It was bad enough for Dr. Conrad Murray to be giving Michael Jackson propofol when he had no training administering anesthetics. His second mistake was using a dangerous drug in an improper setting: a bedroom.

Here was Murray’s surgical suite, according to the Los Angeles County Coroner’s report:

The bedroom to the right of the staircase contained a queen size bed, numerous tables and chairs, a dresser and a television.There was also a large attached walk-in closet. The bedding was disheveled and appeared as though someone had been lying on the left side of the bed. There was a blue plastic pad lined with cotton on the left side of the fitted sheet near the center of the bed. Near the left foot of the bed, there was a string of wooden beads and a tube of toothpaste. Miscellaneous items remained on the right side of the bed including a book, a laptop computer and eyeglasses. Also near the foot of the bed, there was a closed bottle of urine atop a chair.

So this bedroom was being used as a bathroom, too? Seems like the perfect place to open a vein and administer anesthesia.

“There are NO reports of [propofol’s] use for insomnia relief, to my knowledge,” wrote Dr. Selma Calmes in the anesthesiology portion of the coroner’s report. “The only reports of its use in homes are cases of fatal abuse (first reported in 1992), suicide, murder and accident.”

No reasonable practitioner would consider dosing a patient with propofol to get them to sleep. Propofol is supposed to be used by trained anesthesia specialists in medical centers, where a patient can be properly monitored and any emergency can be addressed quickly.

“Full patient monitoring is required any time propofol is given,” Calmes wrote. “The most essential monitor is a person trained in anesthesia and in resuscitation who is continuously present and not involved in the on-going surgical/diagnostic procedure.”

Murray also failed to outfit the bedroom with carbon dioxide monitors, electrocardiograms, infusion pumps or other equipment that would be standard for someone undergoing anesthesia, Calmes points out.

There was a pulse oximeter, but it was in a closet in another room.

Contrast this with the Dr. Andrew Rutland case. Rutland also is accused of administering a lethal dose of anesthesia, but he did so during the course of a surgical procedure – an abortion – and inside a clinic.

Rutland has been questioned by the San Gabriel Police Department, but, five months after the death of Ying Chen, he has not been charged. The Medical Board of California has said that he did not react quickly enough and did not have all the proper equipment and medications on hand to revive Chen.

But Rutland was trained as an ob-gyn. He was working in a clinic, albeit a sketchy clinic, using anesthetic for an established procedure, an abortion. He may have many other facts working against him, but he will be able to argue that he tried as best he could in a clinical setting. He has already persuaded one judge, twice, that he should be allowed to continue practicing medicine despite the cloud hanging over his head.

Murray, on the other hand, was caught using an anesthetic with no training in anesthesia, with no other medical staff around and for no good medical purpose in a very risky setting. The consequences were lethal. And the circumstances are what separate an accident from a homicide.