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No way Jackson died by swallowing anesthetic, expert says

An expert on the powerful anesthetic propofol told jurors Thursday there was no way Michael Jackson could have caused his own death by swallowing the drug — a theory defence attorneys had at one point indicated could become a centerpiece of their case.

An expert on the powerful anesthetic propofol told jurors Thursday there was no way Michael Jackson could have caused his own death by swallowing the drug — a theory defence attorneys had at one point indicated could become a centerpiece of their case.

Dr. Steven Shafer, an expert on propofol, said it's impossible for the drug to enter the bloodstream in any sizeable amount if it is swallowed.

Coroner's officials determined Jackson died from acute propofol intoxication, and defendant Dr. Conrad Murray has acknowledged giving the singer the drug as a sleep aid. 

Conrad Murray looked mainly stoic as he listened to his medical skills and judgment called into question during testimony by prosecution witnesses. (Al Seib/Associated Press)

Defence attorneys for Murray said last week they had abandoned the theory that Jackson swallowed propofol. They will begin questioning Shafer later in the day.

Still, the theory was included in a report by their propofol expert, Dr. Paul White, who also suggested that Murray probably gave Jackson more of the sedative lorazepam than he told police.

Defence lawyers have suggested throughout the four-week trial that Jackson swallowed eight lorazepam pills without Murray's knowledge and that may have been enough to kill him. 

Shafer, however, said the defence's own testing showed Jackson hadn't swallowed any lorazepam pills in the four hours before his death, and the amount of the medication found in his stomach was "trivial."

In addition, prosecutors have said coroner's officials recently conducted tests that showed the levels of lorazepam in Jackson's stomach were far lower than defence attorneys have led jurors to believe.

Regarding oral ingestion of propofol, Shafer on Thursday walked jurors through studies dating back to 1985 on animals and more recently on humans showing propofol that is swallowed wouldn't produce sedation or reach the bloodstream in any sizeable amount.

White is expected to testify during the defence case scheduled to being Friday and feature 15 witnesses.

Murray has pleaded not guilty to involuntary manslaughter. He was Jackson's personal physician for roughly two months before the singer's unexpected death in June 2009.

Multiple violations

Shafer told jurors Wednesday that 17 violations of standard practices by Murray each put Jackson's life at risk. Many concerned modern life-saving equipment that Murray lacked when he gave Jackson propofol in the bedroom of his rented mansion, but Shafer said among the cardiologist's worst transgressions was putting his own interests ahead of Jackson.

He compared the Houston-based cardiologist to an employee who wouldn't say no to his boss.

Anesthesiology expert Dr. Steven Shafer demonstrates how propofol is extracted out of a glass bottle with a syringe during Dr. Conrad Murray's involuntary manslaughter trial on Wednesday in Los Angeles. (Reed Saxon/Associated Press)

"Saying yes is not what doctors do," he testified. 

Shafer, a Columbia University professor and researcher who helped write the guidelines and warnings included with every vial of propofol, repeatedly said Murray's actions were unconscionable, unethical and illegal. He said Murray's case is unlike any he's ever seen.

"We are in pharmacological never-never land here, something that was done to Michael Jackson and no one else in history to my knowledge," Shafer told jurors.

The professor reminded jurors that Murray had bought more than four gallons of propofol to use on the singer over the course of his employment, talked on the phone in the hours before Jackson's death, and delayed calling 911 when he found the singer unresponsive.

I am asked every day in the operating room, "Are you going to give me the drug that killed Michael Jackson ?" ...This is a fear that patients do not need to have.

"The worst disasters occur in sedation and they occur when people cut corners," Shafer said. In Jackson's case, "virtually none of the safeguards were in place," he added. 

While testifying, Shafer leaned forward and spoke to jurors directly at times, as if he were in a classroom. The early portion of his testimony was a crash course on propofol, explaining its effects on the body and why, despite being a remarkable drug, it needed to be used by skilled people in a proper medical setting.

Shafer based much of his opinions about the case on Murray's own words during a lengthy interview with police two days after Jackson's death. He said the lack of record-keeping was a violation of Jackson's rights, especially since something went wrong. 

"He has a right to know what was done to him," Shafer said. "With no medical record, the family has been denied that right."

When Shafer spoke of Jackson's family, a couple jurors looked out into the audience, where the singer's mother, father, sister Rebbie and brother Randy were seated.

Testimony has shown that Murray took no notes on his treatment of Jackson and didn't record his vital signs in the hours before the singer's death.

Shafer said he was testifying for the prosecution without a fee because he wants to restore public confidence in doctors who use propofol, which he called a wonderful drug when properly administered.

"I am asked every day in the operating room, 'Are you going to give me the drug that killed Michael Jackson,"' Shafer said.

"This is a fear that patients do not need to have."

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