The MJ Verdict: What It Means for MDs and You

The jury said (in my view): Conrad Murray practiced outside of his area of expertise – he gave anesthesia or sedation without appropriate monitoring or understanding of how to ventilate for someone who stops breathing after receiving a sedative or anesthetic (or multiple anesthetics and sedatives). If he had practiced appropriately, MJ would more likely than not have survived that episode.

Posted on | Mike Roizen, MD | Comments ()
 The MJ Verdict: What It Means for MDs and You
The MJ Verdict: What It Means for MDs and You

The jury said (in my view): Conrad Murray practiced outside of his area of expertise – he gave anesthesia or sedation without appropriate monitoring or understanding of how to ventilate for someone who stops breathing after receiving a sedative or anesthetic (or multiple anesthetics and sedatives). If he had practiced appropriately, MJ would more likely than not have survived that episode.

I really think the court confirmed one principle and established a new one:

1. The court confirmed: It is negligence when a doctor practices outside his area of expertise. All of us in the medical field know this.

2. It is criminal negligence (not just a civil or a monetary penalty) when a doctor practices medicine outside of his or her area of expertise and experience. Thus, practicing without appropriate diligence to that area being an area of expertise, places a doctor at criminal risk. But like most doctors I have talked with, I feel this lack of expertise has to be a clear breach of predictable experience and responsibility to the patient. In other words, if a patient develops a rare reaction and the doctor has only prescribed the medication eight times, then I feel criminal negligence is not evident (but civil may be). 

Lessons for YOU:

How does a doctor come to prescribe a new drug or try a new technique then? Pretty simple, the way we do now and have always done it – we are mentored in early use by another experienced doctor every time. 

When Mehmet was learning how to repair the mitral valve in a heart, he came to Cleveland Clinic and learned at the knee of a master, Toby Cosgrove. And younger docs have learned at the knee of Dr. Oz; he then watched them do a large number of surgeries before they did any on their own.

It’s the same with medications. When we first tested propofol, we researched it and tested it on animals, with the help of multiple anesthesiologists – even some from other countries where propofol had been used before. And, yes, both Dr. Shafer and Dr. White, the expert doctors who testified during the case, did it that way. Would I want it any other way? No!!!

So, be mindful. Ask your doc: Have you prescribed this pill before? How often? Have you done this procedure before? How often? If the answer isn’t more than 25 times, in my opinion, go for another doc.

This breach of predictable experience and expertise leading to criminal offense may be a relatively new judicial concept, but I think it should be applauded by patients and doctors alike. Above all else, check on your doctor’s experience before you walk in the door. 

Blog written by Mike Roizen, MD
Dr. Roizen is a past chair of a Food and Drug Administration advisory committee and a former editor for 6 medical journals with...