Friday, June 26, 2009

Michael Jackson--In Perspective (2nd Saturday Update)

There is no doubt that Michael Jackson's death at age fifty was an event that the world could hardly fail to notice. There will be considerable press coverage over the next few weeks, and possibly months, regarding his career, his talent, and his title as The King of Pop. This post will be dealing with some nuts-and-bolts issues surrounding his sudden and unexpected death, including some legal issues that will arise over the course of the next few days.

Why was the Medical Examiner called in? The most pressing issue that is absorbing the news sites is the actual medical cause of his death. A heart attack is the known immediate cause, but there are many facets to that. The Medical Examiner's (Coroner's) report took longer than expected, but the preliminary results are inconclusive at the time of this writing. Was there a crime? Not necessarily. There are many reasons why such an examination would be required, many of which have little to do with a suspected crime. The most common reason would explain this one initially. A fifty year old man, with easy access to medical treatment and personal care is not expected to die of a sudden coronary arrest. That alone is sufficient to warrant an official medical examiner's report.

Once the determination to perform an autopsy has been made, the results may go nearly anywhere. Most often, an underlying medical condition that was either unsuspected or undetected is the cause. In the case of a public figure, known medical conditions are often hidden from the public to avoid potential damage to the person's career or privacy. In most of those cases, the examination will reveal that condition, but no further action will be taken on it so long as there was no indication of medical malpractice or foul play.

Given the mystery surrounding Jackson's life, the official medical examination was inevitable, but like so many things in Jackson's life, the results will intrigue people. Many are already speculating that there was either a crime, or a course of medical treatment for pain and other undisclosed diseases that went outside the ordinary bounds of good medicine. The allegations are that Jackson had a personal physician who lived at the residence, and may have been repeating the type of overmedication discovered in the death of Elvis Presley.

In addition, as of this writing, the doctor's car was found near the residence, but the doctor was nowhere to be found. On top of that, there have been allegations that the doctor was not licensed in California, which could then make the course of treatment and medication illegal even if it was otherwise appropriate. One of the drugs alleged to have been prescribed is demerol. This is a powerful opium derivative, used to treat acute pain. Rarely, it is used to treat chronic pain, but is contra-indicated for anyone who has either suffered previous addiction to opiates or who has any history of cardio-vascular disease. Like most pain medications, dependency is always a possibility, and the drug requires larger and larger doses to produce the minimum result.

In any event, this medical issue will not be resolved today or in the next few days. If there is a hint in the Medical Examiner's report that drugs of any kind were involved, no final conclusions can be drawn because the complete toxicology report cannot be finished in less than five or six weeks. If demerol is detected, that proves little or nothing in and of itself, unless an inordinately large amount is found in his system. But drug interactions are often the ultimate cause, and many of those drugs, if there are any, won't be identified for some time to come. The most the Medical Examiner can announce today is that the death was not from natural causes, or that it was from natural causes under suspicious circumstances. A pure finding of death from natural causes is highly unlikely, but possible. More likely the finding will be indeterminate, with some preliminary information about the actual sudden coronary arrest and any medication in Jackson's system. It is highly unlikely that the initial report will actually determine that the death was the result of any criminal act, or even medical malpractice.

California is very loosy-goosy about personal drug use, but when it comes to doctors who prescribe, overprescribe, or illegally prescribe a course of medication which may have resulted in a death, the state can be very tough and unforgiving. In the case of a beloved public figure, the political ramifications of ignoring the doctor's medical procedures would be disastrous for the police and the prosecutors. Although the news reports continually report that the doctor is not a "suspect," the simple fact is the police are looking hard for this phantom doctor, and for very good reason. For one thing, the doctor was allegedly performing the CPR while another person made the 911 call, and then described at least an hour of CPR before the call. That immediately raises the question of why an in-house doctor would not have immediate access to a defribillator, particularly if he knew of a potential coronary problem. One result which could occur from such a scenario are charges of criminal negligence or even homicide against the doctor.

UPDATE: The Medical Examiner's preliminary report has been released. In a brief and terse statement, the announcement stated that the autopsy had been completed, that there was no "immediate" indication of a criminal act, and that no final determination of the cause of death other than sudden coronary arrest was found.

UPDATE: Police are reporting that the residence contained a "treasure trove" of prescription medications, including multiple painkillers and anti-depressants. A full syringe of demerol was found near the body when paramedics arrived. They do not have the doctor in custody, but their information so far indicates that the doctor is a coronary specialist, and that he was employed by AEG, the company which was promoting Jackson's comeback tour. Beyond that, the police say they either have information they are not free to release, or information that has yet to be organized. As of this writing, the spokesman for the LAPD has said that the Department is in contact with the doctor, and will be scheduling an interview with him at the earliest possible time. The announcement also indicated that the detectives believe that the doctor is a California practitioner.

The next question being asked is "what will happen to the children?" California law leans very heavily toward awarding physical custody to the natural mother (assuming both the children and the mother are presently in California where the death occurred). If she chooses, she will get that custody almost immediately, despite the fact that she has not seen the children at all since she signed an agreement with Jackson that he would have sole and exclusive custody. That does not mean she will be allowed to keep the children permanently, or that she even wants them. The marriage was clearly a sham, and many of her actions subsequent to the divorce could be used to prove that she is not a fit parent. Yet under California law, a natural mother must be highly unfit, not merely negligent, eccentric or inattentive, for the court to award custody to anyone except her. And then the question becomes, "if not her, then who is next in line?" That would be family blood relatives. The Jackson family has had many problems, including charges of child abuse, so that's a questionable avenue, yet they have at least been in constant contact with Jackson and the children.

But there is more at stake than mere custody. Unless Jackson left a will (undetermined at this point), the children are entitled to his entire estate. Since they are minors, the court must appoint a guardian ad litem to determine who will be in charge of the fortune (or mound of debts, whichever it turns out to be). If the mother decides she wants the children, but there is serious doubt that she could handle the finances, the court could award her physical custody (guardian of the person) while giving legal and financial custody to a neutral professional third party (guardian of the estate). Even if she is a competent person with money, the court might still choose to appoint a guardian of the estate since Jackson's financial affairs were chaotic at best, and involve millions of dollars and control of certain assets which may be worth millions more. But there is also the matter of settling the debts (he is said to owe the local pharmacy over $100,000). This would be troubling for a team of highly-qualified certified public accountants, let alone a single mother of ordinary talents.

In the long run, this death will result in investigations, lawsuits, possible criminal charges, and estate challenges which will make the Anna Nicole Smith fiasco look like child's play.

If there are any new legal or factual developments in the reports of Michael Jackson's death, we will attempt to update you tonight or tomorrow. At this point, you know everything we know, and perhaps you may even know a little more.

UPDATE: Saturday, June 27--11:45 AM PDT: The Jackson family has ordered a separate autopsy. This was not entirely unexpected, but does firm up the talk that the family was not happy with the Medical Examiner's office so far. The name of the person designated to perform the autopsy has not yet been revealed, but the office of the Medical Examiner issued a brief statement in which it stated that "the family had every right to do this, and given the current status of personnel cutbacks and reductions in funding, it is not unreasonable to think that a private party might be able to act quicker and more efficiently." It's not clear from my point of view whether this is a sneaky plea for restoration of staffs and funding, an admission of incompetence, or a genuine statement of the intelligent concept of getting a second opinion. Much of the validity of the second autopsy will be in question, depending on which expert the family chooses. And there is always the underlying assumption that an independently-paid expert will attempt to find results that the family wants to be found.

UPDATE: Saturday, June 27--3:12 PM PDT: The name of the doctor has been confirmed by official sources. His name is Conrad Murray. Official sources have not yet confirmed news that he is a cardio-vascular specialist or whether he is properly licensed in California. Police repeated that he has been cooperative, and will hold a formal interview as early as Monday. As I suggested in yesterday's post, he is represented by counsel, which could explain the short "disappearance." He has been quoted as denying that he is in any way responsible for the death, but that is unconfirmed, and fully expected.


StlDan said...

Thanks Lawhawk, I also wonder how many claims will be made on the Estate for past and unreported cases of child molestation?

Unknown said...

StlDan: If they held off out of fear of Jackson's financial power, they may come in by the droves. And even when there has been a legal agreement not to talk, an underlying criminal act may void that contract, or modify its terms. I suspect we've only seen the tip of the iceberg.

AndrewPrice said...

Lawhawk, thanks for a very a detailed and intelligent discussion of the on-going process that we can expect. I haven't seen anyone else outline this. Indeed, the MSM seems more interested in tributes or wild speculation.

Nice work.

Unknown said...

Andrew: Thanks. Now I know why reporters get into trouble (well, at least should get into trouble). It's hard to sort through an avalanche of information and glean out only those things that are fact, or subject to genuine speculation preceded by a caveat that "this is just a wild guess." The simple truth is, we've only seen the very beginnings of what this is going to turn into.

Writer X said...

Independent publisher John Blake has already commissioned his biography ( Has it been 24 hours yet? Sheesh...

StanH said...

There was a report today that his debt was in the tune of Five Hundred Million, wow. His largest hard asset is the Beatles catalog that he has hocked to Sony Entertainment, I would recon that they would be first in line? If that’s true his real worth will take time to develop like Elvis or Hendrix who were both essentially broke at the time of their deaths. It’s going to be a real mess.

AndrewPrice said...

StanH, If it was a secured debt (by a lien), then chances are that they will receive the catalog and still have a claim for "the excess debt" against the rest of the estate. If not, they could be lumped with all the other creditors.

Ironically, now that he's dead, a lot of his own assets may have shot up in value, which may ultimately help his creditors.

In any event, his kids better hope that he had very smart people set up trusts for them, or they could be very poor, very soon.

Writer X, I am not surprised. I wonder how long it will take them to write the book?

Unknown said...

StanH: As Andrew said, there are so many nooks and crannies where money and debt are hiding that it's impossible at this time to decide what his estate is worth--if anything. Take a quick look at the Anna Nicole Smith case to get an idea. Secured creditors. Unsecured creditors. Future earnings. State courts fighting for jurisdiction. The federal courts, including the bankruptcy court making contrary decisions. Custody fights (actually for control of the estate). As Andrew said, I hope somebody somewhere had the good sense to set up unbreakable trusts for the kids, or they are going to find out what true poverty is like. Presley was broke, but Jackson was so far in the hole that any future earnings might also be wiped out by debt. He had the same understanding of economics that Obama has.

WriterX: I'm surprised it isn't already written, with just the final chapter to be completed. The vampires will be busy tonight.

BevfromNYC said...

Thanks Hawk. Great article as usual. Shocking as all of this is, is anyone really surprised at his sudden death?

Also I don't want to scare anyone, but you should know that just because someone is a doctor does not mean that they are trained in CPR or how to use an AED (automatic external defibillator). More often than not, they are trained to call 911 unless there are "Good Samaritan" laws in the state. I don't know any doctors (and I know many) who carry around AEDs. Liability risk is too high.

I would bet that Jackson did not have any kind of heart condition, but he was taking a lethal cocktail of prescription drugs. His lawyer all but screamed that at reporters in what little coverage I did see.

packerfaninbhc said...

Another untimely, but not unexpected, celebrity death. When will these flim-flam quacks be held responsible for these deaths? I cannot fathom how another talented person, such as Michael Jackson, was left in the medical care of a "doctor" who does not even know CPR!! As for all the meds that were allegedly found, I hope they set a precedent here and throw the book at any doctor that may have been over medicating Mr. Jackson because it was financially beneficial to do so.
If anything good is to come of this, i hope people finally realize that prescription drugs are just as deadly as street drugs, and the doctors that allow prescription drug dependency or dangerous mixtures, are drug dealers of the worst kind. They are TRUSTED.

StanH said...

I’m not sure of the numbers but Elvis has generated hundreds of millions since his death thirty two years ago, and his daughter sold the rights to Elvis recently for a hundred million, less with Hendrix but similar. Also you would guess that concert promotion company in Britain had Key Man insurance to cover their exposure, and I know we are pooling ignorance but, if Sony’s debt is secured with the Beatles catalog, and he has real good life insurance in a sick purely business overview he may be better off dead? One caveat that I haven’t heard is “suicide,” that would muck things up good? Lots of possibilities here.

patti said...

i wondered about the kiddos. knowing little info about the mom, i imagined the jackson's would assume custody. this is going to get ugly fast.

i also thought that his estate handlers (there's my sad attempt at legal lingo) must be sorry the house he died in was a rental. no turning it into another graceland. "and here's where he was administered the lethal does....allegedly." or burying him in the backyard.

BevfromNYC said...

StanH - Suicide was my first reaction, but then it also depends on your definition of "suicide". I think habitual taking a cocktail of lethal prescription drugs is suicidal, but, as one of my friends put it - Narcissists do not commit suicide.

AndrewPrice said...

Stanh, Any insurance held by the promoter will not be part of the estate. As for future earnings, the problem becomes that others may hold the rights. Again, only speculation, but if, for example, Sony owns the rights to his music, then they get the earnings from that music, and the estate gets nothing. We'll have to wait and see what he really "owned", but if he managed his affairs as poorly as it sounds, don't be surprised if the kids get a pat on the head and that's it.

Patti, if he didn't leave a will detailing where the children go, they will most likely be given to the mother by the state -- barring some nasty legal fight.

If you have kids, always always have a will.

packerfan, if this doctor was writing him all of the prescriptions I'm hearing about, then this guy is in real trouble. However, it's possible that Jackson was using different doctors to get his prescriptions -- I've had clients who do that. They would even visit ER's looking for pain medication.

Unknown said...

Bev: I think it does come as a surprise to most people that paramedics are better at emergency treatment in the field than most doctors. This may turn out to be slightly different in that this doctor appears to be a cardio-pulmonary board certified doctor in residence with Jackson. A G.P. with no prior experience with CPR or the particular patient would and should rely on the emergency medical teams. But this doctor was on-site, knew the patient and his history, and yet didn't have a portable defribillator available. Of course, we really don't know any of this for absolute fact, so I guess we should defer judgment for now. My question is "why there was a cardio-pulmonary specialist on-site in the first place?"

Unknown said...

Packerfaninbhc: The entire mess surrounding this death is indicative of just how dangerous hangers-on can be. The average guy trusts his own instincts, but celebrities seem to think that they're paying good money for these people, so someone will always take care of them. No such luck. As for prescription drugs, you are so right. That message is finally starting to show up on TV public service announcements. I hope they get that message across.

StanH: I think Andrew is probably right. Jackson probably wouldn't even think of life insurance, so what there was is probably owned by AEG to protect their interests (another reason they were paying for an on-site doctor?). As for the debt, we're a long way from knowing how bad it is. The figure that keeps getting thrown around right now is $500 million, and how much of his "future earnings" from the already-soaring sales belong to the estate is entirely unclear.

Unknown said...

Patti: From what is coming out right now, it seems he wasn't even renting the house. The promoters (AEG) were paying for that. Although the natural mother is entitled to the "rebuttable presumption" of custody, it's no guarantee of it. It will, indeed, be a battle royal. There's even a "surrogate parentage" issue involved.

Bev and StanH: Suicide is a possibility, but we're a long way from knowing with any certainty that this, or even an accidental self-administered overdose occurred. We've got a long wait, including the doctor's interview and the final toxicology report.

Unknown said...

Andrew: Please allow me to reinforce what you said. It can't be said enough. IF YOU HAVE KIDS, YOU MUST HAVE A WILL!

In California (and most states), the will cannot determine custody, although some weight can be given to the testator's wishes, particularly if it leads the court to find the other natural parent unfit. But when it comes to distributing the assets of the estate, it can be the difference between inconvenience and disaster. Hire a good estate planning attorney. And set up trusts. The kids in this case are likely going to be the subject of a bitter custody battle, but worse, there's a substantial chance they will also end up destitute if there were no trusts set up for their future.

Unknown said...

Andrew and Packerfan: I just remembered something from the Santa Barbara molestation trial. Three witnesses testified that at the "crime scene" huge amounts of dangerous prescription drugs were found in drawers and cabinets, both in and out of the notorious "kid's room." A large percentage of those drugs were found to have been prescribed by multiple physicians not associated with each other, and prescribed for persons other than Michael Jackson. Now I wonder how much of that type of thing will come up in the current investigation.

AndrewPrice said...


I don't remeber that particularly, but I can tell you that it is a common trick for addicts to use different doctors to keep them in the dark. Moreover, there is a very active "black market" in prescription drugs out there.

AcesAndEights said...

I've been reading yours, Andrew's and Bev's comments over at Big Hollywood. The last few days I noticed that Commentarama's posts were more on-point and better organized than theirs. The Jackson articles and comments over there were weird and not very well thought out. I commented on the lawyer's post over there because his article just threw a custody issue out that didn't go anywhere or answer anything. Hours earlier, your post had already covered it, and did a better job.

Unknown said...

Andrew: That black market includes too many kids. The public service announcement series I mentioned refers to that. There's a teenage boy organizing and marketing his parents' prescription drugs that he simply took out of the medicine cabinet.

AcesAndEights: I didn't get the point of that Big Hollywood column you referred to at all (apparently I wasn't the only one). Starting with the "Exclusive" it went downhill fast. First, it's an exclusive from a source that is about as reliable as Wikipedia. Then he breathlessly announces that Rowe will say that Jackson was not the father of their kids. A lawyer should know better than to publish that kind of salacious gossip when it has no legal value--only "shock" value. That's why I carefully pointed out, before he ever posted that column, that Rowe is the mother under California law, so it doesn't matter what she says about Jackson being the father. And besides, under California law, Jackson's the legal father anyway because the kids were born during the marriage. So what was the guy's point? That was National Enquirer material.

packerfaninbhc said...

LawHawk: Maybe i'm a naive, mid-western girl, so, this prescription drug thing has me perplexed. How is it that MJ (among others) gets all of these doctors to write him scripts under all of these ficticious names? Isn't a visit to the office for an examination and an evaluation of the patient's medical records a requirement before addictive, dangerous drugs can be prescribed? And, of course, i would hope if any physician did see MJ face to face, they would recognize him, know his name wasn't "John Smith", and not prescribe an alka seltzer to him in any name but his own. But, LawHawk, that's what is being reported and i just don't see how this kind of "care" is allowed to happen to such wealthy, connected people. Anyone else would be up on charges of prescription fraud, wouldn't they? Doctor and patient.
Oh, and you are so right about the hangers-on. The poor kids are going to be the object of the scum now. Can you believe that the CPS stated that they will be interviewing the children today or tomorrow (i can't recall) to ensure that they are not being exposed to any illicit drug use? Isn't the said illicit drug user DEAD? Way to be on the case California CPS!! You've known about possible prescription drug abuse by MJ since 2005's investigation. Perhaps, someone should be pointing a finger at the Santa Barbara's Sheriff Dept. and CPS for not following up on this issue THEN possibly forcing MJ to seek treatment to regain custody of his children that are such a concern of CPS now!! But, i'm sure that the media frenzy surrounding the serving of 2005's search warrant, and the excitement of arresting a twice accused celebrity pedophile would erradicate any concerns about the enormous amount of prescription drugs that were found during the search, or that the small children of the accused pedophile/drug addict might be in danger from suspected drug abuse by the father. Small potatos as far as publicity goes, i guess. It was only prescription drugs after all. No big deal, right?

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