LOS ANGELES (RNN) - Regardless of the circumstances, Dr. Conrad Murray should have taken more steps to ensure Michael Jackson's safety, according to a cardiologist who reviewed the case for the California Medical Board.
In his testimony Wednesday, Dr. Alon Steinberg pointed to six instances of "gross negligence" on Murray's part in his care and response to Jackson's not breathing.
He was critical of Murray for calling security guards before trying to contact emergency services.
"What he should've done was first call 911," Steinberg said. "It's basic knowledge in America, you don't have to be a healthcare professional, that when someone is down, you get help."
Like others testifying before him, Steinberg said propofol was an inappropriate drug to treat Jackson's insomnia. He also said the doctor had not prepared for an emergency or for the proper care of Jackson. He named multiple items that were required in most cases while administering the surgical anesthetic propofol, many of which Murray didn't have or use.
Among them was an Ambu bag, a device used to force air into a patient's lungs should they stop breathing on their own. Steinberg said this is the first thing Murray should have used, since he found Jackson with a heartbeat but not breathing.
A photograph from the scene showed an Ambu bag on the floor of Jackson's bedroom, but Murray did not report using the device. Instead he performed chest compressions on the performer, a move that Steinberg called "inexcusable," as Jackson's heart was still beating.
Steinberg and the defense also went head-to-head on whether or not Murray had used an IV drip of propofol, according to the doctor's interview with the Los Angeles Police Department.
Steinberg's findings were based predominantly on the transcripts from this interview.
Tuesday's testimony
The coroner who performed Michael Jackson's autopsy was adamant Tuesday that the pop star's death was a homicide, even if his death was caused by his ingesting too much medication on his own.
It has been central to the Murray's defense that Jackson administered his own fatal dose.
Dr. Christopher Rogers, the deputy medical examiner for Los Angeles County, said Jackson was healthier than the average person of his age, and there were no indications of a natural cause of death.
Rogers named a number of reasons for his ruling Jackson's death as a homicide, including the fact that Murray told police he had been injecting the performer with medications and that propofol, the surgical anesthetic that led to Jackson's overdose, was not administered in the proper setting.
He also said circumstances don't support the theory that Jackson self-administered the drugs needed for an overdose while Murray was quickly using the restroom.
Rogers claimed it was more likely that propofol was being given to Jackson in small doses every hour to keep him asleep.
"We did not find any precision dosing device, so the doctor would be estimating how much he was giving," Rogers said.
An examination of Jackson's stomach contents found no signs of pills or tablets, although he did admit that it was likely that some lorazepam, a sedative, was ingested orally by the performer.
Despite this, Rogers said it was imperative that propofol be taken under the close supervision of a doctor, and said it was Murray's responsibility to make sure Jackson was taken care of.
As part of evidence, the prosecution showed a photo of a naked Jackson post-mortem, taken before the medical examiner began his autopsy.
The coroner's comments came after the court heard the tail end of a two-hour long interview between Murray and the Los Angeles Police Department, given two days after the pop star's death.
The lead investigator on the case, Det. Scott Smith, also took the stand, admitting that even after interviewing Murray, Jackson's personal assistant and a number of his security guards, he did not hear of Alberto Alvarez's claim that Murray had him hide IV bags and vials until two months into the investigation.
Alvarez, Jackson's former head of security, was the first to arrive after Murray found the pop star dead. He claims Murray instructed him to put various vials and a saline bag that appeared to have propofol in it in a bag before paramedics arrived.
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Dr. Conrad Murray sits in the court room as the prosecution lays out the case against him. Murray is on trial for his involvement in Michael Jackson's death in 2009. (Source: CNN)
Dr. Christopher Rogers, the coroner who performed Michael Jackson's autopsy, took the witness stand on Tuesday. (Source: CNN)
Dr. Alon Steinberg, a cardiologist, explained six points where he found "gross negligence" in the treatment of Michael Jackson by Dr. Conrad Murray while testifying Wednesday. (Source: CNN)
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