- It is physically possible Michael Jackson could've self-injected propofol, pathologist concedes
- "There would have to be some oral lorazepam taken somewhere along the line," pathologist says
- Michael Jackson's mother leaves court before the autopsy photo is shown
- "I won't be able to see my daddy," Dr. Murray quotes Paris saying when told her father was dead
A stark photo of Michael Jackson's naked corpse lying on the autopsy table a day after he died was displayed on a large screen in front of the jury Tuesday in the involuntary manslaughter trial of Dr. Conrad Murray.
A Jackson fan who won a lottery for a seat in court became so upset she fled that seat after the prosecutors put the photograph on display, while other fans quietly wept and hugged each other.
Jackson matriarch Katherine Jackson, who was forewarned by the prosecutor, chose to leave the courtroom during the mid-morning break, before the pathologist who autopsied her son took the witness stand.
Michael Jackson's mother and sister Rebbie Jackson were there for the first hour Tuesday, when the last segment of the audio recording of Murray's police interview was played in court.
Jackson's three children "cried and cried and cried" when an emergency room doctor told them their father was dead, Murray said in the interview, which occurred two days after the pop icon's death.
Dr. Christopher Rogers, the deputy medical examiner who conducted the autopsy, said Tuesday that Jackson's death was ruled a homicide because of Murray's reckless use of the surgical anesthetic propofol in Jackson's home to help him sleep.
The Los Angeles County coroner ruled that Jackson died from "acute propofol intoxication" in combination with several sedatives -- all drugs Murray acknowledged in the police interview that he gave Jackson in the hours before his death.
"The risk outweighs the benefit," Rogers said about using propofol to fight insomnia.
He said it was possible that Murray gave Jackson an overdose, since he had no "precision dosing device" to keep Jackson asleep with propofol.
"Essentially, the doctor would be estimating how much propofol he would be giving," Rogers testified. "I think it would be easy under those circumstances for the doctor to estimate wrong and give too much propofol."
Rogers bolstered the prosecution contention that Murray used a makeshift IV setup to keep Jackson medicated and asleep, but that it malfunctioned while the doctor was not monitoring his patient.
The propofol bottle that prosecutors contend Murray used for the IV drip had a slit in the rubber top that appeared to have been made with a medical spike, not a syringe needle.
Murray could have pushed "a spike into the rubber stopper and then the propofol would flow out the end," Rogers said.
Rogers, during his direct questioning by Deputy District Attorney David Walgren, said he ruled out the chance that Jackson self-administered the deadly dose of propofol. He said it was unlikely he would have had time during the two minutes Murray told police he was away from the singer's bedside.
He later conceded under cross-examination that it would have been possible for Jackson to have reached the IV port near his knee to self-inject propofol. If Jackson pushed the drug in quickly, it could have made his heart stop immediately, Rogers said.
He later added, under questioning by the prosecutor, that he would still consider it a homicide even if Jackson administered the fatal overdose to himself since the doctor would have been negligent in leaving the drugs nearby.
Defense lawyer Ed Chernoff, in his opening statements, contended that Jackson died after he swallowed lorazepam pills from a bottle next to his bed, followed by self-administering a dose of propofol while Murray was out of the bedroom.
Rogers, under cross-examination Tuesday afternoon by defense lawyer Michael Flanagan, gave some support to the defense's theory that Jackson ingested lorazepam pills in addition to the drugs that Murray said he gave him through injections.
A toxicology study of Jackson's stomach contents, conducted in recent months, showed a level of lorazepam four times higher in the stomach that in his blood.
"There would have to be some oral lorazepam taken somewhere along the line," Rogers testified, after taking a moment to do some quick math while on the witness stand.
Katherine Jackson was in court earlier to hear Murray describe to detectives the reaction of her 11-year-old granddaughter, Paris, at the news that her father was dead.
"I will wake up in the morning, and I won't be able to see my daddy," Paris said, according to Murray.
Murray is not expected to testify during the trial, but the interview playback means jurors will have heard his story -- at least as he told it two days after Jackson's death.
The prosecution could benefit from the jury hearing Murray say he was away from Jackson for just two minutes before finding him without a pulse. Phone records and witnesses showed that moment came after he spent at least 45 minutes on his cell phone.
Murray's defense, however, may gain by the more personal view jurors get of the doctor without subjecting him to prosecution questioning.
The jury on Friday heard Murray's reasons for not immediately calling 911 for help, his explanation of his much-criticized CPR techniques, and his statement that he was trying to wean Jackson off a dependency on propofol.
Tuesday's interview playback began with Murray relating how Jackson's children "really were weeping, really weeping" when they were told doctors at Ronald Reagan UCLA Medical Center were unable to save their father.
"I hugged them all, gave comfort to Paris, comfort to Prince, comfort to Blanket, which is the last little guy, because whenever they were sick, they would always ask for Dr. Conrad," Murray said.
Murray, who treated Jackson and his children for colds and minor illnesses when they visited or lived in Las Vegas, was hired as Jackson's full-time physician just two months before his June 25, 2009, death.
"After they cried and cried and cried, then his daughter uttered a lot of words of unhappiness and, you know, she will live alone without her dad and she didn't want to be an orphan," Murray said, referring to Paris.
"She asked me, 'Dr. Murray, you said you save a lot of patients. You know, you save people with heart attacks, and you couldn't save my dad,'" he told detectives. "I said, 'I tried my best.' And she said, 'I know that, Dr. Murray. At least I know. I know you tried your best. I know you tried your best, but I'm really sad. You know, I will wake up in the morning, and I won't be able to see my daddy.'"
Murray said he also was unable to explain Jackson's death to other family members gathered in a conference room at the hospital.
"Do you know why he died?" one of them asked, Murray told police.
"My answer was 'No,' and that's the reason why I was recommending to the family to have an autopsy, because I also wanted to know," Murray said.
Prosecutors contend Jackson died because of Murray's criminal negligence, including the use of the surgical anesthetic propofol in his bedroom, without proper monitoring equipment.
But in the portion of the interview to be heard Tuesday, Murray points the finger away from himself to other doctors.
"I was not aware of any other medications that he was taking, but I heard that he was seeing a Dr. Klein three times a week in Beverly Hills," Murray told police. "And he never disclosed that to me."
Defense attorney Chernoff contended at the start of the trial that Dr. Arnold Klein had addicted Jackson to Demerol, a narcotic pain reliever, during the singer's regular visits to his Beverly Hills dermatology clinic in the weeks before his death.
"His production team had said to me recently that his worst days in the set is when he had gone to Dr. Klein's office, which is about three times a week," Murray said in the interview. "And when he came back, he was basically wasted and required at least 24 hours for recovery."
Three earlier prosecution witnesses testified that they were aware of Jackson's frequent visits to Klein's office and that Jackson's speech would be slow and slurred afterward.
Lt. Scott Smith, the Los Angeles Police Department's lead investigator in the case, acknowledged there was "head-butting" between Los Angeles Police and the coroner's office over who would interview Klein.
An LAPD lieutenant called the assistant chief coroner and demanded they not interview Klein "because we had other entities, if you will, that were looking into Dr. Klein and his dealings, so there would be some, perhaps, head-butting over that," Smith said.
Investigators from California's Drug Enforcement Agency were designated to probe Klein, Smith said.
Toxicology tests did not find Demerol in Jackson's blood at the time of his death, but the defense contention is that it played a role. They say Jackson was unable to sleep because he was suffering from withdrawal from the drug.
Murray told police that Jackson was "showing signs of a withdrawal," but he suspected it was from propofol, which he said he was trying to wean Jackson off after two months of nightly use.
Jackson's death came after two nights of not using propofol. Murray said he gave him a series of three sedatives -- Valium, lorazepam and midazolam -- on the third night without getting him to sleep.
"It wasn't working," Murray said. "So, was he going through a withdrawal from that agent? Was it his mind that was forcing him to stay awake?"
After 10 hours of trying, Jackson begged to again be given propofol, which the singer called his "milk," Murray said. He needed rest before an important rehearsal for his "This Is It" comeback shows.
"I've got to sleep, Dr. Conrad," Murray said Jackson pleaded to him. "I have these rehearsals to perform. I must be ready for the show in England. Tomorrow, I will have to cancel my performance, because you know I cannot function if I don't get to sleep."
Eventually, Murray said, he gave in.
"I then decided to go ahead and give him some of the milk, so he could get a couple of hours sleep so that he could produce, because I cared about him," Murray said. "I did not want him to fail. I had no intentions of hurting him. And I was compassionate. But what I was doing, too, recognizing that Michael Jackson may have had a dependency to a substance. I was trying to wean him off."
On the recording, Murray insisted he kept a close watch on Jackson after he finally fell asleep. The physician never mentioned the long list of e-mails and calls that cell phone records later revealed.
The doctor said he left the room for about two minutes to visit the toilet. When he returned, he realized his patient had stopped breathing, Murray said.
If convicted of involuntary manslaughter, Murray could spend four years in a California prison and lose his medical license.