JACKSON VAEGLive May 13

th
2013
Traduzione in Italiano 05/28/13 Please help us!
Deputy Medical Examiner Dr. Christopher Rogers
Plaintiff witness called back from May 6
th
Typed by ToMJRespectIsDue

Cross examination by Kathryn Cahen
Propofol was main factor in death, contributed by others. Besides this case has had one other
case of propofol overdose of a person who was in the medical profession.
* The doctor is shown on the stand Michaels autopsy report*
Q. Is the case number shown here, the same number that has been allocated to Mr. Jacksons
case?
A. Yes
A. And are you the one that did the autopsy on Mr. Jackson
A. Yes
Q. Is this official report that Ive shown you, the report from the Las Angeles county coroners
office, which was supervised by you
A. Yes this is the one created during the course of our investigation
Q. Is this your signature sir on the record, dated August 19
th
2009?
A. Yes thats correct

Q. Is it true that the examination took place between June 25 and August 19th of 2009?
A. It was continuous work, a very delicate job and we wanted to make sure that we had
everything we needed and all information was accurate and to persevere Mr. Jacksons dignity
Q. During this medical examination, did you have a toxicology screen done on Mr. Jackson
A. Yes there was a toxicology screen done and due to the nature of Mr. Jacksons death, it was an
important part of the process
Q. During the medical examination, did the coroners office, use various physicians to gather its
findings that created the final autopsy report
A. Yes we had specialists in their field, which assisted us in determining the cause of death, each
specialists had a different focus and ran various test
Q. See name under there *Koskoff points to an area on the autopsy report* what does that say
and who does that signature belong to
A. Thats the signature of the chief medical examiner coroner and his name is Dr. Lakshmanan
Sathyavagiswaran
Q. Is Dr. Sathyavagiswaran your supervisor and the one that oversees the examination of the LA
county coroners office?
A. Yes that is correct
Q. Does the chief medical examiner normally sign off on autopsies of this nature?
A. No actually he doesnt
Q. If chief medical examiner doesnt typically sign off on the autopsies that your perform, why
did he do so in this case
A. Dr. Sathyavagiswaran did so because he performed the examination with me and oversaw the
reporting of the other specialists involved
Q. So there are certain circumstance Dr. Rogers where the chief medical examiner will perform
the examination with you
A. Yes that is correct
Q. Did you believe at first that Mr. Jackson had a respiratory condition that could have been or
was a contributing factor to his death
A. At the time I was unable to determine if Mr. Jackson had a condition of the lungs that would
have caused or been a contributing factor to his death
Q. Did you have the sequence of events to whether which stopped first, his heart or the breath
into his lungs?
A. At the onset of the autopsy, no I dont think I did.prior to the examination, I didnt have any
information on what actually occurred
Q. At some point did you obtain that information as to which came first?
A. Yes I did
Q. And where did that information come from
A. That information came from Dr. Murrays statement made to the police. In his statement, Dr.
Murray told police that he found Mr. Jackson appearing not to be breathing, but he felt a faint
pulse. Mr. Jackson stopped breathing first and then his heart stopped
Q. I want to make sure I understand a previous answer given, did u ever get information that
suggested that Dr. Murray wasnt Mr. Jacksons only physician
A. Well I was uncertain who his (MJ) primary physician was, and as I understood it he was
seeing more than one doctor

Q. Was one of the doctors you found out he was seeing, Dr. Arnold Klein
A. Yes he was one of them
Q. Where there any other physician that you knew of that Mr. Jackson was seeing
A. I dont recall during that period if I knew of another doctor that Mr. Jackson was seeing,
information was still coming in
Q. Did you become aware that Dr. Klein was making house calls to Mr. Jacksons residence?

*Objection Sidebar*

Q. Do you Dr. Rogers know if there was any other doctor that contributed to Mr. Jacksons
death?
A. No I dont
Q. At the time of autopsy you weigh the deceased, please tell us how this is done
A. When someone first comes into the office they are on gurney, then we put them on a table
from which the weighing is done
Q. Do you use this same method in all autopsies?
A. Yes we do, its standard procedure
Q. How often would you say the scale at your office, the coroners office is checked
A. I believe its checked periodically for accuracy, but Im not certain of that or its frequency
Q. So to your knowledge the weighing of Mr. Jackson at autopsy was accurate
A. Yes to my knowledge it was
Q. How tall was Mr. Jackson?
A. He was 69 inches when measured thats 59
Q. What is the body mass, proportioned to height weight ratio
A. The body mass index is a measure of body fat based on height and weight. With this
calculation we can determine whether we are at our target weight underweight or obese
Q. Do you use a calculator to figure the body mass index out?
A. Actually there is an internet site that I use to get my calculation, you enter height and weight
and the BMI is determined
Q. Did you calculate Mr. Jacksons body mass index in this way and what was the result
A. Yes I calculated Mr. Jacksons body mass this way and it was 20.1 which is on par with his
height and weight

*Shows body index chart*

Q. We put together this chart, showing BMI levels and does this look right so far an index
under 18 would be underweight, an index over 30 is obese and when you measured Mr. Jackson
body mass index at 20.1 he was well within range for his height and weight
A. Yes all of that is correct
Q. Did Mr. Jackson look thin to you?
A. Well I guess he looked thin in comparison to other people, I would say so
Q. have you ever done an autopsy on an anorexic person and if so did they look like Mr. Jackson

A. Yes I have performed autopsies on persons suffering from and anorexia and no I would not
say that Mr. Jackson looked like any of them
Q. Have you ever performed an autopsy on someone who died of starvation; what are the
determining factors of starvation and what does it look like
A. Yes I have examined those who have starved, you can see their bones and there is very little if
at all fat underneath the skin
Q. Is their damage to the heart if a person has starved?
A. Absolutely, yes there is noticeable damage
Q. With Mr. Jackson, did you look at his heart to access whether there was damage that
starvation to his heart
A. Well I looked at his heart under a microscope during the autopsy and I was able to rule out
any damage done to his heart by starvation
Q. Did you see any of other signs of starvation and were you able to rule out starvation as a
cause of Mr. Jacksons death
A. No I saw no other indicating signs of starvation and was able to rule out starvation being the
cause of death. It appeared he was in better than average health for someone of his age
Q. Would you say that Mr. Jackson was in excellent health?
A. As far as the autopsy goes Id say Mr. Jackson was in pretty good health
Q. Dr. Rogers is this why it took so many weeks to determine the cause of death
A. In viewing Mr. Jackson there was no obvious cause of death so we had to do a thorough
investigation to find out why he had died
Q. Is a Pathologist a medical specialist that looks at organic tissue on the micro level?
A. That would be correct
Q. In your line of work do you work with Pathologists often?
A. It varies I do work 1ith them and get consult from them from time to time
Q. In the autopsy report, I want to talk with you about the finding of Dr. Sherwin. He was the
specialist that looked at Mr. Jacksons lung specimen for analysis
A. Dr. Sherwin was consulting with our office on this matter we wanted his insight as he is a
pulmonary pathologist
Q Does this properly access damage or lack thereof
A. , thick slices of organic tissue was taken from Mr. Jacksons lungs and viewed under a
microscopic
Q. In Dr. Sherwins report included in Mr. Jacksons autopsy report, the doctors opinion is given
based on his findings. Would you agree with it?
From autopsy report: The above findings reflect a depletion of structural and functional reserves
of the lung. Reserve depletion this the result of widespread bronchiolitis and chronic lung
inflammation in association with fibrocollagenous scars and organizing/recanalizing
thromboemboli of all small arteries. It should be noted that the above lung injury with reserve
loss is not considered to be a direct or contributing cause of death. However, such an individual
would be especially susceptible to adverse health effects.
Q. We talked about this before when you were here, Dr. Sherwins opinion stats that Mr.
Jacksons lungs reflected a depletion of structural and functional reserves as a result of wide
spread bronchiolitis and chronic lung inflammation. Was this also your agreement and
understanding after reading the report and your examination?

A. I wanted that finding to be conclusive and so Mr. Sherwin was brought in for consult and I do
agree with his opinion and findings
Q. Did you ever come to the conclusion of whether or not Mr. Jackson was suffering from any
chronic diseases?
A. There was no disease found, that would lead to death directly when Mr. Jackson passed or that
would put him on that road in the future. There were no diseases found
Q. So the mentioned lung condition was in no way the cause of Mr. Jacksons death
A. No it was not it would cause some distress occasionally but nothing that would end his life, he
could live quite comfortably. However, in the event of an infection in individuals with this
condition it could some complications
Q. We talked about infections in person with this lung condition the last time you were here, is
that right
A. Yes we did
Q. In someone who has this lung damage what could happen if they got some type of infection?
A. Well an infection may decrease lung function, as I stated if youre healthy you can stand this
type of condition, if not there will be issue that need attention that will arise
Q. If someone with this same condition that Mr. Jackson had gets pneumonia, would this be a
type of infection that would need serious attention over someone with pneumonia that doesnt
already have this underlining condition
A. Yes certainly
Q. I want to talk about the radiological findings in the autopsy report and we can see that you
brought in another specialist to access Mr. Jacksons physiology a radiologist; is that correct

A. We had a radiologist come in and view the slides of Mr. Jackson that we took during the
examination post mortem and we asked the radiologist to consult
Q. And a radiologist typical reads x-ray films and MRIs things of this nature, this is their
specialty, correct
A. Yes that is correct
Q. The radiologist that came aboard you trust his findings and expert opinion
A. That is correct and Mr. Jackson was found again to be in pretty good health
Q. One of the radiologist findings was that Mr. Jackson had, mild degenerative osteoarthritis of
the lower lumbar spine face joints, would you explain that to us in lay terms
A. Well, along Mr. Jacksons spine in the lower portion of his chest he had little degeneration of
the face joints. This would not be his actual face of course, these are the joints that keep the spine
together. And these are the joints that provide support, stability, and mobility to the spine. In Mr.
Jackson his lower back was affected
Q. Would this condition cause Mr. Jackson not to eat?
A. Conceivably it certainly could, but I doubt it in this case, the findings of denegation were
minimal
Q. Does degenerative osteoarthritis of the lumber spin cause pain
A. We are not told how sever the pain was, but yes it could cause pain
Q. In gross degeneration can you say look at a person and tell that they were in pain
A. Yes I suppose so, their posture would be greatly affected the body as a whole would be shifted
out of alignment as the spine crumbles

Q. In Mr. Jacksons case this was not anywhere near that severe, is that correct
A. That is correct
Q. Based on the testimony you are saying that pain could have existed but to best of your
knowledge the gradation of the degeneration was at a cope able stage
A. Yes
Q. Mr. Jackson passed away on June 25
th
2009 and you did the autopsy that day and the next and
then you sent samples obtained to various specialist for their analysis and consultation, is that
right
A. That is true, I had a pulmonary pathologist consult, radiologist consult and an anesthesiologist
consult. There was also specialist consulting from neuropathology and odontology.
Q. So once you have reviewed and conferred with all the specialist and taking that with the
findings and investigation and of your and the chief medical examiner, you were able to
determine the cause of death for Mr. Jackson, is that correct
A. That is correct
Q. Now you were asked before about the diagram in the autopsy report and the marking and
what they meant. You were asked about tattooing on the face and scalp. You were also asked
about scars around Mr. Jacksons ears and nose. You were also asked about pigmentation and
lack of pigmentation
A. Yes that is all correct
Q. Went through all the marking on Mr. Jacksons body that was discovered during autopsy, is
that correct
A. We did go over all of the markings on the diagram
Q. And none of those things was the cause of death, is that also correct
A. Yes that is correct,
Q. When you began the autopsy, the procedures mentioned were done because they are the
standard practice of medical examiners. This examination was not specific to Mr. Jackson
initially
A. Thats correct, as result of no known underlying cause of death I referred to other sources for
help and a more in depth investigation
Q. We talked earlier that you had a toxicologist on the list of specialist that assisted you, is that
right
A. Yes,
Q. Is it typical to bring in a toxicologist if you cannot determine the cause of death in the initial
examination of the deceased?
A. We do bring in toxicologists when the cause of death is not readily known after the initial
examination
Q. In this medical report of evidence collected right after Mr. Jacksons death, it states incoming
mode natural, what is that?
A. When Fleak first prepared her report, she made an estimate of what she thought the cause of
death would be as there were no indications early on of trauma or foul play, and she felt the
findings would come back as accident or natural causes
Q. You have ruled Mr. Jackson death a homicide, yet its not listed on this report, is that because
this is not a homicide or is because this report was prepared by someone other than yourself
A. It was prepared by others and myself

Q. Was there any other cause of death you thought there could be initially before all the reports
came back, were there any concerns?
A. I was concerned about drugs being the cause, because of all the drugs found at the scene by
Ms. Fleak
Q. Page 2 of our exhibit is a list all the medications first found at the scene prepared by Det.
Smith is that correct
A. Yes that is correct
Q. Propofol was added to the list later when it was recovered from the home is that right
A. Yes
Q. With that knowledge and a thorough autopsy investigation, what was the cause of Mr.
Jacksons death?
A. Mr. Jacksons death, was a homicide death caused by another, by way of acute propofol
intoxication with a benzodiazepine affect
Q. What does acute mean
A. It indicates that the concentration of propofol we found in Mr. Jacksons blood was fatal
Q. Would Mr. Jackson be waiting a long time in this case to die?
A. The levels were fatal, he did not wait
Q. And this wouldnt be propofol Mr. Jackson accumulated in his system night after night, night
A. These levels were from the one instance given on June 25
th
2009, this was not an
accumulation as propofol runs out of the system almost as quickly as it enters
Q. Propofol is an anesthetic given intravenously is that correct
A. Correct
Q. Propofol is given in a hospital setting only and not used for insomnia, is that also correct
A. That is correct
Q. Propofol is not something that can be prescribed and picked up at a pharmacy, is this true
A. Yes that is true
Q. The benzodiazepine affect was found as part of the cause of Mr. Jacksons death, what are
they
A. Benzodiazepines sedate the bodys nervous system by slowing them it down which puts a halt
to bodily function
Q. Are benzodiazepines and opiates the same thing
A. No they are generic analgesics, they are anti-anxiety medications, pain reducers and muscle
relaxants, they sedate
Q. Were there any opiates found in Mr. Jackson system at autopsy
A. No opiates, no Demerol or any type of recreational drug
Q. The benzodiazepines are not the sole cause of death is that accurate?
A. Yes that is correct, propofol was main factor and the benzodiazepines had a contributing affect
Q. How did the benzodiazepines contribute to Mr. Jackson Death?
A. Well the propofol at the lethal levels found in Mr. Jacksons body, which were beyond that of
undergoing major surgery made Mr. Jacksons vital functions stop. The benzodiazepines were
working in a similar way by sedating the nervous system and relaxing the muscles, the body had
no opportunity to react, to save itself. The propofol and benzodiazepine combination, had an
overwhelming effect on Mr. Jackson

Direct Exam Jackson attorney
Q. Now youve never seen Mr. Jackson in real life when he was alive have you
A. No I never met Mr. Jackson
Q. So you really wouldnt have any way of knowing what his normal size and appearance was
like
A. No
Q. When described Mr. Jackson as thin, you saw him the day after he had died and rigor mortis
had already set in, did it not
A. Yes
Q. How about lavidity, was that already present
A. Yes
Q. From the time Mr. Jackson was found in bed at his residence and seen by the paramedics, had
he received treatment, and in ambulance, got to UCLA and received emergency treatment
where lines were put and an aortic pump in and attempt to instigate breathingdo you know he
was given any fluids?
A. I believe there were fluids given
Q. Do you know how much fluids were given?
A. No I dont
Q. Do you know how much those fluids that were given to Mr. Jackson from the time he was
found down to the time he arrived in your office, would have contributed to his weight when you
weighed Mr. Jackson.
A. Without knowing how much was give, I really couldnt say
Q. When you saw Mr. Jackson and rigor mortis was present and lavidity had already set in,
would you have an indication of how he appeared at his home when he was found not breathing?
A. No, his appearance, his body consistency everything had already change by the time I saw
Mr. Jackson
Q. Does rigor mortis and lavidity tell you how Mr. Jacksons death in regards to his weight
A. No, I dont know what his normal weight should be
Q. Body mass indexes has to do with your weight, right
A. That is correct
Q. You said that you took Mr. Jackson body mass index and you viewed his structure during the
autopsy, how much fat did he have
A. Well I dont think I made measurement of his (MJ) fat
Q. Ok you didnt measure Mr. Jacksons body fat, from pure recollections how much would you
say he had
A. He didnt have great deal of fat,
Q. Did Mr. Jackson have muscle mass
A. Yes
Q. What weighs more, muscle or fat
A. Muscle does

Q. It is correct only one lung was sent to the lab for analysis
A. Thats right
Q The lung analyesd they didnt find anything significant that would effect his health
A. Correct
Q. Would the Xray findings collaborate there was pain
A. Its only a general finding, no way to tell unless it looks terrible then we would find it caused
pain.
Q. And ermm now in terms of his overall health did you feel as far as organs were concerned
there were no major findings
A. Correct

No more questions