Debunking the Autopsy Report

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Debunking the Autopsy Report

  • on: June 23, 2010, 05:59:22 PM


**This information is for educational purposes only.**



http://en.wikipedia.org/wiki/Fair_use

This was originally posted by Hazzely, yet the author of the blog contacted me that she wanted to be credited, so I did. Yet now she wants  it taken off and is threatening with legal actions.

I am posting this back up because this is important to the investigation. This information is for educational purposes only.

Also, this website is hosted on a Dutch server, so Dutch Law is applicable. We of course have copyright here in The Netherlands, but we also have quote right. This means that we can copy text from internet pages, as long as it's quoted and the source is named. That is why I reposted this like this.

Please start the discussion again on the information below.

(@Hazzely, I have saved your original thread. If you want it, just PM me)


Quote
It's time for your Propofol

So by know everyone knows the plot of the story that’s been flying around. Dr. Troot gives the milk, aka Propofol to the king of pop & then the king is no more.
Based on the autopsy report & the anesthesiologist consult ordered by the coroner’s office, the amount of Propofol found in Michael Jackson’s body is consistent with the amount present in patients undergoing general anesthesia for a general/major surgery. Below you can find a detailed dosage calculation as instructed by FDA. This is the exact method anesthesiologists use to calculate the amount of Propofol required to put a patient under anesthesia. It is worth mentioning that besides the patient’s medical history, his/her weight & age are deciding factors on how much anesthetic a patient might require.

My aim is to clarify that the picture given to us through the alleged autopsy & the unsealed affidavits don't fit together & are full of holes & discrepancies.

a) Induction of General Anesthesia:

General anesthesia by Propofol is induced through IV injection & it usually takes a little less than a minute to achieve total unconsciousness. Patients under 55 years of age require 2 to 2.5 mg/kg of Propofol injectable emulsion whether unpremedicated or premedicated using oral benzodiazepines (i.e. Lorazepam etc). For induction, Propofol injectable emulsion should be titrated (approximately 40 mg/10 seconds) based on the patient’s response until signs of anesthesia are observed. The existence of other benzodiazepines does not affect the induction rate of Propofol, it rather affects the rate at which respiratory or cardiac depression can happen.

------> This means that the combination of drugs given to Michael was not fatal, as a matter of fact it is often customary to give a patient some oral benzodiazepines (depending on their heart condition) before administering Propofol to ease anxiety & pain!!!<-------

b) Maintenance of General Anesthesia:

Once again in patients under 55 years of age once the anesthesia is induced, it can be maintained by administering Propofol injectable emulsion by continuous infusion or intermittent IV bolus injection (this means irregular injection of Propofol in single large doses, but this is usually not recommended as the patient could wake up in between the injections. In Michael's case we were told that the goal was to achieve sleep, hence infusion is the way to go.)

Maintenance by infusion of Propofol injectable emulsion should immediately follow the induction dose in order to provide continuous anesthesia. During the initial period following the induction dose, higher rates of infusion are generally required (150-200 mcg/kg/min) for the first 10-15 minutes. Infusion rates should subsequently be decreased 30%-50% during the first half hour of maintenance. Generally a rate of 50-100 mcg/kg/min should be achieved in adults under 55 during maintenance.

Once again it is worth mentioning that presence of other drugs that cause CNS (central nervous system) depression & lead to respiratory depression can increase the effect Propofol has on CNS. They are not fatal together, they just cause faster depression & that’s why this anesthetic is supposed to be administered in a controlled setting where the patient can be monitored every second he/she is under anesthesia.

Let’s calculated how much Propofol needed to be administered to a man of Michael’s age & weight to keep him under continuous anesthesia:

Age: 50 yrs
Weight: 61.7 Kg

To induce anesthesia we need 2-2.5 mg/kg, so for a 61.7 kg patient we need at least 123.4 mg = 12.34 ml & at most 154.25 mg = 15.43 ml, to be safe let’s say an average of these two amounts, namely 138.83 mg = 13.88 ml of Propofol to induce anesthesia.

In order to maintain the anesthesia we need 50-100 mcg/kg/min. Although we need a higher does in the first 10-15 minutes of the maintenance process, for the purpose of simplifying our calculation & to avoid use of non-layman methods, let’s use 75 mcg/kg/min as the middle marker between the maximum & minimum doses, in order to get an average dose that is not too high or too low.

To calculate the amount needed to maintain anesthesia using the average dosage required:
75 mcg x 61.7 kg (weight of patient) = 4627.5

We know that (1000 mcg = 1mg ) therefore : 4627.5 / 1000 ~ 4.63
Also (1hr = 60 min) therefore: 4.63 x 60 = 277.8 mg/hr ~ 27.78 ml/hr is the average dose required to maintain at least one hour of anesthesia.

Let’s say Michael wanted to get at least 6 hrs of sleep every night, let’s calculate how much Propofol that would require:

He’d need an average of 138.83 mg = 13.88 ml to induce anesthesia & an average of 277.8 mg/hr = 27.78 ml to maintain the anesthesia per hour, for 6 hrs of sleep we need 1805.63 mg = 180.56 ml of Propofol for just one night!

If Michael was using Propofol as they allegedly said for 6 week prior to June 25 every night, they would need a total of 75836.46 mg = 7583.65 ml = 7.58 liters of Propofol!!!!

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Miraculously the unsealed affidavit only contains information on a purchase made by Murray on May 12 for a total of 5 Propofol injectable emulsion vials, 4 of which were 100 ml & 1 was 20 ml. Based on this information we have no way of knowing whether Murray did manage to get this huge amount of Propofol or was this yet another rumor to convince the masses that the king of pop was a junkie!!! Propofol is not a controlled substance, but it’s not like gum that you could go to the store & pick up a carton full of it & not raise any suspicion; somewhere someone should have picked up on the fact that this Dr. is buying way too much Propofol!

It is my personal opinion that Michael Jackson simply could not have received such huge amount of Propofol during course of 6 weeks without showing some side effects during his waking hours; he simply would not be able to do any sort of physical activity yet alone go through rigorous rehearsals & deliver. Medically speaking that is just not possible!

According to the released affidavit that lists the items found in the scene during the visits made by LAPD & the coroner’s investigators a total of 11 vials of Propofol was recovered, from which 3 were 100 ml & 8 were 20 ml, this gives us a total of 460 ml = 4600 mg of Propofol to start with.

In the warrant it is mentioned that 1 of the 20 ml vials as well as 1 of the 100 ml vials were empty & then 1 vial of the 20 ml was 3/4 empty; meaning that a total of 135 ml = 1350 mg of Propofol was consumed by the time the evidence was recovered.

Considering the timeline given by the LAPD, the time at which Murray says he administered Propofol is marked at 10:40 am. 911 was called at 12:21 pm & they arrived at the scene at 12:26 pm.

If we assume that Murray disconnected the Propofol IV right before calling 911, that means that Michael had received Propofol for at least about 100 minutes. Using the same steps I described above it is easy to calculate that 100 minutes of anesthesia requires approximately 601.83 mg = 60.183 ml of Propofol.
Yet the empty bottles point the marker at 1350 mg =135 ml of Propofol?!

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Keep in mind that the toxicology findings confirms that the amount of Propofol found in Michael’s body was equivalent to the amount required for general anesthesia, that means that there wasn’t excessive amount of Propofol in his body, therefore we can trust that our calculation are accurate. Having said that are we to believe that Murray did not get rid of the empty vials that are obviously not used on that date, as he’s supposed to, especially considering that there are minor children in the house (& we know how sensitive Michael was on shielding the kids) or are we to believe that the empty vials were left there to make this about drugs & addiction?!!!!

Also the partial Forensic lab finding that are attached to the autopsy report, as well as the anesthesiologist both point out the fact that the Propofol level were consistent with that of general anesthesia, but amazingly enough the cause of death has been said to be “acute Propofol intoxication”, how could someone have died of acute Propofol intoxication if the Propofol found in their body are within the normal levels of general anesthesia?! If they had to choose anything as cause of death, it should have been Central Nervous System failure (which controls respiration & cardiac activity) & not Propofol intoxication!

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Source: http://xscapemj.blogspot.com/2010/04/it ... pofol.html

Quote
Anatomization of the Living Dead: Part 1
Disclaimer: Mr. Michael Joe Jackson did not participate in this clinical study, his role is played by at least 3 body doubles or probably a dummy!

Case Report: Pages 1-4

The first page hasn't been fully filled out & quiet frankly is missing some routine information that one would expect to see, regardless of whether you're a professional in the medical/law enforcement field or just an average Joe. Anyone who has ever seen an autospy report in thier lives would be able to spot the inconsistencies.

For Example: On the top right hand corner of the 1st page, there's a section that says "crypt" & "S.C." this refers to the tag number of the freezer crypt at the coroner's office where they keep the body before/during/after the autopsy up until the point the body is released to the appointed mortuary by the family. The case report was completed & signed by the coroner's investigator Elissa Fleak on 6/26/09 & then reviewed by the supervisor on the same date. It is a FACT that the body was transfered to the coroner's office on 6/25/09 [remember the infamous helicopter scene transferring the body], so by the time this report was written & signed they did have a crypt number, as they would have needed to put the body in a freezer crypt to prevent it from rotting until they would commence the autopsy. But clearly that information is missing from this form. You could search the internet & would find dozens of autopsies of other high profile people floating on the internet & they all have their crypt numbers listed!!!

Another interesting thing is that Michael's California driver's license was used to identify the body, no finger printing [they did have his finger prints in system from the 2005 booking], no note of next of kin identifying the body. In the United States identity theft is a growing crisis & it it's mostly carried out by people assuming other dead people's identity. [Now I know you're asking who on earth would be bold enough to still Michael Jackson's identity? all I'm trying to say is that there is a protocol that is clearly not followed in this case] Also in the Corey Haim's case & many other similar cases, finger printing was used to ID the body.

Also on the first page of the case report, you'll find the section under "Identified by" is left blank, so no physical Id was done on him, his entire family was there, Frank Delio, Randy Philips, etc. & no one is asked to do a physical ID!!! Makes you wonder about the double theory doesn't it?!

Another funny tidbit is that it is stated that the patient was not clothes & in the course of the autopsy the medical examiner states there there were no clothing for examination, but the hospital gown. I was just wondering how did they manage to get a naked Michael Jackson to the hospital & in the midst of all the mayhem & struggles to save him & get him to the hospital someone remembered to bring his Cali driver's license along to have him identified. Also the clothing is considered as evidence & is not returned to the family until after the autopsy as it could contain forensic evidence & need to be saved from further contamination. So did he come to the hospital with no clothing at all or did they once again not follow the protocol & released his clothing back to the family? We know Michael was a resident of Las Vegas right before making the announcement at London, so was his Cali driver's license still valid?

The description of the events preceding to the involvement of the coroner's investigator, is provided by LAPD detective S. Smith of the Robbery Homicide Division.

On page 2 of the case report it is stated that upon arrival of the EMT (paramedics), the victim was found ASYSTOLIC. EMT respond with CPR/ACLS, two rounds of Epinephrine & Atrophine, incubation & more CPR.

Elaboration on Asystol : in medicine, asystole aka flat-line is a state of no cardiac electrical activity, hence no cardiac output or blood flow. Asystole is one of the condition required for a medical practitioner to certify death. When a patient displays asystole, the treatment of choice is an injection of Epinephrine & Atropine & chest compressions. In asystole, the heart will generally not reposnd to defibrillator because it's already depolarized, so shocking the heart will not give any results. Asystole is usually confirmation of death as opposed to a heart rhythm to be treated, although a small minority of patients are successfully resuscitated if the underlying cause is identified & treated immediately. It is worth mentioning that a world renowned surgeon at the UCLA medical center has pioneered a way to revive people that most doctors would have long written off, including a woman whose heart had stopped for 2 & a half hours. However for these methods to be effective the underlying cause that has lead to an asystole situation must be diagnosed soon & the victim's body must be transported to a medical facility asap.

While the heart is in asystole mode, there no blood flow to the brain unless CPR of internal cardiac massage (the chest is opened & the heart is manually compressed) is performed. After many emergency treatments have been applied if the heart is still unresponsive, it is time to consider pronouncing the patient dead. Even in the rare care that a rythm reappears, if asystole has persisted for fifteen minutes or more the brain has been deprived of Oxygen long enough to cause brain death, and a sign of that is fixed & dilated pupils. However as mentioned about if the patient is transfered to a medical center soon enough where he/she can be hooked up to electronic heart devices to keep providing the brain with oxygen, then efforts could be done to bring electrical activity back to heart.

It is mentioned that the EMT performed CPR/ACLS, let's take a look at what ACLS is.

ACLS Protocol: ACLS stands for "Advanced Cardiac Life Support" & it refers to a protocol for handling patients who are experiencing serious medical emergencies such as cardiac arrest. Here is the summary of the protocol:
Step1: Assess responsiveness (speak loudly, gently shake patient if no trauma)
"Annie, Annie, are you OK?"
Step 2: Perform ABCD (A = Airway, open airway, listen & feel for breathing, B = Breathing, if not breathing, slowly give two rescue breathing, C = Circulation, check pulse, if pulse is slow begin chest compressions at 100/min, 15:2 ratio, D = Defibrillator, not to be used in asystole cases)

Step 3: confirm asystole, check monitor, lead, power & change leads

Step 4: Consider administering bicarbonate

Step 5: Trans-cutaneous Pacing (TCP) aka external pacing is a temporary means of pacing a patient's heart during a medical emergency. All EMT vehicles have this mini pace maker as part of their standard equipment. It is used when the heart rate is extremely low. During TCP pads are placed on patient's chest & attached to a monitor/defibrillator, & a heart rate is selected, & current (measured in miliamps) is increased until the desired heart rate is reached & in the mean time the patient is transferred to the hospital. If TCP is used, it must be considered early & it is not to be used in asystole cases.

Steps 6 & 7: Administer Epinephrine, Atropine, insert ETT (Endo-Tracheal Tube)

Step 8: Consider termination. If patient had > 20 minutes with adequate resuscitative effort & no treatable causes present,consider calling the death.

It's mentioned that the victim remained unresponsive to the CPR/ACLS efforts & his pupils were fixed & dilated, however there's no indication as when the EMT noticed his pupils. We've all heard the rumors circulating about Murray finding Michael with his eyes open. If his eyes were open did Murray close them before the EMT arrive? Did the EMT notice dilation of his pupils after the CPR/ACLS efforts or upon arrival? The time where the pupils are fixed & dilated is extremely important as it can provide an estimation of how long the patient has gone without oxygen reaching his brain. So once again we're missing a crucial timeline here & once again this case report proves to be lacking important details. I'd imagine getting this information would be extremely easy, all it requires is an interview with the EMT personnel who were dispatched to the scene. Murray has been charged with "involuntary manslaughter" which is direct result of un-intended negligence, hence figuring out when the victim's pupils were fixed & dilated could put a rest on many rumors & speculations regarding the exact time at which he has stopped breathing. Why don't we see this crucial information here? Why do we still hear that they weren't sure how long before Murray walked into the room, Michael had stopped breathing? From a medical point of view this is as simple as 2+2, figure out when his pupils were dilated & fixed & you'll have a timeline! Ask the EMT when they checked his pupils & you'll have a timeline! But none of that has happened here!!!

Also if Michael was asystole & his pupils were fixed & dilated there wouldn't be much point in working on him for 40 minutes before finally deciding to take him to the hospital. It doesn't make sense at all! Let's say that this whole thing really happened, wouldn't it make sense for Murray to want to get Michael's body out of the house asap to avoid any future finger pointing at himself? Why would he delay transporting the body for about 40 minutes? A decision that would put him in the defense stand even if Propofol was not administered!

The case report states that under "advisement" of Dr. Murray, Michael's body was placed in the ambulance & transported to UCLA. After looking further into the issue of hierarchy on the the Scene here is the "Medical Response on the Scene Guidelines for the State of California":
If a bystander at an emergency scene identifies him/herself as a physician the 911 responder will work in conjunction with the physician until the arrival of paramedics. The 911 operator is NOT supposed to hang up the phone, he/she has to work with the physician on the scene till the EMT arrive of the scene. Upon arrival the EMT should give the physician on the scene a "note to physician's involvement with the EMT-Is & Paramedics" card (a copy of this card can be found on the EMT website or at the EMT offices).
After identifying yourself by name as a physician licensed in the State of California, and if requested, showing proof of identity you may choose one of the following:


1) Offer your assistance with another pair of eyes, hands or suggestions, but let the life support team remain under base hospital control.

2) Request to talk to the base station physician & directly offer your medical advice & assistance through the base.

3)Take total responsibility for the care given by the life support team & physically accompany the patient until the patient arrives at a hospital & responsibility is assumed by a receiving physician. In addition, you must sign for all the instructions given in accordance with local policy & procedures. Whenever possible, remain in contact with the base station physician throughout the process of providing care for the patient on the scene.

If the physician on the scene has chosen option number 1, the physician should assist the EMTteam or offer suggestions but allow the paramedics to provide medical treatment according to county protocol.
If the physician on the scene has chosen either option number 2 or 3, the EMT should ask to see the physicians medical license, unless the physician is known to the EMT personnel, then contact the base physician & have the physician on the scene speak directly with the base physician


From the information available in the case report, we can infer that Murray chose option number 3, meaning that since he's a physician he was in charge of all the decision making on the scene. Once again let's imagine that Michael was really dying on June 25th, it would make much better sense for Murray to want to delegate the responsibility to someone else so that someone else could be in charge of decision making & calling the death. It doesn't make sense at all, if he knew Michael is dying & he's the physician on the scene, he must have wanted to relieve himself of any responsibility or suspicion, the best & the only logical way is to give total responsibility to the EMT personnel, so that in case things go wrong, there's less blame on him. But by assuming responsibility on the scene Murray is man with a target drawn on his back. He is basically knowingly setting himself up by volunteering to be the decision making authority on the scene & that makes no sense!


The coroner's investigator states in the case report that the victim was still asystolic when arrived to the hospital. It is also mentioned that CL (central lines) & IABP (intra-aortic balloon pupm) was placed in his body, although the reprot is very vague as to when exactly this was done & who administered it (two very key information which yet again seem to be missing in this case report!) Time plays a cricial role in all cardiac arrest cases & these efforts could be ineffective if not done soon enough.
CL (Central Line) Elaboration: is an intravenous line that is used for giving the patient fluids & or medications. it may be used when the patient's veins in the arms are difficult to access or when certain medication or nutrients need to be given that cannot be administered into the smaller veins found in the arms. It's inserted into one of the larger veins of the body. These are found in the neck (jugular veins), the front of the shoulders (subclavian veins) or the groin (femoral veins).

IABP (Intra-Aortic Balloon Pump) Elaboration: consists of a cylindrical balloon that sits in the aorta & counter pulsates. It is used as an attempts to keep the pressure of a weak heart which is not pulsating harmonically, hence carrying oxygen to vital organs such as brain.

I have spent the past week studying & consulting with my professors on this device & have been all over my medical notes & journals, I am yet to find a single study or case where they have used IABP on an asystole patient. IABP is not used on asystole patients due to the fact that the heart is not pulsating to begin with, however if they manage to initiate some kind of electrical activity in the heart & get it to pulsate again then an IABP could help. We've all hear the rumors that at some point they managed to get a faint pulse out of Michael at UCLA, but then they lost him! I have yet to see a document on that & if that is the case, why wasn't it mentioned in the case report? --> VERY TRUE! I wondered the same when I saw the reports!!

Most of you must have seen those fake EMT reports that came out, the one with the heart graph that had the wrong time on it! I'm not even going to dignify those with an explanation here, the wrong time on the graphs says it all!

One method that can help in asystole cases is opening the patient's chest & providing manual heart massaging & then at the same time using a IABP to assist getting the blood to vital organs & prevent brain damage.

The coroner's investigator states that Dr. Cooper called the time of death & that detective Porche reported this death as accidental vs. natural!
The question is why & who called LAPD? If the emergency attending physical, namely Dr. Cooper, in the midst of her efforts to revive Michael, saw any medical inclination pointing to a suspicious death & contacted the coroner's office & LAPD, then why did detective Porche report the death as accidental vs. natural? Why didn't he initially state that the nature of death is pending further investigation. We've seen them make similar statements in the Corey Haim & Britney Murphy cases.
If there was no suspicion on the nature of death, then why was LAPD & coroner's office contacted? my point is if the detective reports the death as accidental vs. natural then what's the point of further investigation & if there's a feeling that the death is suspicious then why was it reported as "accidental vs natural". Of course we all know that a few moths later the death was rules as "Homicide" meaning killed in the hands of other!

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This is the point where coroner's office gets involved & assigns Elissa Fleak as the investigator for this case. Elissa along with the assistant chief coroner Ed Winters spent 1 hr on the scene & collected evidence before returning to the FSC (Forensic Science Center).

It is worth mentioning that contrary to other autopsy reports that I have personally viewed such as Corey Haim, the report number is missing from page 1. When a case is reported by the hospital to the authorities, a report number is automatically generated, it is a 15 digit number, which is coded to include the date of death, the county number & etc. but there's no trace of a such report number in this case. You don't believe me, just go to AUTOPSY FILES.org & compare this autopsy report to other ones conducted in California in recent years .

On page 3, the coroner's investigator mentions performing a brief body exam in the hospital. It is stated that the hospital room temperature is 20°C =68 F.
The coroner's investigator notes that rigor mortis was not present throughout the body. So does this mean that it was present in some parts, but not everywhere? She also mentions that lividity blanches with light pressure & that it is consistent with a supine position (lying down with face up).
Rigor mortis: is one of the recognizable signs of death that is caused by a chemical change in the muscles after death, causing the limb of the corpse to become still & difficult to move or manipulate.

Lividity: settling of the blood in the lower portion of the body causing a purplish red discoloration of the skin. If the area blanched on pressure, it is said that the lividity is not fixed & you could estimate that the person has been dead for about 2 to 10 hrs.

Here is a breakdown of events that happen after heart stops (death) : please note that the time given are approximate
1- The heart stops
2- The skin gets tight & grey in color
3- All the muscles relax
4- The Bladder & bowels empty ( also men will get an erection)
5- The Body's temperature will typically drop 1.5 degrees F. per hour unless outside environment is a factor. The liver is the organ that stays warmest the longest, & this temperature is used to establish the time of death if the body is found within proper time frame.

After 30 minutes you'll start seeing:
6- The skin gets purple & waxy
7- The lips, finger & toe nail fade into a pale color or turn white as the blood leaves.
8- Blood pools at the lowest parts of the body leaving a dark purple-black stain called lividity
9- Hands & feet turn blue
10- eyes start to sink into the skull

After 4 hours you'll start seeing:
11- Rigor mortis starts to set in
12- The purpling of the skin & pooling of the blood continues
13- Rigor mortis begins to tighten the muscles fo about another 24 hrs, then will reverse & the body will return into a limp state.

After 12 hours you'll start seeing:
14- The body is in full rigor mortis

After 24 hours you'll start seeing:
15- The body now has the same temperature of the environment (if not kept in a fridge)
16- In males the semen dies
17- The head & neck are now a greenish color
18- The greenish blue color continues to spread to the rest of the body
19- There's a strong smell of rotting meat (if body not frozen or embalmed)
20- the face of the person is essential no longer recognizable (if body not frozen or embalmed)


As mentioned above Elissa Fleak conducts a brief body examination the hospital & notices the following:

1.- Red discoloration on the center of the chest.
[This could be due to external heart massage & CPR]
2.-There's a ETT (Endo-Tracheal Tube) placed in the victims mouth & held in place with medical tape

[ETT is used for airway management, mechanical ventilation & as an alternative route for many drugs if an IV line cannot be established. The tube is inserted into a patient's trachea in order to ensure that the airway is not closed off & that air is able to reach the lungs. The ETT is regarded as the most reliable available method for protecting a patient's airway. This body examination is done right before transporting the body to the coroner's office. So by this time the ETT is still in place & hasn't been removed. We've all heard various claims & stories about Michael's kids seeing him & saying their goodbye's to him. We've heard La Toya's narration of the event & I really doubt it would be a good idea to let minor children to see a dead body that's still connected to central lines & ETTs. It's a very traumatizing image. Usually if there's minor children that insist to see the deceased body, the social workers & doctor's make sure that there're no medical equipment attached to the corpse in an effort to ease the shock & trauma. Because to most children a dead person looks no different than a sleeping person, but having the medical equipment hooked to the body can disturb that calming image.]
3.-Gauze covering a puncture wound is taped to his right neck.

[This could be the way the EMT tried to get the IABP to his thoracic aorta. Or it could be the place where allegedly Propofol was administered. No detail is given as to the nature of the wound so it's really hard to determined what could have caused it]
4.- IV catheters were present on his left neck & bilaterally in ingulnar area (close to the groin)
[This could be where the CL is inserted. Once again no detail as to the nature of the catheters or possible substances found in them is provided therefore it's very hard to establish what could have caused them.]
5.- Additional puncture marks on his right shoulder, both arms, both ankles.
[Once again no further detail is given as to nature & type of this puncture wound.]
6.- Bruise on his left inner leg, below his knee & 4 discolored indentation on his lower back
[No further detail is given, hence we can't know what might have caused these bruises & mark]

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Source: http://xscapemj.blogspot.com/2010/04/an ... art-1.html

Quote
Anatomization of the Living Dead: Part 2

Case Report: Pages 5-10: Medical Evidence Collected at the Scene

I'm not going to post every drug, since it makes no sense, I will then just mention some incongruences. For more info visit: Xscape MJ
1.- Amoxicillin (500mg capusules): [Prescribed by: Dwight James/Cherilyn Lee]

This medication belongs to a class of antibiotics called penicillins & is a moderate antibiotic used to treat bacterial infections. It does not kill bacteria, but stops them from multiplying. Common infections that amoxicillin is used for include infections of the middle ear, tonsils, throat, larynx (laryngitis), bronchi (bronchitis), lungs (pneumonia), urinary tract & skin. It is also used to treat gonorrhea. Amoxicillin is rarely associated with important drug interactions. Some of the common side effect associate to use of amoxicillin in some patients are: diarrhea, dizziness, heartburn, insomnia, nausea, itching, vomiting, confusion, abdominal pain, easy bruising, bleeding, rash & allergic reactions.

Date of Issue: 2/2/09
Directions: 4 times/day = 1 every 6 hrs
Number Issued: 28
Number remaining: 21

The evidence was logged on 7/9/09, which means Michael took the capsules for only about 2 days. --> NO addiction!

2.- Azithromycin (250mg tablets) : [Prescribed by: Dwight James/Cherilyn Lee]

On the world's best-selling antibiotics; it's used to treat certain infections caused by bacteria, such as bronchitis, pneumonia, sexually transmitted diseases (STDs), & infections of the ears, lungs, skin & throat. It works by stopping the growth of bacteria. It will not work for colds, flu or other viral infections. It should not be taken at the same time as aluminum or magnesium based antacids. The most common side effects are diarrhea or loose stools, nausea, abdominal pain & vomiting which may occur in fewer than 1 in 20 persons who receive Azithromycin.

Date of Issue: 3/9/09
Directions: 2 tablets on 1st day, then 1 tablet for 4 days
Number Issued: 6
Number remaining: 2

The evidence was logged on 7/9/09, which means that Michael took the tablets only for 3 days. ---> NO addiction!
3.- Benoquin (20% lotion)

Benoquin cream 20% is indicated for final depigmentation in extensive Vitiligo.
It is NOT cosmetic bleach, its use is extremely prohibited in any conditions other than disseminated Vitiligo. --> Michael DOES have vitiligo!

To set the records straight for all the crazy people out there & tabloid junkies who were shocked to hear that Michael Jackson had a bleaching cream in his house: This cream in not for cosmetic purposes, one cannot apply it unless they have Vitiligo & that is due to the biochemistry of the cream & its effect on human skin. If a person who isn’t suffering from Vitiligo applied this cream, he/she will end up with severe burns & rashes, something like a 2nd degree burn. Michael Jackson is indeed suffering from Vitiligo & this cream was used as an effort to even out his skin color that by 1992 had lost more than 50% of its pigmentation. Vitiligo sufferers must continue use of this cream in order to maintain the depigmentation results achieved, for the rest of their lives. Also the biochemisty of this cream along with the nature of Vitiligo itself, forces Vitiligo sufferers to refrain from prolonged sun exposure & that’s why Michael would always carry an umbrella, or wear big hats or even surgical masks when outdoors.
4.- Clonazepam (1mg tablets): [Prescribed by: Dr. Metzger]

It is an anti-anxiety medication in the benzodiazepine family, the same family that includes diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), flurazepam (Dalmane), and many more.

Date of Issue: 4/18/2009
Directions: 1 at bedtime
Number issued: 30
Number remaining: 8

The evidence was logged on 6/26/09, which means that Michael took this medication for 22 nights. ---> He was to stressed because of everything he was going trough! NO ADDICTION!

5.- Diazepam (10mg tables): [Prescribed by: Dr. Murray]

It is a benzodiazepine derivative drug & commonly used for treating anxiety, insomnia, seizures, muscle spasms, restless legs syndrome, obsessive compulsive disorder, alcohol withdrawal, benzodiazepine withdrawal, etc. It may also be used before certain medical procedures (such as endoscopies) to reduce tension and anxiety, and in some surgical procedures to induce amnesia. Diazepam is a core medicine in the World Health Organization's "Essential Drugs List," which is a list of minimum medical needs for a basic health care system.

Date of Issue: 6/20/2009
Directions: 1/2 to 1 every 6 hrs
Number issued: 60
Number remaining: 57

The evidence was logged on 6/26/09, if we assume that Michael took the highest recommended dose (which is 1 every 6 hrs), then it means that Michael used the medication for 1 day only. If we assume that Michael took the lowest recommended dose (1/2 tablet every 6 hrs) then it means that Michael took this medication for maximum of 2 days. Hardly an addiction, wouldn't you say so?
6.- Flomax (0.4mg Capsules): [Prescribed by: Dr. Murray]

Flomax is the trade name for Tamsulosin. It is used to improve symptoms associated with an enlarged prostate (benign prostatic hypertrophy). It is sometimes used for the passage of kidney stones. It works by relaxing muscles in the bladder and prostate. This may improve urine flow rates and decrease urinary hesitancy/urgency. This medication should not be used to treat high blood pressure. Some of the side effects are: Dizziness, unusual weakness, drowsiness, trouble sleeping, or runny nose.

Date of Issue: 6/3/2009
Directions: 1 per day
Number issued: 30
Number remaining: 24

The evidence was logged on 6/26/09, which means that Michael took this medication for 6 days. ---> No addiction
7.- Lorazepam (2mg tablet) : [ Prescribed by: Dr. Murray]

Also known as Ativan, is from the same family of benzodiazepines, & as mentioned before benzodiazepines are known for their sedative, anxiety-relieving and muscle-relaxing effects. Its best use is the short-term management of severe chronic anxiety. It is fast acting, and useful in treating fast onset panic anxiety.

The evidence was logged on 6/26/09, which means Michael took this medication for 21 nights. Again given the very addictive nature of this medication & the fact that the medication was prescribed at end of April & by the time it was recovered there were still some tablets left, is a strong proof that Michael Jackson was most certainly NOT addicted to this medication.
Aside from the above mentioned Lorazepam tables, the coroner’s investigator has recovered few injectable vials of Lorazepam from the scene:

Lorazepam (4-5ml liquid) : [no physician or patient name]
It is not mentioned how many were recovered
Lorazepam (2-4ml liquid) : [no physician or patient name]
It is not mentioned how many were recovered

As mentioned above, liquid Lorazepam is administered before other anesthetics, such as Propofol, to reduce the amount of the anesthetic require to achieve full anesthesia.
8.- Propofol [no physician or patient]

Propofol is a drug that reduces anxiety and tension, and promotes relaxation and sleep or loss of consciousness. Because it allows easy arousability and recovery shortly after the infusion stops, it is used in intensive care units, emergency rooms and other areas during minor procedures, intubation and artificial ventilation. Strict aseptic technique must always be maintained in handling of this medication.
The half life of elimination (i.e. the time that takes a substance to lose half its effect) of Propofol has been estimated at between 2 and 24 hours. (So why is propofol mentioned in the autopsy if the effect was gone! Again, doesn't add up!) However, its duration of clinical effect is much shorter, because Propofol is rapidly distributed into peripheral tissues. When used for IV sedation, a single dose of Propofol typically wears off within minutes.

It is worth mentioning that Propofol is not considered a controlled substance & it is the most unlikely medication to develop an addiction to. In response to numerous claims & rumors that Michael Jackson was using Propofol for at least 6 weeks prior to June 25th, for almost every night, in my true humble & professional opinion I have to say that although Propofol is a short acting agent, the side effects of continuous use of Propofol can be very damaging. If Michael was continuously using Propofol he would suffer from: extreme muscle & bone pain through his waking hours, extreme disorientation & lack of balance, faint spells, numb & tingling feeling that would make body movement difficult, shortness of breath & many more side effects that would prevent him from participating in rigorous rehearsal for TII. ---> again, NO addiction

For more info about Propofol re-read "1.It's time for your Propofol"
9.- Temazepam (30mg capsules) : [Prescribed by: Dr. Murray]

It is considered as a short-term (i.e. 7-10 consecutive days) insomnia therapy. Usage for more than 2-3 consecutive weeks requires complete re-evaluation of the patient. Like all other benzodiazepines, Temazepam can be abused and lead to dependence, therefore their use should be avoided in people in certain particularly high risk groups (i.e. people with a history of alcohol or drug abuse or dependence, emotionally unstable patients, people with severe personality disorders).

Date of Issue: 12/22/2008
Directions: 1 at bedtime as needed
Number issued: 30
Number remaining: 3

This evidence was logged in on 6/26/09, which means that Michael took this medication for about 27 nights. Now this is a medication that can be extremely addictive, but as you can see Michael didn’t take all the pills & in the interval between the prescription date till the date the evidence was collected ( almost 6 months) Michael may have used this medication for only about 27 nights. Hardly the behavior of the drug addict!!!!
10.- Trazadone (50mg tablet) : [Prescribed by: Dr. Metzger]

Trazodone is a psychoactive compound with sedative and anti-depressant properties. It is used to treat depressions, an off the label use of the medication is in treatment ofinsomnia.

Date of Issue: 4/18/2009
Directions: 2 at bedtime as needed
Number issued: 60
Number remaining: 38

This evidence was logged in on 6/26/09, which means Michael might have taken this medication for about 11 nights. ---> again, NO addiction

The main purpose of providing this elaborate description is to prove to you that Michael Jackson was not a drug addict. He might have gone to great length to make the world believe that he was. But if we look at all the documents that have been released by officials, we’ll see that the facts point to the contrary. The list of medications recovered from Michael Jackson’s rented mansion include many medications that have a high dependency potential, yet most of the medications recovered were not taken as instructed. A person addicted to prescription medication would finish the prescribed number sooner than expected without missing a single pill/capsule, a pattern of behavior that’s associated with all addicts, the remaining number of pills/capsules is a clear testament that Michael Jackson was not behaving like a drug addict.

------------------------------------------------------------------------------------------------------------------------------------

The following items were logged into the medical evidence data sheet on 6/26/2009:

1- One green Oxygen tank
2- A broken syringe
3- An open box of hypodermic disposable needles
4- An open box of IV catheters
5- UVA Anthelios XL Lotion (one of the best sunscreens in the world produced by LaRoche Posay laboratories)
6- Open bottle of Bayer Aspirin

The following items were logged into the medical evidence data sheet on 6/29/2009:

1- 2 blue plastic/canvas bags
2- 1 square black bag
3- 5 business cards for Dr. Conrad Murray
4- 1 IV side clamp
5- 1 blue rubber strip
6- 1 blood pressure cuff
7- 1 red stained piece of gauze (no indication whether why it’s blood or not!)
8- 1 pulse finger monitor
9-1 bag of medical supplies including crumpled packaging

Another interesting point is that the investigators confiscated most of the above listed medications & supplies on visits made few days after the alleged date of death. Anybody with access to that house could have tampered with the evidence, took items out & have left items inside the house! How are we to rely on these finding knowing that the house was not sealed as crime scene & many people had access to it?!

********************************************************************************************************************
Source: http://xscapemj.blogspot.com/2010/05/an ... art-2.html

Quote


Case Report: Pages 13-15

a) External exam & remarks:

1- The body is identified by toe tag (Federal law states that all the deceased be swabbed for DNA analysis & have their information entered into the newly created DNA bank. There’s no indication of any sort of DNA test in this case. There’s no indication of why they didn't finger print the deceased, although this is the most common method of IDing a body especially since they had Michael’s finger prints on file from the 2005 booking )

2- The body was refrigerated un-embalmed & there’s no indication of future embalmment & whether it is going to be done at the coroner’s or at the mortuary.

** Interesting Observation:The autopsy did not take place till 6/26/09 & as mentioned above the body was refrigerated, however on page 13, the coroner conducting the autopsy mentions presence of ETT (Endo-Tracheal Tube). It is absolutely BIZARRE to have the body refrigerated with the ETT still in place. Because rigor mortis is going to happen & also the cold is going to stiffen the muscles & it will be hard to extract the tube. ALWAYS all the medical extensions must be removed from the body before refrigerating it & before the rigor mortis sets in, otherwise you're jeopardizing the autopsy & it's accuracy, because you will be damaging the tissues & organs. Also the IABP (intra aortic balloon pump) & CL (central lines including IVs) are said to be still in place at the time of the autopsy. Neither myself nor my professor who is a trained coroner has ever seen anything like this. This is either a typo or if they indeed leave this items in his body & refrigerated it they have compromised the accuracy of the autopsy.

3- The body weighs 136 lb = 62 Kg

4- The body’s height is 69 inches = 5.75 ft = 175.26 cm ( Michael’s height according to his driver’s license & passport is 5.9 ft =179.83 cm )

5- A condom catheter is present. [Condom catheter sits over the penis & allows a person to empty his bladder without using a urinal, bedpan, or toilet.]

6- Gauze pads are seen on the right side of the neck, both left & right antecubital fossa (triangular cavity of elbow joint where they usually draw blood from) and left forearm.

7- The central chest has an irregular abrasion of the following size: 1.1/2 x 1.1/4 inch = 3.81 x 3.18 cm. This abrasion is surrounded by a bruise of the following size: 3 x 3 inch = 7.62 x 7.62 cm (could be caused by CPR)

8- The soft tissue of the left anterior chest (left bosom) shows a 3.1/2 x 2 inch = 8.89 x 5.08 cm bruise (could be caused by CPR)

9- The soft tissue of the right anterior chest (right bosom) shows a 5 x 3.12 inch = 12.7 x 8.89 cm bruise (could be caused by CPR)

10- The sternum (long thin bone that connect the ribs in the middle of the chest) is fractured at 3rd rib.

11- Both right & left 4th & 5th ribs are fractured at the rib junction to the sternum bone.

12- Behind both left & right ears a 3/4 inch = 1.9 cm scar is visible

13- A 3/5 inch = 1.52 cm scar on outer wall of each nostril, both right & left

14- Top of right shoulder bears an irregular scar-like area with a diameter of 4 inches = 10.16 cm

15- On the back side of the neck, right at the base, there are two visible scars, the one on the right side measures about 3 inches =7.62 cm & the one on the left side measures about 3.3/4 inches = 9.53 cm

16- Both left & right wrist bear a scar measuring to 1/8 inch = 0.32 cm (there’s no indication whether this scar appears on the front or back side of the wrist)

17- The inside of the arm, close to the triangular cavity of the elbow joint bears a scar measuring to 1/4 inch = 0.64 cm

18- There’s a scar measuring to 7/8 inch = 2.22 cm on the muscle on the palm of the hand just beneath the thumb of the right hand.

19- Right lower quadrant (in medicine we refer to this section of human body as RLQ & it bears the following important organs in males: cecum, appendix, ascending colon, right ureter), the RLQ of the deceased bears a 2 inch = 5.08 cm surgical scar (however later on the report we notice that none of the organs in the RLQ are missing & to claim this scar as a surgical scar just seems bizarre & inaccurate.)

20- There’s a 5/8 inch = 1.6 cm scar around the navel

21- The right knee bears a semicircular scar & few other smaller scars are located at a distance from it, measuring 1/2 to 1/4 inch = 1/27 to 0.64 cm

22- The front of right leg has a 5 x 2.1/2 inch = 12.7 x 6.35 cm area of hyper-pigmentation

23- There are dark tattoos on both eyebrows, eyelids (lower & upper) and on the front half of the scalp. There is also a pink tattoo around the lips.

24- Focal de-pigmentation of skin especially over the front of the chest and abdomen, face & arms (this could be due to his vitiliago)

25- Rigor mortis (rigidity of muscles that happens after death) is present in limbs & jaw. Lividity is fixed (meaning the skin color has turned purple due to the pooling of blood after death & even after applying pressure the color stays purple which means the person has been dead for more than 10 hrs.)

26- There are no abnormalities seen on the head & it is partly covered by black hair which is short & tightly curled. The front of head has some balding.

27- The eyes are brown and the white part of the eye is free of any abnormal coloration. There’s no purple hemorrhage of the inner side of the eye lids.

28- The passage connecting the nose & the mouth is unobstructed.

29- A bandage is seen on the tip of the nose

30- It is stated that he neck is unremarkable (this is a contradiction to previous statements pointing out all the marks & scars on the neck!!!!)

31- There’s no chest deformity, both outer & inner wall of chest seem normal.

32- The exterior & surface of the body doesn’t show any swelling or deformation or abnormality

33- It is mentioned that the body was not clothed. This is very ambiguous, as earlier in the report, when the body was in the hospital it was mentioned that the deceased was wearing a hospital gown. It is common to submit all the deceased clothing to the coroner for investigation. I doubt Michael arrived to the hospital naked & I doubt they transferred his body to the coroner’s office naked.


Case Report: Page 15

I'm only going to post some incongruences, if you want more details visit Xscape MJ

Chest & Abdominal Cavities:
1.- The cavity surrounding lungs contains minimal fluid & no adhesions. [lack of adhesion means that the body hasn’t started decomposing, but lack of fluids in the cavity means that lungs are healthy, this is a contradiction to the respiratory & lung analysis that is given later in the report, if lungs weren’t healthy, there would be plenty of fluid in the cavity]

2.-The inner lining of the chest wall is intact

3.- The lungs are well expanded [this means that they can have a full inhale capacity & maximum intake oxygen, again contradiction to lung & respiratory analysis]
--> Plus remember what we said about propofol
It is my personal opinion that Michael Jackson simply could not have received such huge amount of Propofol during course of 6 weeks without showing some side effects during his waking hours; he simply would not be able to do any sort of physical activity yet alone go through rigorous rehearsals & deliver. Medically speaking that is just not possible!
HE WAS IN GOOD SHAPE!
4.- All the organs in the abdominal cavity are present & have the normal shape.

5.- The abdominal cavity has no inflammation and no adhesion [this means that decomposition of the body hasn’t started yet]

********************************************************************************************************************
Source: http://xscapemj.blogspot.com/2010/05/an ... art-3.html

Quote
Anatomization of the Living Dead: Part 4
This part contains yet the most shocking & inconsistent information & is strong proof that Mr. Michael Joe Jackson did not participate in this clinical study!!!

Case Report: Page 16

Cardiovascular System:

1- The arteries are normal; there are no abnormalities or blockage along the aorta.

2- The heart is normal & weighs 290 grams [this is a perfect weight for heart & means that it was in great shape]

3- All the heart chambers & its connecting blood vessels are in perfect shape


Respiratory System:

1.- Minimal secretions are found in the upper respiratory passages (i.e. nose, oral cavity, chamber below the throat & the voice box)[this means that at the time of death the deceased was not suffering from any infections in his upper respiratory passages]

2- The lining of the area known as the voice box has suffered some bruising & undersurface bleeding. [This might have been cause by the ETT being pushed down the throat.]

3- An abnormal respiratory noise can be heard from the lungs. [the coroner tries inflating & deflating the lungs to see if the deceased was suffering any lung conditions. In this case it seems that the deceased was suffering from a long condition due to the abnormal noise made by the lungs, further analysis is done which will be discussed later]

4- There is congestion is the lungs

5- It is mentioned that the left lung weighs 1060 grams & the right lung weighs 940 grams.

[This is one of the most bizarre statements made in this autopsy report. In all humans the right lung weighs more than the left lung, simply due to the position of human heart, which is in most humans on the left side. In few cases which are very rare, some people have their heart on their right side as opposed to the left side & hence their left lung weighs more than the right one. But there’s no mention of it on the cardiovascular analysis of the report nor anywhere else on the autopsy report that his heart was on his right side. So I don’t know really how to justify this outrageous statement by the coroner]

6- The thin tissue that covers the lungs looks normal & smooth & its veins are without clotting.


Case Report: Page 17


Gastrointestinal System:

1- The gullet (food tube) is intact throughout.

2- There is no swelling in the stomach [this is sign that there was no drug abuse, as people who abuse drugs usually suffer from distended stomach syndrome]

3- It is mentioned that the stomach contains 70 grams of dark fluid [alright why this fluid hasn’t been analyzed? What good is an autopsy if they’re going to live substances unknown & unanalyzed?!]

5- No tablet or capsule portions are seen in the stomach contents [very interesting comment, this can help to establish a timeline, considering the average time each medication’s metabolism takes, why wasn't further analysis done! If the timeline given by Murray is correct there must be some trace of medications in the stomach content especially considering the rumors that have been floating around about Michael being an addict. Considering the timeline given by Murray & the time of death there must be some trace in the stomach content, unless the body has been metabolizing after death!!! ]

6- Both the small intestine & the colon look good & normal inside & out.

7- After cutting open both the small intestine & colon a 2mm polyp (the kind that is attached to the tissue like a skin tag) is seen close to the rectum area. The polyp is pink in color, which means it’s not of a dangerous type.

8- The appendix is present.

9- Everything about the pancreas looks normal


Urinary System:

1- Left kidney weighs 120 grams & right kidney weighs 140 grams. [Although the numbers are well within the normal range, the issue is that in humans the left kidney is slightly bigger & heavier than the right kidney, here again we see a different pattern. Seems like the person who wrote this report had their left & right confused!]

Genital System:

1- The prostate is moderately enlarged but aside from that there are no abnormalities. This moderate enlargement is not dangerous.


Case Report: Page 18

Hemolymphatic System:

1- The lymph nodes in body are all small & normal [being small is a very good sign; it means that the body didn’t have any autoimmune problem. This is another bizarre statement by the coroner. It is a well known fact that Michael was suffering from Lupus. Lupus is an autoimmune disease. In Lupus the lymph nodes are enlarged because they have become over active.Therefore we can conclude that this body belongs to someone who wasn't suffering from any autoimmune disease. Stay tuned for my post on Lupus & Michael Jackson.]


Endocrine System:

1.- The Thymus is not identified. [this report gets bizarre page by page, apparently the coroner was not able to find the thymus, so the dead body is missing his thymus. The thymus is a specialized organ of the immune system. In lupus patients the whole immune system becomes over active attacking the body’s tissues & organs. However in HIV AIDS patients the thymus will be damaged to the point that it cannot be identified in the body. Another cause for missing the thymus is a very rare birth defect called the Digeorge Syndrome, however people suffering from this syndrome have certain facial features that make them stand out, very much similar to Down Syndrome. We know Michael didn’t have Digeorge Syndrome, there’s no mention of the deceased body having HIV, so why is the thymus missing? I can’t find a medical explanation for it!!!!
It is worth mentioning that removal of Thymus is highly unconventional & dangerous, the only time that a surgeon might decide to remove a thymus is in infants with sever heart defects that require heart surgery, the thymus in these cases sometimes have to be removed in order for the surgeon to have an unobstructed access to the heart. however this is not the case in older children or adults. Another very rare case that requires removal of thymus, which again I insist is very rare & it's a tough choice for a surgeon to make, is if a patient is suffering from Myasthenia gravis. Myasthenia gravis is a neuro-muscular disease leading to severe fluctuation of muscles & weakness & fatiguability. Again not all the cases of Myasthenia gravis require removal of thymus. Removal of thymus bears sever neurological side effects & it is a contributing factor in death of HIV patients. So why is the body missing the Thymus?]

Head and Central Nervous System:

1- There is no hemorrhage on the surface or below the surface of the scalp

2- All the tissues covering the brain are intact & without hemorrhage [the deceased suffered from cardiac arrest, which means his brain was left without oxygen for a good while, so there must be some hemorrhage on the interior tissue, the tissue closest to the brain, but the coroner indicates that all tissues are spotless!!!!!]


Neuropathology:

1- The brain was placed in formalin at the time of autopsy to be fixed, in order to undergo further examination.

2- Selected areas of the brain is preserved by the neuro-pathologist on 7/8/09

3- The rest of the brain was released to the mortuary on 7/8/09 [Therefore the whole thing about the delayed burial because theydidn’t have his brain is untrue, the mortuary had the brain on July 8, one day after the memorial]


Case Report: Page 20

Not going to post everything, just some examples

1- 1 photograph taken at the Forensic Science center on 6/25/09 [Why would they take any picture at the Forensic lab? Did they take a picture of the specimen sent to be examined?]

2.- 61 photographs taken before & during autopsy on 6/26/09 documenting resuscitative injury & prostate enlargement whiting the urinary bladder [does this mean that they only photographed the mentioned parts & procedures & not the entire course of autopsy?!]

3.- 3 photographs of a silver BMW 645 Ci taken on 6/29/09 [what does this photo do at the coroners?! This has nothing to do with the autopsy]

4.- 13 photographs taken at the scene on 6/29/09 showing the dressing room with closets where additional medical evidence was collected. [I want to pay close attention to this detail. Many of you thought that the news published by TMZ regarding the hidden closet that contained a plastic bag full of medications (i.e. Propofol) was a new discovery. This is not true. As you can see by the time they wrote this report those evidences had been recovered. Bear in mind that many of the information released/published later in the media was recycled news. Any body who would have taken the time to read the 51 pages of the autopsy report & the 43 pages of the released affidavit would see that all the things that have been mentioned recently in the media already exist in those reports. meaning that there are not new discoveries. What amazes me is the role of media in unfolding this whole case. They're completely relying on the fact that general masses haven't taken the time to read through the pages & chose to publish little sound bites of the released information. But if we all take it upon ourselves to read through these supposed official documents, we'll be able to see through the many inconsistencies surrounding this case & the fact that the District Attorney's office doesn't have a lot to go with for a conviction. The rest is all media hype & how they chose to feed the information to the public. I hope you manage to see through their schemes. Just like Michael said: "Just because you read it in a magazine or see it on the TV screen don't make it factual!"]

5.- 4 photographs of the stokes litter (it’s the kind of stretcher they use in rescue missions) from Sherriff’s Air 5 helicopter used in transporting decedent. [you have all seen the infamous body transfer footage, no body bags used, just wrapped in white sheet,no wonder they had to go back & photograph that…you just don’t transfer a dead body without a body bag! It’s a high risk, you might lose body fluids that could be crucial to the case.]

***NOTE: the witness to the autopsy is LAPD detective Smith.


Case Report: Page 21

Coroner’s Final Opinion:

Although we don’t have the actual toxicology report attached with this autopsy report, but the coroners have made their final opinion about the cause of death based on mostly the toxicology report. The coroner states, based on the toxicology results, high levels of Propofol & benzodiazepines were found in the victim’s blood. Please read my previous post on the Propofol calculation & the amount needed to achieve full anesthesia for a grown male of Michael's size & age. In that post I have explained that the amount of Propofol found in Michael's body couldn't have been fetal, even the anesthesiologist's cons
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »

Offline Loud

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Re: Debunking the Autopsy Report

  • on: June 23, 2010, 06:05:41 PM
Souza thank you. I always asked myself why publish it on a blog when you do not want that people read and most important SHARE it with others.  :roll:

But of course quoting is always allowed and I hope there is no trouble because of this topic for you!
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »

mykidsmum

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Re: Debunking the Autopsy Report

  • on: June 23, 2010, 06:11:10 PM
Yay Souza...you go girl  :D
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »

Offline hotice

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Re: Debunking the Autopsy Report

  • on: June 23, 2010, 08:11:59 PM
Quote from: "~Souza~"


**This information is for educational purposes only.**



http://en.wikipedia.org/wiki/Fair_use

This was originally posted by Hazzely, yet the author of the blog contacted me that she wanted to be credited, so I did. Yet now she wants  it taken off and is threatening with legal actions.

I am posting this back up because this is important to the investigation. This information is for educational purposes only.

Also, this website is hosted on a Dutch server, so Dutch Law is applicable. We of course have copyright here in The Netherlands, but we also have quote right. This means that we can copy text from internet pages, as long as it's quoted and the source is named. That is why I reposted this like this.

Please start the discussion again on the information below.

(@Hazzely, I have saved your original thread. If you want it, just PM me)


Quote
It's time for your Propofol
Anatomization of the Living Dead: Part 1
Anatomization of the Living Dead: Part 2
Anatomization of the Living Dead: Part 3
Anatomization of the Living Dead: Part 4
Anatomization of the Living Dead: Part 5


I'm in awe on the fact that you've made such a choice. All I asked for was to be consulted before reproduction of my work which is my legal & civil right, protected by Global Millennium Copy Right, which is a global treaty & applies without a border.
If this is such an important part of the investigation why don't you recruit your own medical expert to write up an analysis for you?
If I was looking for advertisement of my work or publicity, I would have contacted you. But clearly I was not.
Remember, just because it's on the internet, it doesn't mean you can copy or quote it, the regulations apply no matter where you are.
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »

mykidsmum

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Re: Debunking the Autopsy Report

  • on: June 23, 2010, 08:58:08 PM
get a freaking life!  Souza...don't believe her...you are safe...she is calling your bluff...No lawyer is gonna waste their time and no Med student is gonna fork up the cash to hire one and the fact is, all her information is based on an autopsy report that she never got permission to use.  Even if she didn't publish one word from it, its still plagiarism in theory because the information she used was not created in her own brain...Just do us all a favor and BAN her.  I never thought I could be this evil sounding but I've had it.  Your findings are CRAP anyway and outdated in parts thanks to Lady Medic clarifying!  The things you said about this forum and SOUZA are incomprehensible... Her and I have not seen eye to eye on many things but I would NEVER say the things I read on your blog....Why don't you just leave.  Souza...we don't need her crap anyway.  Lady Medic has already said it's outdated and there was another poster in the other thread that got deleted that offered to help and was willing to give her analysis...If I remember correctly.
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »

Offline hotice

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Re: Debunking the Autopsy Report

  • on: June 23, 2010, 09:01:36 PM
Quote from: "mykidsmum"
get a freaking life!  Souza...don't believe her...you are safe...she is calling your bluff...No lawyer is gonna waste their time and no Med student is gonna fork up the cash to hire one and the fact is, all her information is based on an autopsy report that she never got permission to use.  Even if she didn't publish one word from it, its still plagiarism because the information she used was not created in her own brain...Just do us all a favor and BAN her.  I never thought I could be this evil sounding but I've had it.  Your findings are CRAP anyway and outdated in parts thanks to Lady Medic clarifying!  The things you said about this forum and SOUZA are incomprehensible... Her and I have not seen eye to eye on many things but I would NEVER say the things I read on your blog....Why don't you just leave.  Souza...we don't need her crap anyway.  Lady Medic has already said it's outdated and there was another poster in the other thread that got deleted that offered to help and was willing to give her analysis...If I remember correctly.

1- This matter doesn't require any lawyer or money, I'm by law protected by blogger & they've received my calim & will follow through

2- If my findings are crap, what are they doing up on you page? doesn't that kind of make your page crap? If  it's stinking up your page, then you can get rid of it easily.

3-Banning me is not going to solve your problems my friend. It's my write to oversee my work. Legally & Civilly

4- IF your "lady medic" is such an expert, ask her to write up & analysis & stop using mine.
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »

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Re: Debunking the Autopsy Report

  • on: June 24, 2010, 01:55:33 AM
Quote from: "hotice"
I'm in awe on the fact that you've made such a choice. All I asked for was to be consulted before reproduction of my work which is my legal & civil right, protected by Global Millennium Copy Right, which is a global treaty & applies without a border.
If this is such an important part of the investigation why don't you recruit your own medical expert to write up an analysis for you?
If I was looking for advertisement of my work or publicity, I would have contacted you. But clearly I was not.
Remember, just because it's on the internet, it doesn't mean you can copy or quote it, the regulations apply no matter where you are.

hotice, I am in awe by your reaction and your actions.  You're talking about integrity?  Just by taking a look at your latest blog post it's clear to me whose integrity is at issue.  I guess it's all for love..
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Re: Debunking the Autopsy Report

  • on: June 24, 2010, 08:44:45 AM
Quote from: "hotice"
Quote from: "mykidsmum"
get a freaking life!  Souza...don't believe her...you are safe...she is calling your bluff...No lawyer is gonna waste their time and no Med student is gonna fork up the cash to hire one and the fact is, all her information is based on an autopsy report that she never got permission to use.  Even if she didn't publish one word from it, its still plagiarism because the information she used was not created in her own brain...Just do us all a favor and BAN her.  I never thought I could be this evil sounding but I've had it.  Your findings are CRAP anyway and outdated in parts thanks to Lady Medic clarifying!  The things you said about this forum and SOUZA are incomprehensible... Her and I have not seen eye to eye on many things but I would NEVER say the things I read on your blog....Why don't you just leave.  Souza...we don't need her crap anyway.  Lady Medic has already said it's outdated and there was another poster in the other thread that got deleted that offered to help and was willing to give her analysis...If I remember correctly.

1- This matter doesn't require any lawyer or money, I'm by law protected by blogger & they've received my calim & will follow through

2- If my findings are crap, what are they doing up on you page? doesn't that kind of make your page crap? If  it's stinking up your page, then you can get rid of it easily.

3-Banning me is not going to solve your problems my friend. It's my write to oversee my work. Legally & Civilly

4- IF your "lady medic" is such an expert, ask her to write up & analysis & stop using mine.
it's not my page.... :roll:  Lady Medic never "used" your crap...she commented on a post...that's what forums are for
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Re: Debunking the Autopsy Report

  • on: June 24, 2010, 01:26:22 PM
Quote from: "hotice"
Quote from: "mykidsmum"
get a freaking life!  Souza...don't believe her...you are safe...she is calling your bluff...No lawyer is gonna waste their time and no Med student is gonna fork up the cash to hire one and the fact is, all her information is based on an autopsy report that she never got permission to use.  Even if she didn't publish one word from it, its still plagiarism because the information she used was not created in her own brain...Just do us all a favor and BAN her.  I never thought I could be this evil sounding but I've had it.  Your findings are CRAP anyway and outdated in parts thanks to Lady Medic clarifying!  The things you said about this forum and SOUZA are incomprehensible... Her and I have not seen eye to eye on many things but I would NEVER say the things I read on your blog....Why don't you just leave.  Souza...we don't need her crap anyway.  Lady Medic has already said it's outdated and there was another poster in the other thread that got deleted that offered to help and was willing to give her analysis...If I remember correctly.

1- This matter doesn't require any lawyer or money, I'm by law protected by blogger & they've received my calim & will follow through

2- If my findings are crap, what are they doing up on you page? doesn't that kind of make your page crap? If  it's stinking up your page, then you can get rid of it easily.

3-Banning me is not going to solve your problems my friend. It's my write to oversee my work. Legally & Civilly

4- IF your "lady medic" is such an expert, ask her to write up & analysis & stop using mine.
I corrected the things you had totally incorrect. You may have contact with doctors, but I work in the emergency field. Doctors rarely have any idea what paramedics do. Furthermore, I'm confused why you have such outdated ACLS protocols. Granted EMS uses ACLS more than hospital personnel, but I would have expected you to have some idea. As for the other things, I don't ask doctors their opinions. I know what I know and that's what I present. I never claimed to know much about autopsy reports, but there are some things that are blatantly obvious. For example:
Quote from: "hotice"
No tablet or capsule portions are seen in the stomach contents [very interesting comment, this can help to establish a timeline, considering the average time each medication’s metabolism takes, why wasn't further analysis done! If the timeline given by Murray is correct there must be some trace of medications in the stomach content especially considering the rumors that have been floating around about Michael being an addict. Considering the timeline given by Murray & the time of death there must be some trace in the stomach content, unless the body has been metabolizing after death!!! ]
They're not talking about medications specifically, they're talking about the capsules or tablets. None of the medications administered to the patient by Murray were given PO. It's not saying there are no medications found in the stomach, just no pieces of tablet or capsule.

Point being, don't put yourself on such a high horse. Everyone is here for the same reason.
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Re: Debunking the Autopsy Report

  • on: June 24, 2010, 01:43:15 PM
Oh God..not again .. lol
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »
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Re: Debunking the Autopsy Report

  • on: June 24, 2010, 07:55:56 PM
Ladymedic, you should go thru the entire autopsy report and post your thoughts on it...I would love to get you thinking on it.  It would sure beat googling all the medical terminology!  LOL!  I know that's a lot of work but if you did that, we could replace Hostices work with yours and then we could all add something...
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Re: Debunking the Autopsy Report

  • on: June 24, 2010, 08:00:09 PM
Quote from: "mykidsmum"
Ladymedic, you should go thru the entire autopsy report and post your thoughts on it...I would love to get you thinking on it.  It would sure beat googling all the medical terminology!  LOL!  I know that's a lot of work but if you did that, we could replace Hostices work with yours and then we could all add something...


Sounds like a great idea!
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Re: Debunking the Autopsy Report

  • on: June 28, 2010, 07:56:18 PM
this would be my second attempt to post it when i lost connection and it all gone from my screne  , i will write it down till the dental part
            i think the original writer misunderstood something let me clear those doubts


 1. ACLS  and asystole well defined  BUT according to guidelines 2005 , its absolute indication to administer  45 mins CPR  unless someone is labelled  DNR  wihich means do not resustitae when we think prolonging patients life wont do any better like in cancer terminal patients and the list is huge very rare but  patient actually revived by CPR  so we dont take risk  by leaving them
 2. declaring somone dead is based on a criteria simple dilatiation of pupil doesnt mean the person is dead , but yes it sure means brain stem is dead and hence the need of ventilator wont go in detail


3. thymus regress in adults

5 lupus is autoimmune , true, nothing to do with large lymph nodes, ny the way i mention several times mj didnt suffer systemic lupus it was discoid affecting face and scalp

 6. nothing wrong having heavy lungs its a sign showing patient died of ARDS which in this case means respiratory failure and lack of circulation and back pressure leading to fluid filled lungs

7, nothing wrong taking antibiotics ? why did she find it odd?

8. we do expose chest to attach moniter or defibrillator nothing wrong if chest was exposed , yeah totally body exposure is odd

9 . there is no absolute rule that brain or covering dura mater  should show hemorrhages  

 10 nothing wrong with prostrate enlargment by age of sixty 80 percent suffers BPH

11. kidney weigh  there can be mistakes which measuring them ,


 12 there is absolutly nothing wrong if tubing were attached with body it carries a medicolegal importance like if it slipped from trachea to esophagus all the resustitation step would be wasted , so we make sure if its still in its right place , infact a coroner or seniour doctor check it to make sure if it was in trachea at the time of death or during resustation


        PULMONARY PATHOLOGY

 thromboli of small arteries ....     not always patients cough out blood mild breathlessness is common and again depends upon total or subtotal occlusion

      Eosinophilia .. true can be due to Asthma and COPD but allergic reaction too

    interstitial pnemonitis .... its noT SCARRING its when cells accumilates with in lung tissue due to allergy  or chronic inflammation NOTHING TO DO WITH SMOKING IN CASE OF BRONCHITIS AGAIN MANY FACTOR ARE INVOLVING and causing this condition people are NOT ALWAYS BREATHLESS

  BRAIN taken out for autopsy ,,,, its a common procedure  , i dont know why some people find it unsual , like i said earlier  cross section of brain are made for view  for both gross or  microscopic examination
 after A WEEK OF FIXATION i had slides of cross section brain saved in my laptop  but i still repent for putting my propofol videos some members find it hard to watch them . i apologise but it was for sake of knowlege.
    and autopsy picture never made public its unethical and not everyone can watch them itstoo hard , i remember when i was a medical student many of my class mate left the autopsy room right in the middle , few cried and one or two fainted on the spot , its not an easy task for us too .

     7 RIB RARE condition Mj had it i m surprised
   
  PLEASE there is NO arthritis of FINGER NAILS , it was so obvious Mj when he made prayer sign you can see it in his fingers


 i wrote so many times about propofol  wont discuss it , again i told about lividity and rigor mortis  in my post

why didnt they had stomach content analysis i m surprised
 

 People who know me here know  i m not dentist  but an internist, cant comment on dentisty   , i need some break will  read and write in a while
« Last Edit: June 29, 2010, 09:18:16 AM by mjj_fan »

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Re: Debunking the Autopsy Report

  • on: June 28, 2010, 08:23:31 PM
artery calcification could be an aging process , i just  gone through fast for the remaining part , , why no urine analysis of urine bottle found at scene?????? strange

  catheter .... external or condom one and the same thing, is placed to see the urine output because sometimes the  patient devolops acute kidney failure and its necessary to moniter if urine flow is adequate
 
      Please keep this in mind like i always said earlier and would still maintain the purpose is to provide best knowledge not to distract any one of you , you guys have done wonderful job but remember to keep an open mind  . i know  you do ! and please keep praying , because God listens them !!    
 
   Take care of your selves
      God bless you all
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Offline mjj29081958

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Re: Debunking the Autopsy Report

  • on: June 28, 2010, 09:01:37 PM
Hi!
I made a post some time ago pointing out some of the things you did above, but I just realized it got deleted. Anyway, they did analize the gastric content and the urine found at the scene. Propofol & Lidocaine were Positive in both samples. Urine was also Positive for Ephedrine.
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Re: Debunking the Autopsy Report

  • on: June 28, 2010, 09:05:17 PM
Oh i didnt read your post ,  i dont visit this site more often ,  but i would like to read it , can u paste or  pm that post to me if you still have it , Godbless
« Last Edit: June 29, 2010, 11:44:25 AM by mjj_fan »

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Re: Debunking the Autopsy Report

  • on: June 28, 2010, 10:03:24 PM
Sorry, I had to go.

Oh, I didn't save it, but it was very similar to your analysis. I wanted to point out some things that in my opinion were not totally accurate in this analisys, but then it became in a "Copyright fight" lol and I left the thread!.

I do like to see some other views on this!.

God bless you too.
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Re: Debunking the Autopsy Report

  • on: June 29, 2010, 11:57:24 AM
http://www.youtube.com/watch?v=fPZbc95s ... re=related
     
    above shows abnormal rhythms
     
                 If the rhythm is truly asystole and has been present for more than several seconds, the patient will be unconscious and unresponsive. A few agonal (final gasping) breaths may be noted, but detectable heart sounds and palpable peripheral pulses are absent. based on that , may be thats what dr murray initially found mj breathing  which require immidiate CPR and  life  saving DRUGS
 
    but if mj was breathing spontaneously , there was nothing to do except to make a recovery position means tilt him by his side to avoid any gastric contents or vomit aspiration in the lungs  and place an immidiate call for help    
       even i m confused in which state mj was found in the room , since asystole is a flat line , i wonder  why frank said mj wasnt flat line in the hospital may be he was in ventricular fibrillation or tachycardia both arrthymias with high mortality rates and thats what frank told the press , i can only guess !
« Last Edit: June 29, 2010, 05:21:39 PM by mjj_fan »

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Re: Debunking the Autopsy Report

  • on: June 29, 2010, 12:03:54 PM
okay this one shows rhythms changing within seconds and how one should recognise them before  dangerous arrhythmias like ventricular fibrillation and tachycardia devolop which finally ends up in asystole


http://www.youtube.com/watch?v=XV11kplL ... re=related
« Last Edit: June 29, 2010, 05:20:00 PM by mjj_fan »

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Re: Debunking the Autopsy Report

  • on: June 29, 2010, 01:03:44 PM
@mjj_fan
Do you have any questions about heart rhythms?
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Re: Debunking the Autopsy Report

  • on: June 29, 2010, 10:04:02 PM
Quote from: "mjj_fan"
1. ACLS  and asystole well defined  BUT according to guidelines 2005 , its absolute indication to administer  45 mins CPR  unless someone is labelled  DNR  wihich means do not resustitae when we think prolonging patients life wont do any better like in cancer terminal patients and the list is huge very rare but  patient actually revived by CPR  so we dont take risk  by leaving them
It is actually incredibly rare to go to 45 minutes (or even close to) of resuscitation with no improving rhythm change. ACLS actually recommends termintation of efforts within 10 minutes. However, most medical control doctors do not feel comfortable with that (nor do I), and have set in their protocols anywhere from 15-25 minutes. It's extremely rare to go over that.
And, of course, there are many more reasons to not even begin CPR let alone continue it.  :)
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Re: Debunking the Autopsy Report

  • on: June 29, 2010, 10:43:31 PM
Many people have pointed out flaws inconsistencies and the ridiculous in the autopsy report on this site.  
The rare cervical bone C7 was my first clue that it could not be real. That's why I had the idea of rearranging letters in names in the Coroners case report and other hoax names.

I posted a thread on TMZ live 25-06-2010 Part 1-4 Hash v Pot.

In Part 2 Harvey in answering a question, invites questioning of the autopsy report .
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Re: Debunking the Autopsy Report

  • on: June 30, 2010, 08:48:35 AM
Quote from: "Elsa"
Many people have pointed out flaws inconsistencies and the ridiculous in the autopsy report on this site.  
The rare cervical bone C7 was my first clue that it could not be real. That's why I had the idea of rearranging letters in names in the Coroners case report and other hoax names.

I posted a thread on TMZ live 25-06-2010 Part 1-4 Hash v Pot.

In Part 2 Harvey in answering a question, invites questioning of the autopsy report .

Yes, I heard Harvey say it was Hash instead of Pot on TMZ live. He said his source absolutely knew what he was talking about, haha. Didn't the autopsy report mention Marihuana was found and not Hash? I'm not sure, I can't check it here at work.
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Re: Debunking the Autopsy Report

  • on: June 30, 2010, 08:50:21 AM
Asystole and Pulseless Electrical Activity (Box 9)
PEA encompasses a heterogeneous group of pulseless rhythms that includes pseudo-electromechanical dissociation (pseudo-EMD), idioventricular rhythms, ventricular escape rhythms, postdefibrillation idioventricular rhythms, and bradyasystolic rhythms. Research with cardiac ultrasonography and indwelling pressure catheters has confirmed that pulseless patients with electrical activity have associated mechanical contractions, but these contractions are too weak to produce a blood pressure detectable by palpation or noninvasive blood pressure monitoring. PEA is often caused by reversible conditions and can be treated if those conditions are identified and corrected.

The survival rate from cardiac arrest with asystole is dismal. During a resuscitation attempt, brief periods of an organized complex may appear on the monitor screen, but spontaneous circulation rarely emerges. As with PEA, the hope for resuscitation is to identify and treat a reversible cause.

Because of the similarity in causes and management of these two arrest rhythms, their treatment has been combined in the second part of the ACLS Pulseless Arrest Algorithm.

Patients who have either asystole or PEA will not benefit from defibrillation attempts. The focus of resuscitation is to perform high-quality CPR with minimal interruptions and to identify reversible causes or complicating factors. Providers should insert an advanced airway (eg, endotracheal tube, Combitube, LMA). Once the airway is in place, 2 rescuers should no longer deliver cycles of CPR (ie, compressions interrupted by pauses when breaths are delivered). Instead the compressing rescuer should give continuous chest compressions at a rate of 100 per minute without pauses for ventilation. The rescuer delivering ventilation provides 8 to 10 breaths per minute. The 2 rescuers should change compressor and ventilator roles approximately every 2 minutes (when the rhythm is checked) to prevent compressor fatigue and deterioration in quality and rate of chest compressions. When multiple rescuers are present, they should rotate the compressor role about every 2 minutes. Rescuers should minimize interruptions in chest compressions while inserting the airway and should not interrupt CPR while establishing IV or IO access.

If the rhythm check confirms asystole or PEA, resume CPR immediately. A vasopressor (epinephrine or vasopressin) may be administered at this time. Epinephrine can be administered approximately every 3 to 5 minutes during cardiac arrest; one dose of vasopressin may be substituted for either the first or second epinephrine dose (Box 10). For a patient in asystole or slow PEA, consider atropine (see below). Do not interrupt CPR to deliver any medication. Give the drug as soon as possible after the rhythm check.

After drug delivery and approximately 5 cycles (or about 2 minutes) of CPR, recheck the rhythm (Box 11). If a shockable rhythm is present, deliver a shock (go to Box 4). If no rhythm is present or if there is no change in the appearance of the electrocardiogram, immediately resume CPR (Box 10). If an organized rhythm is present (Box 12), try to palpate a pulse. If no pulse is present (or if there is any doubt about the presence of a pulse), continue CPR (Box 10). If a pulse is present the provider should identify the rhythm and treat appropriately (see Part 7.3: "Management of Symptomatic Bradycardia and Tachycardia"). If the patient appears to have an organized rhythm with a good pulse, begin postresuscitative care.


    When Should Resuscitative Efforts Stop?  
 

The resuscitation team must make a conscientious and competent effort to give patients a trial of CPR and ACLS, provided that the patient has not expressed a decision to forego resuscitative efforts. The final decision to stop efforts can never be as simple as an isolated time interval. Clinical judgment and respect for human dignity must enter into decision making. There is little data to guide this decision.
Emergency medical response systems should not require field personnel to transport every victim of cardiac arrest to a hospital or emergency department (ED). Transportation with continuing CPR is justified if interventions are available in the ED that cannot be performed in the field, such as cardiopulmonary bypass or extracorporeal circulation for victims of severe hypothermia (Class IIb).

Unless special situations are present (eg, hypothermia), for nontraumatic and blunt traumatic out-of-hospital cardiac arrest, evidence confirms that ACLS care in the ED offers no advantage over ACLS care in the field. Stated succinctly, if ACLS care in the field cannot resuscitate the victim, ED care will not resuscitate the victim. Civil rules, administrative concerns, medical insurance requirements, and even reimbursement enhancement have frequently led to requirements to transport all cardiac arrest victims to a hospital or ED. If these requirements are nonselective, they are inappropriate, futile, and ethically unacceptable. Cessation of efforts in the out-of-hospital setting, following system-specific criteria and under direct medical control, should be standard practice in all EMS systems.
 
@ LADY MEDIC
    Practically like i mention earlier if the patient doesnt seem to respond to treatment , CPR terminate and he/she pronounced dead ,BUT It carries a great medicolegal importance like this  high  profile case when the jury can question the paramedical staff/personal physician about their best efforts in patients benefit, and thats why  DR Murray called Prince to witness the whole procedure , he is a key witness in that case , I  dont know what others physician do but if i see patient is improving i ask to keep on working on him , it happened  the patient was flatline all efforts terminated and team was about to declare the patient dead but suddenly rhythm reverted may be thats what people say about UCLA rising the dead alive  

@ Elsa
       7th cervical rib is rare BUT IT CAN BE A SYMPTOMATIC and person might not know  , in some patients it presses the main subclavian artery and major veins leads to emboli ,in others it presses nerve causing muscle wasting of arm and hand , depending upon what  anatomical structure is affected the symptoms varies
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Re: Debunking the Autopsy Report

  • on: June 30, 2010, 09:01:53 AM
Quote from: "mjj_fan"
Asystole and Pulseless Electrical Activity (Box 9)
PEA encompasses a heterogeneous group of pulseless rhythms that includes pseudo-electromechanical dissociation (pseudo-EMD), idioventricular rhythms, ventricular escape rhythms, postdefibrillation idioventricular rhythms, and bradyasystolic rhythms. Research with cardiac ultrasonography and indwelling pressure catheters has confirmed that pulseless patients with electrical activity have associated mechanical contractions, but these contractions are too weak to produce a blood pressure detectable by palpation or noninvasive blood pressure monitoring. PEA is often caused by reversible conditions and can be treated if those conditions are identified and corrected.

The survival rate from cardiac arrest with asystole is dismal. During a resuscitation attempt, brief periods of an organized complex may appear on the monitor screen, but spontaneous circulation rarely emerges. As with PEA, the hope for resuscitation is to identify and treat a reversible cause.

Because of the similarity in causes and management of these two arrest rhythms, their treatment has been combined in the second part of the ACLS Pulseless Arrest Algorithm.

Patients who have either asystole or PEA will not benefit from defibrillation attempts. The focus of resuscitation is to perform high-quality CPR with minimal interruptions and to identify reversible causes or complicating factors. Providers should insert an advanced airway (eg, endotracheal tube, Combitube, LMA). Once the airway is in place, 2 rescuers should no longer deliver cycles of CPR (ie, compressions interrupted by pauses when breaths are delivered). Instead the compressing rescuer should give continuous chest compressions at a rate of 100 per minute without pauses for ventilation. The rescuer delivering ventilation provides 8 to 10 breaths per minute. The 2 rescuers should change compressor and ventilator roles approximately every 2 minutes (when the rhythm is checked) to prevent compressor fatigue and deterioration in quality and rate of chest compressions. When multiple rescuers are present, they should rotate the compressor role about every 2 minutes. Rescuers should minimize interruptions in chest compressions while inserting the airway and should not interrupt CPR while establishing IV or IO access.

If the rhythm check confirms asystole or PEA, resume CPR immediately. A vasopressor (epinephrine or vasopressin) may be administered at this time. Epinephrine can be administered approximately every 3 to 5 minutes during cardiac arrest; one dose of vasopressin may be substituted for either the first or second epinephrine dose (Box 10). For a patient in asystole or slow PEA, consider atropine (see below). Do not interrupt CPR to deliver any medication. Give the drug as soon as possible after the rhythm check.

After drug delivery and approximately 5 cycles (or about 2 minutes) of CPR, recheck the rhythm (Box 11). If a shockable rhythm is present, deliver a shock (go to Box 4). If no rhythm is present or if there is no change in the appearance of the electrocardiogram, immediately resume CPR (Box 10). If an organized rhythm is present (Box 12), try to palpate a pulse. If no pulse is present (or if there is any doubt about the presence of a pulse), continue CPR (Box 10). If a pulse is present the provider should identify the rhythm and treat appropriately (see Part 7.3: "Management of Symptomatic Bradycardia and Tachycardia"). If the patient appears to have an organized rhythm with a good pulse, begin postresuscitative care.


    When Should Resuscitative Efforts Stop?  
 

The resuscitation team must make a conscientious and competent effort to give patients a trial of CPR and ACLS, provided that the patient has not expressed a decision to forego resuscitative efforts. The final decision to stop efforts can never be as simple as an isolated time interval. Clinical judgment and respect for human dignity must enter into decision making. There is little data to guide this decision.
Emergency medical response systems should not require field personnel to transport every victim of cardiac arrest to a hospital or emergency department (ED). Transportation with continuing CPR is justified if interventions are available in the ED that cannot be performed in the field, such as cardiopulmonary bypass or extracorporeal circulation for victims of severe hypothermia (Class IIb).

Unless special situations are present (eg, hypothermia), for nontraumatic and blunt traumatic out-of-hospital cardiac arrest, evidence confirms that ACLS care in the ED offers no advantage over ACLS care in the field. Stated succinctly, if ACLS care in the field cannot resuscitate the victim, ED care will not resuscitate the victim. Civil rules, administrative concerns, medical insurance requirements, and even reimbursement enhancement have frequently led to requirements to transport all cardiac arrest victims to a hospital or ED. If these requirements are nonselective, they are inappropriate, futile, and ethically unacceptable. Cessation of efforts in the out-of-hospital setting, following system-specific criteria and under direct medical control, should be standard practice in all EMS systems.

So what's your opinion about "Michael" or that person who died (if there's any) according to this?
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »
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