Michael Jackson was 'clinically dead' on arrival to hospital, ER doctor says - recap of the first week of the trial.
By Alan Duke, CNN
updated 11:51 AM EST, Sat October 1, 2011
Los Angeles (CNN) -- The emergency room doctor who pronounced Michael Jackson dead testified Friday that the pop icon had "signs of a dying heart" when he arrived at Ronald Reagan UCLA Medical Center.
"He was clinically dead," Dr. Richelle Cooper said. "He did not have a pulse."
Dr. Cooper was the 13th and last witness for first the week in the involuntary manslaughter trial of Dr. Conrad Murray.
Prosecutors argue Murray, who was Jackson's personal physician as he prepared for planned comeback concerts, was criminally responsible for his death because of medical negligence and his reckless use of the surgical anesthetic propofol to help the pop icon sleep.
As Jackson was being rolled into the trauma center after an ambulance ride from his home, Dr. Murray told Cooper that he witnessed when Jackson stop breathing and his heart stopped beating.
Prosecutors argue that Murray was out of the room and had essentially abandoned his patient when Jackson's heart stopped.
Murray told Dr. Cooper Jackson's arrest came after he gave him two doses of Lorazepam, a sedative, Cooper testified.
He did not mention any other drugs, including propofol, which the coroner ruled played a major role in Jackson's death.
Cooper is expected to detail the unsuccessful efforts in the hospital to bring Jackson back to life when her testimony resumes Monday.
A Los Angeles County paramedic who responded to the delayed 911 call from Michael Jackson's home the day he died testified Friday that Jackson was "flatlined" and appeared dead when rescuers arrived.
Paramedic Richard Senneff and his partner Martin Blount both testified that at no time during the 42 minutes they were with Jackson did they see any signs of life in him.
Deputy District Attorney Deborah Brazil asked Blount, who drove the ambulance, about his initial assessment of Jackson's condition when he arrived.
"I felt he was dead, ma'am," Blount said.
Senneff testified that Murray told responders he had only given Jackson a dose of lorazepam to help him sleep and that he was treating him for dehydration and exhaustion, with no mention of the propofol.
Prosecutors contend one of the acts that makes Murray criminally responsible for Jackson's death was that he misled the paramedics by not telling them he had given his patient propofol before he stopped breathing.
The coroner ruled that Jackson's June 25, 2009, death was the result of "acute propofol intoxication" in combination with sedatives.
The judge imposed a gag order Friday, preventing lawyers for Murray from talking to reporters about the case. His order came after he learned Matt Alford, a law partner to lead defense lawyer Ed Chernoff, gave a TV interview to NBC's Ann Curry on Friday morning.
"The court wants to make it clear that the attorneys for the parties in this case are ordered not to comment to anyone outside of their respective teams, either directly or indirectly, on any aspects on this case," Los Angeles County Superior Court Judge Michael Pastor said at the end of Friday's morning session.
Pastor has previously admonished lawyers not to talk to reporters, but until now there has been no official order preventing it.
In his testimony, paramedic Senneff said that when he asked Murray "how long the patient was down," the doctor responded "It just happened right when I called you," Senneff said.
Paramedic Blount recalled Murray saying Jackson was "down" just one minute before their arrival.
Earlier testimony indicated the emergency call was not placed for at least 15 minutes after Murray realized Jackson was not breathing.
"It meant to me that this was a patient we had a good chance of saving," since the paramedics arrived just five minutes after the 911 call, Senneff said.
The paramedic, however, said it "did not add up to me" because of Jackson appeared dead.
"When I first moved the patient, his skin was very cool to the touch, his eyes were open, they were dry and his pupils were dilated," Senneff said. "When I hooked up the EKG machine, it was flatlined."
At one point, Murray told paramedics he felt a pulse in Jackson's upper right leg, but their heart monitor showed no rhythm, Senneff said.
A doctor communicating by radio with the paramedics recommended at 12:57 p.m., a half hour after they arrived, that they cease efforts to revive Jackson and declare him dead, according to a recording of the radio traffic played in court.
Murray then took over responsibility for the effort and continued resuscitation efforts, Senneff said.
The defense appeared to make one important point in their cross-examination of Senneff. The paramedic said when he first walked into bedroom he saw Murray and a security guard moving Jackson off the bed and onto the floor.
That contradicts Thursday's testimony by Alberto Alvarez, who worked for Jackson, who said he helped move Jackson from the bed while he was on the 911 phone call at least six minutes before the paramedics arrived.
The timing is important because it could call into question testimony by Alvarez about when Murray asked for his help in collecting drug vials from around the bed.
Prosecutors argue Murray's medical care as Jackson's personal physician was so reckless that he should be held criminally responsible for his death.
Deputy District Attorney David Walgren said Murray abandoned "all principles of medical care" when he used a makeshift intravenous drip to administer propofol to put Jackson to sleep.
Murray acknowledged in a police interview that he gave Jackson propofol almost every night for two months as the singer prepared for comeback concerts that were set to start in London in July 2009.
The device Murray used to monitor Jackson's pulse and blood oxygen level while he used propofol to put him to sleep was the focus of testimony by the first witness Friday.
An executive with the company that made the Nonin 9500 pulse oxymeter said it was "designed for spot checking of vital signs" and was "specifically labeled against continuous monitoring."
The $275 device did not have an audio alarm, requiring someone to constantly keep an eye on the tiny screen, Robert Johnson testified. Murray would have been better equipped with his company's table top version that would cost $1,200, Johnson said.
Prosecutors argue Murray's lack of professional monitoring equipment was reckless and is one reason the doctor should be held criminally responsible for Jackson's death.
One of Murray's former patients testified Friday that Murray saved his life after a heart attack just months before Jackson's death.
Although Robert Russell was called by the prosecution, his testimony possibly bolstered the defense contention that Murray is a caring and capable cardiologist.
"The advice he gave me saved my life," Russell said, describing how Murray not only put several stents in the arteries near his heart, but he also took time to help him change his unhealthy habits.
"He gave me advice on exercise, on eating, just how to live my life, doing away with pressure and stress that I believe I thrived on in the business world," said Russell, a sales manager for an electrical distribution firm.
The prosecution called Russell as an example of how Murray left his patients without a doctor when he went to be Michael Jackson's personal physician in April 2009.
"I was dismayed, flabbergasted, left out," Russell said. "I did feel abandoned."
His testified, however, that he was still able to contact Murray over the phone for advice and his clinic staff supported his therapy.
Russell's new cardiologist recently checked the Murray's work on his heart and "was very excited how my stents have held up," Russell testified.
In previous testimony, Jackson's chef Thursday defended her decision not to alert a security guard that Murray needed help in Jackson's bedroom after the doctor frantically asked her to do so.
It wasn't until about 10 minutes later that a guard in a trailer a few feet away from chef Kai Chase's kitchen was ordered upstairs to the bedroom where Murray was trying to revive Jackson, according to trial testimony.
Murray "was very nervous, and frantic and he was shouting," when he ran down a staircase near the kitchen where Chase was preparing Jackson's lunch, Chase testified Thursday afternoon.
"Get help, get security, get Prince," Chase said Murray screamed.
The chef's response was to walk into the nearby dining room where Jackson's oldest son, Prince, was playing with his sister and brother, she said.
"I said 'Hurry, Dr. Murray needs you. There may be something wrong with your father," Chase said she told Prince Jackson.
She then returned to the kitchen to continue lunch preparation, she said.
"He's asking for help, he's asking for security," defense lawyer Michael Flanagan said during cross-examination. "Did you think that a 12-year-old child was going to be able to assist this doctor with a problem with Michael?"
"I did what I was told and I went to get Prince," Chase answered.
Murray's lawyers are laying the groundwork to argue that Murray should not be blamed for the delay in calling for help because he relied on the chef to alert security, who then could call for an ambulance.
The prosecution, meanwhile, contends that a delay in calling 911 for an ambulance was Murray's fault and one of the negligent acts that make him criminally responsible for Jackson's death.
Alvarez, the Jackson employee who called 911,at least 10 minutes after Murray's plea to the chef for help, testified earlier Thursday that Murray told him to help gather up drug vials around Jackson's deathbed before he asked him to place the emergency call.
Alvarez, who served as Jackson's logistics director, showed the court how he saw an empty vial of propofol inside a torn IV bag that was hanging on a stand.
During questioning by the defense, however, Alvarez indicated it was another IV bag with a clear saline solution, not propofol, that was attached by a tube to Jackson's leg.
Alvarez testified that when he first rushed into the bedroom where Murray was trying to revive Jackson, the doctor asked him to help put drug vials into bags.
"He reached over and grabbed a handful of vials, and he asked me to put them in a bag," Alvarez testified.
Prosecutors contend that Murray was trying to gather up evidence of his criminal responsibility for Jackson's death, even before asking that someone call for an ambulance.
Under cross-examination, defense lawyer Ed Chernoff led Alvarez slowly through his steps during a half-minute period, apparently trying to show that his memory is wrong about the sequence of events.
When Chernoff asked him whether all of the events he described could have happened in the 30 seconds, Alvarez answered, "I'm very efficient, sir."
Chernoff also hinted that the defense would argue that Alvarez altered his account of events two months later after conferring with other witnesses.
After helping Murray place the vials in bags, the doctor asked him to call 911. The recording of the call was played in court Thursday.
Alvarez said he's been offered up to $500,000 for interviews about Jackson's death. He's turned them all down, despite financial problems and the lack of employment, he said.
The trial began Tuesday.
Chernoff contends that Jackson, desperate for sleep, caused his own death by taking a handful of sedatives and self-administering propofol while the doctor was out of the room.
If convicted of involuntary manslaughter, Murray could spend four years in a California prison and lose his medical license.