Death of Michael Jackson
On June 25, 2009, the American singer Michael Jackson died of acute propofol intoxication in Los Angeles, California, at the age of 50. His personal physician, Conrad Murray, said that he found Jackson in his bedroom at his North Carolwood Drive home in the Holmby Hills area of the city not breathing and with a weak pulse; he administered cardiopulmonary resuscitation to no avail, and security called 9-1-1 at 12:21 p.m. Pacific Daylight Time. Paramedics treated Jackson at the scene, but he was pronounced dead at the Ronald Reagan UCLA Medical Center in Westwood at 2:26 p.m.
On August 28, 2009, the Los Angeles County Department of Medical Examiner concluded that Jackson's death was a homicide. Jackson had been administered propofol and anti-anxiety benzodiazepines lorazepam and midazolam by his doctor. Murray was convicted of involuntary manslaughter in November 2011, and was released in 2013 after serving two years of his four-year prison sentence with time off for good behavior.
At the time of his death, Jackson had been preparing for a series of comeback concerts, This Is It, that were due to begin in July 2009 in London, United Kingdom. Following his death, there were unprecedented surges of Internet traffic and a spike in sales of his music. A televised memorial service, held at the Staples Center in Los Angeles, had an estimated 2.5 billion viewers. In 2010, Sony Music Entertainment signed a US$250 million deal with Jackson's estate to retain distribution rights to his recordings until 2017 and to release seven posthumous albums of unreleased material over the following decade, although only two were ever released.
Circumstances
At the time of his death, Jackson was preparing for a series of comeback concerts, This Is It, due to begin in July 2009 at the O2 Arena in London. On June 24 Jackson arrived for rehearsal at the Staples Center, Los Angeles, at around 6:30 p.m. According to the magician Ed Alonzo, Jackson jokingly complained of laryngitis and did not rehearse until 9 p.m. "He looked great and had great energy," Alonzo said. The rehearsal went past midnight.Jackson returned to his home at 100 North Carolwood Drive in the Holmby Hills neighborhood around 12:30 a.m. the following morning and retired to bed one hour later. Jackson had long suffered from insomnia, and had a history of using drugs in an attempt to help him sleep. Jackson's personal physician, Conrad Murray, was present to help Jackson sleep and gave him various drugs including diazepam, lorazepam, and midazolam while monitoring him by his bedside. After several hours and several drug injections, Jackson was still unable to fall asleep, and, according to Murray, was repeatedly asking him for "milk", a nickname for the powerful surgical general anesthetic propofol, which Jackson had used in the past as a sleep aid. At 10:40 a.m., with Jackson still not asleep, Murray relented to his requests and injected him with 25 milligrams of propofol diluted with lidocaine. With Jackson finally asleep, Murray testified that he left his bedside to go to the bathroom, and after returning two minutes later, discovered that Jackson was not breathing and had a weak pulse.
Murray testified that he tried to revive Jackson for around ten minutes by performing Cardiopulmonary resuscitation and administering flumazenil, a drug used to counteract sedative overdose, after which he called for help from staff present in the house. Statements described Murray using a non-standard CPR technique on Jackson. The recording of the emergency call was released on June 26, one day after Jackson's death, and it described Murray administering CPR on a bed, not on a hard surface such as a floor which would be both standard practice and more effective. Murray said that he placed one hand underneath Jackson and used the other for chest compression, whereas standard practice is to use both hands for compression. Murray controversially did not call 911; he said that he was hindered because there was no landline telephone in the house and because he did not know the house's exact address. It was later discovered that in the hour after discovering Jackson not breathing, Murray made several private calls on his cell phone that he did not inform law enforcement about. A security guard eventually called 911 at 12:21 p.m., nearly an hour and a half after Jackson was first discovered not breathing. Paramedics reached Jackson at 12:26 p.m. and found that he was not breathing and had no pulse.
Paramedics performed CPR for 42 minutes at the house. Murray's attorney stated that Jackson had a pulse when he was taken out of the house and put in the ambulance. A Los Angeles Fire Department official gave a different account, stating that paramedics found Jackson in "full cardiac arrest", and that they did not observe a change in his status en route to the hospital. LAFD transported him to the Ronald Reagan UCLA Medical Center. The ambulance arrived at the hospital at approximately 1:14 p.m., and a team of medical personnel attempted to resuscitate him for more than an hour. They were unsuccessful, and Jackson was pronounced dead at 2:26 p.m. at the age of 50.
Investigation
Autopsies
Jackson's corpse was flown by helicopter to the Los Angeles County Coroner's offices in Lincoln Heights, where a three-hour autopsy was performed the next day on behalf of the Los Angeles County Coroner by the chief medical examiner Lakshmanan Sathyavagiswaran. The Jackson family arranged for a private, second autopsy, a practice that could yield expedited, albeit limited, results. After the preliminary autopsy was completed, Craig Harvey, chief investigator for the coroner's office, said there was no evidence of trauma or foul play.On August 28, 2009, the Los Angeles County coroner classified Jackson's death as a homicide, determining that Jackson died from acute propofol intoxication, exacerbated by the anxiolytic lorazepam, and less significantly midazolam, diazepam, lidocaine, and ephedrine. The coroner kept the complete toxicology report private, as requested by the police and district attorney.
The autopsy report revealed that Jackson was otherwise healthy for his age and that his heart was strong; his most significant health issue was that his lungs were chronically inflamed, but this did not contribute to his death. His other major organs were normal and he had no atherosclerosis except for some slight plaque accumulation in the arteries in his leg. The Associated Press reported that his weight was within the acceptable range.
Law enforcement agencies
Jackson's death was investigated by the Los Angeles Police Department and the Drug Enforcement Administration ; the latter agency had the authority to investigate issues otherwise protected by doctor–patient confidentiality, allowing it to trace the complex trail of prescription drugs supplied to Jackson.On August 28, 2009, the LAPD announced that the case would be referred to prosecutors. Because the LAPD did not secure Jackson's home and allowed the Jackson family access to it as well before returning to remove certain items, the department raised concerns by some observers that the chain of custody had been broken. The police maintained that they had followed protocol. California Attorney General Jerry Brown announced that his office was helping the LAPD and DEA to create a statewide database of all medical doctors and prescriptions filled.
The LAPD subpoenaed medical records from doctors who had treated Jackson. Police considered, but did not bring, homicide charges against those who had supplied drugs to Jackson.
Drug use allegations
Marc Schaffel, Jackson's former video producer, said that the singer had used propofol, alprazolam and sertraline. Other drugs included omeprazole, hydrocodone, paroxetine, carisoprodol, and hydromorphone. After his death, police found several drugs in his home, which included propofol. Some of these drugs had labels made out to fraudulent names, and others were unlabeled. A 2004 police document prepared for the 2005 People v. Jackson child abuse trial said that Jackson was taking up to 40 alprazolam pills a night. Alprazolam was not found in his bloodstream at the time of death. Jackson's friend A. J. Farshchian stated that Jackson was scared of drugs.Eugene Aksenoff is a Tokyo-based physician who had treated Jackson and his children on a few occasions, and he expressed concern about Jackson's use of various drugs. He said that Jackson asked for stimulants so that he could get through some demanding performances, but Aksenoff said that he refused to prescribe them. He recalled that Jackson had chronic fatigue, fever, insomnia, and other symptoms, and he took a large amount of drugs. He suspected that one of the major factors causing these symptoms was excessive use of steroids or other skin-whitening medications.
His sister Janet Jackson claimed that their family tried to stage an intervention in early 2007 when Michael was living in Las Vegas. She and some of their brothers allegedly traveled to his home but were turned away by security guards who were ordered not to let them enter. He was also rumored to have refused phone calls from his mother. However, the family denied that they had tried to intervene.
Propofol
Of all the drugs found in Jackson's home, the one that most concerned investigators was propofol, a powerful anesthetic administered intravenously in hospitals to induce and maintain anesthesia during surgery. Nicknamed "milk of amnesia" because of its opaque, milk-like appearance, the drug has been associated with cardiac arrest, but it still may be increasingly used off-label for anxiolytic and other medically unsubstantiated purposes. Several propofol bottles—both opened and not—were found in his home.On June 30, Cherilyn Lee, a nurse practitioner who had worked as Jackson's nutritionist, said that he had asked her in May to provide propofol to help him sleep, but she refused. He told her he had been given the drug before for persistent insomnia, and that a doctor had said it was safe as long as he was being monitored. Lee said she received a telephone call from an aide to Jackson on June 21 to say that Jackson was ill, although she no longer worked for him. She reported overhearing Jackson complain that one side of his body was hot, the other side cold. She advised the aide to send Jackson to a hospital; Lee thought she recognized the symptoms, and suspected that Jackson was on propofol.
Arnold Klein said that Jackson used an anesthesiologist to administer propofol to help him sleep while he was on tour in Germany. The anesthesiologist would "take him down" at night and "bring him back up" in the morning during the HIStory World Tour of 1996 and 1997.