that he found Murray's treatment deviated from the standard code of care in at least six areas.

Each area of failure, Dr Steinberg said, amounted to "gross negligence".

"Giving propofol for sleep is an extreme deviation of care," Dr Steinberg said.

"You do not leave their side... And you should not give them propofol for sleep."

The expert also criticised Dr Murray for commencing cardiopulmonary resuscitation (CPR) on Jackson while he still had a heartbeat.

Dr Steinberg insisted that Jackson's physician should have called emergency services immediately upon finding the singer was not breathing.

He insisted the singer would still be alive if responders were alerted first, rather than Dr Murray attempting to revive Jackson beforehand.

"It makes logical sense to call 911, he didn't have any appropriate equipment and waiting did not help," Dr Steinberg said.

"Personally, I would have called 911 first."

Pulmonary critical care and sleep medicine specialist Nader Kamangar then gave evidence to the court.

An associate professor of medicine at UCLA, he said he was an expert at propofol use, and that it is often used for deep sedation while a breathing tube is placed inside a patient's throat.

"We use it on a daily basis on multiple patients in the intensive care unit.

"Propofol can have a pretty profound effect on blood pressure... that is very important to recognise."

Prof Kamangar said it was "inconceivable" to use the strong sedative outside of a tightly-controlled medical facility.

He said that depending on the depth of sedation with propofol, it was necessary to reduce drip supplies and attendants were highly trained in this task.

"Those are very strict rules," he said. He added that he had never heard of a doctor administering propofol to a patient at home.

Prof Kamangar said the cause of the singer's insomnia should have been investigated by Murray before even thinking of medicating.

He also said at least two people should have been involved in Jackson's propofol care - one to administer and another to monitor the patient.

He agreed that Murray's actions were "gross negligence" and should not have left Jackson without another medically-qualified person in attendance.

Murray told investigators Jackson stopped breathing while the physician visited the toilet.

Citing the medical profession's code of ethics, Prof Kamangar looked critically upon Murray's crucial decision to leave Jackson unmonitored at that time.

"The fundamental basics of the Hippocratic oath, the ethics and morals physicians swear by, the first rule is not to abandon your patient," Prof Kamangar said.

Murray is accused of involuntary manslaughter of Jackson in 2009, a charge he denies.

The prosecution said he administered a fatally large dose of propofol to the singer and then failed to properly monitor his patient.

Meanwhile, lawyers for Murray said the defence team was dropping its main argument that the superstar self-administered a fatal drug dose of propofol.

Lawyer J Michael Flanagan told the court that a study commissioned by the defence showed any effect from swallowing propofol would be trivial.

Prosecutor David Walgren and judge Michael Pastor appeared surprised by the disclosure, which was not made in front of jurors.

Lead defence lawyer Ed Chernoff had said during opening statements that his team would try to show that Jackson gave himself the fatal dose.

The trial is now in its third week.

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