On June 25, 2009, American singer Michael Jackson died of acute propofol intoxication in Los Angeles, California, at the age of 50. His personal physician, Conrad Murray, said that he found Jackson in his bedroom at his North Carolwood Drive home in the Holmby Hills area of the city not breathing and with a weak pulse; he administered cardiopulmonary resuscitation (CPR) to no avail, and security called 911 at 12:21 p.m. Pacific Daylight Time (UTC–7). Paramedics treated Jackson at the scene, but he was pronounced dead at Ronald Reagan UCLA Medical Center in Westwood at 2:26 p.m.
On August 28, 2009, the Los Angeles County Department of Medical Examiner concluded that Jackson's death was a homicide. Jackson had been administered propofol and anti-anxiety benzodiazepines lorazepam and midazolam by his doctor. Murray was convicted of involuntary manslaughter in November 2011, and was released in October 2013 after serving two years of his four-year prison sentence with time off for good behavior.
At the time of his death, Jackson had been preparing for a series of comeback concerts, This Is It, that were due to begin in July 2009 in London, England. Following his death, there were unprecedented surges of Internet traffic and a spike in sales of his music. A televised memorial service, held at the Staples Center in Los Angeles, had an estimated 2.5 billion viewers. In 2010, Sony Music Entertainment signed a US$250 million deal with Jackson's estate to retain distribution rights to his recordings until 2017 and to release seven posthumous albums of unreleased material over the following decade, although only two were ever released.
Background
At the time of his death, Jackson was preparing for a series of comeback concerts, This Is It, scheduled to begin in July 2009 at the O2 Arena in London. On June 24, Jackson arrived for rehearsal at the Staples Center in Los Angeles at around 6:30 p.m. According to the magician Ed Alonzo, Jackson jokingly complained of laryngitis and did not rehearse until 9 p.m. Alonzo said that "he looked great and had great energy." The rehearsal continued past midnight.
Jackson returned to his home at 100 North Carolwood Drive in the Holmby Hills neighborhood at around 1:00 a.m. the following morning and went to bed approximately half an hour later. He had long suffered from insomnia and had a history of using drugs in an attempt to sleep. His personal physician, Conrad Murray, was present to help him sleep and administered various drugs including diazepam, lorazepam, and midazolam while monitoring him by his bedside. After several hours and multiple drug injections, Jackson remained unable to fall asleep and, according to Murray, repeatedly asked for "milk", a nickname for the surgical anesthetic propofol, which he had previously used as a sleep aid. At 10:40 a.m., with Jackson still awake, Murray relented and injected 25 milligrams of propofol diluted with lidocaine. Once Jackson was asleep, Murray testified that he left the bedside to use the bathroom. He returned two minutes later to find Jackson not breathing and with a weak pulse.
Murray testified that he attempted to revive Jackson for about 10 minutes by performing cardiopulmonary resuscitation (CPR) and administering flumazenil, a drug used to counteract sedative overdose, before calling for help from staff in the house. Statements described Murray using a non-standard CPR technique. The recording of the emergency call, released on June 26, one day after Jackson's death, described Murray performing CPR on a bed, not on a hard surface such as a floor which would be both standard practice and more effective. Murray said he placed one hand underneath Jackson and used the other for chest compressions, whereas standard practice is to use both hands for compression. Murray did not call 911; he said he was hindered by the absence of a landline in the house and by not knowing the exact address. It was later discovered that during the hour after finding Jackson not breathing, Murray made several private calls on his cell phone that he did not disclose to law enforcement. A security guard eventually called 911 at 12:21 p.m., nearly an hour and a half after Jackson was first found unresponsive. Paramedics arrived at 12:26 p.m. and found that Jackson was not breathing and had no pulse.
Paramedics performed CPR for 42 minutes at the house. Murray's attorney stated that Jackson had a pulse when he was taken from the house and placed in the ambulance. A Los Angeles Fire Department (LAFD) official gave a different account, stating that paramedics found Jackson in "full cardiac arrest" and that they observed no change in his condition en route to the hospital. Jackson was transported to Ronald Reagan UCLA Medical Center. The ambulance arrived at approximately 1:14 p.m., and a team of medical personnel attempted to resuscitate him for more than an hour. Their efforts were unsuccessful, and Jackson was pronounced dead at 2:26 p.m. at the age of 50.
Investigation
Autopsies Jackson's body was flown by helicopter to the Los Angeles County Coroner's offices in Lincoln Heights, where a three-hour autopsy was performed the next day (June 26) by the chief medical examiner, Lakshmanan Sathyavagiswaran. The Jackson family arranged for a private second autopsy, a practice that could yield expedited, though limited, results. After the preliminary autopsy was completed, Craig Harvey, chief investigator for the coroner's office, said that there was no evidence of trauma or foul play.
On August 28, 2009, the Los Angeles County coroner classified Jackson's death as a homicide, determining that he died from acute propofol intoxication, exacerbated by the anxiolytic lorazepam and, to a lesser extent, midazolam, diazepam, lidocaine, and ephedrine. The coroner kept the complete toxicology report private at the request of the police and district attorney.
The autopsy report stated that Jackson was otherwise healthy for his age and that his heart was strong; his most significant health issue was chronic inflammation of the lungs, though this did not contribute to his death. His other major organs were normal, and he had no atherosclerosis except for slight plaque accumulation in the arteries of his leg. The Associated Press reported that he weighed 136 pounds (62 kg) at the time of his death.
Law enforcement agencies Jackson's death was investigated by the Los Angeles Police Department (LAPD) and the Drug Enforcement Administration (DEA); the latter agency had the authority to investigate matters otherwise protected by doctor–patient confidentiality, allowing it to trace the complex trail of prescription drugs supplied to Jackson.
On August 28, 2009, the LAPD announced that the case would be referred to prosecutors. Because the LAPD did not secure Jackson's home and allowed the Jackson family access to it before returning to remove certain items, some observers raised concerns that the chain of custody had been broken. The police maintained that they had followed protocol. California Attorney General Jerry Brown announced that his office was helping the LAPD and DEA in creating a statewide database of all medical doctors and prescriptions filled.Finn, Natalie. "Jackson Doc On the Move Again as Investigation Continues With State Attorney, DEA's Help", E!, July 2, 2009.
The LAPD subpoenaed medical records from doctors who had treated Jackson. Police considered, but did not bring, homicide charges against those who had supplied drugs to him.
Drug use allegations Marc Schaffel, Jackson's former video producer, said that the singer had used propofol, alprazolam and sertraline. Other drugs included omeprazole, hydrocodone, paroxetine, carisoprodol, and hydromorphone. After his death, police found several drugs in his home, including propofol. Some of the drugs had labels made out to fraudulent names, and others were unlabeled. A 2004 police document prepared for the 2005 People v. Jackson trial stated that Jackson was taking up to 40 alprazolam pills a night. Alprazolam was not found in his bloodstream at the time of death. Jackson's friend A. J. Farshchian said that Jackson was scared of drugs.
Eugene Aksenoff, a Tokyo-based physician who had treated Jackson and his children on several occasions, expressed concern about Jackson's use of various drugs. He said that Jackson asked for stimulants to help him get through demanding performances, but Aksenoff refused to prescribe them. He recalled that Jackson had chronic fatigue, fever, insomnia, and other symptoms, and that he took a large number of drugs. He suspected that one of the major factors causing these symptoms was excessive use of steroids or other skin-whitening medications.
Jackson's sister Janet Jackson said that the family tried to stage an intervention in early 2007 when Michael was living in Las Vegas. She and some of their brothers allegedly traveled to his home but were turned away by security guards who had been instructed not to let them enter. He was also rumored to have refused phone calls from his mother. However, the family denied that they had attempted an intervention.
Propofol
Of all the drugs found in Jackson's home, the one that most concerned investigators was propofol (Diprivan), a powerful anesthetic administered intravenously in hospitals to induce and maintain anesthesia during surgery. Nicknamed "milk of amnesia" because of its opaque, milk-like appearance (and a play on "milk of magnesia"), the drug has been associated with cardiac arrest, but it still may be increasingly used off-label for anxiolytic and other medically unsubstantiated purposes. Several propofol bottles—both opened and unopened—were found in his home.
On June 30, Cherilyn Lee, a nurse practitioner who had worked as Jackson's nutritionist, said that he had asked her in May to provide propofol to help him sleep, but she refused. He told her that he had been given the drug before for persistent insomnia and that a doctor had said it was safe as long as he was being monitored. Lee said she received a telephone call from an aide to Jackson on June 21 reporting that Jackson was ill, although she no longer worked for him. She said she overheard Jackson complain that one side of his body was hot and the other cold. She advised the aide to send Jackson to a hospital; Lee believed she recognized the symptoms and suspected that Jackson was on propofol.
Arnold Klein said that Jackson used an anesthesiologist to administer propofol to help him sleep while he was on tour in Germany. The anesthesiologist would "take him down" at night and "bring him back up" in the morning during the HIStory World Tour of 1996 and 1997.
Medical professionals The DEA focused on at least five doctors who prescribed drugs to Jackson, trying to determine whether they had had a "face to face" relationship with him and whether they had made legally required diagnoses. At least nine doctors were under investigation. Police sought to question 30 doctors, nurses, and pharmacists, including Arnold Klein. Klein said that he had occasionally given Jackson pethidine to sedate him, but had administered nothing stronger and had turned his records over to the medical examiner.
Personal physician
Cardiologist Conrad Murray joined Jackson's camp in May 2009 as part of Jackson's agreement with AEG Live, the promoter of his London concerts. Murray first met Jackson in 2006 in Las Vegas when he treated one of Jackson's children. AEG Live said that Jackson insisted the company hire Murray to accompany him to England. During Murray's trial, it emerged that AEG employed Murray and that Jackson did not sign the contract for that employment.