<p>It said the cause was a mixture of the powerful anesthetic propofol and the anti-anxiety drug lorazepam, both of which, previously disclosed court documents say, Jackson’s doctor has acknowledged administering to him the day he died.<br />“The manner of death has been ruled: homicide,” the coroner’s office said in a brief statement. It said the full coroner’s report and a complete toxicology report were being withheld at the request of the police and the district attorney’s office, whose investigation continues.<br /><br />That investigation has focused on the role played by the last physician to treat Jackson, Dr Conrad Murray, a cardiologist who was acting as the entertainer’s personal physician at the time. Court documents filed by the authorities in July say they suspect him of manslaughter. Some of those documents, filed in Texas so the authorities could gain permission to search Dr Murray’s office and storage unit there, quote him as telling investigators that in the six weeks before death, he administered propofol intravenously to Jackson nightly to help him sleep. <br /><br />‘Gamesmanship’<br />On June 25, the day Jackson died, Dr Murray again gave him propofol, briefly left the bedroom of the star’s home here and returned to find him unconscious. Dr Murray has denied any responsibility for Jackson’s death, and the doctor’s lawyer, Edward Chernoff, criticised the coroner’s office on Friday for releasing only a brief summary of the autopsy results, telling The Associated Press that doing so seemed to him “gamesmanship.”<br />The office’s summary said that along with propofol and lorazepam, Jackson had several other drugs in his system, including midazolam, an anti-anxiety medication; diazepam, or Valium; lidocaine, a local anesthetic; and ephedrine, a stimulant and decongestant.<br />Propofol, normally used to anesthetise patients for surgery, is extremely fast-acting. Medical experts say if a patient receiving it is not carefully monitored with instruments that measure oxygen levels, blood pressure and heart rate, it can quickly cause problems.<br />“It affects your breathing and can cause significant diminishing of respiration, to the point where it could actually stop respiration,” said Dr Ken Elmassian, an anesthesiologist at Ingham Regional Medical Center in Lansing, Mich. “It can also drop your blood pressure and set up a scenario where your heart and brain’s not getting enough oxygen.”<br /><br />These effects can be compounded when there are other drugs in the system, especially those like lorazepam, a member of a class of medications called benzodiazepines. Benzodiazepines also slow breathing, and Jackson was given three different benzodiazepines in the six hours before receiving propofol, according to court documents.<br />As the coroner’s office issued its summary, Jerry Brown, the California attorney general, announced on Friday that his office had also undertaken an investigation into Jackson’s death.<br /></p>
<p>It said the cause was a mixture of the powerful anesthetic propofol and the anti-anxiety drug lorazepam, both of which, previously disclosed court documents say, Jackson’s doctor has acknowledged administering to him the day he died.<br />“The manner of death has been ruled: homicide,” the coroner’s office said in a brief statement. It said the full coroner’s report and a complete toxicology report were being withheld at the request of the police and the district attorney’s office, whose investigation continues.<br /><br />That investigation has focused on the role played by the last physician to treat Jackson, Dr Conrad Murray, a cardiologist who was acting as the entertainer’s personal physician at the time. Court documents filed by the authorities in July say they suspect him of manslaughter. Some of those documents, filed in Texas so the authorities could gain permission to search Dr Murray’s office and storage unit there, quote him as telling investigators that in the six weeks before death, he administered propofol intravenously to Jackson nightly to help him sleep. <br /><br />‘Gamesmanship’<br />On June 25, the day Jackson died, Dr Murray again gave him propofol, briefly left the bedroom of the star’s home here and returned to find him unconscious. Dr Murray has denied any responsibility for Jackson’s death, and the doctor’s lawyer, Edward Chernoff, criticised the coroner’s office on Friday for releasing only a brief summary of the autopsy results, telling The Associated Press that doing so seemed to him “gamesmanship.”<br />The office’s summary said that along with propofol and lorazepam, Jackson had several other drugs in his system, including midazolam, an anti-anxiety medication; diazepam, or Valium; lidocaine, a local anesthetic; and ephedrine, a stimulant and decongestant.<br />Propofol, normally used to anesthetise patients for surgery, is extremely fast-acting. Medical experts say if a patient receiving it is not carefully monitored with instruments that measure oxygen levels, blood pressure and heart rate, it can quickly cause problems.<br />“It affects your breathing and can cause significant diminishing of respiration, to the point where it could actually stop respiration,” said Dr Ken Elmassian, an anesthesiologist at Ingham Regional Medical Center in Lansing, Mich. “It can also drop your blood pressure and set up a scenario where your heart and brain’s not getting enough oxygen.”<br /><br />These effects can be compounded when there are other drugs in the system, especially those like lorazepam, a member of a class of medications called benzodiazepines. Benzodiazepines also slow breathing, and Jackson was given three different benzodiazepines in the six hours before receiving propofol, according to court documents.<br />As the coroner’s office issued its summary, Jerry Brown, the California attorney general, announced on Friday that his office had also undertaken an investigation into Jackson’s death.<br /></p>
