The Michael Jackson Fan Club

(20-10-2011) Day 14 of the involuntary manslaughter trial of Dr. Conrad Murray saw anesthesiology expert Dr. Steven Shafer back on the witness stand under direct examination by the prosecution.

Shafer told jurors there was no way Michael Jackson could have caused his own death by swallowing propofol - a theory defense attorneys had at one point indicated could become the centerpiece of their case. Shafer said it’s impossible for the drug to enter the bloodstream in any sizeable amount if swallowed.

He also told jurors it was highly unlikely Jackson gave himself the fatal injection of the anesthetic.

"The possibility of a direct self-injection seems extremely unlikely," Shafer said, explaining that it would be difficult for Jackson to have time to inject himself based on Murray’s timeline of being out of the singer’s bedroom for only two minutes.

Shafer testified that patients don't wake up from anesthesia that easily saying, "it's a crazy scenario. People just don't wake up from anesthesia like that - wake up, hell-bent on grabbing a syringe and sticking it in again."

Shafer further stated that propofol is painful if not mixed with a painkiller. "You would not want to try to inject this [yourself] into a vein and miss."

Shafer explained it was much more likely that Murray gave Jackson a much higher dose of propofol than he told police.

Attorneys for Dr. Murray have also suggested that Jackson swallowed eight lorazepam pills without Murray’s knowledge and that may have been enough to kill him.

Shafer, however, said the defense’s own testing showed Jackson had not swallowed any lorazepam pills in the four hours before his death, and the amount of the medication found in his stomach was "trivial."

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

On Wednesday, Shafer told jurors that Murray's treatment of Jackson for insomnia with a "polypharmacy" of multiple drugs was "a pharmacological Never-Never Land" that had never been tried on any other patient and was potentially fatal.

He reminded jurors that Murray purchased more than four gallons of propofol to use on Jackson over the course of his employment, left his patient's bedside to talk on the phone in the hours before Jackson’s death, and delayed calling 911 when he found him unresponsive.

"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.

At times Shafer's voice sounded angry as he told the jury Murray had committed 17 separate "egregious violations" of medical standards. Four of those mistakes were "egregious, unethical and unconscionable," he said. But all 17 were direct causes of Michael Jackson's death, he said.

Shafer said he didn't believe Murray's statement to police that he only left the room for 2 minutes to use the bathroom, returning to find him not breathing. He said it was more likely that Murray was distracted by 45 minutes of phone calls, text messages and e-mails. He said from a distance, it would have been difficult to tell that Jackson was not breathing and Murray wouldn't have realized it for "a considerable period of time," Shafer said. "I actually believe that is what happened," he said.

Shafer said he also didn't believe Murray's statement to police that for about 80 nights he had given Jackson only 50 milligrams of propofol, ending with a smaller, 25-milligram dose on the day of his death. Shafer said the evidence indicated nightly 100-milligram doses.

Shafer said that if Murray, lacking the proper monitoring and resuscitation equipment, had called 911 immediately instead of delaying the call for about 20 minutes, Jackson would have survived but with some brain damage due to the loss of oxygen for about 8 minutes.

If the proper monitoring and resuscitation equipment had been on hand, "Mr. Jackson would be alive and uninjured," Shafer said.

Shafer still has yet to be cross-examined by the defense. He is expected to be the prosecution's final witness. As of this posting, Shafer is still on the witness stand and court was in a short recess.

Source: MJFC / washingtonpost.com / usatoday.com / AP