Official Katherine Jackson v AEG (2013 07 03)

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An upset judge said: This is my concern, we are 9 weeks in this trial and it's getting into mistrial territory. I don't want to go there!

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Judge: there's a ruling prohibiting any testimony, by any expert, on the issue!

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Panish: I know you're upset, I can tell that Judge: I'm not upset, I think it's entirely appropriate Panish: I told her not to do it

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Judge: This is your crucial, central issue in the case Mr. Panish. I'm surprised you had no discussion with her about it

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Judge said that violated the motion in limine regarding this issue. Experts are NOT to give their opinion on whether AEG hired Dr. Murray.

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Outside the presence of the jury, judge discussed with the attorneys about Jean Seawright's testifying yesterday that AEG hired Dr. Murray.

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Dr. Schnoll said some of the patients might have been addicted to Propofol, but others were just abusing it.

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Dr. Schnoll said he has treated tens of thousands of patients and only 5-6 were addicted to Propofol. These people were in the medical field

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The doctor agreed that some lay people could identify the symptoms as flu.

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Dr. Schnoll said most doctors would be able to put all the symptoms together and conclude it is opioid withdrawal.

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Some of opioids withdrawal include chills, running nose, tearing of the eyes, dilated pupil, goose bumps.

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The expert said people would recognize there was something wrong with MJ, but may not be able to recognize it as withdrawal from opioids.

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Dr. Schnoll said people get confused as to whether the patient is addicted or dependent of drugs.

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Cahan: There has got to be some amount of trust between doctor and patient? Dr. Schnoll: Right

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Dr. Schnoll: Well, of they came to me to treat addiction, they usually would come because they wanted to treat their addiction

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Cahan: Did some patients did not want to get treatment?

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Cahan: When you are evaluating a patient you rely on the patient being honest with you, correct? Dr. Schnoll: Yes

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Dr. Schnoll did not offer opinion whether the amount or type of drug MJ was taking for cosmetic and dental work was appropriate.

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"There was no evidence of addiction at that time," Dr. Schnoll said about MJ in 2009.

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Dr. Schnoll said he last prescribed Demerol in the late 1970s. He stopped treating patients in 2001.

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Dr. Schnoll: Probably not at all at this point, pain specialist would not keep Demerol handy

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Dr. Schnoll said use of Demerol for pain went into question in the '90s. Cahan: How common is for pain specialists to have Demerol handy?

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Dr Schnoll said Demerol is not commonly used anymore because it has other effects than just opioids, considered a dirty drug the doctor said

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Dr. Schnoll responded he didn't know, since he doesn't do these procedures.

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Cahan asked if it's common practice to use Demerol for Botox injections and facial fillers treatment.

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Just the fact that Dr. Klein injected MJ with Demerol doesn't raise concern of a relapse of Demerol dependency, Dr. Schnoll.

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Dr. Schnoll: If they have a severe pain problem that can only be treated by opioids, it is appropriate to give it.

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A professional doctor knows the difference between addiction and pseudoaddiction. (nurse juror nodding in agreement)

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Pseudoaddiction is when a patient is undertreated for pain, Dr. Schnoll said.

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Dr. Schnoll said doctor shopping is going from doctor to doctor to receive medication.

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There were weeks he put in 7-8 hours, some didn't do anything. He said it would be hard to estimate, spoke with plaintiff atty 10-15 times

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Dr. Schnoll said he has no idea how many hours he has worked in this case. He was retained back in January.

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Cahan said Pinney Associates is charging $790/hour for Dr. Schnoll's time.

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Dr. Schnoll works for Pinney Associates, he's a salaried employee and receives bonus at the end of the year, should there be one.

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Cahan: You were never hired as a doctor to accompany a band on tour? Dr. Schnoll: That's correct

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"I knew most of them and I knew them well," Dr. Schnoll said.

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Cahan asked if Dr Schnoll brought medical students to help him out. He said yes. She asked if he did background or credit checks on them

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Dr. Schnoll said he acted ethically at that job. He worked at rock concerts in the '70s.

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Cahan: Did you think that created a conflict of interest? Dr. Schnoll: As long as I acted ethically, I did not

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Dr. Schnoll said his primary duty was to treat concert goers. He was paid by the promoters.

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Dr. Schnoll said at times he was asked to treat performers, was hired to provide medical treatment at the facility to fans or artists.

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I know some people who worked at concerts, Dr. Schnoll said. He has been one.

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Cahan: Do you think it's ethical for doctors to go on tour? Dr. Schnoll: It depends on what they do when they go on tour with them

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Dr. Schnoll created the term "Rock Doc", referring to doctors who work on rock n roll concerts.

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Koskoff finished direct examination. AEG attorney Kathryn Cahan did cross examination of Dr. Schnoll.

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Dr. Schnoll said he's reading Richards' book, but hasn't finished yet. Defendant's objected to the doctor talking about it based on hearsay.

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Keith Richards and The Rolling Stones have been performing for 50 years. Richards writes in his autobiography about his drug addiction.

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If MJ got proper treatment, he would have like normal life expectancy, Dr. Schnoll said.

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Drug addicts can die early due to overdose; infections are very common, like HIV, Dr. Schnoll said.

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Dr. Schnoll: If appropriately treated, it would have no affect

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Koskoff: Assuming he was not addicted, but had periods of drug dependency, would that have an impact on his life expectancy?

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Dr. Schnoll agreed MJ had the means to get proper drug dependency treatment.

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Koskoff: Based on Mr. Jackson's family, do you know if any members of his family were addicted? Dr. Schnoll: I have no indication of that

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Dr. Schnoll: Some of the best outcomes in treatment are with people who have a lot to lose if they continue their addiction.

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"The autopsy said he was in really, very good condition," Dr. Schnoll told the jury about MJ.

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Having a supportive family and environment is critical in overcoming addiction, Dr. Schnoll explained.

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Dr. Schnoll: He could've been treated, he could've been treated if he had the proper people

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Koskoff: Let's assume MJ really was addicted to Demerol in 2009, do you have an opinion as to his prognosis for successful treatment?

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Koskoff: Assuming MJ was dependent, do you think proper treatment would be able to eliminate his dependency? Dr. Schnoll: Yes

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Dr. Schnoll said if MJ were treated appropriately for pain and sleeping problems, it would not have an effect in shortening his life.

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Dr. Schnoll: Should MJ have someone knowledgeable for treatment of pain, he could've been treated appropriately

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Dr. Schnoll testified MJ had two major problems: pain and insomnia.

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"He would've been able to continue to perform if he was appropriately treated for the underlying medical conditions," Dr. Schnoll said.

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Dr. Schnoll: If his underlying medical condition, pain, insomnia, had been appropriately treated, he may have been able to get off the drugs

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Koskoff asked if MJ were under the care of a competent doctor, would he have been able to get off the drugs, Demerol and benzodiazepines.

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"They pass catheters and look at hearts, which is totally unrelated to pain," Dr. Schnoll said about cardiologists.

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Dr. Schnoll: Dr. Murray was an interventionist cardiologist and that is a highly specialized field. He had no background in treating pain.

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Koskoff: Assuming AEG hired Dr. Murray, was he fit and competent to treat Michael's sleep problems? Dr. Schnoll: No, he was not

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Koskoff: Assuming AEG hired Dr. Murray, was he fit and competent to treat Michael's pain problems? Dr. Schnoll: No, he was not

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Koskoff: Was Dr. Murray competent to handle MJ's sleep problems? Dr. Schnoll: He was not competent

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Koskoff: Was Dr. Murray competent to handle MJ's drug dependency issues? Dr. Schnoll: He was not competent

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Koskoff: Was Dr. Murray competent to handle MJ's pain? Dr. Schnoll: He was not competent

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The hospital computer overloaded with people trying to get information on what happened with Sinatra, Dr. Schnoll said.

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Dr. Schnoll said once Frank Sinatra went to the hospital he worked after collapsing on the stage.

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Sometimes prescription is given under other people's names, Dr. Schnoll said, since celebrities often don't want people prying their records

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"If you are dependent, you could have some insomnia if you go off of it," Dr. Schnoll testified.

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Koskoff: What does Demerol do to sleep? Dr. Schnoll: When you are taking it, it could make you sleepy

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He also said this drug would not have had effect on MJ on June 25.

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Dr. School said there was no trace of the drug in MJ's body at the time of his death.

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The very last Demerol injection MJ received from Dr. Klein was on June 22, 100 mg dose, according to the records, Dr. Schnoll testified.

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Koskoff: Is there a record MJ was getting Demerol from any other doctor? Dr. Schnoll: No

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Dose went up in January 2009. Dr Schnoll said if a person was previously dependent on Demerol, stops and then resumes, tolerance is built up

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Dr. Schnoll talked about Dr. Klein giving MJ 100mg doses of Demerol in 2008. He said from mid-year to December it was the same amount.

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Dr. Schnoll said Propofol is not appropriate to treat insomnia, even if MJ suggested it.

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Koskoff asked if there was any evidence MJ was addicted or dependent of Propofol up until Dr. Murray. Dr. Schnoll said no.

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Dr. Murray used Propofol for sleep, which Dr. Schnoll said was inappropriate. "Plus, he was not an anesthetic or an anesthesiologist."

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The drug was used for dental procedures and cosmetic treatment, Dr. Schnoll said, adding it was appropriate for that.

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Between 1994 and 1996, Dr. Schnoll saw no evidence of any use of Propofol by MJ under any circumstance.

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Koskoff: What kind of specialist was on that tour for Michael? Dr. Schnoll: He was anesthesiologist

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Dr. Schnoll testified Debbie Rowe said yes, but she wasn't sure if it was Propofol or Fentanyl. He didn't think Rowe was a licensed nurse.

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Koskoff showed a timeline and asked if there was any record MJ received Propofol during the Dangerous tour in 1994.

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Propofol is the most popular anesthetic in the world, Dr. Schnoll said. Propofol is the generic term.

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Dr. Schnoll said after the Propofol infusion stops, the effect wears off quickly.

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"Typically, they steal it from operating room or critical care unit or inject it in a home, or a bathroom," Dr. Schnoll explained.

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Dr. Schnoll treated patients addicted to Propofol. They were health technicians and none had it administered by another person.

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Koskoff: Did he use it for sleep? Dr. Schnoll: Yes K: Is that appropriate? Dr: Yes K: Did MJ have a sleep problem? Dr: Yes

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Dr. Schnoll said MJ was prescribed Midazolam and Versed which is commonly for short term surgical procedures, dental procedures.

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Koskoff: Was there a time MJ did take benzodiazepines? Dr. Schnoll: Yes

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Dr. Schnoll: I don’t know if MJ was an addict. I haven’t seen the information that would allow me to make a diagnosis of addiction

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Koskoff: On Dangerous tour, was MJ getting opioid drugs according to Dr. Finkelstein? Dr. Schnoll: Yes

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Dr. Schnoll talked about the surgery MJ to repair damage to his scalp.

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The expert said he saw evidence MJ was afraid of needles; didn't take medications in excess of what was prescribed by doctors.

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Dr. Schnoll said he saw no evidence that MJ ever used recreational drug or self-injected in the absence of a doctor.

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Koskoff: Do you agree with that opinion? Dr. Schnoll: No

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Koskoff asked if Dr. Schnoll read testimony from Dr. Earley saying MJ was a drug addict and that he was going to die early.

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Koskoff asked if that was consistent with a drug addict. Dr. Schnoll answered no.

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Koskoff said based on the medical records in the last 16 years of MJ’s life, he was Demerol free for 13 1/2 years.

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The patch was done for treatment of Demerol dependency in early 2000s. The drug would block the effect of the opioid, Dr. Schnoll said.

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Dr. Schnoll said he reviewed medical records that Dr. Farshian implanted a patch into MJ's abdomen.

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Koskoff: Was there a period of time when MJ used Demerol for scalp treatments? Dr. Schnoll: Yes

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Koskoff: Any evidence from any witness that MJ used Demerol outside the medical setting? Dr. Schnoll: No

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“Opioids are most popular because they work," Dr. Schnoll said. "Pain is the most common complaint that comes to a doctor's office.”

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Dr. Schnoll explained pain threshold is the level at which someone feels discomfort. They are quite variable, he said.

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Dr. Schnoll: The figures indicate 10 to 12% become addicted, the same percentage of people who become addicted to alcohol.

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Some patients become addicted, Dr. Schnoll said. But it's not s large percentage.

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Dr. Schnoll: if they're on long term opioid treatment, they'll become dependent. Opioids are the most commonly prescribed drugs in the US.

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Koskoff: If a person is being treated, as part of good medical practice, can someone become drug dependent?

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Dr. Schnoll said addiction can also be treated by competent and fit physicians.

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Koskoff: Any famous people who have been opioid dependent? Dr. Schnoll: President John F. Kennedy (Judge asks why?) Back pain.

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If a person has underlying condition and take opioid they could function better, Dr Schnoll explained. There's no harm in doing it medically

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Koskoff: What if a person has chronic osteoarthritis? Dr. Schnoll: May have remain on medication all his life

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Dr. Schnoll said the most important factor in determining if the person should go off the drug is to find out what the underlying problem is

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Methodone is an opioid drug used for pain and treatment of opioid addiction. Dr. Schnoll explained how the drug works.

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Koskoff asked if you take someone off Demorol suddenly what happens. Dr. Schnoll: “like falling off a cliff, you don’t want that to happen.”

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Katherine Jackson was present in court wearing a long periwinkle jacket and pearl earrings.

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Addiction specialist Dr. Sidney Schnoll resumed testimony. Jackson's attorney Michael Koskoff did direct examination.
 

Jingles

New member
Thank you for the news. I've been trying to follow this trial the best I can. Some of the news is troubling, like the state of Michael's health. This is one verdict I will be waiting on.
 
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