Defense Expert: Murray Deviated From Standard of Care

Los Angeles - Michael Jackson's personal physician deviated from the accepted standard of care in the months leading up to the singer's death and on the day the entertainer died, a key defense witness acknowledged today.

Testifying in Dr. Conrad Murray's involuntary manslaughter trial, Dr. Paul White told jurors he had never heard of anyone administering the powerful anesthetic propofol in a patient's bedroom and had never done it himself. He said he would not administer propofol in a home setting.

"Without careful bedside monitoring, it could be dangerous," the veteran anesthesiologist testified when Deputy District Attorney David Walgren asked if it would be extremely dangerous to administer propofol with an IV drip for about two months.

In his interview with two Los Angeles police detectives two days after Jackson's death, Murray said the highest amount of propofol he had been giving Jackson before "starting the (IV) drip on him" was 50 milligrams. But he said he gave the singer 25 milligrams -- half of the previous dose -- the day of his death because he had already given him other medication and had been trying to wean him off propofol.

Murray told police he monitored Jackson carefully for a time, left the bedroom for about two minutes to use the bathroom and then returned to find Jackson was not breathing.

The defense has contended that Jackson gave himself the fatal dose of propofol while Murray was out of the room.

In his third day on the stand, White said he believed that Jackson injected himself with a syringe that Murray had already drawn up -- likely while the doctor was on a series of phone calls that Murray did not discuss with police.

White also said that given Murray's statement that Jackson had expressed familiarity with propofol and how to use it, a doctor should be careful about giving such a patient access to the medication

"It would certainly make me careful about allowing access to (propofol)," he said. "... No, I would not leave the room."

When asked if it was an extreme deviation from the standard of care for Murray not to keep medical records of his treatment of the singer, White answered, "I think it's a deviation from the standard of care. ... I would say it's perhaps between minor and serious, not extreme in my opinion."

White also conceded that if he had been in Murray's position, he would have "immediately" called for help when he discovered that the singer had stopped breathing, adding that he could not justify any delay in making such a call.

But he added, "I think he should have called 911 sooner. ... I do not, however, think it would have made any difference in the outcome of this case." Under renewed questioning by defense attorney J. Michael Flanagan, the defense expert said propofol intoxication usually occurs as the drug is being administered or shortly thereafter.

White said it could have been a simple oversight by Murray not to mention to paramedics and emergency room doctors that he had given propofol to the singer. White added later that it wouldn't have changed either the treatment of Jackson or the outcome.

Dr. Steven Shafer, an anesthesiologist who testified during the prosecution's case, said earlier in the trial that Murray's failure to keep medical records and to call 911 for help were among 17 "egregious" violations by the doctor during his treatment of Jackson, and that Murray's failure to notify emergency personnel that Jackson had been given propofol showed that he was putting himself, not his patient, first.

White said he speculated earlier this year in "preliminary thoughts" after first being consulted that Jackson may have died from drinking propofol or self-ingesting the drug, but said he has since ruled out the theory that Jackson swallowed the anesthetic.

He has disputed Shafer's theory that Jackson was being given an infusion or "drip" of propofol that was continuing even as the singer was dying.

White testified last week that he believed the evidence showed the entertainer had rapidly given himself 25 milligrams of propofol less than an hour after Murray slowly infused 25 milligrams of the anesthetic into his system. He also said Jackson had taken eight tablets of the sedative lorazepam in the hours leading up to his June 25, 2009, death from acute propofol intoxication.

Murray, a 58-year-old cardiologist, faces up to four years in prison if convicted of the felony charge stemming from Jackson's death.

Prosecutors allege Murray gave the singer a fatal intravenous dose of propofol, then spent about 45 minutes on the phone or sending emails instead of monitoring him. Jackson was in Los Angeles rehearsing for a series of 50 concerts in London dubbed "This Is It."

In his opening statement, defense attorney Edward Chernoff countered that the evidence would show Jackson "self-administered a dose of propofol" after Murray left the room, which "created a perfect storm" and "killed him instantly."

Murray told police he only left Jackson's