Re: Jacksons vs AEG - Day 43 - July 3 2013 - News Only (no discussion)
ABC7 Court News @ABC7Courts 10h
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ABC7 Court News @ABC7Courts 10h
That concluded Day 43 of testimony, Week 10. We hope to see you all back on Monday. Happy 4th of July everybody!
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ABC7 Court News @ABC7Courts 10h
Panish told the judge he's now estimating to finish his case in chief another week or so after the July 8th week, his last estimate.
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Jury ordered to return on Monday at 10 am PT. Plaintiffs will play Dr Finkelstein's deposition. Kenny Ortega set to testify in the afternoon
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Koskoff: And Dr. Murray gave it to him?
Dr. Schnoll: Yes
Dr. Schnoll was then excused and session adjourned. No court tomorrow or Friday.
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Koskoff noted that MJ replied it would be safe if done under the supervision of a doctor.
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Dr. Schnoll said Lee responded that MJ was taking chances.
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Cahan in re-cross: What did nurse Cherilyn Lee said to MJ when he was looking for a doctor to give him Propofol?
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Koskoff asked in re-direct if Propofol was given for the drug or underlying condition. Dr. Schnoll said MJ asked Propofol to help him sleep.
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"They were not symptoms of Demerol withdrawal, but probably of Propofol," Dr. Schnoll testified about MJ's symptoms in June 2009.
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Dr. Schnoll said he looked at the totality of the picture, like a puzzle, trying to put everything together to understand what was going on.
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Dr. Schnoll said he saw a concern one time of MJ going to Santa Ynez Cottage Hospital for excessive use of Demerol.
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Cahan asked if Dr. Schnoll reviewed testimony that MJ had boxes of Propofol at Neverland and asked a doctor to inject him. He said yes.
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Cahan asked about MJ's family failed interventions. He said he doesn't know if they were appropriately done; practice not used as much.
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Dr. Schnoll: MJ could've been off the drugs or taking the drugs in appropriate dosages if properly treated
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Dr. Schnoll said he didn't have 100% success rate in his practice and that no one does.
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"That's why your job is to motivate them and help them see the problems with the dependency," Dr. Schnoll responded.
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Cahan asked about patients who think they have their addiction under control and don't want to quit the drug.
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He doesn't think the symptoms MJ was having on June 19, 2009 were related to Demerol withdrawal.
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Dr. Schnoll: It was very hard for me to say he was dependent that time.
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"It didn't coincide with when I expected that withdrawal to occur," Dr. Schnoll said about MJ.
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"Was he really dependent?" Dr. Schnoll asked himself. He said the appearance of withdrawal from Demerol usually shows within 24-36 hours.
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Dr. Schnoll said he asked for a chart to be made to be able to see how much Demerol MJ was getting and how frequent.
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The expert said that if the withdrawal symptoms were present, someone might have asked why MJ had the flu.
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Dr. Schnoll said he would probably give her initial dose of 50 mg.
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Cahan asked what would happen if doctor gave her 375 mg of Demerol. "For you? You'd probably sleep for a while, about several hours" he said
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In April 2009, MJ received 375 mg of Demerol, the highest amount given by Dr. Klein.
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Dr. Schnoll said he doesn't think MJ was dependent on Demerol in January of 2009.
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Dr. Schnoll said he could not opine whether the treatment after the burn on MJ's scalp was appropriate.
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He's also not absolutely sure, but says MJ was probably dependent on Demerol in 1993.
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He said he continued to investigate the case, looked at more records, and is now uncertain.
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However, Dr. Schnoll says today he's not sure MJ was dependent on Demerol in 2009.
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Cahan asked if Dr. Schnoll testified in his deposition that MJ was dependent on Demerol? He answered yes, the time around the Dangerous tour
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Cahan: Is it legal to write prescription to someone under another name?
Dr. Schnoll: Yes, it's illegal
C: Have you ever done it?
Dr: No
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Dr. Schnoll said you try to look at the whole picture of what was going on and not look at the possibilities, but probablilities.
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Dr. Schnoll: I don't like to work under possibilities, since everything under the sun is possible. I like working with probablilities
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Cahan: Could MJ have opiates in pill forms in 2009 from doctors while having Demerol injections from Dr. Klein?
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Cahan: Did Dr. Klein write prescriptions to Mr. Jackson under other names?
Dr. Schnoll: Yes
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Cahan: Are you aware of Dr. Klein being investigated...
Panish stopped and objected as improper. He asked for a sidebar.
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Cahan asked if MJ was seeing other doctors at the same time he saw Dr. Murray, like Dr. Klein. Dr. Schnoll said yes.
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Cahan resumed questioning Dr. Schnoll. Katherine left for the day.
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Instruction cont'd: she believed they, AEG, hired Dr Murray. That violated a court order, the statement is stricken, shouldn't be considered
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Jurors brought in at 3:27 pm PT. Judge read them the following instruction: Yesterday, plaintiiff's expert Jean Seawright said
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Judge admonished Panish to tell all experts to abide by her motions in limine.
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Judge: I don't know why you are pointing your fingers that way, Mr. Panish (to AEG's side). I really don't.
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Putnam said he agreed with the judge and agrees the instruction should be given as written.
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Panish: She said it, I wish she hadn't, I don't want a mistrial
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Judge: There are bright lines Mr. Panish and you don't even go near it because you may cross it accidentally
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Judge: I don't want a mistrial, it's a waste of resources
Panish: I don't want a mistrial either
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Judge: Every expert is only to make assumptions about hiring. I specifically did that (ruling) for a reason. Advise them about my order!
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Apologies, reached the limit of tweets again.... Here's the remaining of today's testimony.
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Judge: I don't want this kind of problem that can lead to mistrial. I'm asking you to speak with all your experts
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An upset judge said:
This is my concern, we are 9 weeks in this trial and it's getting into mistrial territory. I don't want to go there!
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Judge: there's a ruling prohibiting any testimony, by any expert, on the issue!
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Panish: I know you're upset, I can tell that
Judge: I'm not upset, I think it's entirely appropriate
Panish: I told her not to do it
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Judge: This is your crucial, central issue in the case Mr. Panish. I'm surprised you had no discussion with her about it
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Judge said that violated the motion in limine regarding this issue. Experts are NOT to give their opinion on whether AEG hired Dr. Murray.
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Outside the presence of the jury, judge discussed with the attorneys about Jean Seawright's testifying yesterday that AEG hired Dr. Murray.
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Dr. Schnoll said some of the patients might have been addicted to Propofol, but others were just abusing it.
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Dr. Schnoll said he has treated tens of thousands of patients and only 5-6 were addicted to Propofol. These people were in the medical field
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The doctor agreed that some lay people could identify the symptoms as flu.
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Dr. Schnoll said most doctors would be able to put all the symptoms together and conclude it is opioid withdrawal.
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Some of opioids withdrawal include chills, running nose, tearing of the eyes, dilated pupil, goose bumps.
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The expert said people would recognize there was something wrong with MJ, but may not be able to recognize it as withdrawal from opioids.
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Dr. Schnoll said people get confused as to whether the patient is addicted or dependent of drugs.
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Cahan: There has got to be some amount of trust between doctor and patient?
Dr. Schnoll: Right
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Dr. Schnoll: Well, of they came to me to treat addiction, they usually would come because they wanted to treat their addiction
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Cahan: Did some patients did not want to get treatment?
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Cahan: When you are evaluating a patient you rely on the patient being honest with you, correct?
Dr. Schnoll: Yes
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Dr. Schnoll did not offer opinion whether the amount or type of drug MJ was taking for cosmetic and dental work was appropriate.
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"There was no evidence of addiction at that time," Dr. Schnoll said about MJ in 2009.
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Dr. Schnoll said he last prescribed Demerol in the late 1970s. He stopped treating patients in 2001.
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Dr. Schnoll: Probably not at all at this point, pain specialist would not keep Demerol handy
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Dr. Schnoll said use of Demerol for pain went into question in the '90s.
Cahan: How common is for pain specialists to have Demerol handy?
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Dr Schnoll said Demerol is not commonly used anymore because it has other effects than just opioids, considered a dirty drug the doctor said
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Dr. Schnoll responded he didn't know, since he doesn't do these procedures.
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Cahan asked if it's common practice to use Demerol for Botox injections and facial fillers treatment.
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Just the fact that Dr. Klein injected MJ with Demerol doesn't raise concern of a relapse of Demerol dependency, Dr. Schnoll.
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Dr. Schnoll: If they have a severe pain problem that can only be treated by opioids, it is appropriate to give it.
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A professional doctor knows the difference between addiction and pseudoaddiction.
(nurse juror nodding in agreement)
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Pseudoaddiction is when a patient is undertreated for pain, Dr. Schnoll said.
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Dr. Schnoll said doctor shopping is going from doctor to doctor to receive medication.
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There were weeks he put in 7-8 hours, some didn't do anything. He said it would be hard to estimate, spoke with plaintiff atty 10-15 times
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Dr. Schnoll said he has no idea how many hours he has worked in this case. He was retained back in January.
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Cahan said Pinney Associates is charging $790/hour for Dr. Schnoll's time.
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Dr. Schnoll works for Pinney Associates, he's a salaried employee and receives bonus at the end of the year, should there be one.
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Cahan: You were never hired as a doctor to accompany a band on tour?
Dr. Schnoll: That's correct
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"I knew most of them and I knew them well," Dr. Schnoll said.
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Cahan asked if Dr Schnoll brought medical students to help him out. He said yes. She asked if he did background or credit checks on them
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Dr. Schnoll said he acted ethically at that job. He worked at rock concerts in the '70s.
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Cahan: Did you think that created a conflict of interest?
Dr. Schnoll: As long as I acted ethically, I did not
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Dr. Schnoll said his primary duty was to treat concert goers. He was paid by the promoters.
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Dr. Schnoll said at times he was asked to treat performers, was hired to provide medical treatment at the facility to fans or artists.
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I know some people who worked at concerts, Dr. Schnoll said. He has been one.
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Cahan: Do you think it's ethical for doctors to go on tour?
Dr. Schnoll: It depends on what they do when they go on tour with them
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Dr. Schnoll created the term "Rock Doc", referring to doctors who work on rock n roll concerts.
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Koskoff finished direct examination. AEG attorney Kathryn Cahan did cross examination of Dr. Schnoll.
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Dr. Schnoll said he's reading Richards' book, but hasn't finished yet. Defendant's objected to the doctor talking about it based on hearsay.
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Keith Richards and The Rolling Stones have been performing for 50 years. Richards writes in his autobiography about his drug addiction.
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If MJ got proper treatment, he would have like normal life expectancy, Dr. Schnoll said.
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Drug addicts can die early due to overdose; infections are very common, like HIV, Dr. Schnoll said.
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Dr. Schnoll: If appropriately treated, it would have no affect
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Koskoff: Assuming he was not addicted, but had periods of drug dependency, would that have an impact on his life expectancy?
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Dr. Schnoll agreed MJ had the means to get proper drug dependency treatment.
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Koskoff: Based on Mr. Jackson's family, do you know if any members of his family were addicted?
Dr. Schnoll: I have no indication of that
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Dr. Schnoll: Some of the best outcomes in treatment are with people who have a lot to lose if they continue their addiction.
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"The autopsy said he was in really, very good condition," Dr. Schnoll told the jury about MJ.
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Having a supportive family and environment is critical in overcoming addiction, Dr. Schnoll explained.
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Dr. Schnoll: He could've been treated, he could've been treated if he had the proper people
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Koskoff: Let's assume MJ really was addicted to Demerol in 2009, do you have an opinion as to his prognosis for successful treatment?
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Koskoff: Assuming MJ was dependent, do you think proper treatment would be able to eliminate his dependency?
Dr. Schnoll: Yes
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Dr. Schnoll said if MJ were treated appropriately for pain and sleeping problems, it would not have an effect in shortening his life.
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Dr. Schnoll: Should MJ have someone knowledgeable for treatment of pain, he could've been treated appropriately
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Dr. Schnoll testified MJ had two major problems: pain and insomnia.
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"He would've been able to continue to perform if he was appropriately treated for the underlying medical conditions," Dr. Schnoll said.
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Dr. Schnoll: If his underlying medical condition, pain, insomnia, had been appropriately treated, he may have been able to get off the drugs
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Koskoff asked if MJ were under the care of a competent doctor, would he have been able to get off the drugs, Demerol and benzodiazepines.
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"They pass catheters and look at hearts, which is totally unrelated to pain," Dr. Schnoll said about cardiologists.
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Dr. Schnoll: Dr. Murray was an interventionist cardiologist and that is a highly specialized field. He had no background in treating pain.
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Koskoff: Assuming AEG hired Dr. Murray, was he fit and competent to treat Michael's sleep problems?
Dr. Schnoll: No, he was not
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Koskoff: Assuming AEG hired Dr. Murray, was he fit and competent to treat Michael's pain problems?
Dr. Schnoll: No, he was not
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Koskoff: Was Dr. Murray competent to handle MJ's sleep problems?
Dr. Schnoll: He was not competent
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Koskoff: Was Dr. Murray competent to handle MJ's drug dependency issues?
Dr. Schnoll: He was not competent
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Koskoff: Was Dr. Murray competent to handle MJ's pain?
Dr. Schnoll: He was not competent
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The hospital computer overloaded with people trying to get information on what happened with Sinatra, Dr. Schnoll said.
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Dr. Schnoll said once Frank Sinatra went to the hospital he worked after collapsing on the stage.
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Sometimes prescription is given under other people's names, Dr. Schnoll said, since celebrities often don't want people prying their records
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"If you are dependent, you could have some insomnia if you go off of it," Dr. Schnoll testified.
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Koskoff: What does Demerol do to sleep?
Dr. Schnoll: When you are taking it, it could make you sleepy
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He also said this drug would not have had effect on MJ on June 25.
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Dr. School said there was no trace of the drug in MJ's body at the time of his death.
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The very last Demerol injection MJ received from Dr. Klein was on June 22, 100 mg dose, according to the records, Dr. Schnoll testified.
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Koskoff: Is there a record MJ was getting Demerol from any other doctor?
Dr. Schnoll: No
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Dose went up in January 2009. Dr Schnoll said if a person was previously dependent on Demerol, stops and then resumes, tolerance is built up
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Dr. Schnoll talked about Dr. Klein giving MJ 100mg doses of Demerol in 2008. He said from mid-year to December it was the same amount.
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Dr. Schnoll said Propofol is not appropriate to treat insomnia, even if MJ suggested it.
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Koskoff asked if there was any evidence MJ was addicted or dependent of Propofol up until Dr. Murray. Dr. Schnoll said no.
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Dr. Murray used Propofol for sleep, which Dr. Schnoll said was inappropriate. "Plus, he was not an anesthetic or an anesthesiologist."
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The drug was used for dental procedures and cosmetic treatment, Dr. Schnoll said, adding it was appropriate for that.
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Between 1994 and 1996, Dr. Schnoll saw no evidence of any use of Propofol by MJ under any circumstance.
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Koskoff: What kind of specialist was on that tour for Michael?
Dr. Schnoll: He was anesthesiologist
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Dr. Schnoll testified Debbie Rowe said yes, but she wasn't sure if it was Propofol or Fentanyl. He didn't think Rowe was a licensed nurse.
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Koskoff showed a timeline and asked if there was any record MJ received Propofol during the Dangerous tour in 1994.
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Propofol is the most popular anesthetic in the world, Dr. Schnoll said. Propofol is the generic term.
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Dr. Schnoll said after the Propofol infusion stops, the effect wears off quickly.
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"Typically, they steal it from operating room or critical care unit or inject it in a home, or a bathroom," Dr. Schnoll explained.
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Dr. Schnoll treated patients addicted to Propofol. They were health technicians and none had it administered by another person.
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Koskoff: Did he use it for sleep?
Dr. Schnoll: Yes
K: Is that appropriate?
Dr: Yes
K: Did MJ have a sleep problem?
Dr: Yes
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Dr. Schnoll said MJ was prescribed Midazolam and Versed which is commonly for short term surgical procedures, dental procedures.
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Koskoff: Was there a time MJ did take benzodiazepines?
Dr. Schnoll: Yes
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Dr. Schnoll: I don’t know if MJ was an addict. I haven’t seen the information that would allow me to make a diagnosis of addiction
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Koskoff: On Dangerous tour, was MJ getting opioid drugs according to Dr. Finkelstein?
Dr. Schnoll: Yes
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Dr. Schnoll talked about the surgery MJ to repair damage to his scalp.
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The expert said he saw evidence MJ was afraid of needles; didn't take medications in excess of what was prescribed by doctors.
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Dr. Schnoll said he saw no evidence that MJ ever used recreational drug or self-injected in the absence of a doctor.
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Koskoff: Do you agree with that opinion?
Dr. Schnoll: No
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Koskoff asked if Dr. Schnoll read testimony from Dr. Earley saying MJ was a drug addict and that he was going to die early.
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Koskoff asked if that was consistent with a drug addict. Dr. Schnoll answered no.
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Koskoff said based on the medical records in the last 16 years of MJ’s life, he was Demerol free for 13 1/2 years.
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The patch was done for treatment of Demerol dependency in early 2000s. The drug would block the effect of the opioid, Dr. Schnoll said.
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Dr. Schnoll said he reviewed medical records that Dr. Farshian implanted a patch into MJ's abdomen.
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Koskoff: Was there a period of time when MJ used Demerol for scalp treatments?
Dr. Schnoll: Yes
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Koskoff: Any evidence from any witness that MJ used Demerol outside the medical setting?
Dr. Schnoll: No
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“Opioids are most popular because they work," Dr. Schnoll said. "Pain is the most common complaint that comes to a doctor's office.”
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Dr. Schnoll explained pain threshold is the level at which someone feels discomfort. They are quite variable, he said.
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Dr. Schnoll: The figures indicate 10 to 12% become addicted, the same percentage of people who become addicted to alcohol.
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Some patients become addicted, Dr. Schnoll said. But it's not s large percentage.
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Dr. Schnoll: if they're on long term opioid treatment, they'll become dependent. Opioids are the most commonly prescribed drugs in the US.
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Koskoff: If a person is being treated, as part of good medical practice, can someone become drug dependent?
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Dr. Schnoll said addiction can also be treated by competent and fit physicians.
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Koskoff: Any famous people who have been opioid dependent?
Dr. Schnoll: President John F. Kennedy (Judge asks why?) Back pain.
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If a person has underlying condition and take opioid they could function better, Dr Schnoll explained. There's no harm in doing it medically
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Koskoff: What if a person has chronic osteoarthritis?
Dr. Schnoll: May have remain on medication all his life
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Dr. Schnoll said the most important factor in determining if the person should go off the drug is to find out what the underlying problem is
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Methodone is an opioid drug used for pain and treatment of opioid addiction. Dr. Schnoll explained how the drug works.
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Koskoff asked if you take someone off Demorol suddenly what happens. Dr. Schnoll: “like falling off a cliff, you don’t want that to happen.”
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Katherine Jackson was present in court wearing a long periwinkle jacket and pearl earrings.
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Addiction specialist Dr. Sidney Schnoll resumed testimony. Jackson's attorney Michael Koskoff did direct examination.
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Re: Jacksons vs AEG - Day 43 - July 3 2013 - News Only (no discussion)
Anthony McCartney @mccartneyAP 18h
Schnoll spent about another hour on the witness stand, reiterating his point that there was no sign in records that Jackson was an addict.
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Anthony McCartney @mccartneyAP 18h
The judge said the jury should disregard her testimony about whether AEG Live hired Conrad Murray.
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Anthony McCartney @mccartneyAP 18h
The jury was brought in, and Palazuelos read an instruction stating that Seawright violated a court order.
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Anthony McCartney @mccartneyAP 18h
Palazuelos: “I don’t know why you’re pointing the finger that way.” She told Panish to make sure he warns his experts from now on.
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Anthony McCartney @mccartneyAP 18h
Panish also said that he was trying to counter questions from AEG’s attorneys that suggested Seawright didn’t have an opinion.
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Anthony McCartney @mccartneyAP 18h
Palazuelos: “This is my concern. Nine weeks into this trial and this is getting in a mistrial situation.” (We’re in 10th wk of testimony.)7
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Anthony McCartney @mccartneyAP 18h
Panish protested, saying “All I was trying to show was that she was trying to show was that she has an opinion.”
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Anthony McCartney @mccartneyAP 18h
The judge said the answer veered into mistrial territory, and that Panish should have warned Seawright to not state her opinion.
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Anthony McCartney @mccartneyAP 19h
Panish had asked whether Seawright she had an opinion on whether AEG Live hired Murray. He said today he thought it was a yes-no question.
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Anthony McCartney @mccartneyAP 19h
Seawright told the jury she thought AEG did hire Murray, based on a question from plaintiff’s attorney Brian Panish.
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Anthony McCartney @mccartneyAP 19h
The judge noted that expert witnesses had been instructed not to state opinions on whether AEG Live hired Conrad Murray.
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Anthony McCartney @mccartneyAP 19h
After the afternoon break, Judge Yvette Palazuelos returned to the testimony of HR expert Jean Seawright. She was upset about yesterday.
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Anthony McCartney @mccartneyAP 19h
The doctor said he probably hadn’t prescribed Demerol since the 1970s. (He hasn’t been practicing with patients for several years.)
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Anthony McCartney @mccartneyAP 19h
AEG defense attorney Kathryn Cahan also asked Schnoll about Demerol. He called it a “dirty opioid.”
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Anthony McCartney @mccartneyAP 19h
On cross-examination, she tried to make the point that it’s hard for a lay person to tell difference between addiction and dependency.
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Anthony McCartney @mccartneyAP 19h
Schnoll said even if Jackson were addicted to medications, with proper treatment he could have lived a long, healthy life.
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Anthony McCartney @mccartneyAP 19h
The doctor also addressed Demerol use, saying there was no sign Jackson received the drug between 2003 and 2008.
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Anthony McCartney @mccartneyAP 19h
Schnoll’s point about the documented use of propofol by Jackson was that it was in medical settings with proper supervision. Until C. Murray
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Anthony McCartney @mccartneyAP 19h
He said Rowe used two different names for medications she saw Jackson receive in 1993, so it wasn’t clear if propofol was used.
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Anthony McCartney @mccartneyAP 19h
Schnoll said it wasn’t clear if Jackson received propofol during the 1993 “Dangerous” tour because Debbie Rowe wasn’t clear.
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Anthony McCartney @mccartneyAP 19h
The records showed that Jackson received propofol for dental procedures dating back to 1997, Schnoll said.
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Anthony McCartney @mccartneyAP 19h
Schnoll reviewed medical records dating back until at least 1997. They included dental records, and files of Arnold Klein.
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Anthony McCartney @mccartneyAP 19h
Schnoll said based on his review of medical records, he saw no evidence that Jackson was addicted to prescription meds.
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Anthony McCartney @mccartneyAP 19h
I’ve been dealing with some tech issues and a time crunch today, so will address the main points of Schnoll’s testimony.
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Anthony McCartney @mccartneyAP 19h
As for today's proceedings, testimony of Dr. Sidney Schnoll concluded today.
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Anthony McCartney @mccartneyAP 19h
Finkelstein's deposition will take the morning session. Kenny Ortega is scheduled to be the Monday afternoon witness.
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Anthony McCartney @mccartneyAP 19h
We're done for the day in Jackson vs. AEG Live. Court resumes on Monday at 10 a.m.
They'll play the deposition of Dr. Stuart Finkelstein.
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Anthony McCartney @mccartneyAP 3 Jul
He's also started to discuss Michael Jackson's medical history. I may have more updates in a little while. Gotta review some notes.
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Anthony McCartney @mccartneyAP 3 Jul
Schnoll is being questioned by plaintiff’s attorney Michael Koskoff. He started out discussing pain management drugs, addiction solutions.
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Anthony McCartney @mccartneyAP 3 Jul
Dr. Sidney Schnoll, an addiction and pain management expert, remains on the stand.
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Anthony McCartney @mccartneyAP 3 Jul
We’re on a break in Jackson vs AEG Live trial. Katherine and Trent Jackson are here today.
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