"What I saw was a patient who stated what he wanted. 'I want this. I want this. I want this.' And I saw [Jackson physician] Conrad Murray say: 'Yes. Tell me what you want and I'll do it. That is what an employee is,'" Dr. Steven Shafer, a New York anesthesiologist and expert witness for the government, told jurors in Los Angeles Superior Court Wednesday -- the day before prosecutors were expected to rest their case.
When Jackson told Murray he wanted a powerful intravenously administered hypnotic anesthetic, normally used to sedate patients before surgery, to cure his insomnia, "Dr. Murray should have said: 'Michael Jackson, I am not giving you propofol. I am not giving you anything. You have a sleep disorder and you need to be evaluated,'" Shafer testified.
Murray, 58, is charged with involuntary manslaughter and is accused of acting with criminal negligence in giving Jackson, his only patient, a propofol overdose that killed him.
Murray has pleaded not guilty in the June 25, 2009, death and contends the singer gave the fatal dose to himself.
Shafer, who teaches at Columbia University and edits the peer-reviewed medical journal Anesthesia & Analgesia, said Murray had more than 4 gallons of propofol shipped to him -- averaging nearly 2,000 milligrams a day -- in the months before Jackson's death.
He called the quantity "an extraordinary amount to purchase to administer to a single individual."
In a police interview recorded two days after Jackson died, Murray said he had given a single 25 milligram dose to Jackson before his death, but only after spending hours trying to get the singer to sleep using milder drugs.
Jackson had called propofol as his "milk," Murray told police. Propofol is sometimes referred to as "milk of amnesia" -- a pun on milk of magnesia -- because of its milklike appearance.
Shafer, who testified without a fee in the case, said Murray committed at least 12 "egregious" violations of the proper standard of care, which the Los Angeles Times said Shafer defined as acts posing a foreseeable danger to his patient's life.
These acts included not having monitoring equipment for Jackson's heart, breathing and blood pressure and not keeping medical records.
"Each one individually could be expected to lead to a catastrophic outcome including death?" Deputy District Attorney David Walgren asked.
"Absolutely," Shafer said.
Shafer earlier narrated a silent video showing what Shafer said were the correct procedures for using propofol.
The video showed doctors wearing scrubs and gloves in a sterile high-tech operating room, checking monitors and machines prosecution witnesses have testified Murray didn't have in Jackson's bedroom when Jackson died.
"The facts in this case, in my view, suggest that virtually none of the safeguards for sedation were in place when propofol was administered to Michael Jackson," Shafer said.
Murray's lawyers were expected to open his defense Friday.
Ed Chernoff, Murray's lead defense lawyer, told the jury in his opening statement last month he would stake his case on "powerful science" from anesthesiology expert Paul White, clinical research director in the anesthesia department of Cedars-Sinai Medical Center in Los Angeles. White is also a retired anesthesiology professor at the University of Texas Southwestern Medical Center in Dallas.
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