Investigators are focusing on at least five doctors who prescribed drugs to Michael Jackson as they try to unravel the circumstances surrounding the pop star's death, according to law enforcement sources.
Authorities removed drugs and other medical evidence from the Holmby Hills mansion where Jackson was stricken and are trying to determine whether the medications were properly prescribed and whether they played any role in his death.
The names on some of the prescriptions were Jackson pseudonyms, and in some cases, the drugs had no prescription labels on them at all, the sources told The Times.
One of the most significant clues so far is the discovery of what one source described as "numerous bottles" of the powerful sedative Diprivan at the home. The source, who spoke on the condition of anonymity because it is an ongoing investigation, said some of the bottles were full and others were empty. None had prescription labels, and investigators are trying to determine how Jackson got the drugs.
Diprivan is an extremely potent drug that is supposed to be dispensed by a person trained to administer anesthesia, such as an anesthesiologist or a certified registered nurse anesthetist, and it is typically used in hospitals. Experts expressed alarm that it would be used at a private home.
"It's a very dangerous drug if self-administered or administered by someone not trained in airway management and cardiac life support," said Ethan Bryson, an assistant professor of anesthesiology at Mt. Sinai School of Medicine in New York. "You need to have someone who knows what they are doing when they administer it."
Diprivan, the market name for propofol, is one of the most widely used IV drugs for general anesthesia. The product label from the U.S. Food and Drug Administration says a patient being given the drug should be monitored at all times for early signs of abnormally low blood pressure, low oxygen levels and stopped breathing. Problems with the heart or breathing are more likely to occur after rapid administration of the drug. The label states that equipment to provide artificial ventilation, supplemental oxygen, and cardiopulmonary resuscitation "must be immediately available."
It's unclear whether any of this equipment was found in Jackson's home.
Abuse of Diprivan is a growing problem, said Paul Wischmeyer, an anesthesiologist at the University of Colorado.
