Even if the toxicology report shows large amounts of prescription drugs in Jackson's blood, the district attorney's office may not file charges, the senior law enforcement official said.
If Jackson's death is determined to be the result of a heart defect or caused by decades of drug abuse, "probably you have no case at all," he said.
If propofol is determined to be the cause of death, he said, the district attorney's office is more likely to act. The anesthetic, which renders surgical patients immediately unconscious, is not designed for use outside the operating room, and it is unclear how Jackson obtained it and who may have administered it to him.
Vesna Maras, a former L.A. County deputy district attorney who prosecuted physicians and nurses in medical cases, said fatal overdoses can present a challenge for prosecutors when numerous doctors are prescribing drugs.
"If it is a combination of drugs, and these drugs . . . were coming from multiple sources, the argument can be made that the doctors did not know their patient was doctor-shopping. . . . That can make it really hard to prosecute," said Maras.
But, she said, that calculus can change when a drug such as propofol -- which is only meant for use by anesthesiologists -- is involved. If investigators determine that a doctor who wasn't an anesthesiologist administered the drug to Jackson without the required devices to assure proper breathing, "in that case, I would not rule out filing a murder case," she said.
In 2004, Maras prosecuted two Burbank nurses for involuntary manslaughter for administering the anesthetic to a cancer patient without authorization of an anesthesiologist. The patient died. One nurse pleaded no contest to a lesser charge. The other was acquitted.
Bryan Liang, executive director of the Institute of Health Law Studies at California Western School of Law, said he would not be surprised if prosecutors decided not to charge the doctors.
He said evidence in Jackson's death may be used more effectively in civil court or by the state medical board, which can strip doctors of their licenses.
"The medical care system has traditionally been regulated through civil cases, so juries generally don't like to find physicians criminally liable," he said. "They are happy to grant damages, but in terms of throwing a physician in jail, you really have to rise to really egregious behavior . . . and prosecutors recognize that."
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jack.leonard@latimes.com
harriet.ryan@latimes.com
Times staff writers Cara Mia DiMassa, Andrew Blankstein, Joel Rubin and Richard Winton contributed to this report.
