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Video: Expert faults care from Michael Jackson’s doctor

  1. Transcript of: Expert faults care from Michael Jackson’s doctor

    JEFF ROSSEN reporting: Hey, Ann , good morning to you. Powerful day here in court yesterday. And prosecutors are trying to make this real easy for the jury. They put two doctors on the stand who literally went through it point by point by point about why Dr. Conrad Murray , in their opinion, is guilty and basically said choose one. But this morning sources, close to the case tell NBC News Murray 's defense lawyers are about to fight back with a new theory about why Michael died.

    Mr. JOE JACKSON: I can't get over him being dead.

    ROSSEN: With Michael Jackson 's family in court Tuesday, perhaps the most compelling testimony yet. That's Dr. Alon Steinberg. He reviewed the case for the California Medical Board and told the jury Dr. Conrad Murray was grossly negligent. Giving Michael Jackson propofol in his own bedroom, leading to his ultimate death. Dr. Steinberg listed six what he calls deviations from standard care. Number one...

    Unidentified Man: Is the use of propofol as part of a doctor's medical practice to treat insomnia, gross negligence .

    Dr. ALON STEINBERG (Prosecution Witness): Yes.

    ROSSEN: Reason two...

    Dr. STEINBERG: Giving someone propofol in someone's home was also an extreme deviation.

    ROSSEN: Reason three...

    Dr. STEINBERG: You want to have an alarm saying, help, there's a problem. Dr. Murray 's machine did not have an alarm.

    ROSSEN: Reason four, Dr. Murray , he says, left Jackson alone.

    Dr. STEINBERG: It's like leaving a baby that's sleeping on your kitchen countertop.

    ROSSEN: Reason five, he says Dr. Murray didn't call 911 fast enough.

    Dr. STEINBERG: So instead of that huge 20 minute delay, he could've gotten help that he needed within four minutes.

    ROSSEN: And reason six...

    Dr. STEINBERG: Dr. Murray did not document a single thing. These deviations would not have happened, Mr. Jackson would've been alive.

    ROSSEN: Prosecutors even called a second doctor to back him up.

    Dr. NADER KAMANGAR (Prosecution Witness): Kind of beyond a departure of standard of care .

    ROSSEN: But sources close to the case tell NBC News Murray 's defense won't focus on propofol or how it was given. Instead, they'll claim Michael Jackson took eight pills of lorazepam, an anti-anxiety drug, just hours before his death, and never told Dr. Murray . That, the defense will argue, killed Michael , not the propofol. The official cause of death is propofol, so is this a tough argument for the defense ?

    Ms. ROBIN SAX (Former Los Angeles Prosecutor): It's not as hard as one would think because the defense doesn't have to prove anything. They don't need to prove that he actually took the pills, all they need to do is raise the questions to cause reasonable doubt.

    ROSSEN: Murray 's defense team still says that Michael injected himself with a final dose of propofol and pushed it into his bloodstream too fast. They will continue to argue that in court, they tell us. However, they say without the lorazepam, Ann , Michael Jackson would still be alive today. So we're going to see how it all shakes out here in court. Prosecution could rest their case as early as today.

    CURRY: All right, Jeff Rossen this morning. Jeff , thanks. Savannah Guthrie is TODAY's legal correspondent, Star Jones is a former prosecutor and veteran legal commentator. Good morning to both of you.

    SAVANNAH GUTHRIE reporting: Good morning.

    Ms. STAR JONES (Attorney and Former Prosecutor): Good morning, Ann.

    CURRY: Again to you, Savannah . And you say, Star , that five of the six so-called deviations from standard care as laid out by this doctor are enough for a conviction in this case?

    Ms. JONES: Oh, absolutely. We -- the -- as a prosecutor...

    CURRY: Each one alone?

    Ms. JONES: The prosecution wanted to stack the deck, and this doctor laid out six deviations. Five of them, the argument is, if you take them individually, that's enough of a deviation from the standard of care to get you to gross negligence . It's called boxing the defense into a corner. You can't get yourself out.

    CURRY: Even if the defense is able to be successful at arguing that this drug lorazepam was taken by Mr. Jackson , was hidden by Mr. Jackson from Dr. Murray , and that that ultimately was key in causing his death?

    GUTHRIE: According to this doctor, even if you buy every defense theory we've heard, the new ones and the old ones, it still won't matter. It still adds up to gross negligence . One of the doctors said, look, even if he, this Michael Jackson the addict, took these drugs, he should never have been left alone in the room with these drugs with that opportunity. One doctor said it's like leaving a baby on the countertop and then walking away.

    CURRY: But don't you need to make sure? Don't you need the proof of what actually killed him to prove involuntary manslaughter?

    GUTHRIE: Yes, and these doctors actually -- they were effective because number one, they -- to me it was like a mini closing argument. They pulled together all the evidence that the jurors have heard so far, added it up, laid out the six different deviations of care and then most importantly they said there was a causal link. But for this negligence, they said, Michael Jackson might have been alive today. And -- yeah.

    CURRY: Well, then...

    Ms. JONES: And they used Conrad Murray 's statement.

    CURRY: Hm.

    GUTHRIE: Yes.

    Ms. JONES: I think probably the defense is sitting down thinking the worst thing and the best thing. Best thing is, I put him in front of the cops so now he doesn't have to testify. Worst thing? I put him in front of the cops, now he can't testify.

    GUTHRIE: Yeah.

    Ms. JONES: They -- I really think he was trying to manage a PR nightmare.

    CURRY: Hm.

    Ms. JONES: And he may have managed himself right into the pokey.

    CURRY: Meantime, this 911 call, the fact that it wasn't made, that it took so long for it to be made, could that alone, if none of these others -- none of the five or the six, if this alone, the idea that it took so long, is that enough to convict Dr. Murray of involuntary manslaughter?

    GUTHRIE: Absolutely. I mean, you don't have to be a doctor to think that...

    CURRY: So what's the defense against that?

    GUTHRIE: Well, they're saying that he was administering help and that's why he didn't call 911. But look, if the jurors believe these prosecution experts, they will find that gross negligence was committed. They're saying that because of Conrad Murray 's own words that Michael Jackson was in a position where he was savable and the failure to call for 20 minutes was what ultimately caused his death.

    Ms. JONES: To hear a doctor say that the victim was savable...

    CURRY: Oh.

    Ms. JONES: ...is a devastating piece of evidence. The defense needs to counter that. They need to counter no matter what Michael Jackson would be dead.

    CURRY: Do they, are they now more likely to need to counter that with Dr. Murray on the stand?

    Ms. JONES: He will not testify. Ann , you never have heard me in the 20 years we've worked together say he will never do it.

    CURRY: How do you know?

    Ms. JONES: There is not a defense attorney that would put Conrad Murray on the stand right now. And if he did, it would be malpractice. It would be reason for an appeal. I cannot imagine putting Conrad Murray on.

    CURRY: All right.

    GUTHRIE: The cross examination would be ferocious.

    CURRY: OK. You heard it here, Savannah Guthrie and Star Jones , thank you so much this morning for weighing in.

IMAGE: Conrad Murray
Robyn Beck  /  AP
Dr. Conrad Murray faces four years in prison and the loss of his medical license if convicted of involuntary manslaughter in Michael Jackson's death.
updated 10/12/2011 8:59:22 PM ET 2011-10-13T00:59:22

Dr. Conrad Murray's defense on Wednesday abandoned a theory that it touted for over a year that Michael Jackson swallowed the drug that killed him, an abrupt shift in strategy that potentially undermines its case.

The reason was clear: The defense had learned that its claim that the singer swallowed the anesthetic propofol while Murray was out of the room in June 2009 can't be supported with scientific evidence.

The developments, along with a medical expert's repudiation of Murray's medical skills, suggested that the defense must recoup significant lost ground in its bid to acquit him of involuntary manslaughter in Jackson's death.

Murray has pleaded not guilty. It was not clear whether the defense would still argue that Jackson gave himself a dose of the drug some other way, such as injecting it into an IV tube that was sending the drug into him.

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"This is potentially devastating for the defense," said Manny Medrano, a former federal prosecutor who now practices criminal defense. Since the defense proposed in opening statements that Jackson may have self-administered propofol, he said, "that will become the elephant in the room for jurors."

Story: Coroner: No evidence Jackson took fatal dose

Medrano said the 11th-hour switch shows "a lack of preparation and failure to really think the defense theory through."

Superior Court Judge Michael Pastor and prosecutor David Walgren appeared stunned when attorney Michael Flanagan arose in a hearing outside the jury's presence and announced the defense's decision.

"We are not going to assert at any point in this trial that Michael Jackson at any time orally ingested propofol," said Flanagan, who revealed he had commissioned his own study about oral ingestion of the drug. He said the study concluded that it would not be absorbed into the body when ingested.

The defense first offered the theory that Jackson swallowed the fatal dose at last year's preliminary hearing. Both in and out of court, attorneys suggested that the singer may have poured some into fruit juice and drank it. Experts have testified this week that the theory was unreasonable.

Jurors have seen charts which note that a small amount of propofol was found in Jackson's stomach, but Flanagan told the judge on Wednesday the method of oral ingestion was not specifically mentioned in openings.

Flanagan's recent questions to witnesses indicated that he might now say that Jackson swallowed pills on his bedside table, specifically the sedative lorazepam. If they do focus on the sedative, they would be challenging the coroner's ruling that propofol killed the singer.

Moments after Flanagan's announcement, the jury was reconvened and a prosecution expert took the stand, saying that Murray was guilty of extreme deviation from the standard of medical care practiced by physicians.

Murray was "responsible" for Jackson's death, said Dr. Alon Steinberg, a cardiologist from Ventura, Calif., who evaluated Murray's actions for the California Medical Board.

"If all of these deviations didn't happen, Michael Jackson might have been alive," he said.

Jurors listened and took notes as he enumerated six "extreme deviations" by Murray, including using propofol, a powerful anesthetic normally given through an IV in hospital settings, to treat insomnia.

"I have never heard of it," he said.

Dr. Nader Kamanger, a UCLA sleep expert, testified later Wednesday that Murray didn't appear to take any steps to diagnose why Jackson couldn't sleep. He agreed that propofol shouldn't be used as a sleep aid.

"It's beyond a departure from the standard of care into something unfathomable," he said.

Kamanger, who walked jurors through a guide to various causes of insomnia, said Jackson should have been tested physically and psychologically before any drugs were given. He was to return for cross-examination on Thursday.

Steinberg called Murray's behavior "strange" and said that the single most important thing he could have done to save Jackson was to call 9-1-1 when he found Jackson not breathing.

"Every minute counts," he said, adding that even a five-minute delay in calling could be the difference between life and death.

According to Murray's own statement to police, he waited at least 20 minutes before telling a security guard to call 9-1-1. In the meantime, he said, he was doing CPR. Steinberg said he was doing it wrong.

Legal experts had questioned the defense decision early on to allow Murray to talk to police detectives. His three-hour interview was played for jurors earlier this week and it turned out that Steinberg's assessment came from that interview.

Steinberg said he based his testimony and his evaluation of Murray for the board on "his own words."

In an odd twist, this led Flanagan to suggest during cross examination that Murray may have lied when he said he was gone from Jackson's side for only two minutes.

"Do you know for a fact Dr. Murray was gone longer than two minutes?" Flanagan asked.

"No" said the witness, who stressed he was relying on Murray's account.

When Steinberg said he believed Jackson was "savable" because Murray detected a pulse, the attorney asked, "How do you know that Dr. Murray checked the pulse?"

"Because he described it," Steinberg said.

Defense attorney Thomas Mesereau Jr., who won Jackson's acquittal of molestation charges and has been following the case closely, said it was a "very, very strong day" for the prosecution and the defense cross examination merely gave the expert a chance to reinforce his opinions.

"But remember the trial isn't over till it's over," he said. "The defense hasn't called a single witness yet."

Story: Smokey Robinson feels sorry for Jackson's doctor

Mesereau said the abandonment of the defense's central theory shows that "they're having a difficult time coming up with a viable explanation of why or how Michael Jackson would have caused his own death."

The defense's announcement came a day after a coroner testified that it was unreasonable to believe that Jackson could have swallowed the drug.

Defense attorneys have claimed that Murray is not to blame for Jackson's death because the singer, desperate for sleep, probably gave himself an extra dose when he was out of the room. They also suggested at one point that Jackson could have injected the drug into his IV line.

The coroner said that that was an unreasonable theory given that he was already groggy from sleep medication and the dose of propofol Murray had administered.

Loyola Law School professor Stan Goldman said the lorazepam theory might be sufficient to give jurors an element of reasonable doubt.

"I think the defense had a better argument that Jackson got up and took all these pills and that in combination with whatever else was in his system did him in," said Goldman. If the jury is looking to the defense for reasonable doubt and want to acquit Murray, he said, that might help.

"It's not a lot to hang its hat on," he said, "but in a lot of criminal cases you have nothing."

Do you feel sorry for Murray? Tell us on Facebook.

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Photos: Michael Jackson’s life and career

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  1. Little boy Michael

    Jackson was just 12 when this picture was taken in May 1971, but his career was already stratospheric. Berry Gordy had signed the Jackson 5 to Motown Records in 1968, and Michael and his brothers had already topped the charts with "ABC" and "I'll Be There." It was a bright start for the boy from Gary, Ind. (Henry Diltz / Corbis) Back to slideshow navigation
  2. Signs of success

    Michael Jackson, far left, and the rest of the Jackson Five; the five brothers from Indiana were signed to Berry Gordy's Motown record label pose in 1972. (Frank Barratt / Getty Images file) Back to slideshow navigation
  3. All in the family

    The Jackson 5 performs in Los Angeles on a 1970s Bob Hope TV special. Michael continued to front the band, but his solo career was already on the rise, starting with 1971's "Got to Be There." (Neal Preston / Corbis) Back to slideshow navigation
  4. A wonderful Wiz

    Michael Jackson at the opening of "The Wiz." The 1978 movie musical was the first time Michael worked with legendary producer Quincy Jones, who would soon produce Jackson's breakout solo album, "Off the Wall," and eventually the "Thriller" album as well. Jackson's "Wiz" co-star was friend and mentor Diana Ross, who had introduced the world to the Jackson 5 back in 1969. (Bettmann / Corbis) Back to slideshow navigation
  5. Wanna be startin' somethin'?

    Michael Jackson performs in concert during a 1981 tour with his brothers. During the tour Michael began writing down ideas for a solo project that blossomed into the highest-selling album of all time. (Susan Phillips / Corbis) Back to slideshow navigation
  6. Michael Jackson and Diana Ross hold their American Music Awards in L.A. Jackson won for favorite soul album and Ross won for favorite female soul vocalist. (Juynh / AP) Back to slideshow navigation
  7. Fright night

    Michael Jackson stands with a group of dancers dressed as zombies while filming his 1983 video "Thriller." "Thriller" was revolutionary in the music industry. The zombie-themed minimovie put MTV on the map and essentially confirmed music videos as an art form of their own. The album sold 25 million copies in the United States alone. (Corbis / Sygma) Back to slideshow navigation
  8. Moment of stardom

    Michael Jackson performs the moonwalk for the first time on television's "Motown 25," a tribute to Berry Gordy. The dance move that would become Michael's trademark stunned viewers and the crowd, and marked his imminent crowning as the King of Pop. (Bettmann / Corbis) Back to slideshow navigation
  9. Handfuls of glory

    With Quincy Jones at his side, Michael Jackson holds six of the eight awards he won for "Thriller" at the 1984 Grammy Awards. His outfit, complete with epaulettes, sequined glove and dark shades, became a quintessential Michael look. (AP) Back to slideshow navigation
  10. Role model

    During a May 1984 ceremony at the White House, Michael Jackson accepts a Presidential Award from President Reagan as First Lady Nancy Reagan looks on. Jackson was honored as a model for American youth, and for lending his hit song "Beat It" to a new campaign against drunk driving. (Bettmann / Corbis) Back to slideshow navigation
  11. A scary day

    Michael Jackson, background, is seen with his hair on fire during a taping of a Pepsi TV commercial in Los Angeles on February 1984 as brother Jermaine Jackson, foreground, continues to perform, apparently unaware of the situation. (AP) Back to slideshow navigation
  12. LONDON-1985: Michael Jackson is lead through a crowd by policeman on a promotionial tour of Great Britain in London.(Photo by Dave Hogan/Getty Images)UK NEWSPAPERS OUT WITHOUT PRIOR CONSENT FROM DAVE HOGAN. PLEASE CONTACT SALES TEAM WITH ENQUIRIES (Dave Hogan / Getty Images) Back to slideshow navigation
  13. They were the world

    In January 1985, a who's-who of the music and movie worlds came together to sing "We Are The World," written to benefit famine victims in Ethiopia. Michael Jackson can be seen front and center, along with Stevie Wonder, Lionel Richie, Diana Ross, Elizabeth Taylor, and dozens of other stars. Michael's sister Janet can be seen bottom right. (Bettmann / Corbis) Back to slideshow navigation
  14. Victory lap

    Guitarist Eddie Van Halen, left, makes a July 1984 guest appearance during Michael Jackson's Victory Tour concert in Irving, Texas. Van Halen had recorded the now immortal guitar riff on "Beat It," to the displeasure of bandmate David Lee Roth, but to the delight of nearly everyone else. (Carlos Osorio / AP) Back to slideshow navigation
  15. Who's bad?

    Michael Jackson and his dancers in concert during a 1987 Tokyo concert on Jackson's "Bad" tour. The previous year, he had starred in the 3-D film "Captain EO," one of the most expensive short films ever. But Jackson had begun to draw more criticism as his albums and videos grew costlier and more infrequent. His next album, "Dangerous," wouldn't arrive until 1991. (Neal Preston / Corbis) Back to slideshow navigation
  16. A difficult year

    A cameraman photographs Michael Jackson and Oprah Winfrey in January 1993. This was the year Jackson was first accused of child molestation, and he took an opportunity on a 90-minute Oprah TV special to address the charges. The criminal allegations eventually were dropped, but Jackson reportedly paid as much as $25 million to settle the claims. (Neal Preston / Corbis) Back to slideshow navigation
  17. Black and white at the Super Bowl

    Michael Jackson gives a performance with 30,000 children during the Super Bowl XXVIII halftime show, on January 31, 1993, in Pasadena, Calif. Despite allegations against him, Jackson's career had regained momentum with hits like "Black or White" and "Remember the Time," and the "Dangerous" album was a multi-platinum seller. (Ralf-Finn Hestoft / Corbis) Back to slideshow navigation
  18. Michael Jackson and French mime Marcel Marceau clowning for the cameras at the Beacon Theatre in New York on Dec. 4, 1995. (Bob Strong / AFP - Getty Images) Back to slideshow navigation
  19. Power marriage

    Michael Jackson and his wife Lisa Marie Presley are seen at Neverland Ranch in preparation of the Children's World Summit in April 1995. Presley would file for divorce less than a year later, prompting speculation about just what had inspired the relationship. (Steve Starr / Corbis) Back to slideshow navigation
  20. Golden man

    Michael Jackson performs on stage during is "HIStory" world tour concert at Ericsson Stadium in November 1996 in Auckland, New Zealand. (Phil Walter / Getty Images) Back to slideshow navigation
  21. Marriage 2.0

    Just months after his divorce from Lisa Marie, Michael Jackson walked back up the aisle with Debbie Rowe. This wedding photo was released by Jackson's publicist minutes after the Nov. 13, 1996, ceremony in Sydney, Australia. But the pairing was less about romance and more about bearing Jackson a child, and the two would divorce three years later, with Rowe eventually ceding parental rights to Jackson. (Reuters / Corbis) Back to slideshow navigation
  22. Best of friends

    Michael Jackson and actress Elizabeth Taylor arrive at a Sept. 7, 2001, concert celebrating the 30 years of Jackson's career. The two stars had been longtime friends, and Taylor is godmother to two of Michael's children. (Jeff Christensen / Reuters / Corbis) Back to slideshow navigation
  23. (FILES) Photo dated November 13, 2002 shows US entertainer Michael Jackson testifying in Santa Maria, Calif. Superior Court in a trial in which he is accused of cancelling concert appearances, costing the promoter several million dollars. (- / AFP - Getty Images) Back to slideshow navigation
  24. Not so invincible

    Michael Jackson poses for photographers during a Nov. 2001 appearance in New York's Times Square. Jackson made his first ever in-store appearance to promote his new album, "Invincible," which was released Oct. 30. "Invincible," at the time the most expensive album ever produced, fared better with critics and fans than 1995's "HIStory," but questions began to surface about the future of Jackson's career. (Brad Rickerby / Reuters/Corbis) Back to slideshow navigation
  25. One big mistake

    Michael Jackson holds a towel-covered Prince Michael II over the balcony of a Berlin hotel on Nov. 19 2002. Jackson later called the incident a "terrible mistake," but the image of him dangling his baby son out a window shocked even many die-hard fans. And his reputation was to receive far worse damage just a few months later. (Tobias Schwarz / Reuters) Back to slideshow navigation
  26. Arresting development

    Michael Jackson is pictured in this Santa Barbara County Sheriff's Department mug shot from Nov. 20, 2003. In a February 2003 documentary, Jackson acknowledged letting boys sleep in his bed. Soon after, Santa Barbara district attorney Tom Sneddon launched a probe into allegations that Jackson had molested a teen boy who appeared in the program. Authorities raided Neverland Ranch in November, and Jackson surrended for arrest days later. (Santa Barbara County Sheriff's D / Reuters) Back to slideshow navigation
  27. Family support

    Michael, center, and sisters LaToya, left and Janet Jackson walk over to greets fans during a lunch break at a pretrial hearing in Santa Maria, Calif. in this Aug. 16, 2004 file photo. (Pool / Reuters) Back to slideshow navigation
  28. MJ's PJs

    Michael Jackson wears pajama pants and is aided by bodyguards after arriving more than an hour late to court on Mar. 10, 2005, during his trial on the 2003 molestation charges. Jackson appeared after Judge Rodney Melville threatened to revoke his bail. (Kimberly White / pool via Reuters) Back to slideshow navigation
  29. Singin' with the kids

    Michael Jackson sings with some of his young fans at the World Music Awards at Earls Court in London on Nov. 16, 2006. (Graham Jepson / WireImage) Back to slideshow navigation
  30. Fans in uniform

    Michael Jackson receives a letter of appreciation from Col. Robert M. Waltemeyer, the garrison commander of Camp Zama, on March 10, 2007 in Zama, Japan. Michael greeted thousands of U.S. troops and their family members at the U.S. Army base. (U.S. Army via Getty Images) Back to slideshow navigation
  31. Father figure

    Michael Jackson walks with kids Prince and Paris through a studio parking lot in Los Angeles in March 2009. The singer had been spotted with his entourage going to a studio on a cold rainy day in the city. The pop star stayed at the studio for more than two hours, and there were many production people working around him, suggesting that the star was filming. (Splash News / Splash News) Back to slideshow navigation
  32. Concert tour planned

    Fans take pictures of an electronic screen projecting a press conference by Michael Jackson at the O2 arena in London on March 5, 2009. The pop megastar announced he would play a series of comeback concerts in London in July, his first major shows in more than a decade. (Ben Stansall / AFP/Getty Images) Back to slideshow navigation
  33. Reaching for redemption

    Jackson, center, is shown in Los Angeles on May 6 during rehearsals for his planned concert tour in London. "He was on the eve of potentially redeeming his career a little bit," said Billboard magazine editorial director Bill Werde. "People might have started to think of him again in a different light."

    Discuss the life and impact of Michael Jackson in PhotoBlog. (Courtesy of Michael Jackson via) Back to slideshow navigation
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