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Exclusive - Jackson & Diprivan - FDA Issued Alert Two Years Ago

Posted by Jane Akre
Wednesday, July 01, 2009 10:43 AM EST
Category: Major Medical, Protecting Your Family
Tags: Diprivan, Anesthesia, Michael Jackson, Prescription Drug Abuse, Propofol, Painkillers

Diprivan was the drug Michael Jackson reportedly craved and was the focus of an FDA Alert two years ago.

IB News Exclusive - FDA Issued Alert On Drug Two Years Ago

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IMAGE SOURCE: Society for Ambulatory Anesthesia Web site/ Diprivan image

 

As the world prepares for Michael Jackson’s funeral, ABC News is reporting that his former nurse and Los Angeles nutritionist, Cherilyn Lee, says she refused Michael’s calls for Diprivan, a sedative he wanted to be able to get to sleep.

Lee also spoke to CNN’s Campbell Brown Tuesday after an exclusive interview with AP.

Lee says she rejected Jackson’s demands for the drug four days before his death, but feared somehow he had obtained Diprivan to induce sleep.

Diprivan is used primarily in hospitals to knock out patients. 

Lee says Jackson said he was extremely uncomfortable and desperate for sleep and she warned Jackson the drug could kill him.

"'I look at you Michael and I've been around you long enough now, I love you as family. I would not give this to anyone,'" Lee said she told Jackson. "I said, 'This is not a safe medicine, please don't take this.'"

Lee says four days before he died she urged Jackson to go to the hospital after he complained his body was alternately hot and cold.

“He was in trouble Sunday and he was crying out" she says.

He never went to the hospital.   She never saw him again. 

What is Diprivan?

In a hospital setting Diprivan, (also called propofol), a general anesthetic, is used to start or maintain anesthesia during surgeries.  Drugs.com reports you should not use the drug if you have allergies to medicines, foods or eggs.   It is commonly used in veterinary medicine as an agent of choice for use on small animals. 

AP reports, “An overdose of a sedative like Diprivan can cause a person to stop breathing, leading to a buildup of carbon dioxide in the body that ultimately leads to erratic heartbeat and cardiac arrest.”

IB News finds two years ago the FDA issued an Alert to inform healthcare professionals that several clusters of patients had experienced chills, fever, and body aches shortly after receiving propofol for sedation.  The agency tested several vials in the lots used to treat patients with those symptoms. The tests did not identify any contaminants in the vials.   

Dr. John Dombrowski, of the American Board of Anesthesiology, speaking to ABC News, says that the hot - cold feelings in the body could result from someone receiving IV drugs.  He says the patient risks respiratory failure and the collapse of the heart rate and blood pressure, especially if other painkillers and prescription drugs were involved. 

The toxicology tests, which could take up to eight weeks to conclude, should show what was in the singer’s system at the time of his death. 

Jackson’s personal physician, Dr. Conrad Murray says he never gave Jackson either OxyContin or Demerol. He has said nothing about Diprivan.   # 


33 Comments

Anonymous User
Posted by AriG
Wednesday, July 01, 2009 11:56 AM EST

Dr. Murray was staying at MJ's home to be with him 24/7, and was paid 150K per month! I don't believe he was hired to say no.

I read Murray's Texas medical clinic was closed and his MD partner lost his med license b/c it was a "pill mill".

Murray's story here is just completely unbelievable. Little wonder he hired some very good criminal defense attorneys.

Posted by Jane Akre
Wednesday, July 01, 2009 12:03 PM EST

We see this too often and people are suffering in silence, even people who can afford the best medical care in the world.

Please feel free to share your stories of addiction to prescription medication here.

Posted by Jane Akre
Wednesday, July 01, 2009 12:11 PM EST

Diprivan is reportedly becoming a deadly problem as abuse of the drug increases.

The problem is so severe that the May issue of Anesthesia News highlighted the problem, noting that 1 in 5 anesthesiology residency programs reported at least one case of abuse, reports surgery.About.com.


LINK

There is a narrow margin between a dose that works and a dose that kills.

Death from Diprivan abuse is not unheard of, it is believed that 40% of medical residents who abuse the drug die from an overdose reports surgery.about.com.

Anonymous User
Posted by Ed
Wednesday, July 01, 2009 2:59 PM EST

I'm a British Vet and to me it seems amazing that this drug can be abused.

Veterinary use is for very short term anaesthesia in cats and dogs, usually as an anaesthesia induction agent before transfer onto an inhalation agent for maintenance.

As far as I can see the effects of taking this drug yourself would be to fall asleep for a few minutes, then wake up and gradually regain all your faculties over about 10 minutes. Hardly something useful for insomnia?

Can anyone enlighten me?

Anonymous User
Posted by JILL PAUL RN
Wednesday, July 01, 2009 6:28 PM EST

Jane, I am shocked that Diprivin is abused in our society. At our hospital, this drug is only used by Anesthesiologists or in ICU or CCU as a sedative for a patient whose respirations are supported by a ventilator. Not only is the patient on a heart monitor, but also, a BIS monitor to control the depth of sedation. This is one drug (in my opinion) that should never be prescribed outside of the hospital or vetinary setting and used only for its intended purpose - never for insomnia.

Anonymous User
Posted by Linda RN
Wednesday, July 01, 2009 10:02 PM EST

I was shocked when I heard MJ requested this drug as a solution for his insomnia. This is not a drug that most people know about even if they have had surgery or been in ICU, because it is only used in those settings and is not even available by prescription. I hope it is not found out that a doctor who is supposed to use prudent judgement when it comes to giving patients medications, gave this drug to MJ in an inappropriate manner.

Anonymous User
Posted by JILL PAUL RN
Wednesday, July 01, 2009 10:26 PM EST

Linda, I too was shocked that MJ even knew about this drug. Where is the FDA on this one? They are trying to eliminate Vicodin and Percocet (2 very efficient pain killers used in hospital settings) and leave diprivan alone? I realize that the 2 aforementioned drugs are used outside of hospital settings and are sometimes abused but please, deiprivan should never be given to those who do not know what they are doing. It is a very dangerous drug in the wrong hands.

Anonymous User
Posted by Maria
Thursday, July 02, 2009 2:33 PM EST

My son got this (he was 4) when he needed an IV and the only place left was his neck. We were in the PICU and it was a very controlled situation. I can imagine taking this drug lightly.

Anonymous User
Posted by JILL PAUL RN
Thursday, July 02, 2009 4:13 PM EST

Jane, after reflecting on what I wrote yesterday re MJ & Diprivan, several important factors come to mind. 1) Since Diprivan is not a narcotic, it is not included in our narcotic drug count - or any count - for that matter. Since it appears that it is unavailable through an MD prescription, that does not say that any unscrupulous health care professional, could not provide the drug for monetary gain. 2) When I watched CNN last night and Larry King, thoughts came to my mind watching RN Cherilyn Lee while she described her relationship with MJ, asking for Diprivan etc. Is she in violation of the HIPPA Act? Only you, as Attorneys and members of Injury Board, can answer that question. I would like to hear your thoughts on that issue. In our hospital, we are extremely cautious on what information we divulge even to family members let alone the media. 3) Because of the Levine vs Wyeth case, we no longer provide Phenergan and use Zofran instead - even if the Doctor writes for Phenergan. Wouldn't it be purdent to start counting bottles of Diprivan now that the public has been made so much aware of this potentially lethal drug? Thanks.

Posted by Jane Akre
Thursday, July 02, 2009 5:08 PM EST

Jill-

Thanks for writing. I'm sorry I missed that interview on Larry King. It's fascinating how money doesn't buy you happiness or even good medical advice. Now a question for member attorneys- Do HIPPA restrictions expire when the person does???

It sounds as if Diprivan is not likely to be abused because few people have medical personnel on hand, whom they trust, to repeatedly administer it.

Anonymous User
Posted by JILL PAUL RN
Friday, July 03, 2009 4:00 PM EST

Jane - Does HIPPA restrictions expire when the person does? I was told today that, Yes, they do. He/She is considered a non-person at that point. What about Attorney/Client privilege? Does that expire when the client expires, as well? Would like to hear from members of Injury Board if this is accurate. Thanks.

Posted by Rick Shapiro
Friday, July 03, 2009 4:15 PM EST

Jane: Excellent reporting here on Diprivan.

No, as a lawyer, the attorney-client privilege would not simply evaporate when your client expired/died, especially if any disclosures had an possible adverse interest on your client's estate. As a matter of fact the US Supreme Court ruled in 1998 that the privilege survives death in Swidler & Berlin v. United States, 118 S. Ct. 2081 (1998.



There, the United States Supreme Court held that there is no posthumous exception to the attorney-client privilege for communications with substantial impact on criminal proceedings.
The Supreme Court stated that preservation of the privilege after death would be consistent with clients' best interests. Survival of the privilege would encourage the kind of open and frank communication between client and counsel which the privilege was intended to achieve. The court did discuss reputation, civil liability, and potential harm to friends and family, as other reasons.
Rick Shapiro/Injuryboard Regional Blog Editor
Virginia Beach/Norfolk/NE NC Injuryboard blogs.

Posted by Rick Shapiro
Friday, July 03, 2009 4:20 PM EST

Jane:
Note that I posted an article yesterday analyzing California State Board of Medicine policy statements on drugs for intractable pain, and other relevant CA medical board regulations.

The link is:

LINK

You might want to add it to the side panel on your story above....

Rick Shapiro
Va. Beach Injuryboard co editor.

Anonymous User
Posted by JILL PAUL RN
Friday, July 03, 2009 7:36 PM EST

Rick - What about HIPPA. Do you have a take on that and MJ'S RN and what she revealved? I personally would never have revealed that information. That is way too much. Thanks.

Posted by Rick Shapiro
Saturday, July 04, 2009 9:12 AM EST

Jane and commenter Jill RN:

So many attorneys and medical professionals are stunned by Cherilyn Lee's appearance and disclosures on CNN, so yes, I posted an article exploring HIPAA privacy of patients and whether the attorney client privilege survives death. Jane-another side panel click?
Click here or copy/paste this link to the Injuryboard article:

LINK

Anonymous User
Posted by "Carol"
Monday, July 06, 2009 4:46 AM EST

Isn't it amazing that the people discussing this issue with reason and rationality are on medical forums and while readers of gossip forums hang on to every word they're fed?

I have some insight into this situation and I can tell you all with 100% certainty that your suspicions of Lee correct. Though it's not about publicity or money. Every bit of information and everyone who comes out publicly serves a purpose to the family. I could elaborate but I'm sure you don't want this forum used for that, I just don't want you to waste any more time contemplating anything said by Lee.

Posted by Jane Akre
Monday, July 06, 2009 9:06 AM EST

Carol-

Go ahead inform us further. We're listening.

Anonymous User
Posted by Carol
Monday, July 06, 2009 10:58 AM EST

Well, I'll differentiate what I know from what I think. I know that Ms. Lee was sent to go public by the family. The findings of diprivan were also intentionally leaked by the family. This happens frequently with the Jacksons. Certain information is handed to the press to keep them satiated. Keep in mind, everything you see about diprivan is based on only two things: one source who said bottles were found and Ms. Lee's comments. A lot of money is at stake depending on the results of his autopsy. There are things that could void the insurance policy taken out him by the concert promoter. His family, and many other parties with a stake in his money, will say anything to keep these things quiet.

Now what I don't know but am wondering: It's my understanding that diprivan doesn't stay in the blood long enough to be detected by autopsy. Is that correct? And since it is NOT a controlled substance, what's the precedent on someone being held liable? Especially considering you can't prove it was associated with his death, even if it were.

Anonymous User
Posted by Jo -- no RN, no Esquire
Monday, July 06, 2009 2:48 PM EST

I second Carol's amazement.

However, I also add that it's often the "gossip" that first reveals the facts.
Especially, with cases in which the "reasonable, rational" folks are just too polite to mention the most likely scenario.

I'm not convinced that Jackson was using propofol for his supposed insomnia -- self-treatment, or otherwise.
But, I do feel it's relevant to better describe the drug, and the effects of it.

Certainly, propofol is not normally used outside the medical environment.
So, my first thoughts -- having heard it mentioned that Diprivan was found at Jackson's home --
were of the exotic animals that Jackson was known to be keeping...and the possibility that such a drug might be of great use, should one of those animals become uncontrollable, and thus, dangerous.

Then, when it was rumored that Jackson might have been self-medicating, against insomnia...
just as has been pointed out by Ed -- this is hardly the drug to use for a good, long sleep!

However, wouldn't propofol be a great example of the perfect "date rape" drug?
Short...deep....quick...and with little noticeable side-effects.
Add the amnesia factor, and my honest opinion -- albeit, not originating from within the traditional medical field --
would have to be that the three "Jackson children" should be provided with a
thorough medical examination, and soon.

Sadly, everyone seems to be more concerned about the overall condition of the dead, in this case...
than they are about the living.
~~~~~~~~

Anonymous User
Posted by Carol
Monday, July 06, 2009 7:57 PM EST

Gossip forums reveal... information. Forums where experts congregate (like, here) reveal facts.

If you hear hooves, think horses... not zebras.

Anonymous User
Posted by Jo -- no RN, no Esquire
Tuesday, July 07, 2009 11:28 AM EST

I agree.
After all, wasn't it the experts at "The National Enquirer," who first reported the love child of a certain 2008 presidential contender?

But, what has that to do with Michael Jackson?
Or even zebras, for that matter.

I suspect that I'm being politely told to 'make like water, and seek my own level.'
For indeed, I can claim no particular field of expertise...save a bit of old fashioned common sense, and a fair amount of street smarts.

I hold no medical degree -- yet, I have managed to save a life, or two.
I have no law license -- yet, have certainly noticed the glut of "experts," in that field.

So, before I bid you all a fond farewell...
to seek out a venue better suited to my own
station --
I will again attempt to communicate my grave concerns regarding the actual subject of this thread....and why I see, even through my own incompetence, good reason for "experts" in not only the medical and legal fields, but those in law enforcement, as well --
to be just as concerned.

The health, safety, and overall welfare of the three Jackson children should certainly take precedence over the toxicology report of a dead man...even here, inside the mortuary.

Up to this point, those kids have been the sole "property" of a single parent, with a questionable background, who has had more than one contact with the criminal justice system...involving minor children.

According to reliable sources, these kids have never been schooled outside the home, and have never been provided the opportunity to socialize with other children.
Their access to the outside world -- even television...has been referred to as "limited."

Not so long ago, the State of Texas forcibly removed nearly 500 children from their homes, placed them under foster care, and ordered that each undergo a medical, developmental, and psychological evaluation....due to an almost identical report of alleged abuses.

However, those particular reports came from an anonymous source...whom, as it turned out, had no
personal knowledge of -- nor, any direct connection to the children, or the accused.

In the Jackson case, however, the statements were made by friends and staff of Jackson....people who had actually been on the premises....
people who actually knew Jackson, and his kids.

Also, the three Jackson children stand to inherit a great deal of wealth...and are likely to become the focus of a very nasty custody battle.

Therefore, it would seem to me -- the professional outsider of this group --
that the Jackson children are in dire need of caring representation, from both the legal, and medical fields.

And now, I'll be utilizing that expert advice I've been so graciously awarded.
Sadly, I have little to offer, in kind....save this one minor detail --
zebras are hoofed, and they can run.

But, then again, I didn't expect you to be an expert in zoology. ;)

Posted by Nick Carroll
Tuesday, July 07, 2009 1:56 PM EST

Jo:

InjuryBoard encourages participation from everyone. Thanks for your input.

Anonymous User
Posted by Carol
Tuesday, July 07, 2009 4:15 PM EST

That proverb means only that shouldn't always assume the craziest explanation of something. The most obvious explanation is usually correct.

I think your comments - up until the zebra running - are pretty on point.

Anonymous User
Posted by Jo -- no RN, no Esquire
Tuesday, July 07, 2009 11:14 PM EST

Thank you, Nick.
Admittedly, I was getting a bit feisty.
And that's certainly no way to repay your hospitality.
I will try harder, from here on.

Carol, thank you, as well.
You are very diplomatic.
I do hope to learn from you.

Posted by David Stockton
Thursday, July 09, 2009 8:44 AM EST

Have read up a bit on Diprivan and according to some forensic websites Diprivan can be detected in hair and several body organs if the person used the drug frequently.

Anonymous User
Posted by latisha
Thursday, July 09, 2009 4:29 PM EST

I wanted to know during a regular autopsy,the test that are taken do they detect diprivan. The reaason why I'm asking is because Michael jackson died on thursday and autopsy was being done on friday, if I'm not misstaken Mrs. Lee came out three days after after it was done to say he asked her for diprivan. I think knowing how long this drug stays in your system is very important to the investigation. What also concerns me is after Mrs.Lee came forth, that is when the policy started the investigation and went though the house. however that was after the family had been though the house with moving vans. Another concern if the doctor didn't ride with Michael to the hospital and stayed behind even for a little while befor going to the hospital if he had give Michael diprivan why didn't he get reed of it? I sound like once agian michael jackson is going to be used,used though his death to set regulations on doctor giving medication to patients. Aren't there other thing that Michael could have done instead of using hard drugs that could have caused his death like Water pills? Another reason I'm say this is because didn't michael pass a medical exam.

Anonymous User
Posted by Ed
Thursday, July 09, 2009 6:13 PM EST

Off topic: please unsubscribe me from this list. The link at the bottom of the emails doesn't work! ( LINK ).

Anonymous User
Posted by Robert Peter Juan
Tuesday, July 14, 2009 4:45 AM EST

A doctor agreed with the family to not sedate a family member with the hypnotic/sedative diprivan/propofol, but he ordered a nurse to administered it anyways. I discovered the diprivan/propofol bottle in a garbage container and questionned the assigned nurse which the nurse refused to admit that diprivan/propofol was part of the therapy.

the person became very strange-have crakles in lungs, cannot swallow, and was sweating as if he had a pneumonia episode, and he had fever. He experienced cardio-respiratory depression on and off, severe edema from head to toes, hypotension, his heart rate elevated and dropped rapidly (tachy/bradycardia).
some nurses have no knowledge about how to monitor this Hypnotic/sedative, I believe.

Is diprivan/propofol abused in hospital settings as well-hell yes.

Lots and lots of patients died on this drug before the person I'm talking about and while in the hospital floor, feeding tube, ventilation, and in ICU. I don't think they should use this drug for agitation and for anaphylactic shock. Another patients next to the person I'm talking about received this drug for agitation and he experienced the same condition and died.

patients tend to stay in the hospital room with a certified nurse aid (a sitter that have no knowledge about monitoring diprivan/propofol in hospital floor). In ICU, nurses are at the nurses station and don't care about the beeping of medical devises to do what's right for the patient.
Based on the person's previous medical history, diprivan/propofol wasn't apprepriate.

A nurse forced the doctor to put the patient on this drug just because the family complain the staff and didn't want any family to be by the bedside.

The diprivan/propofol is labeled in the medical record though.

Latisha, I'm 100% sure that the diprivan/propofol may not be revealed in Michael Jackson's autopsies, but may be revealed in the toxicology instead.We don't know what Dr.Murray did to wash away this drug in MJ's system.

Being unconcious (patient cannot count) prior to administering it, having oxycontin-induced long deep-sleep episodes or being allergic to narcotics and Azo drugs, having drug-induced anaphylactic shock in the present or in the past, having arrhythmias, renal problems, having drug induced agitation or other agitation, panic attacks, apnea, breathing episodes prior and during administering it etc diprivan/propofol must have an absolute contraindication to these patients.

I strongly believe that diprivan/propofol contributed to that person's death; therefore, FDA should initiate a class I recall as soon as possible whether it kills Michael Jackson or not.

For a drug to be in the market, it has to be safe and effective. The benefits must outweigh the risks. diprivan/propofol is not safe. Its risks outweigh its benefit; Why not recall it. It kills many people in hospital as well.
There should be regulation on how doctors and nurses administer the knock out drug diprivan/propofol.

Michael Jackson may have an anaphylactic shock or agitation from heavy narcotics used and someone may administer diprivan to sedate him. That happens a lot in hospital settings. Pharmacists,doctors, enablers, pushers to perform on stage should be jailed, fined, and brought to justice.

Anonymous User
Posted by George Larynth Mae
Tuesday, July 14, 2009 5:02 AM EST

A patient was spitting on the hospital wall, pulling bed sheet, and couldn't stay still in bed. The person didn't want to eat and was put in feeding tube.
diprivan/propofol was used to calm the person down and he died while in the feeding tube with cardiorespiratory arrest, hypotension, and bradycardia.
How many people does this drug will kill?

Anonymous User
Posted by George Larynth Mae
Tuesday, July 14, 2009 1:16 PM EST

Diprivan/propofol is a dangerous drug when administering it both in hospital settings and on the street for some people.

why giving patients a drug that can put one in cardio-respiratory depression and death. why giving a drug to someone while health care professional cannot monitor it properly.

This is painful. some people worst off after taking it.

diprivan/propofol; is not safe. many men and women at the hospital shouldn't die from it.

stop treating people as animal for financial profit.

Anonymous User
Posted by Mae
Tuesday, July 14, 2009 1:42 PM EST

FDA,DEA, the medical board, state laws and the federal government fail patients so many ways.

doctors prescribed narcotics as candy. pharmacies deliver them without cooperating with doctors as candy.

a man fake an oxycodone prescription at a pharmacy, the pharmacist report the man and authority didn't do anything about it.

How does diprivan get in MJ's home?

Joe Jackson, MJ's father, claimed foule play. this is ended foule play.

I believe diprivan/propofol is more powerful than Oxycodone. Being allergic to oxycodone, diprivan is dangerous...the patient never woke up and died of bradycardia and cardio - respiratory arrest.

If this board really want to protect people, ask FDA to recall diprivan and oxycodone ASAP.

Anonymous User
Posted by mrs h
Tuesday, July 14, 2009 6:11 PM EST

I have used this drug to sedate cats. It works really quickly and wears off really quickly. I agree with the poster who says that the children should be medically examined asap.
The drug may not have been used on Jackson

Anonymous User
Posted by Jon
Wednesday, July 15, 2009 11:41 PM EST

Someone wrote a book and indicated that Michael Jackson had emphyzema.
I knew a person that took diprivan/propofol as well and developped emphysema out of the blue.

could this be a side effect or adverse reaction of diprivan/propofol that's not listed on the lable.
When taking this hypnotic/sedative, abnormal breathing is likely to occur.
I don't see any condition that could cause the person to develop emphysema-he never smoked.
I'm certain that someone administered diprivan/propofol on MJ-they use medical devises to control his breathing and oxygen level etc.MJ knew nothing about how to monitor this drug.why will he pay dr. Murray Comrad a six figure salary. I don't believe MJ administered this drug by himself. Someone else did.
multiple vials diprivan/propofol were found in the home.

what about doctors to not deliver medical records?

they must be guilty of something. The autopsy and toxicology shouldn't be released before all doctors delivers MJ's medical records-they might falsify the record depending on the auptosy and toxicology results.
Many people took this drug in hospital settings and they died.
This is a dangerous drug for the weak, elderly, children, addicts, and for those who are allergic to Narcotics, I think.

Comments for this article are closed.

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