Updated 8/31/09:
From the
Los Angeles Times:
The Los Angeles County coroner's office said Friday that it had officially ruled Michael Jackson's death a homicide and determined that a surgical anesthetic combined with other medication killed him.
In a one-page statement, officials listed the cause of Jackson's June 25 death as "acute propofol intoxication" with the additional factor of "benzodiazepine effect."
Three different sedatives that fall into the benzodiazepine drug class were in Jackson's system, but only the anti-anxiety medication lorazepam, often known by the brand name Ativan, was cited alongside propofol as "the primary drugs responsible for Mr. Jackson's death."
Jackson's personal physician, Dr. Conrad Murray, has acknowledged administering both medications to Jackson in the hours leading up to his death, according to search warrant affidavits.
The cardiologist told detectives that in an effort to get the insomniac singer to sleep on the morning of his death he administered the sedatives lorazepam, midazolam and diazepam, and that when they proved ineffective, he complied with Jackson's request for propofol, a powerful anesthetic intended for use in operating rooms, the affidavits state.
Toxicology tests also detected two other medications, the local anesthetic lidocaine and ephedrine, commonly used as a stimulant, according to the coroner's statement.
The complete toxicology results and the final coroner's report were not made public at the request of the LAPD and the Los Angeles County district attorney's office, the coroner's office said.
While cautioning that the absence of public lab results made it impossible to analyze the coroner's conclusions, toxicology experts said that the coroner's identification of benzodiazepine as a contributing factor suggested the sedative lorazepam might have intensified the effect of the propofol.
Forensic toxicologist
Robert Middleberg, laboratory director at Pennsylvania's private
NMS Labs, said both drugs depress the central nervous system and can have an additive effect when used together.
"When you combine them, it's not just one plus one equals two anymore. It's one plus one equals three, four, five, six, seven or some other number," he said.
Brain activity can slow to the point that breathing stops altogether, he said.
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From
msnbc.com:
The Los Angeles County coroner ruled Michael Jackson's death a homicide Monday after a search warrant affidavit revealed that Jackson had lethal levels of the powerful anesthetic
propofol in his system when he died.
The document unsealed Monday allowed officials to raid the Houston offices and storage facility of Dr. Conrad Murray last month.
According to the warrant, Murray, Jackson's personal physician, had been treating the singer for insomnia with the sedative for six weeks. According to the document, Murray said he had been trying to wean Jackson off the powerful sedative by using smaller doses in combination with the sedatives
lorazepam and
midazolam.
On the morning Jackson died, Murray said he tried to induce sleep without using propofol, starting first with valium at 1:30 a.m. When he was still awake at 2 a.m., Murray injected Jackson with lorazepam, then injected him with midazolam at 3 a.m. Murray told police he administered several other drugs over the next few hours.
By 10:40 a.m., Jackson, still unable to sleep, urged Murray to give him propofol. Murray said in court documents that he administered 25 milligrams of the drug at that time, then left Jackson alone under the influence of the drug to make phone calls to his Houston office. When he returned, Jackson was not breathing. He performed CPR while a member of Jackson's staff called 911. The singer was rushed to UCLA Medical Center where he was declared dead sometime later.
The affidavit says , while Murray acknowledged to police that he administered propofol, authorities said they could find no evidence that he had purchased, ordered or obtained the medication under his medical license or Drug Enforcement Administration tracking number. The newspaper also reported that police detectives found about eight bottles of the aneesthetic in Jackson's house along with other vials and pills that had been prescribed to Jackson by Dr. Murray, Dr. Arnold Klein and Dr. Allan Metzger.
Valium, lorazepam, clonazepam, tamsulosin and other drugs also were confiscated in the search, and propofol was found in Murray's medical bag. According to the warrant, Murray told police he was not the first doctor to administer propofol to the singer.