Chicago Medical Malpractice Lawyer Blog

For weeks, Dr. Conrad Murray's defense team has been arguing Dr. Murray did not cause Jackson's death. Instead, the defense has been blaming Jackson himself claiming Jackson gave himself additional propofol when Dr. Murray temporarily left the room. In doing so, the defense has sought to shift blame from Dr. Murray to Jackson claiming Jackson is the cause of his own death. At various points in the trial, the defense has introduced another figure as being at least partially responsible for Jackson's death. That person is Jackson's former dermatologist, Dr. Arnold Klein. As a Chicago medical malpractice lawyer, I am quite familiar with this defense tactic commonly referred to as the "empty chair" defense.

Although Dr. Murray is on trial for involuntary manslaughter, the case has played out much like a civil medical malpractice trial. Like a civil case, the prosecution must show Dr. Murray deviated from the standard of care and that Dr. Murray's deviation from the standard of care was at least a cause of Jackson's death. In some malpractice cases, the defense will seek to blame another person who is not a defendant in the lawsuit. The defense may literally, if not figuratively, point to an empty chair saying the person is responsible for the malpractice is not even in this courtroom. This is commonly referred to as the "empty chair" defense. With this tactic, the defense seeks to avoid responsibility by shifting blame from their client to someone not a party to the lawsuit. In the trial against Dr. Murray, his defense lawyers are blaming Jackson and another doctor, Dr. Arnold Klein.

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Dr. Murray's defense team continues to deny he is responsible for Michael Jackson's defense, claiming Jackson gave himself the fatal dose of propofol. The latest evidence offered by the defense at trial came from two witnesses. Jackson's former nutritionist (and nurse) testified Jackson often discussed his need for propofol to sleep. Jackson's former concert promoter testified about the demands of Jackson's upcoming tour. As a Chicago medical malpractice lawyer, I continue to be fascinated by how this case is being tried.

Dr. Murray is on trial in California charged with involuntary manslaughter for the death of pop singer Michael Jackson in 2009. The prosecution claims Dr. Murray recklessly provided the anesthetic propofol for sleep, which ultimately resulted in Jackson's death. The defense denies Dr. Murray acted recklessly and, in either event, denies Dr. Murray's actions resulted in Jackson's death. If convicted, Dr. Murray faces up to four years in prison.

Although Dr. Murray claims Jackson killed himself by giving himself propofol while Dr. Murray temporarily left Jackson's room, the defense does not seem to have any direct evidence of this claim. Instead, the defense is relying on circumstantial evidence. The defense hopes the jury will piece together various evidence to create reasonable doubt on whether Jackson gave himself the fatal dose of propofol. However, this theory is problematic. If the jury concludes it does not matter whether Jackson gave himself propofol because, ultimately, Dr. Murray should have never brought propofol into Jackson's home, then Dr. Murray could still be found guilty. Consistent with this theory, prosecution experts earlier testified they still believe Dr. Murray is responsible for Jackson's death regardless of whether Jackson gave himself the fatal dose. They reason it was extreme medical malpractice to give propofol in a home for sleep purposes.

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From the beginning of this trial, the defense has been claiming Michael Jackson caused his own death when he gave himself propofol. Thus, the defense has argued that Dr. Conrad Murray is not guilty because he did not cause Jackson's death--Jackson did. Last week, Dr. Murray's defense team officially dropped the defense Jackson "swallowed" propofol himself. As a Chicago medical malpractice lawyer, I am amazed the defense ever made such an allegation because, even if true, swallowing propofol would almost certainly not cause death.

Dr. Murray's defense team gave up on Jackson swallowing propofol after medical studies showed propofol has no major effects on a person when swallowed. This is, no doubt, a major set back for the defense. That said, the defense's mistake is not necessarily fatal. After all, Dr. Murray can still make the general claim Jackson gave himself propofol when Dr. Murray left the room for two minutes. They just can no longer argue Jackson swallowed propofol. Instead, they will likely argue Jackson injected himself with propofol. No doubt, a self-injection of propofol, depending upon the circumstances, could result in death.

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Many clinical physicians have financial interests in private health companies (or organizations) including pharmaceutical companies. This fact has long been known. However, according to a recent study, most clinicians who draft practice guidelines have a financial interest in at least one private health company or organization. As a result, there is an inherent financial conflict of interest for these clinicians who draft practice guidelines. Among those doctors who have financial conflicts of interests, some fail to even disclose their conflict of interest yet actively participate in drafting important practice guidelines that directly effect patients. As a Chicago medical malpractice lawyer, I believe these conflicts of interest are extremely concerning. This is particularly true when the clinician fails to disclose their financial conflict of interest yet participates in drafting practice guidelines that further their own financial interests.

A practice guideline is a document designed to guide medical decisions and criteria regarding diagnosis, management, and treatment in particular areas of medicine. These documents often include a summary of consensus on best practices in healthcare. Doctors routinely rely upon these guidelines in formulating important medical decisions for their patients. For all these reasons, it is critical that these guidelines be completely safe, sound, and reliable.

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An Illinois woman filed a medical malpractice suite after losing both legs following weight loss surgery. Mary Beth Ruphard underwent bariatric surgery at Provena St. Joseph Medical Center in Joliet, Illinois. She chose surgery because, at 278 pounds, and suffering from diabetes and hypertension, she was worried about her health. Weeks after surgery, on Thanksgiving, Ms. Ruphard went back into the hospital complaining of pain and tingling in her legs. She was diagnosed with blood clots in her legs. However, the hospitals did not get a surgeon in to operate on Ms. Ruphard until 36 hours later. By that time, it was too late according to her attorney. As a result, both of Ms. Ruphard's legs had to be amputated. The surgeon who performed the surgery was reportedly furious, stating "[w]hy was I not called earlier?"

As a Chicago medical malpractice lawyer, I have handled many hospital negligence cases including those involving complications from surgery. Of course, anytime a patient undergoes surgery, there are certain risks of the procedure. This includes blood clots in one or more legs. In patients with diabetes, these blood clots can be particularly dangerous in regard to vascular problems and requires even prompter attention.

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Week two of the criminal trial against Dr. Murray for Michael Jackson's death is now complete. Dr. Murray is accused of manslaughter in connection with the pop singer's death. The prosecution's primary contention is Dr. Murray' recklessly gave Jackson propofol, a surgical anesthetic, which led to Jackson's death. The defense claims Jackson caused his own death when he secretly took propofol while Dr. Murray was out of the room. As a Chicago medical malpractice lawyer, I have been following this trial closely. I am particularly interested in learning what evidence the defense will use to claim Jackson took propofol himself without Dr. Murray's knowledge or consent. Thus far, there has been no direct evidence to support the defense's contention. Instead, the evidence on Jackson allegedly taking propofol himself has been circumstantial.

It seems Dr. Murray will not be taking the stand in his own defense. Thus, Dr. Murray will seek to rely on other sources of evidence for his claim Jackson took propofol behind Dr. Murray's back. A recorded statement by Dr. Murray to detectives has yielded some evidence to support Dr. Murray's claim Jackson caused his own death with propofol. On the recorded statement, Dr. Murray is heard telling detectives that Jackson begged for his "milk," the nickname Jackson apparently used for propofol. Dr. Murray told detectives he had been trying wean Jackson off propofol, after suggesting Jackson may have been addicted to the drug. Dr. Murray further told detectives he had not given Jackson propofol for three days before his death but relented the morning just before Jackson died. That morning, Dr. Murray told detectives he gave in and provided Jackson a small dosage of propofol after Jackson begged and pleaded for the drug. Dr. Murray then claims that, after stepping away from monitoring Jackson for a two-minute bathroom break, he returned to find Jackson not breathing.

Based on the recorded statements to detectives, Dr. Murray's defense has provided some evidence for its theory Jackson taking propofol when Dr. Murray was not looking. During Dr. Murray's two-minute bathroom break, the defense suggests Jackson took propofol. Jackson was not breathing when Dr. Murray returned because of the added propofol he gave himself and that added dosage resulted in Jackson's death.

Continue reading "No Direct Evidence Jackson Took Propofol Himself: Week 2 Dr. Murray Trial" »

According to a recent study by the Harvard School of Public Health, the "worst" hospitals in the US are more likely to treat the poorest patients than the best hospitals. Of course, this is not surprising. However, under the new Affordable Healthcare Act, these worst hospitals will soon have a choice: 1) improve; or 2) fail. This will happen because the new healthcare law punishes bad medical care by withholding a portion of their federal funding. In contrast, hospitals that improve their patient care, even those now considered among the worst, will be rewarded with an increase in federal funding. As a Chicago medical malpractice lawyer, I think forcing bad hospitals to either improve or fail is actually a good thing.

The Affordable Healthcare Act provides that any hospital that fails to improve patient care will see a one percent reduction in federal funding, beginning October 2011. According to Dr. Ashis Jha of the Harvad School of Public Health, some hospitals already on the brink of closure could fail under the new law. Says Dr. Jha, "I worry they're going to get worse over time and possibly even fail. I worry that we're going to see a bunch of that happening over the next three to five years." Dr. Jha believes an unintended consequence of the new law could be "increased health disparities for minorities."

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According to recent research, hospitals that have won the "Magnet Hospital" designation for high nursing standards were more likely to adopt safe patient care practices. A magnet hospital is one that has earned Magnet Recognition Status from the American Nurses Credentialing Center (or ANCC) . As a Chicago medical malpractice lawyer, I agree hospitals that have earned this recognition tend to provide safer patient care than those that have not but this should not be the sole basis upon which to choose a hospital.

There are currently 383 Magnet hospitals across the country. These hospitals tend to concentrate on certain characteristics like nursing autonomy, evidence-based care, and job satisfaction (among other variables). As reported in the Journal of Nursing Administration, magnet hospitals had significantly higher composite safe practice scores than non-magnet facilities. The ANCC states on its website that "Magnet Recognition Program recognizes healthcare organizations for quality patient care, nursing excellence and innovations in professional nursing practice." ANCC also claims patients rely on whether a hospital has been awarded Magnet status in choosing a hospital.

To be fair, Magnet hospitals have certain advantages that may explain, in part, their higher scores. For example, Magnet hospitals are more likely to have larger bed size, be nonprofit, and have reduced percentage of Medicare and Medicaid patients. In addition, they tend to have more advanced technology, have a greater percentage of RNs to LPNs and nursing assistants, and a higher level of nurse intensity (based on nursing hours per patient day). These and other characteristics may allow Magnet hospitals to be better able to adopt the safe practices outlined by the ANCC.

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As week two of Dr. Murray's criminal trial begins, the testimony from week one was very damaging but not necessarily fatal. Dr. Murray is accused of involuntary manslaughter. The prosecution seeks to prove Dr. Murray recklessly caused the pop singer's death by giving Jackson the surgical anesthetic drug propofol. In their opening statement, the primary defense was that Michael Jackson was the cause of his own death saying he gave himself addition propofol when Dr. Murray left the room. In addition, Dr. Murray's team smartly avoided focusing on Dr. Murray's own actions. As a Chicago medical malpractice lawyer, I believe last week's testimony (as outlined below) has caused serious damage to Dr. Murray's case. However, Dr. Murray still has a chance of being found not guilty if the jury is left with reasonable doubt about the cause of Jackson's death.

The first round of damaging testimony against Dr. Murray was from Jackson's former security guard, Alberto Alvarez. In short, Mr. Alvarez testified that Dr. Murray asked him to gather up all the propofol and other drug related items before calling 911. Propofol is a surgical anesthetic that, according to prosecution, Dr. Murray recklessly administered to Jackson and ultimately led to Jackson's death. Investigators later found eleven bottles of propofol hidden in a cabinet drawer in another bedroom of Jackson's home. Assuming Dr. Murray did seek to conceal the propofol before calling 911, this is strong evidence that Dr. Murray attempted to cover up the cause of Jackson's death.

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