Dr.

Petros Levounis(Addiction Specialist)

(The following proceedings were held in open court outside the presence of the jury:)
Judge. Good morning. Welcome back. Did you want to talk to me about the designations?
Mr. Panish. No. This is on the witness that's up right now. Dr. Levounis is his name. Do you have a copy?
Ms. Cahan. You should, your honor. It's the chart that says propofol for sleep. It's not in those records. There
should be a set of slides as well. This is a mini printout.
Judge. Propofol for sleep.
Mr. Panish. Okay.
Judge. Is this all one?
Ms. Cahan. These are two different boards, your honor.
Mr. Putnam. There are two boards, yes.
Ms. Cahan. Then this is a set of slides that's put together. Then there is one other exhibit.
Judge. This is all part of Levounis's testimony?
Ms. Cahan. Yes. I think it's just this propofol for sleep board they are concerned about.
Judge. Tell me.

Ms. Cahan. While they are getting organized, your honor, he wasn't designated as a propofol expert. He's not
designated as a life expectancy expert. He said at his deposition he has not treated propofol addicts. We're not
asking him to render an opinion outside the scope of his deposition. At his deposition, he talked about secrecy
and doctor shopping he saw in Mr. Jackson's use of opioids where he does express an opinion about addiction,
benzodiazepine and propofol, and he is going to use this chart to illustrate doctor shopping and secrecy evidence
that he believes relates to Michael's use of propofol or attempt to use propofol for sleep.
Mr. Putnam. Obviously, all the things on the bottom show where the testimony is from. We've indicated on
the bottom where all of the testimony from the various witnesses otherwise came from.
Judge. I see.
Mr. Putnam. This is --
Ms. Cahan. This is all in evidence or medical records that we believe should be in evidence.
Mr. Panish. Now that I'm objecting, can I state the grounds for -- they have already argued their side. In this
deposition, page 91, line 16, the witness was asked -- that's records.
Judge. Read it to me.
Mr. Panish. "are you assuming for purposes of your opinion in this case that Michael began using propofol on
a certain day on a regular basis, is that relevant to -- is that a relevant factor opinion?" answer, "I've not really
focused on the propofol side of Michael Jackson's medical issues." "if you don't -- if you aren't going to talk
about propofol in terms of your opinions, then I don't have to ask about it." Ms. Cahan, "just to be clear, we're
not designating him as an expert on propofol or life expectancy. This is outside the scope of his being here."
question, "so you are not here to talk about whether or not Michael had a propofol addiction?" Ms. Cahan,
"correct." answer, "you can answer, sorry." "I wouldn't -- that's not the focus of what I'd like to testify on, or I'd
like to render opinion." so we were asking specifically -- and I can keep going on -- about the propofol, and they
said, "no, he's not going to use it. He didn't use it for any of his opinions." and now we've been sandbagged
again when we asked him specific questions in the deposition and he says no, and there is nowhere in the
deposition where he brought this to his deposition or that he said this was the bases of any of his opinions.
Ms. Cahan. Your honor, this isn't about propofol addiction. He's not going to be expressing an opinion about
propofol addiction. What he did make clear at his deposition is that he'd reviewed all the materials, that he was
expressing general opinions about Michael's behavior with respect to drugs and secrecy and doctor shopping.
We did one of these one-page lists of sort of notes of elements of his opinions that we made an exhibit to his
deposition and turned over. Under the category secrecy of addiction in general, MJ in particular, there is a bullet
that says "propofol abuse incredibly rare." it was something discussed. But this testimony just read was about
"are you opining on propofol addiction?" he said, "no, that's outside of my scope." but he can -- and this is
probably max five minutes of my exam with him, but he can show how this pattern of the behaviors associated
with opioid addiction are also seen in the attempts to get propofol for sleep.
Judge. Did he testify to that in his deposition?
Mr. Panish. No, no.
Ms. Cahan. Yes, he did.
Mr. Panish. I mean, I just read you the questions on propofol.

Mr. Putnam. But the questions he read, "will you be talking about propofol addiction?" that, he absolutely is
not doing. As an addiction specialist, if you look at patterns and behavior, what patterns and behaviors speak to
the idea of addiction and, also important to this case, shows those very patterns are things that make it difficult
to be able to ascertain what is wrong with the person.
Mr. Panish. Your honor, the question had nothing to do with addiction at page 91, line 16. "assuming for
purposes of your opinions, using propofol on a regular basis, is it relevant to any fact in any of your opinions?"
it wasn't addiction. We did ask that specific question. When he says no, what are we supposed to do?
Judge. Does he mention propofol at all in the rest of the deposition?
Ms. Cahan. Yes, he does, your honor.
Mr. Panish. He doesn't say it's one of these bases at all.
Ms. Cahan. Your honor, what happened in the deposition is plaintiffs' counsel asked about certain things. I
went back to make sure he was able to express all of his opinions for the record and cover that. I'm look up the
additional testimony on that. So he's asked 160 at page 10 --
Judge. What are his opinions? Let's go back and explain what are his opinions.
Ms. Cahan. It's in the slide, your honor. It's slide -- in that packet we've put together, it's slide four. These are
the same as the opinions he's disclosed at his deposition.
Judge. Michael Jackson addicted to opioids.
Ms. Cahan. Engaged in doctor shopping primarily with respect to opioids and also in respect to
benzodiazapines. He was secretive about his medical care, apparent drug use. He expresses an opinion of
addiction on opioids but talking about the classes of drugs that are prominent in Michael Jackson's medical
history, and then this issue of proper boundaries which you've heard about in talking about friendships with
doctors. And that is exactly what was disclosed and discussed at his deposition.
Judge. So where is he -- okay. The doctor shopping and the secretiveness.
Ms. Cahan. Yes.
Judge. But where in the deposition does he talk about that?
Ms. Cahan. He talks --
Judge. If that's part of his opinion, it should be explored even if the plaintiffs didn't. If you brought it out, then
it was incumbent upon them to further explore it as long as it's brought out somewhere.
Ms. Cahan. Yes, your honor, and it was. There was some discussion on questioning by plaintiffs' counsel at
page --
Mr. Putnam. Our numbers aren't lining up. That's why we're -- they are a little off. Sorry.
Ms. Cahan. At page 121, he's sort of going through this list, and plaintiffs' counsel asked "secrecy is under the
category of addiction behavior" --
Mr. Panish. What line are you on?

Ms. Cahan. 121, line 8. He says "correct." question, "correct. So all these bullets fall under the examples of
behaviors of addicts that are characteristic." this is -- would it be helpful for your honor to be able to see what
they are talking about?
Judge. Okay.
Ms. Cahan. And the answer is "yes, things that help the secrecy and create a bigger problem for the addicted
person -- " the question -- he's cut off. The questioner says, "I think we've covered that to our satisfaction." so
they see that there, and they stopped asking about it.
Mr. Panish. Your honor, that --
Mr. Putnam. The basis -- they say "we're not going to ask any more about this."
Mr. Panish. He says rare. According to this, it wouldn't look rare. We asked before is it relevant for any of his
opinions. He says no. Clearly, there is not a place where he said this -- all these instances -- this is created after
the fact, after his deposition. It's basically a summary of argument of counsel. They can argue that at the end of
the case. This witness didn't give this opinion, and he didn't rely on this for any of his opinions.
Judge. Look for it.
Ms. Cahan. Your honor, page 56 of the deposition, he's asked about -- he's expressed a point on opioids and
asked about any other substances to which Michael was addicted in that time frame. He says "there is propofol
use as well, and that was quite prominent." question, "and that rises to the level of an addiction?" answer, "it
seems like there is an addiction as well." question, "and what do you base that on?" "the frequency with which
he'd be using the propofol, also the overall deterioration, the overall difficulties he had in missing appointments,
not being able to function at 100 percent." he's not expressing that as a formal opinion but --
Judge. It was discussed in the deposition.
Mr. Panish. Then we ask him "is it for any relevance?" "no." they say he's not giving opinions on propofol
addiction which no one says he was addicted to.
Mr. Putnam. Your honor, it goes to he talks about patterns. We provided this one page where he talks about
the various patterns that are there, and he uses this as an example just precisely how he's using it here today. It's
indicative of his other opinions. He's allowed to provide things that were the basis for those opinions. He's
provided it thereby which they were provided for in the deposition. It wasn't created after the fact.
Judge. I'm asking you to show me the deposition --
Mr. Panish. We asked him specifically.
Judge. -- where he's talking about these incidents of propofol that support the secrecy that support these two
opinions, doctor shopping and secrecy about medical care?
Mr. Putnam. Your honor, if I may. One of the things that -- certainly, too, in the case of the demonstrative that
you've been provided, he talks about the testimony that's been provided at trial that provides further evidence of
the things that he has testified to as to his opinions at his deposition. What that summarizes there are those very
things which every single expert has done here. Every single expert that has come to speak has rightly been able
to say I have things that further bolster what my opinions were, and these are things that have been shown here
at trial. And that's -- if you look at things like what Debbie Rowe said, etc., talk about these things that come out

at trial. That's what the demonstrative demonstrates. He wouldn't be able to talk about that previously. He's now
saying at trial is an example of his opinion.
Judge. That would be fine if Michael engaged in doctor shopping, and he says somewhere there is an example
of that with respect to propofol.
Mr. Panish. He doesn't.
Judge. If he doesn't identify anything about that in the deposition, this would not be further evidence of
anything unless it was explained somewhere in the deposition. Now it sounds like he went through it in detail
with respect to the opioids. It sounds like he's covered with the opioids.
Mr. Panish. Not really but...
Judge. Mr. Panish, please.
Mr. Panish. I'm sorry.
Judge. It sounds like this is great for closing. If he didn't explore this, not even an example of this in the depo,
I don't see how it can be admitted.
Mr. Panish. If he had all of this information at the time of his deposition, this isn't new information.
Judge. Frankly, you can still argue that he engaged in doctor shopping with respect to propofol. You can still
argue that he was secretive about his medical care with respect to propofol.
Ms. Cahan. That's fine. We won't put up the demonstrative, your honor. This is all evidence that's in the record
now that he had reviewed -- that he's reviewed and considered. It's things people have come in at trial and
testified. It's additional support for the existing opinion that he offered. To be clear in his deposition, when he
was talking about doctor shopping and secrecy, he wasn't limiting it to "I only saw that with opioids." he's
talking about in Michael Jackson's entire medical record, all the doctors he saw. He was getting opioids from
some of the same doctors he was getting benzodiazapines from. There is not a complete enough record to
express an opinion on addiction with respect to anything other than opioids in his view. But he does talk about
the totality. It's the behavioral aspects of how Michael was going to doctors, using doctors, the things he was
saying. Some of those do relate to propofol.
Judge. Let's look at it.
Ms. Cahan. At page 90, he's being asked about propofol use, and he says, "I suspect from the beginning of his
use of propofol and the setting" --
Mr. Panish. What line?
Ms. Cahan. 13. " -- in the setting he started using it, meaning outside of the general anesthesia of major
surgical operation" --
Mr. Putnam. In other words, where it's not for general use but for sleep use.
Ms. Cahan. "it's very likely that he suffered from an addiction to propofol rather quickly." question, "I don't
know that that quite answered my question, so let's just go back. Are you aware of certain sporadic occasions
when Michael used propofol prior to April 2009?"

Mr. Putnam. This is plaintiffs counsel asking the questions. She objects.
Mr. Panish. She objects "outside the area of a medical procedure."
Mr. Putnam. "outside the context of the medical procedure."
Mr. Panish. Then it goes right to the question we just read to you. If we go back, your honor, if I could --
Ms. Cahan. May I finish?
Judge. Finish.
Ms. Cahan. Plaintiffs counsel says "no, I'm just asking the question. Are you aware of sporadic uses?" the
witness says "I am. I'm aware of his using propofol before, but I cannot recall right away from the record when
was the first time he used propofol or the first incident in the chronology of records when I can see that." he's
asked question, "when did he begin to use it on a nightly basis, approximately?" I object. The witness says "I
don't recall." and then question, "are you assuming for the purposes of your opinions in this case that Michael
began to use propofol on a certain day, on a regular basis? Is that a relevant fact to your opinions?" and then he
says -- he hasn't really focused on the propofol side of Michael Jackson's medical issue and that leads to
discussion.
Judge. I think it's excluded.
Mr. Panish. I mean, all of that.
Mr. Putnam. Let us talk to him so he understands.
Judge. Okay. Opioids and benzodiazepines, fine.
Mr. Panish. He didn't give any opinions on that.
Judge. He specifically says later he's not giving an opinion about it. He's not giving an example about
propofol. And the two opinions concerning doctor shopping or being secretive concerning propofol...
Mr. Panish. May I ask a question for exhibit 13079. What is the source of this?
Ms. Cahan. That is the American Psychiatric Association, I believe. What slide is that?
Mr. Panish. Slide number five.
Ms. Cahan. That's just --
Mr. Putnam. Your honor, may I approach so I can take it out of his packet?
Judge. Yes.
Mr. Putnam. I don't want him to see something up here he's not supposed to be using.
Judge. Like I said, it can be used. The chart and the evidence is -- arguments are all there. I just don't think it's
appropriate of this witness.
Ms. Cahan. DSM-44. It's the one that was in effect in 2009 when Mr. Jackson passed away.

Mr. Panish. The TR version.

Ms. Cahan. He will know. I don't know. It's the one in effect as of 2004.
Mr. Panish. Can you ask the source of that. Is that in his exhibits, his depo or anything?
Ms. Cahan. It's exhibit -- I think it's exhibit 4.
Mr. Panish. It doesn't say the source though. This is different.
Ms. Cahan. I'll go ask him if you'd like me to step out.
Mr. Panish. That's fine. This is not in this exhibit 4. I don't know the source of -- if you can talk to him.
Ms. Cahan. Sure. It's an existing trial exhibit. I'll double check.
Judge. Do you have another issue?
Mr. Panish. Well, maybe. I'm trying to work it out.
Ms. Cahan. DSM-4 he said the language on the text, the actual explanation changed between DSM-4 and
DSM-4 TR, which is text revised.
Mr. Panish. Before, what I thought was referred to in his deposition is not the same thing. Maybe we can just
ask him. This is not from TR, and this is not from four.
Judge. Talking about the slides.
Mr. Panish. Yes, slide number five, criteria for determining drug addiction, and it doesn't give a source. It
gives seven factors or criteria.
Mr. Putnam. That's not the source?
Mr. Panish. Well, that might be, but where does the information on that exhibit come from? That's the
question. Is it DSM-44? DSM-4 TR? Do you understand my question?
Judge. Do you want to call him in before we call the jury in?
Mr. Panish. We can do that.
Judge. Do you want to bring him in? You can ask him now before we -- without the jury being in.
Mr. Putnam. Right, right. The process, I mean.
Judge. Dr. Levounis, before we call the jury in, I think there was a question about some foundation regarding
addiction. One of these slides, where you discuss addiction -- criteria for determining drug addiction. I think
Ms. Cahan represented it came from DSM something. We wanted you to clarify it before we call you on the
witness stand.
Witness. This paper here lists the criteria for substance dependence of DSM-4 and DSM-4 TR. TR stands for
text revised.

Mr. Panish. Can I ask?

Judge. Go ahead.
Mr. Panish. Doctor, so what I'm referring to is slide 5. Are you familiar with this?
Witness. Yes.
Mr. Panish. Where it says "criteria for determining drug addiction," this is exactly what it says in the DSM-4
TR?
Witness. No. It says -- somewhat, for example, there are more words in the actual definition which is this
piece of paper here. This is more of my summary of this.
Mr. Panish. This says "determining drug addiction in the DSM-4 TR?"
Witness. No. It says "substance dependence." I'll be happy to explain.
Judge. Do you have a copy of whatever he's looking at?
Ms. Cahan. Exhibit to his deposition.
Mr. Panish. So in other words, drug addiction in the DSM-4 TR doesn't say that, does it, "criteria for
determining drug addiction"?
Witness. DSM-4 says "substance dependence." nowhere in the DSM-4 or DSM-4 TR does the word
"addiction" show up.
Judge. That's something to explore on cross. That's something --
Mr. Panish. But it's not in the -- that's my point. They represented something, but it's not what is in the --
Ms. Cahan. It's a demonstrative we prepared sourced from the exhibit to his deposition which is from the
DSM-44.
Mr. Panish. Then say that and not represent this is from the DSM-4 because it's not.
Ms. Cahan. It's sourced from the DSM-4 as a demonstrative.
Judge. Overruling your objection. You may use the slide. You can remain in here.
(THE FOLLOWING PROCEEDINGS WERE HELD IN OPEN COURT IN THE PRESENCE OF THE
JURY)
Judge. Defendants, you may call your next witness.
Ms. Cahan. Your honor, at this time, defendants call Dr. Petros Levounis.

Judge. Thank you. You may begin.

DIRECT EXAMINATION BY MS. CAHAN
Q. Good morning, Dr. Levounis.
A. Good morning.
Q. What do you do for a living?
A. I'm a physician.
Q. Do you have a specialty?
A. Yes.
Q. What do you specialize in?
A. Specialize in psychiatry and I have a sub-specialization in addiction psychiatry and addiction medicine.
Q. You're here to testify as an expert witness for defendants, correct?
A. Yes.
Q. Before we get into the opinions you've formed about this case, let's talk a bit about your background. Where
did you go to college?
A. Stanford University.
Q. What year did you graduate?
A. In 1986.
Q. And what degree did you receive?
A. I received a bachelor's degree in chemistry and biology and masters degree in biological sciences with
emphasis in biophysics.
Q. Did you graduate with honors from Stanford?
A. Yes.
Q. Were you Phi Beta Kappa?
A. Yes.
Q. What did you do after you finished college?

A. I went to medical school. I did my basic sciences, years at Standard University School of Medicine and my
clinical years at the Medical College of Pennsylvania.
Q. And what year did you graduate from the Medical College of Pennsylvania?
A. 1994.
Q. Did you then go on to do an internship and residency?
A. Yes.
Q. Where?
A. I did my internship and residency at Columbia university. I did my internship in internal medicine and my
residency in psychiatry.
Q. That's in New York city?
A. Yes.
Q. When did you finish your residency?
A. 1998.
Q. Did you receive any awards in connection with your residency?
A. Yes. I received the national institute on mental health outstanding resident award.
Q. That's a prestigious award?
A. It is.
Q. Did you then go on to do further training in the form of a fellowship after finishing your residency?
A. Did a two year clinical and research fellowship at New York university at Bellevue hospital in 0New York.
Q. What area was that in?
A. Addiction psychiatry.
Q. When did you complete the fellowship?
A. In 2000.
Q. What did you do after that?
A. I stayed at Bellevue hospital as the unit chief of the dual diagnosis unit which is an inpatient unit that
specializes in the treatment of those who suffer from mental illness and severe addiction.
Q. So dual diagnosis at Bellevue is people with mental illness and have addiction?

A. Correct.
Q. That's an inpatient program?
A. Inpatient unit, yes.
Q. What did you do after that?
A. After that, I moved to what was then called Smithers alcoholism treatment and training center in New York
city, that was in 2002, as the chief of Smithers. Smithers changed its name in 200 to the Addiction Institute of
New York where I was the director for ten years.
Q. And the director means you were the head of the institute?
A. Yes.
Q. Is the Addiction Institute of New York one of the largest addiction programs in New York?
A. Yes, it is. It's most likely the largest 0one.
Q. You haven't checked the numbers recently?
A. Yes.
Q. And is the Addiction Institute of New York associated with any hospitals?
A. It is associated clinically with St. Lukes and Roosevelt hospitals in New York and academically with
Columbia university college of physicians and surgeons.
Q. The college of physicians and surgeons, that's what Columbia calls its medical school?
A. Yes.
Q. Does the addiction -- does St. Lukes and Roosevelt hospitals have inpatient or residential facilities for
addiction treatment?
A. Yes, we have both. We have inpatient facilities for detoxification and rehabilitation of patients who suffer
from addiction. We also have residential facility, a halfway house on the upper west side of Manhattan for
extended care, and we have a large number of outpatient services as well.
Q. And about how many patient visits does the Addiction Institute of New York do for outpatients on a yearly
basis?
A. About 80,000 patient visits a year.
Q. When you were the director of the Addiction Institute, about how many staff members were under your
supervision?
A. About 200 to staff.
Q. Generally speaking, what kind of responsibility did you have when you were working at the Addiction
Institute as director?

A. Clinical responsibilities in seeing patients. I had teaching responsibilities in teaching medical students from
Columbia, residents in psychiatry and internal medicine, fellows in addiction psychiatry but also nurses,
counselors, social workers. I also had a responsibility to oversee research at the Addiction Institute and
extensive administrative responsibilities as the director of the whole program.
Q. And about what percentage of your time, when were at the Addiction Institute, was spent seeing patients?
A. About percent and perhaps a little higher with all the supervision that I was doing there.
Q. And did there come a time, when you left the Addiction Institute, and took a different job?
A. Yes.
Q. When was that?
A. March of 2013, about six months ago.
Q. Where are you currently employed?
A. Now I am at Rutgers New Jersey Medical School, r-u-t-g-e-r-s, where I am the chairman of the department
of psychiatry.
Q. And generally speaking, are your duties at Rutgers New Jersey Medical School as the chair of the
department in psychiatry similar to the work you were doing the Addiction Institute?
A. Yes, they are similar. Perhaps I have more administrative responsibilities. But the main difference is that,
while I was at the Addiction Institute of New York, all my work was in addiction while now I'm responsible for
the entire field of psychiatry including, of course, schizophrenia, depression, anxiety, other disorders.
Q. Where are you licensed to practice medicine?
A. New York state and the state of New Jersey.
Q. Is a license to practice medicine the same thing as board certification?
A. No.
Q. What's the difference?
A. You are required by law to have a license to practice medicine in order to treat the patient. You are not
required by law to be board certified in order to treat patients. Being board certified is an honor in -- certainly in
psychiatry, and it's something that a lot of people opt to pursue.
Q. And are you required to do anything to maintain your license to practice medicine?
A. Yes. You need to renew your license typically every three years. That is more of an administrative renewal.
You pay your fee, and you get renewed.
Q. What about board certification? Is there a recertification process for boards, and specifically I'll ask you
about psychiatry because that's what your board in?

A. There is a recertification process for board certification in psychiatry. It involves primarily taking an exam
every ten years.
Q. So you're boarded in psychiatry?
A. Uh-huh. I'm sorry, yes.
Q. Are you board certified in any other areas?
A. I'm board certified in psychiatry. I'm board certified in addiction psychiatry, and I'm also board in addiction
medicine, although the American board of addiction medicine is not one that is fully recognized by the
American board of medical specialties at this time.
Q. What's the difference between addiction psychiatry and addiction medicine?
A. There is significant overlap between the two specialties. Addiction psychiatry concerns itself more with the
emotional aspects of addiction, the psychological aspects of addiction as well as co-occurring psychiatric
disorders, things like depression and anxiety, for example. Addiction medicine focuses more on the physical
manifestation of addiction having to do with detoxification, with hepatitis c, hiv, other co-occurring medical
disorders that happen with patients who suffer from addiction.
Q. Is it fair to say addiction psychiatry focuses more on the mental aspects of addiction and addiction medicine
focuses on the whole body with respect to addiction?
A. Yes.
Q. Have you published in the field of addiction medicine?
A. Yes, I have.
Q. Generally speaking, about how many publications do you have?
A. I have authored and co-written five books, currently finishing the sixth one, and I have published about or
so articles and book chapters as well, monographs.
Q. The articles, do those include publication in -- publication of articles of peer reviewed journals?
A. Yes.
Q. Can you tell us some of the journals you've published in?
A. The journal of psychiatric substances, the American journal of drug and alcohol abuse, the journal of
addiction medicine, the journal of addictive disorders.
Q. What is the DSM?
A. The DSM is the diagnostic and statistical manual published by the American psychiatric association that
essentially defines the different mental illnesses. It is published rather infrequently. The DSM-44, the fourth
edition of the diagnostic and statistical manual, was published in 1994, and the fifth edition was published in
may of 2013. A lot of people refer to it as the bible of mental illness. I don't like the term, but that's what is used.
Q. The DSM-4 is commonly used in the field of addiction to -- in the field of psychiatry to diagnose patients?

A. DSM system, yes.

Q. Is there a case book that goes along with the current edition of the DSM? I think you said it was the DSM-
45, right?
A. There is an accompanying case book of the DSM-45, and I have written a chapter in this case book.
Q. What chapter did you write?
A. It's titled "Addiction."
Q. What's the function of the DSM case book? How does it work with the DSM itself?
A. The DSM is a rather dry textbook of mental illnesses. It's a very well thought out and researched listing of
the different criteria, while the DSM-4 case book brings these diagnosis to life with real case patient
descriptions.
Q. So you wrote the chapter on addiction in the DSM five-case book?
A. Yes.
Q. Have you also given presentations at meetings or conferences relating to addiction medicine and addiction
psychiatry?
A. Yes, both nationally and internationally.
Q. About how many?
A. I'd say over 200.
Q. Are you a member of any notable professional societies or organizations in the field of psychiatry or
addiction psychiatry or addiction medicine?
A. Yes.
Q. Can you tell us about a couple of those.
A. Member of the American academy of addiction psychiatry, the American society of addiction medicine, the
American psychiatric association, and an honorized society in psychiatry called the American college of
psychiatrists, which is less than percent of psychiatrists.
Q. And have you received any notable awards for your work in the field?
A. Yes, I have.
Q. Can you just tell us a couple of those?
A. I have received the teacher of the year award several times. The Irma Bland award for excellence, the
speaker and specialist award from the united states state department.
Q. Have you been named a Betty Ford scholar?

A. I have been named a Betty Ford scholar.

Q. Are you listed in New York super doctors?
A. Yes, I am.
Q. Have you served on any committees in the field of addiction medicine?
A. Yes. I'm on the board of directors of the American society of addiction medicine. I'm a member of the
council on addiction psychiatry of the American psychiatric association, and I was the chair of the national
committee on addiction treatment for five years in the mid 2000's.
Q. And you mentioned the American society of addiction medicine a couple times. Can you just tell us a bit
what that society is and does?
A. It is the premier organization for addiction medicine in the united states. I believe it has about 3,000
members, and it's the go to organization for physicians in terms of addiction medicine.
Q. Did you help draft the definition of addiction for the American society of addiction medicine?
A. Yes, I did.
Q. When was that?
A. It got published two summers ago.
Q. Published in --
A. 2011.
Q. Let's talk a little bit about your treatment of patients. Generally speaking, what sort of treatments do you
provide to patients who suffer from addiction?
A. There are three major areas of addiction treatment. The first one is counseling and psychotherapy,
discussing with the patient different aspects of their addiction. That can be done in a group setting or in an
individual setting. It can be done as an inpatient or as an outpatient. The second major area of addiction
treatment would be medications. We don't have safe and effective medications for all addictive disorders, but for
the ones that we do have some of these medications, we do use them. And the third area, very, very important
one but not the one that is just so supervised by professionals, is engagement in 12-step programs, things like
alcoholics anonymous, narcotics anonymous and other mutual help groups.
Q. How many years have you worked with addicted patients?
A. As the major focus of my work, for the past years.
Q. And in your -- how many patients do you think you've seen over the past years if you can estimate?
A. A few thousand, I would say.
Q. And which types of substances are most common for your patients to be addicted to?

A. The most common substances would be nicotine and alcohol. And after nicotine and alcohol, we probably
have the opioids, both heroin and prescription opioids. And then we have cocaine, marijuana, and then some of
the less frequently used substances like lsd, for example.
Q. Are you able to estimate about how many of your patients have been addicted to opioids?
A. Several hundred, perhaps 1,000 or more.
Q. Can you tell us the names of some opioids that people are commonly addicted to in your experience?
A. There are the naturally occurring opioids like morphine and codeine that are still quite abused. Then there
are the semi synthetic and synthetic opioids that derive from these naturally occurring opioids like oxycodone,
hydrocodone, hydromorphone, meperidine. I could go on.
Q. Are you speaking -- in using drug names, are you using the pharmacological name of the drug as opposed
to the brand name of the drug?
A. Yes.
Q. Is that common in your field?
A. Very common.
Q. What is the brand name for the common brand name for meperidine?
A. That's Demerol.
Q. Can you just tell us some of the other brand names of opioids that people commonly become addicted to?
A. Oxycodone would be oxycontin. Hydrocodone would be Vicodin. Hydromorphone would be dilaudid.
These would be the major ones.
Q. Have you also treated patients addicted to benzodiazapines?
A. Yes.
Q. Generally speaking, what are benzodiazepines?
A. Benzodiazepines are medications that specifically activate the gaba system. The gaba system stands for
gamma-aminobutyric acid, a-m-I-n-o-b-u-t-y-r-I-c, acid, which is the major inhibitor system in the brain. That's
often called the brakes of the brain and can be activated by alcohol, can be activated by benzodiazepines like,
for example, diazepam, d-I-a-z-a-p-a-m, valium, alprazolam, a-l-p-r-a-z-o-l-a-m, which is xanax, and other
benzodiazepines. It can also be activated by barbiturates.
Q. Approximately how many of your patients over the years have been addicted to benzodiazepines?
A. Several hundred, a few thousand.
Q. And is it common for the patients that you see who are addicted to prescription drugs to be addicted to
more than one category of drugs?

A. It's quite common, quite frequent to have polysubstance abuse or dependence and is something that we see
very commonly in our work.
Q. Of the thousands of patients you've treated for drug addiction, have you ever treated a patient for addiction
to propofol?
A. I have not.
Q. Are you aware of your colleagues ever, that you work with and have worked with over the years, treating
patients who are addicted to propofol?
A. No.
Q. Based on your experience, how common is it for people to become addicted to propofol?
Mr. Panish. Object, beyond the scope of opinions he was giving. No opinions on propofol.
Judge. Sustained.
Q. Did my law firm engage you to serve as an expert witness in this case?
A. Yes.
Q. Who were you first contacted about being involved in this case?
A. I was contacted by GLG, which stands for Gerson Lehrman group, which is a consulting firm.
Q. Is that a firm that you have a relationship with?
A. I've done consultations for them before.
Q. Do you remember about when GLG first contacted you?
A. I believe it was in the fall of 2012.
Q. Did I then give you a call a few weeks later to talk about this case?
A. Yes, you did.
Q. Do you remember about when that was?
A. I think that was November.
Q. And at some point after that conversation, were you -- did you agree to serve as an expert witness for the
case?
A. Yes.
Q. And do you remember about when that was that you agreed to be an expert witness?
A. I think it was beginning of 2013, perhaps January.

Q. Are you being paid to serve as an expert witness in this case?

A. Yes.
Q. Who pays you?
A. The GLG group.
Q. Is it your understanding that the defendants in this case paid GLG, and then GLG pays you?
A. Yes.
Q. Do you know what rates GLG charges the defendants for your work in this case?
A. No.
Q. But you do know what GLG pays you for your work in this case?
A. Yes.
Q. What is that?
A. $500 an hour for reviewing materials and preparing for the case, $3,000 for half day of testimony or
deposition, and $5,000 for a full day of testimony or deposition.
Q. Did you give a deposition in this case?
A. Yes.
Q. Approximately when?
A. March. Somewhere around March, I think.
Q. Were you paid to appear for your deposition?
A. Yes.
Q. Do you know who ultimately was responsible for paying for that deposition?
A. I believe it was the plaintiff.
Q. Before your deposition in this case, how many times have you testified in the deposition as an expert
witness?
A. Once.
Q. And before today, how many times have you testified in court as an expert witness?
A. Never ever. Let me qualify that. I have appeared in court a couple -- a few times when I was working in the
inpatient unit at Bellevue primarily to retain patients in the inpatient psychiatric unit or medicate them against
their will but never in a kind of regular court.

Q. Never as an expert witness in a civil lawsuit like this?

A. Certainly not.
Q. Did you prepare some slides to use for your testimony here today?
A. Yes.
Ms. Cahan. Counsel, do you want us to show you each slide before we put it up?
Mr. Panish. Just give me the number.
Ms. Cahan. Start with the first slide.
Mr. Panish. If you identify the number and the exhibit number, then I'll --
Ms. Cahan. It will be exhibit number 13545. It's slide one.
Mr. Panish. 13545. That's okay to put that up.
Ms. Cahan. Thank you.
Q. What is this slide?
A. This is the short form of the deposition of addiction that we came up with at the American society of
addiction medicine. As I mentioned before, I was in the small group that drafted this definition. But then again,
I was also a member of the board of directors of the American society of addiction medicine that voted to adopt
this definition as the official definition of addiction.
Q. So this is a short version of the definition?
A. This is the short form of the definition. There is a longer form of the definition that is several pages long.
Q. Can you tell us -- boil this down even further and tell us in a sentence or so how you would define
addiction?
A. I think the most salient part, the most prominent part of addiction is taking over control over a person's life.
The person is no longer in control of her or his life. It's the drug that is in control of the person's life.
Q. Is the definition that's shown on the slide here commonly accepted in your field?
A. It is commonly accepted. It is not the same as the diagnostic and statistical manual, the DSM definition, but
they are certainly compatible.
Q. Is there a substantive difference in the interpretation of what addiction is between the DSM and this
definition?
A. No, there is not a substantive difference. It's more the fact that the DSM focuses on criteria, specific criteria
that have to be met to get the diagnosis of addiction while this one here is a more qualitative approach to the
meaning of addiction.

Q. And we've heard the terms addiction and dependence used in this case. Is there a difference between
addiction and dependence as you use them?
A. If I may just try to explain what is going on here with these terms. Trust me, they are quite confusing to
most of us, but I'm going to try to do my best to explain. There are essentially two concepts and three terms. The
two concepts is the concept of addiction and the concept of physiological dependence. Pretty much everybody
agrees what addiction is. Pretty much everybody agrees what physiological dependence is. Addiction is the
really severe form of the illness. That's when you lose control of your life over the drug of abuse. That's when
essentially you have been kind of subjected to the full form of the illness. Physiological dependence simply
means tolerance and withdraw which are two characteristics of addiction but by themselves do not really give
you the diagnosis, the illness of addiction. There are people out there who may be physiologically dependent to
benzodiazepines or to opioids, but they may not have the psychosocial deterioration that is required to get the
definition of addiction. So physiological dependence can very well be part of addiction but in itself is not really
addiction. So these are the two concepts. We're all pretty comfortable with these two concepts. The confusion
comes in with the word "dependence," the unqualified word "dependence." in parts of medicine, in psychiatry
more specifically, dependence and addiction are essentially the same thing. There was a debate in the DSM
committee. They went back and forth. They ended up being a four to three vote, and they ended up voting for
the term dependence instead of the term addiction. There's not really conceptually any difference between the
two in the DSM system. However, in other parts of medicine, pain management, for example, or internal
medicine, dependence and physiological dependence are the same thing to be distinguished from addiction
which is the superior form with psychosocial deterioration. That's what gets us so confused.
Q. So just to make sure I'm following this, physiological dependence is tolerance and withdrawal?
A. Correct.
Q. Addiction is the full-blown form of the disease?
A. Yes.
Q. And people are pretty clear on that. But sometimes the word "dependence," depending on what kind of
medical provider you're talking to, can be used for one or the other?
A. Correct.
Q. Can we use addiction today to keep things clear?
A. I like the word addiction better.
Q. Okay. Generally speaking -- and I think we can take this slide down -- what causes someone to become
addicted to a drug?
A. In terms of the cause of addiction -- can I have the next slide? That would be helpful. I know we're going
back and forth with the lights. I think it's big enough letters that we can keep the lights on.
Ms. Cahan. Any objection to exhibit 13546?
Mr. Panish. Is that slide number two?
Ms. Cahan. Slide two.
Mr. Panish. That's okay.

Witness. So what we understand today as the causes of addiction run through biological, psychological and
socio forces meaning there is a genetic component to addiction. if both your parents are alcoholics, you have a
significantly higher chance to become an alcoholic yourself than the general public. We know this is true of
alcohol. We now think that this is quite likely true of other drugs of abuse including opioids. Then there is
psychological reasons why somebody become addicted, most notably self-medication. Somebody suffers from
depression or pain, and they start using the drug to self-medicate some kind of untreated, underlying physical or
psychological condition. The third tier is social, meaning that somebody may find herself or himself in a drug-
infested environment, in a subculture or a group that is very conducive to use of drugs. And then, although they
may not have the genetic predisposition, they may not have any kind of psychological reason to start using,
simply because of peer pressure and the environment, they start using drugs.
Q. Is that like binge drinking at college?
A. Binge drinking at college, smoking marijuana at high school. Classic examples of the third socio
component of the etiology or the cause of addiction. But now we have a fourth one as well that the use of the
drug itself can very well get you addicted. There was a time when we thought that, if you didn't have the
biological psychological and social vulnerabilities to become addicted, then the chances of becoming addicted
were very, very low. now we know better, and there are situations where people truly do not have any of these
biological and social risk factors. And yet, when they start using, they can become fully addicted.
Q. Is that something that you see commonly with people who are prescribed opioids or other drugs by a doctor
and then become addicted?
A. That is exactly right. We used to think that, if a patient takes opioids or benzodiazepines from a physician
for a good medical reason, then the chance of developing an addiction was negligible. It was a major mistake
that we made, and we are paying the price right now with the explosion of the prescription opioid epidemic that
we have on our hands. The vast majority of these patients are now addicted to prescription opioids started using
their opioids not from street vendors but from going and seeing their doctor.
Q. Can you explain the right-hand half of the slide. I see there is a reference to a brain switch?
A. Yes. Once these forces come together in a particularly nightmarish fashion, they do something to the brain
to the more primitive part of the brain. They hijack the pleasure reward pathways of the brain. From that point
on, the addiction engraves in this primitive part of our brain and has a life of its own to a large extent
independent of the forces that set it in motion to begin with. What am I talking about here? We do have these
pleasure reward pathways in our brains. You can use the next slide, perhaps.
Ms. Cahan. Is that okay if we put up the next slide, 13547, slide three?
Mr. Panish. Yes.
Witness. So all of us have this pleasure reward pathways in our brains that essentially scan the world at all
times and tell us what's pleasurable and rewarding, things like food, nurturing, sex, water would be natural
reenforcers. Now about -- out of about 30 million chemicals that we've identified in all of the universe, there are
only about a hundred of them who have this peculiar quality of targeting exactly the same pleasure reward
pathways of the brain and hijacking them and making them mimic to a very large extent what the natural
reenforcers do. These, of course, are the addictive drugs, the drugs of abuse. Once the pleasure reward pathways
have been hijacked by a drug of abuse, then they tend to have a life of their own, and they give the patient the
addiction which lasts for a long time if not for the rest of the person's life.

Q. So if a person becomes addicted to opioids that they started taking as prescribed by a doctor for a legitimate
pain condition, can you resolve that addiction and reverse this process just by addressing the underlying pain
condition?
A. The answer to that is no. Unfortunately, a lot of our patients, a lot of the lay public leave with the fantasy
that, if only we were smart enough to go back and really address the underlying cause of the addiction, unpack
whatever it is, whether it was a trauma or a bad environment or whatever it was, and address this kind of issue
of addiction, boom. From that point on, the patient would be addiction free for the rest of his or her life. It
doesn't happen that way. Once the brain switch has been turned on, it tends to stay on for a long, long time if not
for the rest of the person's life. And chances are, that for the patient to do well, she or he will need specific
treatment for the addiction and at the same time trying to relieve whatever caused the addiction to begin with.
As an example here, somebody started using cocaine because they were self-medicating some kind of
underlying depression. Once they get addicted to cocaine, chances are they'll need treatment for the addiction to
cocaine and treatment for the depression if they have any kind of chance of succeeding to be able to beat a
rather difficult disease.
Q. Did you review the trial testimony of Dr. Sidney Schnoll in this case?
A. Yes.
Q. Do you remember a story that he told about a patient he saw who had developed a painkiller addiction, and
she was taking the pain pills for debilitating headaches, and he ultimately was able to figure out that the
headaches were caused by skipping meals. And once he -- they addressed that issue, the headaches went away,
and the addiction was curable?
A. Yes, I do remember that.
Q. And in your view of his testimony, what point was he using that to illustrate?
A. He was really presenting a rather outdated way of thinking about addiction, thinking about the fact that we
could just simply, by relieving the cause of the addiction, save the patient from the illness. Unfortunately, that is
not enough. Once the brain switch has been turned on, it does tend to stay on. I don't doubt the particular case
that he brought up. There are always cases outside the norm. But by no means -- this is what I see day in and
day out in my work, and that's not what my vast majority of my colleagues see in their work day in and day out.
Q. Do you remember whether Dr. Schnoll expressed an opinion as to whether Michael Jackson's opioid use
could be controlled and appropriate if his underlying medical conditions were addressed?
A. Yes.
Q. Do you have a view on that opinion?
A. I disagree with him.
Q. Why is that?
A. Because Michael Jackson's addiction was quite extensive, and I have very little doubt within a degree of
medical certainty that his pleasure pathways had been hijacked by drugs of abuse and he did suffer from the
illness of addiction.
Q. Have you received extensive training and education in how to diagnose someone with an addiction or how
to recognize an addiction, a drug addiction in someone?

A. Yes.
Q. And would you expect somebody like me, who hasn't had that training, to be able to easily recognize the
signs of addiction?
A. It's rather tough.
Q. Are there some things that are obvious signs that somebody has a problem, like getting a dwi?
A. Yes, there are some, both physical manifestations of the illness. Somebody who smokes has yellow teeth
and yellow fingers, and you can just suspect that they are smokers. And there are other times when it's much
more difficult to tell that somebody is addicted to a drug.
Q. But you have some additional training and skills to help you do that?
A. Yes.
Q. Are there ever times when even you are fooled as to whether somebody is using drugs?
A. Yes. Quite often that does happen. Especially in the context of someone who I think is doing very well, they
have been recovering for a while. They tell me they go to their AA meetings, and they tell me that everything is
going wonderfully, and they are functioning well in their lives. And then I do a urine toxicology examination
and find drugs of abuse, and I feel fooled, and I feel betrayed. But it's the nature of the illness. It's a chronic
relapsing illness, and the majority of the patients go through extreme lengths to keep their disease secret.
Q. So there are drug tests you can do to see somebody has certain drugs in their system?
A. For the majority of drugs of abuse, we do have these tests, but they only tell us if the patient is using within
the past 24 or 48 hours.
Q. Is there a test like --
A. 72 at most. Sorry.
Q. Is there a lab test or other that will allow you to say, yes, somebody is an addict?
A. No.
Q. Do you look at a number of criteria in order to be able to evaluate addiction?
A. Yes.
Q. We'll get to that in a little bit. First, I want to ask what you were asked to do.
A. Okay.
Q. When you were reserved as an expert witness, generally what were you asked to do?
A. Offer my opinion on matters of my specialty -- addiction, psychiatry, addiction medicine and psychiatry.
Q. Were you asked by me or anyone at my firm to come to any specific conclusions?

A. No.
Q. After you were retained in this case, did we provide you with materials relating to Mr. Jackson?
A. Yes.
Q. What kinds of materials, generally speaking?
A. Medical records, depositions of witnesses, and the autopsy report and some trial transcripts.
Q. And the trial transcripts you got more recently?
A. Yes.
Q. And are you relying on some of the materials you reviewed to offer -- form and offer opinions in this case?
A. Yes, I do.
Q. Do you have a list up there with you of the medical records and documents that are most pertinent to your
opinions?
A. Yes.
Q. Can you just tell us which of the records you've reviewed you consider most pertinent to your opinions?
Mr. Panish. Your honor, is that the deposition from his -- exhibit he's referring?
Ms. Cahan. It's a subset of what he identified at his deposition but just a little more.
Mr. Panish. Thank you. Go ahead.
Witness. Would you like me to read them?
Q. First, tell us the paper documents that are most important to your opinions in the case.
A. Medical records, deposition testimony, trial testimony, and videotaped deposition testimony.
Q. So let's start with the medical records. Which sets of records are you principally relying on?
A. Medical records from Dr. Farshchian, Mr. Fournier, Dr. Gordon, Dr. Klein, Mr. Metzger.
Judge. Slow down a little bit. The court reporter needs to type those.
Q. You said Dr. Farshchian, Mr. Fournier, Dr. Gordon, Dr. Klein and Dr. Metzger?
A. Yes.
Mr. Panish. I'm sorry. Can you say that one more time.
Ms. Cahan. It's the list you have right in front of you.

Mr. Panish. He skipped some.

Ms. Cahan. No.
Mr. Panish. Everything on the list. Okay. Thank you.
Q. Continue.
A. Ms. Cherilyn Lee, the Santa Barbara county sheriff's office production, Santa Ynez Valley Cottage Hospital,
Sasaki, Sasaki Summary of Treatments, Slavit, Von Valin, and coroner's report and toxicology report.
Q. Did you also -- are you also focused on certain deposition testimony from the case including some of the
video depositions that we've seen here at trial?
A. Yes.
Q. For whom -- whose deposition testimony is most important to your opinions?
A. Dr. Adams, Dr. Farshchian, Dr. Finkelstein, Mr. Fournier, Dr. Gordon, Prince Jackson, Mr. Randy Jackson,
Mr. Michael Laperruque, Ms. Cherilyn Lee, Dr. Metzger, Mr. Payne, Dr. Quinn, Dr. Ratner, Ms. Debbie Rowe,
Dr. Sasaki, Dr. Saunders, Dr. Schnoll, Dr. Shimelman, Dr. Slavit and Dr. Von Valin.
Q. Are there particular pieces of trial testimony -- that was deposition testimony. Are there particular pieces of
trial testimony that are especially relevant to your opinions?
A. Yes.
Q. Can you just tell us who those witnesses are?
A. Dr. Schnoll, Ms. Karen Faye, Mr. Kenny Ortega, Mr. Travis Payne, Ms. Kathryn Jackson, Mr. David
Fournier, Mr. Michael Laperruque, Ms. Debbie Rowe and Prince Jackson.
Q. Have you asked us for any materials, either testimony or records, that we haven't agreed to give you?
A. No.
Q. How would you describe what materials you wanted to review?
A. I reviewed quite a number of records, and I focused on the ones that they had the most medical significance
especially in terms of addiction.
Q. So you reviewed a large set of materials and sort of told us which ones are relevant to your opinions?
A. Correct.
Q. How did you figure out what the large set of materials you wanted to review was?
A. I asked for materials from the lawyer's office, and they were sending them to me, sometimes as a cd or
sometimes by e-mail.
Q. Do you have an understanding as to whether you were given all the medical records produced in this case
for review?

A. I believe they were all the medical records. They may be some other medical records that were not directly
related to the areas that I was asked to focus on. I wouldn't know that.
Q. I noticed in the list of testimony that you talked about you didn't mention Paul Gongaware or Randy
Phillips's testimony. Is there a reason that you don't consider that particularly pertinent to your opinions?
A. It didn't seem to me that they were directly related to the area where I'm focusing on which is, again, the
medical determination of Michael Jackson's addiction.
Q. Do you know whether any of the other addiction experts in this case, either for plaintiffs or defendants, are
relying on the testimony of Mr. Phillips or Mr. Gongaware?
A. I'm not sure offhand, no.
Q. Have you reviewed Dr. Schnoll and Dr. Shimelman and Dr. Early's testimony, right?
A. Oh, these colleagues have not as far as I remember. Also, they haven't reviewed testimony from Mr.
Gongaware or Mr. Phillips either.
Q. Approximately how many hours have you spent working on this case from January of this year, when you
were retained, up until today?
A. Say almost a hundred hours.
Q. Have you reached any opinions in this case about Michael Jackson?
A. Yes.
Q. Do you consider those opinions that you're offering in this case to be independent?
A. Yes.
Q. How is that true if we're paying -- defendants are paying for your time in this case?
A. Because they are -- it's my responsibility as a physician to offer independent testimony and dependent
opinions and dependent recommendations both for my patients and to the court.
Q. Did you prepare a slide of the opinions you're offering?
A. Yes.
Ms. Cahan. Slide number four, 13548. Any objection to us putting that up?
Mr. Panish. It's okay.
Q. These are your opinions in this case?
A. Yes.
Q. Can you read them for us.

A. One, Michael Jackson was addicted to opioids. Two, Michael Jackson engaged in doctor shopping. Three,
Michael Jackson was secretive about his medical care and drug use. Four, Michael Jackson and his treating
medical providers did not maintain proper boundaries.
Q. I want to go through these one by one. But first, I want to ask you do you hold each of these opinions to a
reasonable degree of medical certainty?
A. Yes.
Q. So your opinion that Michael Jackson was addicted to opioids a diagnosis?
A. No. It's -- I've never met Michael Jackson. I've never examined Michael Jackson. He was never my patient,
so I cannot definitively offer a diagnosis for the patient. But I can certainly offer a diagnostic impression that I
have within the realm of reasonable medical certainty.
Q. So let's talk about this first opinion here. You believe that Michael Jackson was addicted to opioids?
A. Yes.
Q. And how did you form that belief generally speaking?
A. I relied on the criteria, the diagnostic and statistical criteria, the fourth edition, because that's what was in
effect when Michael Jackson died, and also that's the edition, that seems to be the one that is still used
extensively in most of the research that's been done is based still on the DSM-44.
Q. And was there a particular opioid that you saw Mr. Jackson having a preference for in your review of the
record?
A. Yes.
Q. The brand for name for that is Demerol?
A. Yes.
Q. But you prefer to call it meperidine?
A. I can call it Demerol. That's fine.
Q. That's fine. I want to make sure we're talking about the same thing here.
A. It is.
Q. And in your review of the records and the testimony, did you see any evidence that suggested that Michael
Jackson might have other -- might have abused other types of drugs?
A. I did see some evidence -- some significance evidence of benzodiazapine use. He may very well have been
addicted to benzodiazepines as well. It's just that the evidence was not as compelling as for the opioids to reach
that level of certainty.
Q. You're not expressing an opinion as to whether Mr. Jackson was addicted to benzodiazepines?
A. Correct.

Q. What about propofol? Did you look at the record discussing Mr. Jackson's use of propofol?
A. Yes, I did.
Q. Do you have an opinion as to whether he was addicted to propofol?
A. It was not the focus of my work with propofol, but I did see significant use of propofol.
Mr. Panish. Move to strike the last portion.
Judge. Motion granted. It will be stricken.
Ms. Cahan. He did testify to that at deposition, your honor.
Mr. Panish. We had a hearing on this already.
Judge. We did.
Q. Did you review the testimony of plaintiffs' addiction expert, doctor -- I think you said you did -- Dr.
Shimelman and Dr. Schnoll?
A. Yes, I did.
Q. Did you review deposition testimony for Dr. Shimelman and Dr. Schnoll?
A. Yes.
Q. Did you also review trial testimony for Dr. Schnoll?
A. Yes.
Q. Does Dr. Schnoll agree with you that Michael Jackson was addicted to opioids?
A. No.
Q. Does Dr. Shimelman agree with you that Michael Jackson was addicted to opioids?
A. Yes.
Q. Did Dr. Shimelman also offer an opinion about whether Michael Jackson was addicted to benzodiazepines?
A. Yes.
Q. What was his opinion?
Mr. Panish. Objection, hearsay. It's not anything he relied on for his opinion, 721.
Judge. We're talking about -- not Schnoll but Shimelman?
Mr. Panish. He's trying to get in his opinion -- he doesn't have an opinion in that regard. Now he's trying to
use a hearsay statement for somebody else's.

Ms. Cahan. He's not piggybacking on that. I'm just going to ask him if he came to a different conclusion based
on the review of the records. He's read Dr. Shimelman's testimony which we're expecting to present to the jury.
Judge. Overruled. You may answer.
Ms. Cahan. Do you need me to repeat the question?
Witness. Yes, please.
Q. What was the opinion that Dr. Shimelman expressed with respect to Mr. Jackson's use of benzodiazepines?
A. He thought he was addicted to benzodiazepines as well.
Q. And you said you saw some evidence of abuse in the records but not enough for you to confidently agree
that Mr. Jackson had an addiction to benzodiazepines?
A. Correct.
Q. Did Dr. Shimelman give a time period for which you believe Mr. Jackson suffered from drug addiction?
A. Yes.
Q. What was that time period?
A. From 1993 to the end of his life in 2009.
Q. And do you agree with plaintiffs' expert Dr. Shimelman that Mr. Jackson was addicted to opioids from 1993
until the time he passed away in 2009?
A. Yes.
Q. Did you see any significant gaps in medical records during the 1993 to 2009 time period?
A. Yes.
Ms. Cahan. At this point, I'd like to show the jury the demonstrative on the opioids and benzodiazepines. It
will be exhibit 13550 -- I'm sorry 549.
Mr. Panish. Say that again.
Ms. Cahan. Exhibit 13549. We have it as a board. Your honor, may I approach to put up that board?
Judge. You may.
Mr. Putnam. May I approach, your honor, to help?
Judge. Yes.
Ms. Cahan. We printed out 1/ x copies of this as well.
Judge. If you want to pass it out. Is it this thing, a blow up of this?

Ms. Cahan. Yeah.

Judge. Sure, if you want to pass it out.
Q. We were talking about whether you saw any significant gaps in the medical records that were available for
review from the 1993 to 2009 time period.
A. Yes.
Q. And when did those gaps occur?
A. The first gap has been in the mid to late 90's from 1994 to 2000, 2001. And the second major gap is from
2003 to 2008.
Q. Have you seen any testimony in this case about times that Michael Jackson used opioids for which there is
not a corresponding medical record available for your review?
A. Yes.
Q. Can you just give us an example of that?
A. There is testimony from Debbie Rowe that Dr. Klein gave Demerol to Michael Jackson from the period '93
to '97, and we have no records of that.
Q. And that's one of the bullets that's noted on this timeline?
A. Yes.
Q. And have you also reviewed Mr. Fournier's testimony?
A. Yes.
Q. Do you recall when he said he began treating Mr. Jackson?
A. I believe it was in the early parts of 2000.
Q. Okay. But from your review of the records, there are several times --
A. I'm sorry. Mr. Fournier did start treating Michael Jackson all the way back to '93, I believe.
Q. Did you see records from Mr. Fournier's records going back to '93?
A. No.
Q. There are some instances you've seen where there is testimony about medical care but no corresponding
medical records?
A. Correct.
Q. Does the lack of records or even the lack of testimony covering a certain time period mean Mr. Jackson was
not using drugs during that time period?

A. No, it does not.

Q. Is it common for a patient's medical record to contain a full documentation of their drug abuse or use?
A. No. Most typically it does not have the full record of somebody's use.
Q. How often does a person have to use a drug to be considered an addict?
A. We don't define addiction on the basis of frequency of use, although, when the use is extraordinarily high,
this is highly suggestive that an addiction may be present.
Q. Do you typically know the exact frequency of drug use by your patients?
A. No. Typically, it is patients underestimate their use of drugs.
Q. So is it fair to say that you look at criteria other than frequency and dosage of drugs to determine whether
somebody is addicted?
A. Yes.
Q. Did you prepare a slide of the criteria that you use and the people in your field use to determine whether
someone is addicted to drugs?
A. Yes.
Ms. Cahan. That would be exhibit 13550, slide five. Is there any objection to putting that one up?
Mr. Panish. No, as long as we identify the source.
Ms. Cahan. Okay.
Judge. I'm sorry.
Ms. Cahan. 13550 and its slide number five at the bottom right.
Q. What is the source for this slide?
A. This is based on the DSM-4 criteria of substance dependency, and I have summarized the seven criteria
needed for somebody to be addicted.
Q. So this is your summary of the DSM-44's seven criteria for substance dependence?
A. Correct.
Q. As you use it, substance dependency and addiction are the same term, concept?
A. Yes.
Q. How many criteria of these have to be present before someone is considered to be addicted?
A. Three.

Q. In a certain time period?

A. In a 12-month period.
Q. In the case of Michael Jackson, based on your review of the records and testimony, were three or more of
these criteria present in any 12-month period?
A. Yes. We do have most evidence of Michael Jackson's addiction around 1993, then again in the period of
2001 to 2003, and then towards the end of his life from 2008, 2009.
Q. So there were three separate time periods where you identified at least three of the criteria in a 12-month
span?
A. Yes.
Q. Hypothetically speaking, if you had only identified three of the criteria present in the 1993 time period,
would that mean Mr. Jackson stopped being addicted after 1993?
A. No. The way that we think about this is that once you get addicted to a drug of abuse, once the pleasure
reward pathways of the brain get hijacked by the drug of abuse, you remain addicted for the rest of your life.
Now I'm not saying that people do not beat the disease. The majority of people at some point met criteria, let's
say for smoking, end up giving up smoking. But the vulnerability to go back to using stays with you for a long,
long time if not for the rest of your life. If somebody has met the criteria at some point, got the diagnosis of
addiction and then stops, we often call that in remission.
Q. But in your field, once someone has been diagnosed with addiction, it's a diagnosis that remains with them
even if they are not actively using?
A. Correct.
Q. But here you can pinpoint three time periods where Mr. Jackson met the criteria based upon your review of
the materials available to you?
A. Correct.
Q. And which criteria did Mr. Jackson's drug use, opioid use meet?
A. We have the most evidence for criteria 1, 3, 4, and 7. There is some evidence for and as well, but I'd like to
focus on 1, 3, 4, and for which I have the most evidence.
Q. Let's look first at the first criteria, tolerance. What does tolerance mean?
A. Tolerance means that you need the higher, higher doses of a particular drug in order to achieve the same
affect. Or put in reverse, if you continued using the same dose, the affect will be less and less.
Q. Do you have a slide that summarizes your opinion with respect to tolerance of Michael Jackson?
A. I have two slides in this respect. Should we put them up.
Ms. Cahan. So the first one which is numbered slide six is exhibit 13551. Any objection?

Mr. Panish. No.

Q. What does it show?
A. This shows the escalation of dose of Demerol, meperidine in Michael Jackson from the 1990's to the end of
his life. While typically he'd get a dose of 100 milligrams in the early 90's, the dose went up to typically 200
milligrams during the beginning part of the 2000's. Towards the end of his life 2008, 2009, we see doses of
Demerol that go up to 375 milligrams.
Q. You said there was another slide on that which would be exhibit number 13552, slide number seven. Any
objection there? It's the one on the top.
Mr. Panish. Okay. That was 135 -- the last number of that.
Ms. Cahan. 13552, slide number seven. This was also previously used with Dr. Schnoll as exhibit 984-1.
Mr. Panish. That's fine.
Witness. There are two ways of looking at tolerance. There is tolerance from the micro level when we're
talking about several years, decades and that's the previous slide that I just showed which shows the escalation
of those. There is another way of looking at tolerance at a more micro level, if you like, more within a period of
a few months or perhaps several weeks. What we see here is from October 2008 to April of 2009, we have an
escalation of the doses of Demerol from 100 milligrams to up to 375 milligrams in April of 2009.
Q. Let me just stop you there. Do you understand this to be prepared from the medical records of one of Mr.
Jackson's physicians?
A. Correct. This is from the medical records of Dr. Klein.
Q. I'm sorry. You said it escalates up to 375 in April?
A. Right.
Q. I didn't mean to cut you off.
A. Then there is an attempt to deescalate the dose. We don't really have much information about exactly why
that happened, if it was initiated by Michael Jackson or Dr. Klein, how they came to the decision. But there is
an effort to cut down on the dose of Demerol.
Q. If we can take that one down. Did you also see any medical records for Mr. Jackson commenting on Mr.
Jackson's tolerance to opioids?
A. Yes. There are several physicians who have expressed concern about Michael Jackson's escalating doses of
prescription opioids, certainly Dr. Saunders and Dr. Finkelstein have been particular concerned about that. Ms.
Debbie Rowe has significantly shown concern about his dosage of medications. Dr. Metzger at some point
directly told Michael Jackson "I don't think you should get big pain medicine for procedures." suddenly, there is
a concern that has been expressed.
Ms. Cahan. I'd like to put up exhibit 2121. You have a copy of that. That's the Santa Ynez hospital records at
page 153.
Mr. Panish. What page?

Ms. Cahan. 153 to start. Your honor, may I approach?

Judge. You may.
Mr. Panish. Does that mean the last three numbers?
Ms. Cahan. Yeah, the exhibit numbers.
Mr. Panish. Is this in evidence?
Ms. Cahan. It's one of the medical records.
Mr. Panish. He can talk about it. I don't think you should put it up.
Ms. Cahan. Do we need to call in a custodian of records declaration for this?
Mr. Koskoff. Okay.
Judge. At the very bottom.
Ms. Cahan. Yes. This is the medical record of Mr. Jackson from Santa Ynez valley cottage hospital. We can
put that up.
Q. There is a section here I see it says emergency department course. Can you just read that for those of use
whose eyes are aren't as good as yours.
A. "emergency department course. The patient will be sent home to follow up with Dr. Saunders. He received
Demerol 200 milligrams and vistaril 50 milligrams intramuscularly. I had a long discussion with him about the
high dose of medication and the need to try to cut it down."
Q. And approximately when does this -- do you understand this to be a record from the Santa Ynez valley
cottage hospital of treatment for Mr. Jackson?
A. Right, dated February 2001.
Q. Was this something you considered in the first criteria of tolerance?
A. Yes, it goes hand-in-hand with the third criteria that the doses are going up.
Q. Let's also take a look at page 79 of exhibit 2121. It's the bottom right numbers. You'll have to flip actually
the other way. Your honor, may I approach to help him find the page?
Judge. You may.
Q. By Ms. Cahan. Is there a discussion here that you also found significant to your opinion that Mr. Jackson
exhibited tolerance to opioids?
A. This is also from -- this is from the Santa Ynez valley cottage hospital dated January 2002, under
assessment and plan.
Q. Can you read that for us.

A. "assessment and plan. I am very concerned about the patient's obvious narcotic tolerance, and that this
reflects significant ongoing narcotic use. I am somewhat concerned that his pain may be out of proportion to his
physical findings. I am also concerned about the obvious potential adverse effects of ongoing large narcotic
doses, specifically adverse reactions related to Demerol metabolites as well as the obvious addictive potential.
This will be discussed at length with Dr. Van Valin."
Q. Who is Dr. Van Valin with respect to Mr. Jackson in this time frame?
A. One of the main treating physicians at this time.
Q. Did you see any evidence, in your review of the record, that Mr. Jackson ever took any opioids other than
Demerol meperidine?
A. Yes. We have evidence he took percocet that contains oxycodone. We have evidence that he took morphine.
We have evidence that he took fentanyl, a number of other opioids. There is some mention of dilauded which is
hydromorphone as well.
Q. Let's take a look at the next criteria you said was significant to your opinion, criteria three. Do you have a
slide on that as well?
A. Yes.
Ms. Cahan. That's exhibit 13553. Any objection?
Mr. Panish. Number eight.
Ms. Cahan. Criteria number three at the top.
Mr. Panish. Okay. Number again -- 135
Ms. Cahan. -- -53.
Mr. Panish. That's it right there?
Ms. Cahan. Yes.
Mr. Panish. Okay.
Q. By Ms. Cahan. What does this third criteria mean?
A. That means that no matter what dose is considered to be appropriate from the physician to the patient, that
the drug ends up being taken at higher amounts or for longer periods of time than it was originally intended.
Q. Did you have some examples there of the high amounts or the extended duration?
A. It's an interesting situation with Dr. Sasaki. When Dr. Sasaki started prescribing percocet for the patient, 45
pills at a time, then he ended up prescribing on July 3, July 20th and August 10th. And Dr. Sasaki testifies that
this was too much. That it was larger amounts than was originally intended. The frequency was going up. And
so he preferred to stop really doing the pain management part of the treatment. There is also kind of interesting
what Michael Jackson said to Dr. Gordon later in 2003 where he went to Dr. Gordon for a procedure, finishes
the procedure, gets some pain medication for that, and then asks Dr. Gordon for 300 milligrams of piperazine

for the road at which point Dr. Gordon refused to do so because it was above and beyond what is considered to
be intended use of the drug. If I may just say here also, that this is within the context of a medical world that
was far more liberal about the use of opioids than we are today. These situations in the 90's and early parts of
the 2000's where we hadn't quite realized how addictive opioids can be, prescription opioids can be. So even
though they all medical community supports rather liberal use of opioids, these physicians are expressing
significant concern that these doses are way, way, way higher and more frequent than what was intended.
Q. So let me just make sure I understand that. You're saying that -- you talked about this a little earlier -- that
the understanding in the medical community has shifted about the safety of opioids as to when and how much
they should be prescribed in the last decade or so?
A. The last few years, I'd say in the last five years or so.
Q. Are you saying that, even under the standards of the 90's and the early 2000's, that this is significant to you
because, even under those standards, some of these doctors are saying this is too much?
A. Correct.
Q. Do you remember Dr. Schnoll testifying about it being appropriate to use opioids to treat chronic pain?
A. Yes.
Q. Is that something that you -- what was his opinion as you remember it?
A. Essentially Dr. Schnoll expressed the old idea that we had that, as long as you suffer from legitimate pain,
then it's perfectly okay to get opioids, and the sky is the limit. Keep on giving opioids until the patient reports
no more pain, and nobody will get hurt. That was the overall understanding that we had. If I can expand a little
bit, this is something that we continue to use in a lot of cancer settings. But taking the cancer data, cancer
research and applying it to non-cancer settings end up giving us this huge problem.
Q. That's the shift you're talking about in the thinking over the last couple years?
A. Correct.
Q. Do you know if Mr. Schnoll continues to see patients? He's somebody you know in the field, right?
A. I do know in the field. I don't know if he continues to see patients.
Q. Can someone -- let's talk for a minute about the idea of doctor shopping.
A. Okay.
Q. That's something we've heard a little bit about. What is doctor shopping?
A. It's an unofficial term. It's not something that you will find in DSM or in any official document. But it's one
of the characteristics of addiction when patients who suffer from the illness end up jumping from one physician
to another in pursuit of securing access to the drugs of abuse.
Q. Is doctor shopping something that you see sometimes within this third criteria of the substance being taken
in larger amounts or over a longer period than was intended?
A. Absolutely.

Q. Why is that?
A. That is, a number of physicians may have the limit. They may at some point say "this is enough. I'm not
going to give you any more." if the patient is addicted to the drug and has money and has access and can jump
to another doctor, then they'll try to find another doctor to get the drugs to feed their addiction.
Q. In your opinion, did Mr. Jackson engage in doctor shopping?
A. Yes.
Q. And why do you say that?
A. Well, we have direct testimony from Dr. Metzger, who tells us that Michael did doctor shopping throughout
the 90's and the 2000's. We have a couple examples that stick in my mind from the early 2000's and that is with
--
Q. I don't mean to interrupt you. Do you have a slide on this as well that you want to show?
A. Yes, yes.
Ms. Cahan. That would be, for our records, slide number 9, exhibit 13554. Any objection to showing that one.
Mr. Panish. No, it's okay.
Q. By Ms. Cahan. Go ahead, Dr. Levounis.
A. I'm not going to go into all the examples here that I have on this slide, but I want to focus on Dr. Saunders
and Dr. Van Valin who seem to be the two physicians that were closest to him, or at least we have evidence
about in the early parts of 2000's. Both of them have expressed a friendship with Michael Jackson, and there
seemed to be a mutual trust between Michael Jackson and his physicians. Then we have two examples where
Dr. Saunders ends up giving Michael Jackson an extra dose of Demerol on top of some other dose of Demerol
that Michael Jackson never told Dr. Saunders about, and Michael Jackson ends up in the emergency room, and
only then Dr. Saunders really realized that Michael Jackson is getting injections from other people as well as
him. So that's one example. The other example is, when Dr. Van Valin is about to give an injection to Michael
Jackson and sees a little blood spot on Michael Jackson's shirt. And underneath the blood spot, there is a round
band-aid which is so typical, so telltale of an injection. He confronts Michael Jackson, and Michael Jackson
denies it, but it's pretty obvious that he's doctor shopping. He's getting multiple opioids, multiple doses of
opioids from different physicians.
Q. I see Dr. Farshchian listed there as well. Is he seeing, based on your review of the records, seeing Mr.
Jackson at the same time as Dr. Saunders and Van Valin?
A. He was. He was seeing Michael Jackson in Florida at the time and primarily in Florida, and that's -- he had
no idea about Dr. Van Valin and Dr. Saunders.
Q. When you were talking about Dr. Van Valin a minute ago, you said that Dr. Van Valin saw a spot of blood
from another injection when he was about to give Mr. Jackson a Demerol injection. Did he actually give Mr.
Jackson a Demerol injection then?
A. I believe he did not. I'm not sure about that. I would have to check.

Q. We can check that at break.

A. Yes.
Q. Did you review trial testimony of Debbie Rowe?
A. Yes.
Q. Do you recall that Ms. Rowe expressed in your belief Mr. Jackson was not a doctor shopper, that he just
had -- he traveled a lot and had a lot of doctors for a lot of different conditions in a lot of different places?
A. Correct.
Q. Do you recall whether Ms. Rowe testified about whether she had any firsthand knowledge of Mr. Jackson's
drug use or medical care after 2000?
A. She told us that he -- that Michael Jackson continued get Demerol injections from Dr. Klein all the way up
to 1997.
Q. But after 2000, did she say she had any firsthand knowledge of Mr. Jackson's medical care after they were
no longer married?
A. No.
Q. And so most of the examples on your slide are from after the time period when Ms. Rowe stopped being
aware of Mr. Jackson's medical care?
A. Correct.
Q. Let's talk about the next factor which I think was number four. Do you have a slide on that as well?
A. Yes.
Ms. Cahan. That's slide number ten. It would be exhibit number 13555. Any objection?
Mr. Panish. Okay.
Q. What does this factor mean?
A. That means the patient or maybe his environment are trying to do something about it, and there is a desire
or effort to cut down on the doses of the drugs or to control the substance use or completely discontinue it.
Q. Do you have some examples there of how you believe Mr. Jackson met that criteria?
A. Yes, two major examples of that. One is in 1993 when Debbie Rowe tried with Dr. Metzger tried to detoxify
the patient over a three-week period. That eventually led to a discontinuation of the dangerous tour and the
admission of the patient to rehab in England. Michael Jackson himself went out and said that he was addicted to
opioids, or I think he just said pills, and then checked himself into rehab in England.
Q. I want to ask you about a couple of the other things you've noted on the slide. What's the med alert bracelet
in 2001 about?

A. 2001 is the second time period when Michael Jackson makes several efforts to get the monkey off his back,
as he said at some point, I believe, to Dr. Farshchian. He tried to treat his opioid dependence with bona fide
medication for opioid addiction which is buprenorphine that was given by Dr. Saunders. And he also discussed
buprenorphine with Dr. Farshchian. He went to the extraordinary treatment of getting naltrexone implants,
which is another medication for the treatment of opioid dependence again in 2003 by Dr. Farshchian. We also
see that he was wearing a bracelet, a medical alert bracelet which said that he was allergic to meperidine. He
was allergic to Demerol. 2 now this is not a, frank, allergy. In order to be allergic to something, you have to
break out in hives, and it's a different syndrome. But very often what this alert means to me is that he's making
an effort to not receive any opioids, not receive Demerol because he was addicted to it.
Q. I see the last item listed there is relapses. What is that about?
A. That's what we see here in this diagram is there are three periods of more recorded drug use and an effort to
contain it. In 1993 he goes to rehab but then after a little while relapses. In 2003 he puts in the naltrexone
implants, makes an effort, has the bracelet on, and then he relapses from what Mr. Fournier and others have told
us. And then in 2008, 2009 we see the use of Demerol and benzodiazepines and propofol of course that ends up
with Michael Jackson's death.
Q. Let's take a look at the next factor which is factor six. And that's slide 11, exhibit -- it will be exhibit
135556. Any objection?
Mr. Panish. Nope.
Q. What is this factor about?
A. This is the extent of consequences of addiction. It's not only a matter of doses or a matter of withdrawal, it's
also the psychosocial deterioration I mentioned before in terms of the extent of the consequences of the illness.
The important social, occupational, or recreational activities are given up or reduced because of the substance
abuse. So a couple of examples there, Mr. Laperruque told us about Michael Jackson passing out at meetings in
the early 2000's, direct occupational consequence of his drug use on the social side. On the family side, we have
testimony from Randy Jackson of how he would isolate from his family in the late 2000's. We have evidence
from Mr. Ortega and Mr. Payne of Michael Jackson missing rehearsals, an obvious occupational consequence of
his drug use.
Q. And there is a reference there where Kenny Ortega came to visit Dr. Klein. What does that signify?
A. We have medical records of Michael Jackson seeing Dr. Klein in that period of time, and then we have
testimony from Mr. Travis Payne that he would see Michael Jackson being assisted, as he puts it, or being not
himself after coming back from seeing Dr. Klein. And then Mr. Payne would basically say that he felt that this
was simply a consequence of being on the drugs.
Q. And that was in the time period where Mr. Ortega and Mr. Payne said that Mr. Jackson was missing
rehearsals?
A. Yes.
Q. Let's take a look at the last factor that you're focusing on and that would be slide 12, exhibit 13557.
A. In some respect --
Ms. Cahan. Let me make sure we put that up first. Any objection?

Mr. Panish. No.

Q. What is this factor about?
A. This is perhaps one of the most important factors in addiction. That is continued use despite knowledge of
adverse consequences. Substance abuse is continued despite knowledge of having a persistent or recurrent
physical or psychological problem that is likely to have been caused or exacerbated by the substance. That is the
idea that Michael Jackson several times knew that there was something wrong, and yet the addiction was more
powerful than his own insight into his illness.
Q. And there is a reference to Dr. Saunders being told by Mr. Jackson "I don't want to end up like my father-
in-law." who was Mr. -- do you have an understanding who Mr. Jackson was refer to?
A. Yes. I believe he was referring to Elvis Presley.
Q. Do you have an understanding of what was -- what Elvis Presley is reported to have died of?
A. Yes. Reported he died of pills -- opiate overdose.
Q. Let's talk now, in a few minutes before the break, about some of the other behaviors you noted that are
consistent with Mr. Jackson having an opiate addiction. Okay?
A. Okay.
Q. Is secrecy one of those behaviors?
A. Certainly one of the most poignant ones in that patients, contrary to a lot of other medical illnesses when
things go bad, the patient seeks help and comes to the doctor more. In addiction, we see the reverse. When
things go bad, the patient moves away from the doctor, moves away from the anybody who could possibly help
her or him with the addiction part, pursuing doctors who would give them the medication but not any help in
terms of addiction treatment.
Q. Is secrecy something that you see commonly in the addicts that you treat?
A. Yes, I do.
Q. And why would an addict be secretive about their drug use?
A. It can be several factors here. It could be a very conscious factor in order to make their life a little easier in
terms of procuring the drugs of abuse. If people find out how much you use, then they may stop giving you the
drugs, so there may be a very conscious effort to procure the drugs, to improve the access to the drugs. It can be
more of an unconscious effort as well to compartmentalize your life and keep this part much more private in
what the external image that you want to portray to the world.
Q. Are shame and embarrassment associated with drug abuse in our society?
A. It's a highly stigmatized illness, shame and guilt, appropriate concern about the feelings of loved ones is
very much part of the illness.
Q. Do you remember Dr. Shimelman talking about secrecy as a characteristic of addiction?
A. Yes.

Q. Do you remember what Dr. Shimelman said about addiction and secrecy?
A. He said that -- I believe he was asked if it happens frequently, and he answered something to the effect of it
happens always.
Q. Do you have an opinion about whether Michael Jackson engaged in secretive behavior that's consistent
with a person who is suffering from a drug addiction?
A. Yes. I have a slide on that, too.
Q. That would be exhibit 13558, and I believe it is slide number 13.
A. I have 14 here.
Q. The one titled secrecy factor or the one entitled secret behavior and denial?
A. Whichever.
Q. You tell me.
A. They are similar slides if we're talking specifically about -- let's first go to 13. Let's first look at 13.
Ms. Cahan. So slide 13, exhibit 13558, and then I think it sounds like we're going to move to slide 14 which
will be exhibit 13559. Any objection to either of those.
Mr. Panish. None to 558 and none to 559.
Judge. You have a few more minutes.
Ms. Cahan. We'll stop after that second slide.
Witness. I just list here some of the aspects of the secrecy factors. There is specific secret behavior. Very often
in AA language that is called denial of the drug. There is an aspect of being high functioning that I'd like to
elaborate a little bit later. There is difficulty of lay people to recognize the illness which also fuels secrecy. The
fact that a lot of the symptoms of addiction are nonspecific, so it can be attributed to the flu or insomnia or some
other kind of problem. And, finally, the particular problem that we have with prescription drugs that as a society
we tend to say, if they are prescription drugs, they must be okay. And of course, as I mentioned earlier, we have
found out the hard way that this is not the case. I'd like to elaborate on some of these in a little more detail.
Ms. Cahan. I do, but I don't want to have us run over the lunch break. This is probably a good time to stop.
Judge. Okay. Ordered to return at 1:30.
LUNCH
(The following proceedings were held in open court, in the presence of the jurors:)
Judge. Good afternoon, everybody. Juror number 7, are you okay to go forward?

Juror number 7: yes.

Judge. Okay. If you feel bad or you can't go forward, let us know, raise your hand, we can stop for the day and
resume the next day. Okay?
Juror number 7: okay.
Judge. Thank you. Okay. You may continue.
Ms. Cahan. Thank you, your honor.
Continued direct examination by Ms. Cahan:
Q. Dr. Levounis, right before the lunch break, we were talking about secrecy. Early in the morning, you had
mentioned on your slide 9, which is exhibit 13554, that example of Dr. Van Valin seeing a spot of blood that you
talked about as one of the examples of doctor shopping.
A. Yes.
Q. And you said you wanted to go back and review the testimony about whether Dr. Van Valin gave an
injection. Did you have an opportunity over lunch to do that?
A. Yes, I did.
Q. Okay. And do you want to elaborate a little bit there?
A. Yes. What happened is that Dr. Van Valin gave a shot of Demerol, then saw the blood spot, and then said
something like -- to the effect, "I cannot do that," meaning "I cannot do that in the future." so he had already
given the injection, then recognized that this would have been -- this was a double injection, and then he
mentioned the fact that this is a very dangerous thing and he wouldn't -- he shouldn't be doing that in the future.
Q. Okay. So going back to -- I think we're about to go to your slide 14, which was exhibit 13559.
A. Yes.
Q. And this is one of the components of secrecy, right?
A. Yes.
Q. And can you just tell us what -- what you have there and why you put these things on the slide?
A. These are some examples of secretive behavior and denial for Michael Jackson in terms of his illness, his
addiction. The first one about Dr. Fournier is the episode that happened in early summer of 2003 when Michael
Jackson comes in and Mr. Fournier gives him the anesthesia resulting in an apneic episode. That means that
Michael Jackson stopped breathing for five minutes, as it was reported. And the reason for that was that he had
the naltrexone implant already on board, he had --
Mr. Panish. Excuse me, your honor. I'm going to object to this testimony. Number 1, there was a big hearing
about this regarding this exact issue before at a sidebar, and it was excluded.
Ms. Cahan. No.

Ms. Bina. No.

Judge. I don't think so. I think we heard this testimony. Overruled.
A.. Very briefly, what happened is that he didn't tell the anesthesiologist that he had a naltrexone implant on
board, which is a major risk factor for ending up with too much anesthesia and overshooting the bar and ending
up with an apneic episode, which means that the -- stopping the breathing.
Mr. Panish. It's also beyond the scope of this witness's qualifications. Anesthesia is an area that he was not
testifying in --
Judge. Overruled.
Mr. Panish. -- as to what happened.
Judge. Overruled.
Ms. Cahan. And there's an example there with respect to Cherilyn Lee.
Q. Remind us, who is Cherilyn Lee?
A. Cherilyn lee was one of the people who treated Michael Jackson in the early part of 2009; and she was
primarily helping him with his nutrition, but she took a very comprehensive history from Michael Jackson. And
Michael Jackson essentially did not tell her about his other treatments or any struggles that he had with opioids
or with addiction.
Q. And what about Dr. Slavit?
A. Dr. Slavit is a physician from New York who came and did a full physical exam for insurance purposes,
again, in the first part of 2009 for Michael Jackson. And as part of this physical, Michael Jackson was asked
about prior medications, prior medical problems, and then Michael Jackson really denied any of those -- I think
he might have said something that he took an Ambien 13 years ago.
Q. So these are three examples that you noted from the records where Mr. Jackson didn't tell medical care
providers information that they were asking about his drug use or history of drug use?
A. Yes.
Q. And I think you said that the next component of secrecy is someone being high-functioning. Are some
addicts able to remain highly functional despite their addiction?
A. Yes, this is true. And I would like to bring up slide number 15.
Ms. Cahan. Okay. And I think that would be exhibit 13560. Is there any objection?
Mr. Panish. No.
Ms. Cahan. Okay.
Q. What is this slide?

A. These are examples from four shows that Michael Jackson was involved in where he was able to perform,
the three of them, you know, in 1993, 1996 and 2001 without, essentially, having any problems until -- that's
exactly what I'm saying, that he was able to perform and function well despite the fact that he was on rather
high doses of -- of these medications.
Q. So how does the ability to appear highly functional relate to secrecy and addiction?
A. This is another way that helps, in quotation, addicted patients keep their -- their illness secret from the world.
The way that we understand illness, most of us, is if you are able to function, then everything must be okay with
you; and unfortunately, that's not the case.
Q. So in your review of the records and testimony with respect to Michael Jackson, do you think his ability to
perform and appear highly functional during times that he was using drugs helped perpetuate his addiction?
A. Yes.
Q. And would it make it harder for laypeople to recognize that he was an addict?
A. Yes, most classically when you talk about the functional alcoholic or the high-functioning alcoholic. And a
lot of research has been done, a lot has been written about that, people who are alcoholics and drink in amounts
where they can still go to work and somehow able to cover their illness by their adequate functioning in -- in the
different responsibilities that they have in life.
Q. We've talked a little bit about sort of the difference between what you can see as a trained addiction expert
and what laypeople see. Do you have experience in your practice counseling people who have relationships
with people who have addiction issues but are themselves not addicts?
A. Yes, I do. I have treated several people with network therapy, which is a type of therapy where you not only
involve the patient but loved ones around the patient, where you recruit a number of people to help the patient
stay sober. We ended up writing a book about this called "sober siblings" focusing on siblings of people who
suffer from alcoholism who are sober and how they can best help their alcoholic brothers or sisters.
Q. And you talked about support groups like AA And NA Do any of those support groups also work with the
people who -- friends and family of people who have addiction issues?
A. Yes; most notably al-anon. Al-anon is an organization that -- that specifically caters to the needs of the
families of people who suffer from alcoholism.
Q. So based on your experience, how common is it for people who are not trained experts in addiction to miss
seeing an addiction in their loved one?
Mr. Panish. Excuse me, your honor. This is a different opinion he didn't give before that's not listed on his sheet
of opinions.
Ms. Cahan. It's on the slide -- it's one of the components of secrecy.
Judge. It looks like it's on slide 13.
Ms. Cahan. Yes.
Judge. It looks like he's going to address it in the next one if he's not addressing it now. Overruled.

Ms. Cahan. Okay.

Q. So do you need me to repeat the question?
A. Please, yes.
Q. So based on your 15 plus years of experience working in the field with people who are -- loved ones, friends
and family of people with addiction issues, how common is it for those people not to see that an addict is
suffering from an addiction?
A. It is quite common. Even people like myself who specialize in this area can get fooled quite frequently, let
alone people who do not have the specialized training.
Q. And you just mentioned a minute ago that you wrote a book about -- called "sober siblings"?
A. Yes.
Q. Can you just tell us a little bit more about what the -- the premise of that book is?
A. The premise is that brothers and sisters of people who suffer from addiction are in a unique position to be
particularly helpful to the addict. They share a love and affection, they do have some empathy for the person
who is addicted, but at the same time they have enough distance they can be objective about their -- their
feelings for the person. Very often they share the same age, but they're not financially related to one another, so
we have a very -- very helpful mix of love and affection on one hand but objectivity on the other. And that's
why we find brothers and sisters of addicted patients to be particularly helpful in treatment.
Q. I think you said you reviewed Randy Jackson's testimony that -- Michael Jackson's brother's testimony in
this case. Did you note anything about his relationship with Michael, his ability to recognize issues there?
A. Yes. He reports that there were several attempts by the family, several attempts by him personally, to
intervene. I think he mentioned something about ten times that he could recall that there was some sort of an
effort for an intervention with Michael Jackson.
Q. And you mentioned network therapy a minute ago. Does that network therapy ever include coworkers or
colleagues of someone with an addiction issue?
A. It does. It's --
Q. And in your experience, is it harder for those coworkers or colleagues even than family members,
sometimes, to recognize that someone is suffering from an addiction?
A. Somebody who lives with a patient day in and day out has a little more of an advantage of seeing the signs
and symptoms of addiction because they also observe the patient with their hair down, if you like, under
circumstances that they are not -- when the patient does not have her or his guard up. So both can be helpful.
Employers and employees, coworkers, can be helpful; but, of course, the family has a little bit more of an
advantage of having seen the patient up front and personal.
Q. So how does the -- the difficulty that laypeople have recognizing addiction factor into secrecy?
A. It makes it easier for the patient to conceal the -- the signs of the addiction, it makes -- it feeds the denial that
the patient may very well have about her or his illness.

Q. Okay. And I think you had identified nonspecific symptoms as the next element of secrecy.
A. That's the next slide, slide 16.
Ms. Cahan. And that would be exhibit 13562 -- 1. 13561. Any objection?
Mr. Panish. This is slide 16?
Ms. Cahan. Yes; nonspecific symptoms of opioid withdrawal.
Mr. Panish. Okay. Because you were referring to this as secrecy. It's 13561?
Ms. Bina. Yes.
Q. So before we put that one up, what's the basis for the information that you put in slide 16? Is that based on
your experience and training, or is there some specific source that you're referring to there?
A. It's my basic understanding and -- and training in addiction, as well as seeing my patients.
Q. Okay. We'll show 13561.
A. This is an example of -- sorry.
Q. Go ahead.
A. This is an example of symptoms of opioid withdrawal, and I listed several of them here which one can
recognize rather readily. They mimic a number of other medical conditions. They're called flu-like symptoms
because they resemble the flu; runny nose, cough, chills, lightheadedness, nausea, vomiting. The one symptom
that I have not included here is intense cravings for the drug that the patient experiences, and that's the one that
can be concealed most readily.
Q. Okay. But these other symptoms are symptoms that somebody might see someone exhibiting, but you're
saying they're -- why do you call them nonspecific?
A. Because somebody may have the flu, somebody may not have slept well the night before, somebody may
have been exhausted because they were exercising, somebody -- all kinds of things can give you body aches and
nausea apart from opioid withdrawal.
Q. So how does the fact that the symptoms of opioid withdrawal are nonspecific factor into secrecy?
A. If somebody exhibits symptoms of withdrawal, then the people around the person who would be most likely
to raise the red flag that something is wrong here can very well chalk these symptoms to maybe the person
having the flu, or maybe the person is having a bad day, or maybe the person did not sleep well last night, or
any one of the other things that can give you body aches and nausea and a runny nose.
Q. And, again, you're talking here from the perspective of a layperson might not know -- you know, they might
observe these symptoms and not know what to attribute it to?
A. Correct. Even us, when we see these symptoms, our level of suspicion for addiction is much more -- it's
much higher; but, still, we can be fooled even with a lot of training.

Q. Okay. And I think the next component of secrecy that you listed on the overall slide was prescription drugs
versus illicit drugs. So before we pull that slide out, we've talked about Mr. Jackson's misuse of prescription --
abuse of prescription drugs?
A. Yes.
Q. Did you see anything in the record that you reviewed or the testimony that you reviewed to suggest that Mr.
Jackson was also abusing street drugs?
A. No.
Q. Is it easier for addicts to hide their addiction if they're abusing prescription drugs like Percocet or Demerol as
opposed to illegal drugs like heroin or cocaine?
A. Absolutely.
Q. Why?
A. Because everybody around walks with the assumption that if these medications, if these drugs, have been
prescribed by a physician or a nurse practitioner or somebody who has the training, they must be okay, they
must be fine for you. And this very fallacy is the one that fuels the opioid prescription -- the prescription opioid
epidemic that we're now in, and also the benzodiazepine problems that we have.
Q. Well, sometimes people do take prescription opioids or benzodiazepines for appropriate reasons, right?
A. That's correct.
Q. You're not saying it's never appropriate to take those kind of drugs?
A. No.
Q. But you -- what you're saying is that if you see someone with heroin, for example, that's a big red flag that
there might be a problem?
A. I think that most people would see somebody taking heroin as problematic, just by definition; while if
somebody sees a person taking a prescription opioid, they may think that this could be okay or may not be okay.
Q. Okay. So talking now from the perspective of someone who might be a friend or family member of someone
who's been prescribed prescription drugs, how would that person be able to tell if the person who's taking the
prescribed drugs is taking them appropriately or not? Could they call up the doctor and say, "hey, why did you
prescribe these drugs to my sister?"
A. It is very, very difficult to do that, especially if the patient is doctor shopping, because if the patient is doctor
shopping, then whom do you call, really, or who do you get this kind of direction from? So it becomes very
difficult.
Q. Are doctors typically allowed to tell friends or family members or other people about the diagnoses that
they've rendered of a patient or what prescriptions they're prescribing or why?
A. No. They should have a written release of medical information; and this is not something that happens
routinely, this is not something that I think that patients are very happy to sign.

Q. So let's talk a little bit about Michael Jackson in 2009. Based on your review of the records and testimony,
was Michael Jackson being treated by multiple medical professionals in 2009?
A. Yes.
Q. Who were some of those professionals?
A. Dr. Klein treated Michael Jackson with Meperidine, with Demerol; Dr. Murray treated Michael Jackson with
benzodiazepines. We also have Ms. Lee who also treated the patient at the same time, so -- we have Dr. Metzger
also in the picture. Several people.
Q. So just in 2009 you noted Dr. Murray, Dr. Klein, Dr. Metzger and Ms. Lee?
A. At least, yes.
Q. Okay. And in your review of the record, and I think you alluded to this before lunch, did you see any
instances where somebody observed Mr. Jackson appearing to be under the influence of prescription drugs in
2009?
A. Yes. Mr. Payne reports that he would see Michael Jackson look assisted, look like as if he just was under
some kind of influence.
Q. And do you remember whether Mr. Payne testified at trial here that that was -- he understood that to be a
result of some particular doctor's care?
A. He felt that this could very well have been the result of treatments that Michael Jackson was receiving from
Dr. Klein.
Q. And do you recall whether Mr. Payne testified about any belief he had about whether that was appropriate or
not appropriate? Did he speak to that at all?
A. I think that Mr. Payne essentially shrugged -- not shrugged. That's the wrong word -- just basically attributed
the symptoms that he would see to, perhaps, appropriate medical care that the patient may have been getting
from Dr. Klein.
Q. Did it surprise you to see Mr. Payne's testimony that he saw Mr. Jackson appear assisted at times after
visiting Dr. Klein, but he thought it might be okay because it was medication he was getting from a doctor?
A. No.
Mr. Panish. Speculation. Objection.
Judge. I'm sorry. What was your question?
Ms. Cahan. I asked him if it surprised him to see the testimony from Mr. Payne that Mr. Jackson -- surprised to
see Mr. Payne's testimony that Mr. Jackson seemed to be assisted after visiting Dr. Klein, he didn't necessarily
see that as a problem, he thought it might just be an appropriate -- the result of appropriate medical care.
Mr. Panish. It's also misstating Mr. Payne's testimony, but it's speculation.
Judge. Overruled.

A. I don't find that surprising at all. I think that's rather routine, for people to have this kind of reaction.
Q. and is that something that you've seen in working with the non-addicted friends, family members and
coworkers of people with addiction issues that they don't necessarily recognize?
A. That is true, yes, except in 2013, the overall awareness of this kind of problem is considerably higher than it
was four or five years ago.
Q. I'd like to switch topics a little bit now. I think this was the last of the slides on the secrecy issue, right?
A. Yes.
Q. Okay. And I think the last opinion that was listed on your overall opinion sheet was about a failure to
maintain proper boundaries --
A. Yes.
Q. -- between Mr. Jackson and his doctors. So let's talk about that a little bit. In all your years of education,
training and experience, do you find that it's common for patients to become friends with their treating
physicians outside of the office?
A. No. It's unusual.
Q. And do you have an opinion regarding Mr. Jackson's relationships with his medical providers as it relates to
his addiction?
A. Yes.
Q. And what is that opinion?
A. That he developed very close friendships that were, to say the least, atypical of what we see with
patient/physician relationships. I have a slide on that if you'd like to put that up.
Ms. Cahan. Okay. And that's slide 17, exhibit 13562. Any objection?
Mr. Panish. No.
A. I apologize how busy the slide is. There are quite a few incidents of very close friendships between Michael
Jackson and his providers. I can elaborate on any one of them that you may want me to. I can say some of them
are most notable to me. Dr. Van Valin testifies that not only is he best friends with Michael Jackson, but he
cannot imagine anybody being better friends with Michael Jackson, and vice versa, that he himself was -- both
ways, they were each other's best friend. He -- Dr. Metzger was the best man at Michael Jackson's wedding.
Debbie Rowe ended up marrying Michael Jackson. It's a pattern here of very close relationships, primarily
friendships, between Michael Jackson and his providers.
Ms. Cahan. And I see Dr. Murray is listed there at the bottom of the slide.
Q. Why is he included?
A. Dr. Gordon mentioned that he felt that Dr. Murray and Michael Jackson had a very close relationship and a
close friendship. At some point Dr. Murray essentially tells Dr. Gordon that, "don't worry about the pain
medication. I can take care of that."

Q. And that was back in 2007 in Las Vegas?

A. Correct.
Q. So just generally speaking, what effect, if any, did these relationships have on Michael Jackson's drug use, in
your view?
Mr. Panish. I'm just going to object for the record; speculation, no foundation.
Judge. Overruled.
A. A very close friendship between an addicted patient and his doctors is problematic on two counts. It makes
the patient -- it makes it much easier for a patient to ask for drugs, and it makes it much more difficult for the
provider to resist giving the drugs. So it's a collusion on both sides with rather problematic if not catastrophic
results.
Ms. Cahan. So you said -- you have used the word "collusion."
A. Yes.
Q. are you saying that it was intentional on Mr. Jackson's part that he befriended all these doctors in order to
get -- make it harder for them to say no to him to give him drugs?
A. I don't know. It could be voluntary -- a conscious effort to gain access to the drugs of abuse, or it could be an
unconscious effort to perpetuate his addiction within the realm of denial that we talked about before.
Mr. Panish. I'm going to object, move to strike as speculation, no foundation, beyond the scope of any expert
testimony.
Judge. Sustained.
Ms. Cahan. He testified to this at his deposition.
Mr. Panish. It doesn't matter.
Ms. Cahan. I can lay some foundation.
Mr. Panish. In his standards he says he doesn't know, so to put out some hypothesis that is not to a reasonable
degree of medical certainty would not meet the standard of medical testimony.
Judge. Sustained. Maybe you can.
Ms. Cahan. Okay.
Q. In your experiences, have you ever encountered people with addiction issues who have cultivated or
attempted to cultivate close relationships with their doctors?
A. Yes.
Q. And have any of them ever told you that they were doing it intentionally to maintain an access to drugs?

A. Yes.
Q. And have any of them ever told you that they didn't realize that that's what they were doing until maybe you
pointed it out to them?
A. Yes.
Q. Okay. Is it illegal for doctors to be friends with their patients if the doctors are also prescribing medication?
A. No, it's not illegal.
Q. Is it unethical?
A. Strictly speaking, it's not unethical. It's highly problematic.
Q. And that's because that's the erosion of the boundaries that you talked about, it's easier for the patient to ask
for the drugs, and it's harder for the prescriber to say no?
A. Correct.
Q. And you think that was true in the case of Mr. Jackson?
A. I think it was true in the case of Mr. Jackson, and I think the number of people who develop this close
relationship with a patient does point out to the overall pattern of befriending medical providers.
Q. So this pattern of befriending medical providers -- Dr. Murray, did he ever prescribe opioids to Mr. Jackson,
as far as you can tell from the records and the testimony you've reviewed?
A. He -- no.
Q. Okay. And what about Dr. Farshchian? Do you see any record of him prescribing opioids? Is this going to be
a trick question because of the naltrexone implant?
A. Correct.
Q. I'm sorry. I didn't mean to do that.
A. Naltrexone is an opioid antagonist, means that it does attach itself to the opioid receptor, but blocks the
receptor so other opioids cannot come in and activate it. So in some ways it is -- it does affect the neuro opioid
receptor; but instead of activating, in fact, it blocks it so you do not get the euphoric effect, you don't get the
pain relief, you don't get anything from the naltrexone.
Q. So the friendships that you've identified here that you observed in the records and testimony were not only
with medical providers who were prescribing opioids only?
A. Correct.
Q. And what about secrecy? Is that something that you saw Mr. Jackson exhibit only with people who were
prescribing opioids to him, or other types of drugs?
A. Other types of drugs, as well.

Q. And what about doctor shopping, was the same true? Was it limited only to shopping for doctors who would
prescribe opioids, or was it broader for that in, maybe, the other types of drug use that you noted?
A. It was broader than that.
Q. We talked a little bit early on in the day about this idea of addiction, it being common for people to be
addicted to more than one type of prescription drug.
A. Yes.
Q. Is it also common for people to be addicted to a class of prescription drugs, and then maybe some other type
of drugs? A Street drug or alcohol, something like that?
A. It is common.
Q. Are there particular combinations that you see frequently with people who are opioid addicts?
A. People who suffer from opioid addiction quite often also use or abuse benzodiazepines, and the reason for
that -- one of the reasons for that is that benzodiazepines mask the symptoms of withdrawal. They partially treat
opioid withdrawal; and therefore, patients who suffer from opioid addiction would very well also use
benzodiazepines as a bridge to the next dose of opioid.
Q. Now, in your experience, is it common for somebody who abuses opioids to also abuse anesthesia?
Mr. Panish. Well, your honor, it's -- it's beyond --
Judge. Was there any opinion offered?
Mr. Panish. No.
Ms. Cahan. He testified earlier that he has treated -- and he said this at his deposition, as well. He's treated over
1,000 opioid addicts, and he's never had a Propofol addict, which is the point I'm trying to get to.
Judge. Okay. Sustained.
Mr. Panish. It was excluded before.
Judge. Okay. Sustained.
Q. You said you reviewed the autopsy and toxicology report for Mr. Jackson?
A. Yes.
Q. And did you see a cause of death for Mr. Jackson there?
A. Yes.
Q. What was it?
A. Propofol overdose.
Q. And was there any Demerol, or Meperidine, in Mr. Jackson's system at the time of his passing?

A. No.
Q. Were there any opioids of any kind in Mr. Jackson's system at the time of his passing?
A. No.
Q. And based on your review of the records and the testimony, where did Dr. Murray administer Propofol to Mr.
Jackson on June 24th and into the 25th, 2009?
Mr. Panish. Same objections. We went down this road. They keep asking these questions.
Judge. I'm assuming it's something to do with opioids and Demerol?
Mr. Panish. No. Nothing to do with it.
Ms. Cahan. It's just a couple questions.
Judge. Sustained. He had no Demerol or other opioids. We can leave it at that.
Ms. Cahan. And I was just asking where Mr. Jackson was being treated by Dr. Murray on the last day of his
life.
Mr. Panish. That's beyond what his opinions are.
Judge. Sustained.
Q. And based on your review of the testimony and records, when was the last time Mr. Jackson was
administered Demerol prior to his passing?
A. Let me just check here. June 22nd of 2009.
Ms. Cahan. Okay. I have nothing further at this time, your honor.
Judge. Thank you. Cross-examination?
Cross-examination by Mr. Koskoff:
Q. Good afternoon, Dr. Levounis.
A. Good afternoon.
Q. Dr. Levounis, I wanted to go back over some of the things that you discussed with attorney Cahan; but first I
want to go back over your credentials to get clear -- are you listening to me?
A. Sure, yes.
Q. -- to get clear -- he's reading his file -- to get clear for the jury what your actual qualifications are.
A. Okay.
Q. Okay? You are a board certified psychiatrist; is that right?

A. Yes.
Q. And you are board certified by the -- you have a psychiatry board in addiction medicine?
A. No.
Q. Okay. So you just have a board in psychiatry from the American psychiatric association, whoever issues that
board; is that right?
A. No.
Q. What is the board?
A. I have three --
Q. Let's start off with from the psychiatric board. That's what I want to know about.
A. The psychiatric board is administered by the American board of psychiatry and neurology.
Q. So you have a board from the American board of psychiatry and neurology, and that is a board that is an
officially recognized board by the American board of medical specialties; is that correct?
A. Correct.
Q. The ABMS right?
A. Correct.
Q. Okay. And is that a local board in New Jersey, or is it a national board?
A. It's a national board.
Q. Okay. Are there local board exams you take in new jersey where you practice?
Ms. Cahan. Objection; vague as to "board."
Judge. Sustained.
Q. Are there local boards? Do you understand the question, sir?
Ms. Cahan. Same objection.
Judge. Well, do you understand the question?
A.. I can explain. The boards are national. Where you take it, you can take it in any state you want.
Mr. Koskoff. That's what I thought.
Q. The states don't have their own board exams, do they?
A. Correct.

Q. And as far as you know, the State of California doesn't administer board exams --
Ms. Cahan. Objection; calls for speculation.
Q. -- To physicians, does it?
Ms. Cahan. Sorry. I didn't mean to tread on the question. It calls for speculation. He's not licensed here.
Judge. Sustained.
Mr. Koskoff. Let me ask you this, then.
Q. Can you not answer this question because you are not licensed in the state of California, or -- you can always
say, "I don't know."
A. You can take the boards in any state you want. You can take the board in one state, but then you are
nationally board certified.
Q. Yes. But there is no separate board, as far as you know, that any state gives?
A. Correct.
Q. Correct?
A. Sorry.
Ms. Cahan. It's okay. You just need to give me a chance to object.
A.. I'm sorry.
Judge. Wait a minute. Wait a minute. If you hear somebody speaking, you need to stop speaking so that they
can object, because you may not have to answer the question.
A.. Absolutely.
Judge. All right.
Mr. Koskoff. Now, so that is one board you have.
Q. The second board you have is a board that is within the psychiatry boards, right? Another AMBS -- is there
another ABMS Certified board that you've taken?
A. Yes.
Q. Which one is that?
A. This is in addiction psychiatry.
Q. Okay. Addiction psychiatry. That's, again, another national board. Now, do you have any other ABMS.
Certified boards?

A. No.
Q. You took a test with another organization, ASAM, the American Society of addiction medicine -- you took a
test with ASAM is that right?
A. I did.
Q. And that's a separate organization of people who deal with addiction; is that right?
A. That's correct.
Q. That board is not an approved board by the American board of medical specialties, is it?
A. Correct.
Q. Now, as far as -- now, what you are not, as I understand it, is you have no specialty in pharmacology, you're
not a PHD you have no degrees in pharmacology; is that right?
A. I have a bachelor's degree in chemistry.
Q. Okay. I asked about pharmacology, sir.
A. Pharmacology is very closely related to chemistry.
Q. Just listen to the question, please. Do you have a PHD. In pharmacology?
Mr. Putnam. He's cutting him off in his answers. I would ask he allow him to finish his answers completely.
Judge. Overruled.
Mr. Koskoff. You do not have a PHD. In pharmacology. You do not have any boards in internal medicine,
correct?
A. I do not.
Q. You do not have any boards or any specialty in the field of dermatology, do you?
A. No.
Q. You do not have any specialty in the field of dermatologic surgery; is that right?
A. Correct.
Q. You have no specialty in the field of general surgery; is that correct?
A. That's correct.
Q. You have no specialty in the field of maxillofacial surgery; is that right?
A. That's correct.
Q. And when it comes to the qualification -- and, by the way, you have no specialty in anesthesiology?

A. No, I don't.
Q. Do you know how to read an anesthesia chart?
A. There are parts of it that I absolutely can read and understand.
Q. There are parts -- I think there are probably parts everybody can understand. But there are parts of an
anesthesia chart that you can't read; is that correct?
Mr. Putnam. I move to strike, your honor. He keeps --
Judge. Motion granted. It's argumentative.
Q. Are there parts of an anesthesia record that you can't read?
A. Yes.
Q. Did you read the anesthesia records of Mr. Fournier in this case?
A. Yes.
Q. Were you able to read the whole record?
A. The majority of it, I was able to understand completely; and I certainly can render opinions about the
medications given.
Q. I see. But you're not qualified as an anesthesiologist, are you?
A. That's correct.
Q. And when it comes to the question of the appropriateness of anesthesia treatments, you are not an expert;
isn't that correct?
A. I'm not an expert.
Q. And when it comes to the appropriateness of treatment for dermatologic conditions, you are not an expert; is
that correct?
A. That's correct.
Q. And when it comes to the appropriateness of treatment for surgical matters, you are not an expert; is that
correct?
A. That's correct.
Q. Now, in the beginning of this exercise, this discussion that you had with attorney Cahan, you said that you
were not -- specifically, you were not making a diagnosis of what was wrong with Michael Jackson; isn't that
correct?
A. That's correct.

Q. So that when the jury goes back to deliberate, they should not believe that you have made a diagnosis here,
correct?
A. Correct.
Q. You said it was an impression that you had?
A. Correct.
Q. Now I want to go back a little bit to your work. And do you -- you're now a -- at Rutgers, you're at New
Jersey medical college; is that right?
A. New Jersey medical school.
Q. New Jersey medical school. And before that, you were at Smithers?
A. I was at the addiction institute of New York, which used to be Smithers.
Q. And your work at present, what percentage of the work that you do now is administrative?
A. I would say maybe 30 percent or 40 percent.
Q. 30 or 40 percent of the work you do. And then you have -- you do a lot of lecturing, as well, right? You do a
lot of speaking engagements around?
A. With my new job, less so than I used to; but yes.
Q. Okay. And what percentage of your time is spent on those kind of activities?
A. Teaching and training, supervising, probably another 30 percent.
Q. Okay. So that's another 30 percent. So you've got -- I'm sorry. The first -- the first was 30 to 40 percent, so
let's say that's now 70 percent of your time. And then you mentioned to counsel that you do writing. Do you do
writing?
A. I do writing, that's correct.
Q. About what percentage of your time do you spend writing?
A. Perhaps 5 percent or so.
Q. Okay. And you have other activities? Do you do reviews of -- of files in the hospital?
A. I put that with my administrative responsibilities that I do, it's included in that.
Q. Okay. And what percentage of your time do you actually spend treating patients on an ongoing basis? In
other words, not just patients you see once, but a patient who you treat on an ongoing basis, sir, right now.
A. Right now, maybe -- so that does not exclude the emergency room patients or patients in medical surgical
floors or inpatients. I would say about 10 percent.

Q. 10 percent. So right now, you're spending about 10 percent of your time actually treating patients on an
ongoing basis?
A. Correct.
Q. And for how long have you been doing that, treating patients on an ongoing basis at about 10 percent? Is that
since you've been at New Jersey?
A. Five and a half months.
Q. Five and a half months. Now, before that, when you were at Smithers, was it about this -- or what -- the new
name for Smithers?
A. Addiction institute of New York.
Q. Was there -- were you spending about the same amount of time actually treating patients on an ongoing
basis?
A. It was higher than that.
Q. About how much, please?
A. The outpatient service would be maybe 15 to 20 percent.
Q. 15 to 20 percent. And you were at that institution for how long?
A. For ten years.
Q. For ten years. So -- and you've been out of your training for how long?
A. I finished my residency in 1998.
Q. Sir?
A. Finished my residency in 1998.
Q. 1998. So for -- from 1993 -- okay. 1998. Okay. So -- and after you finished your residency, what did you do?
A. I did a fellowship in addiction psychiatry.
Q. Okay. And then after that, after you finished all your training?
A. I did a stint as interim chief of the inpatient dual diagnostic unit at Bellevue hospital.
Q. So that, again, was hospital-based work, correct?
A. Correct.
Q. That was not treating patients on an outpatient basis for people who have long-term issues that they have to
deal with as far as drugs?
A. At that time, I did also have private practice at a separate location on the upper west side of Manhattan.

Q. And what percentage of your time did you spend at private practice?
A. It was above and beyond my work at Bellevue hospital, and I would say that perhaps was another 10 percent
or so.
Q. So, again, what I'm trying to do is get the idea of actually -- and I think you've given me a pretty good
accurate description here that over the years, you've really been spending about 10 percent of your time actually
treating patients on an ongoing basis.
Ms. Cahan. Objection; mischaracterizes --
Q. 10 to 15 percent; is that right?
Ms. Cahan. Objection; mischaracterizes the witness's testimony.
Judge. Overruled.
A. I think it's a little higher than that, because for -- my time at the addiction institute was ten years; and during
that time, I would say it was more like 15 percent. So I would say 15 percent on the ongoing basis excluding
patients in medical surgical floors, inpatient psychiatry and emergency medicine visits.
Mr. Koskoff. Okay.
Q. Now, in your -- do you actually have admitting privileges at any hospitals right now?
A. Yes.
Q. Which hospital?
A. University hospital in Newark, New Jersey.
Q. Okay. So you do not have admitting privileges at Columbia, right?
A. Columbia?
Q. Columbia university -- any of the Columbia medical school colleges -- I mean hospitals?
A. I believe that I still have my admitting privileges at St. Luke's Roosevelt hospital. At some point that is going
to expire because I changed affiliations. Up until march of 2013, I certainly had full admitting privileges to St.
Luke's Roosevelt hospital, which is an academic affiliate of Columbia university.
Q. But you have -- when you said earlier about your teaching responsibilities, you have what you call -- what
they call a -- you were a clinical -- associate clinical professor; is that right?
A. Correct.
Q. You are not on the faculty, as such, of Columbia, are you?
A. I'm absolutely on the faculty of Columbia.
Q. Well, you're not -- as a clinical professor, you are -- you obligate yourself to train residents; is that right?

A. Part of my responsibilities, yes.

Q. And you do that in exchange for getting privileges at the hospital? That's one of the things you have to do to
get privileges, is to train residents; isn't that right?
A. It's part of the responsibilities of being at the job that I'm doing, yes, part of my responsibilities.
Q. And you are conferred the title of associate clinical professor; is that right?
A. Correct.
Q. You are not a -- you are not a full professor at Columbia university?
A. I am not a full professor at Columbia university.
Q. And at NYU you were an adjunct associate professor, again, not on the permanent faculty, correct?
A. Not correct. When I was at NYU In the period of 1998 to 2002, I was fully on the faculty of NYU.; and then
when I left NYU I was given the adjunct professorship because I continued to do lectures and work at NYU.
Q. And I'm saying right now, you are an adjunct; is that right?
A. Correct.
Q. And in addition to that, you have other activities, don't you? You go -- you do media events?
A. Ever since I started at the new job in New Jersey, I have done very little, if any, media work.
Q. Did you say, "very little, if any"?
A. Correct.
Q. Is it very little or is it none?
A. I think that a couple of -- one or two interviews that I was already scheduled to do before I left the addiction
institute still happened, perhaps, given the time when I was at New York.
Q. And you have a group that you work with called GLG.; is that right?
A. Correct.
Q. And GLG. Is what? Gerson Lehrman group; is that right?
A. Yes.
Q. And they're kind of -- do they sort of broker your services as a -- as an expert?
A. I wouldn't use the word "broker." they ask me to do consultations occasionally, which sometimes I do,
sometimes I don't.
Q. Well, did you -- how did you get affiliated with GLG.?

A. They -- I believe they sent me an e-mail a long time ago.

Q. Excuse me, sir?
A. I believe they sent me an e-mail a long time ago.
Q. So they recruited you?
A. I believe so. It's been several years.
Q. And they said would you like -- they had an expert witness service; is that right?
A. Correct.
Q. And if you would like to participate and get hired as an expert, they would introduce you to people?
A. They never hired me. I never get paid from GLG unless I do a consultation. When I do a consultation, then I
get paid by GLG.
Q. Yeah. But that's -- you get paid by GLG for working for them -- I don't mean you're a full-time employee of
theirs, I just mean things in connection with the expert work that you do, you work -- you get paid by GLG.?
A. Correct.
Q. And so they go and they -- do they put your name out on the internet as somebody who they could hire to
testify -- people could hire?
A. I have no idea. I've never seen my name on the internet being advertised for GLG I don't know how they do
that.
Q. Well, do you get any of your media appointments through GLG.?
A. Never.
Q. Who do you get those through?
A. The hospital.
Q. So the hospital public relations department is the one who got you on the various media events; is that right?
A. That's correct.
Q. And in addition to that, have you been in a movie?
Ms. Cahan. Objection; relevance.
Judge. Sustained.
Q. And what -- what else does GLG. Do for you, if you know?
A. Once they've asked me if I will be interested in being an expert witness in a legal case.

Q. That was another legal case?

A. No. This one.
Q. What about the other legal case you were an expert witness in?
A. That other legal case was not through GLG.
Q. You got that on your own?
A. No. Somebody contacted me and said, "Wed like you to consider helping us with that case."
Q. Have you gone on GLG.'s website to see what -- how they promote their experts?
A. No, I haven't.
Q. But you do know, do you not, that AEG Got to you through GLG.?
A. That's correct.
Q. Okay. And GLG. Pays you $500 an hour, correct?
A. Yes.
Q. For the work that you do for AEG.?
A. I believe it's AEG. Live, yes.
Q. AEG Live. And how much does GLG. Get paid for that service?
A. I have no idea.
Q. Did you ask anyone from OMelveny about that when you were talking --
A. I did not.
Q. And were you asked to sign a contract?
Ms. Cahan. Objection; vague.
Mr. Koskoff. With anybody. I'm -- I'll --
Q. GLG -- were you asked to sign a contract with GLG.?
Judge. You may answer.
A. There was -- there was a contract that at some point I signed. I believe it had mostly to do with
confidentiality issues.
Mr. Koskoff. Okay. Were you asked to sign a contract with OMelveny & Myers?

A. I can't remember exactly. Again, I signed some papers. I believe they primarily had to do with confidentiality
issues more than anything else.
Q. Well, do you have those papers?
A. I don't have them with me, no.
Q. And what were the terms -- well, what was expected of you for $500 an hour? Did anyone tell you what was
expected of you?
A. Yes.
Q. What was expected of you?
A. To render my professional opinion on legal matter -- on medical matters.
Q. Who was it you spoke with first?
A. Ms. Cahan.
Q. And did you -- and when was it that you first spoke with Ms. Cahan?
A. It was in the late fall of 2012. I believe it was November.
Q. And it was November of 2012, you think?
A. Yes.
Q. Did you make notes of that conversation?
A. No.
Q. Were you told not to make notes?
A. I was not told not to make notes.
Q. As a physician, are you used -- accustomed to making notes about conferences and interviews?
Ms. Cahan. Objection; vague.
Judge. Overruled.
A. When I see patients, I always take notes. In other parts, I very infrequently would keep notes.
Mr. Koskoff. I'm sorry, sir?
A. When I see patients, I always keep notes. When I have other conferences, I most typically do not take any
notes.
Q. So the first discussion was with Ms. Cahan in the fall, you believe late November of last year. And then did
she send you some materials at that time?

A. I believe these are the materials we're talking about that I signed.
Q. Oh, you mean the contract, if it was a contract?
A. Right.
Q. And was the contract that you signed with OMelveny & Myers or was it with AEG. Live?
Ms. Cahan. Objection; asked and answered.
Judge. Overruled.
A. I'm pretty sure it was not with AEG Live, but I'm not sure if it was with GLG. Or with OMelveny.
Q. Qnd so they sent you the contract; and then after they sent you the contract, what else did they send you?
A. Then they started sending me materials relating to this case.
Q. What did they send you first?
A. They sent me medical records and they sent me transcripts of depositions of, primarily, different medical
providers.
Q. And whose -- who -- was -- were there a series of submissions to you of various doctors' records?
A. Yes.
Q. Who was the first -- what was in the first round of records that -- that you were sent?
A. I can't remember which specifically was the first, which was the second or the third.
Q. You've heard about this case, I assume, before you got contacted?
A. No, I had not.
Q. You had heard about the death of Michael Jackson?
A. Yes, I had.
Q. And you had read about it, had you not?
A. I had read some things, absolutely.
Q. And so when they called you and said that it was -- it pertained to the death of Michael Jackson, you knew
who they were talking about, and you knew that there was an issue about his death that was going to be
involved in this; is that right?
A. Yes.
Q. And at that time when you were called, did you know already from the media and from things you'd read that
Michael Jackson had a history of drug problems?

A. I was aware of his 1993 public announcement of having problems with pills, and that was pretty much the
extent that I had of that. I also had heard about 2009 that he -- it was possible that he died of some drug
overdose.
Q. So that -- but you certainly know -- knew about Michael Jackson saying publicly to the world that he had a
drug problem?
A. Yes, I did know that.
Q. And you've talked a lot here about secrecy; but, sir, let me ask you this. Have you ever had any patient of
yours who has ever been less secret about having a problem than Michael Jackson? Have you ever had that?
Mr. Putnam. Objection; vague as well as argumentative, your honor. Less secretive as to --
Judge. As to the drug use? Less secretive as to what?
Mr. Koskoff. As to the drug problem, having a drug problem.
Judge. You may answer.
A. Yes, certainly.
Q. You have had?
A. Absolutely, yes.
Q. And have you had any other patient who you have ever treated who publicly announced to the world that he
had a drug problem?
A. Yes; but I would like not to go further into that because that's private patient information.
Q. Sir, if he announced it to the world, it's not very private, is it?
Ms. Cahan. Your honor, we were very careful not to invade the physician/patient privilege with any of his other
patients. He didn't testify about the specifics of any patient. It's not appropriate to ask him to violate the
privilege that he has with his patients to give an example in response to cross. He did not offer testimony about
this, and we were very careful to maintain that privilege.
Mr. Panish. He became an expert witness, signed a contract, is getting paid through this service. He's talked
about secrecy at length. Clearly, his -- he's talked all about his experience in all those exhibits. He said was
based on experience and training that he's had --
Judge. Well, I think you're missing the issue. The issue is how can it be secretive if somebody announced it to
the world?
Ms. Cahan. The fact that he may have treated someone who made a public announcement about having an
addiction problem -- the fact that he is a treating physician for that person is not public information as far as --
I'm hearing about this for the first time, but I understand that that would not be public information. If there was
some press conference where he stood up next to a celebrity and the two of them said -- the celebrity said, "this
is my doctor and I have an addiction to x," there wouldn't be an issue. But just because someone announces
publicly that they have an issue doesn't mean that Dr. Levounis's treating relationship is open for public
consumption.

Mr. Koskoff. I'm not going to ask him who the person is. I think I understand your concern, sir.
Q. Do you agree that by announcing it to the world, a person is not -- and that statement is not being secretive
about a drug problem? Do you agree or do you not?
Mr. Putnam. I will again object, your honor. Announcing to the world has very different meanings. I can
announce to my family and --
Mr. Koskoff. That's a speaking objection. He's trying to --
Judge. Sustained.
Mr. Koskoff. -- feed the witness an answer.
Mr. Putnam. No, I'm not. It's ridiculous.
Mr. Panish. Then don't say that.
A. At the time --
Ms. Cahan. It was sustained.
Mr. Koskoff. May I have the question re-read, please, so that he can answer the question that was asked?
A. At the moment he made the announcement, he was not secret. That very moment, he was not secret. Can I
explain further?
Mr. Koskoff. Your lawyer will have a chance later on. At this stage in the cross-examination stage, it's basically
I ask the questions, you try to answer it as succinctly as you can. Your honor, are you taking a break this
afternoon?
Judge. No. We started late because --
Mr. Koskoff. I have no problem with that. Because I thought it would be a good time.
Judge. Juror number 7, are you feeling okay?
Juror number 7: yes.
(discussion held off the record.)
Q. Now, after you got those records, did you then -- you had a deposition taken; is that right?
A. Correct.
Q. And how much time did you spend before -- before the deposition to come to your conclusions that it was
your impression that Michael Jackson had a problem with addiction?
A. Something like 25 hours, I believe, something like that.

Q. And would it -- would it -- all right. But if I told you at your deposition you said, "I think 19 hours," would
that be correct?
A. I think I put the deposition in itself and altogether -- somewhere there, between 20, 25 hours.
Q. Actually, I think what you said in your deposition, sir, was that prior to the deposition, you'd spent a total 19
hours on the case.
A. Okay.
Q. How much of that 19 hours did it take you to come to your impression that Michael Jackson had a drug
problem?
A. My diagnostic impression became more and more solid as I was reading more materials and I was having
more studying of the case, so I would say it took all of it to come to the conclusion that I end up --
Q. It took all of it so that before you went into your deposition, you had not told counsel what your opinion
was? Is that what you're saying?
A. No.
Q. Well, you were disclosed as an expert witness sometime in February, weren't you?
A. I believe so.
Q. And had you come to your conclusions before you were disclosed as an expert witness or did you come to
the conclusions after they disclosed you as an expert witness?
A. Starting of a case is a process. My impression became more and more solid as I was studying more and
more. I formulate this impression early in the case, and then became more and more solid as we were
progressing in the start of the case.
Q. In fact, you had your impression pretty much from day 1, didn't you?
Ms. Cahan. Objection.
Q. Day 1 when you got those records in the mail, you pretty much had your impression that Michael Jackson
was a drug addict and you were going to be able to say that, right?
Ms. Cahan. Objection; argumentative.
Judge. Overruled.
A. No.
Q. Well, how many hours did it take you of that 19 hours before you determined that he was a drug addict?
Four?
A. Perhaps -- I don't know. Maybe halfway, maybe ten or so.
Q. Ten hours?

A. Yeah.
Q. Ten hours --
A. It's a difficult question.
Q. -- you reached an impression that seven doctors who treated him on a daily basis never got, never reached; is
that right?
Ms. Cahan. Objection; assumes facts not in evidence.
Judge. Sustained.
Q. Well, did you -- I'll withdraw that question. Did you see anything in the record that Dr. Klein treated
Michael Jackson, thought he had a drug problem?
A. Yes.
Q. What did he say?
A. He said that he was doctor shopping and that he was very concerned about the different medications that he
was taking.
Q. Where did Dr. Klein say that, sir? Was it in his deposition?
A. Dr. Klein in his -- I believe in his deposition, yes.
Q. Yes. And, in fact, that's pretty interesting, sir, because there was no deposition of Dr. Klein. Did you have a
deposition of Dr. Klein that nobody else has in the courtroom?
A. Let me review my records here. I had a list of my -- that I gave the court reporter in the morning, and I don't
think I got it back. It's a different court reporter.
Mr. Panish. I have one here.
Mr. Koskoff. You can't trust those court reporters. Sorry.
Mr. Panish. You can borrow mine. Is this what you're talking about?
A. Yes, that's the one. Thank you.
Mr. Panish. Was there a number on there?
Ms. Cahan. We didn't number it.
Mr. Panish. That's the one they gave me this morning.
Ms. Cahan. Yes. That was mine.
Judge. Is he refreshing recollection, I guess, with this document?
A. Yes.

Ms. Cahan. I think he's just confused about the doctor's name, so --
Mr. Panish. Okay. You just testified. Come on, your honor. She should be admonished for that. That's coaching
the witness.
Ms. Cahan. I'm sorry, your honor, I wasn't trying to --
Judge. No comments, please.
A. I did not find that in the deposition --
Mr. Koskoff. In fact, there was no deposition of Dr. Klein. I'll save you the trouble of looking for it.
Q. What you really did, sir, is you had that impression you said after ten hours of looking through materials that
he was a -- that he was a drug addict, and then what you did is you went back over 20 years of his life to try to
find anything you could find to support that impression, didn't you?
A. As I mentioned before, I formed an opinion, and then I kept on building on this to make sure that what I say
is substantiated.
Mr. Koskoff. I think that's pretty much what I said.
Mr. Putnam. Move to strike, your honor.
Judge. Motion granted.
Mr. Panish. I'll withdraw that.
Judge. Stricken.
Mr. Koskoff. You didn't start off so that you -- question withdrawn.
Q. What did you review -- what were the records that you reviewed in the ten hours?
A. These are the records here that -- the medical records and the deposition testimony that I reviewed. These are
the number of things that I reviewed at the time. Primarily medical records, but also depositions. I cannot
specifically remember which ones were for the first on ours versus maybe a little later.
Q. So you don't remember as of today which ones you read that made you form that impression; is that right?
A. What I'm saying is it was a gradual process.
Q. Gradual process. Culminating with today?
A. Yes.
Q. Now, after your deposition and before today, did you continue to receive additional information?
A. Yes.

Q. And how much -- how many hours -- you said it was 19 hours up until the time of your deposition. It was a
pretty short deposition, wasn't it? About a two-, three-hour deposition at most?
A. I think it was about three hours.
Q. How much did you bill for the deposition? 1500? Or is that a half day?
A. It was a half day, so that was 3,000.
Q. How much?
A. 3,000.
Q. 3,000. And how much -- since that time, how many hours have you spent?
A. Perhaps another 25 hours or so.
Q. And let's go into that 25 hours. How much of the 25 hours was spent reviewing additional records?
A. Perhaps another 10 or so.
Q. And how much of it was -- and does that include depositions?
A. Yes.
Q. And did you -- how much of the time did you spend with the attorneys in the case?
A. I spent about three, four hours over the -- with phone calls, maybe five, six, and I spent some times in person
over the past three days.
Q. Okay. So three days. When did you get here?
A. I got here on Friday evening.
Q. And was that late? You were coming from New York -- the east coast?
A. Yes, I did.
Q. JFK. Or something, and flew in?
A. Yes.
Q. And what time did you arrive?
A. 9:00, 10:00 o'clock in the evening, something like that.
Q. Okay. And the next day was -- that was Friday night. Saturday, did you spend time with the attorneys?
A. Yes.
Q. Which attorneys?

A. Ms. Cahan, Ms. Kleindienst and Mr. Rosenberg.

Q. And in addition to the three attorneys, were there any paralegals you spent time with?
A. No.
Q. Was there anyone else besides attorneys that you spent time with?
A. No.
Q. And did they -- when you talked about those demonstrative exhibits that were shown, and you said, "well, I
made this exhibit, I made that --" you actually didn't make those exhibits, did you?
A. Some of the exhibits I made exclusively myself, some of them I made in collaboration with the attorneys.
Q. Okay. So you and the attorneys collaborated on some of these exhibits; is that right?
A. Correct.
Q. And what about the verbiage, the language that was used? Did you discuss what language you were going to
use in those exhibits?
A. There was a lot of collaboration and a lot of back and forth. I stand by the language of these --
Q. Yeah, well, I'm particularly interested in some of the language you used. Like you used the word "hijacked."
A. Correct.
Ms. Cahan. Objection; misstates the demonstratives.
Q. Did you ever see --
Judge. Counsel, hold on. I don't think there's anything --
Ms. Cahan. "hijacked" is not on the slides. Ms. Koskoff: he's used the term "hijacked" a number of times.
Q. Did you discuss with the attorneys the use of the term "hijacked"?
A. I do not remember expressly discussing the word "hijacked." it's one of my favorite words. I use it all the
time in teaching. I don't think the attorneys really came up with anything like that.
Q. But that's one of your favorite words?
A. It is.
Mr. Koskoff. If we're going to take a break, this is good.
Judge. Let's just do ten minutes. Okay? Thank you.
(14-minute recess taken.)
Judge. You may continue.

Mr. Koskoff. Thank you, your honor.

Q. Doctor, during the course of your testimony here, you've been reviewing certain notes that you have; is that
correct?
A. Yes.
Mr. Koskoff. May I approach, your honor? I'd like to get those notes, please.
Judge. Yes.
Mr. Koskoff. And may these be marked, your honor?
Mr. Panish. Just mark the first two.
Ms. Cahan. Your honor, I don't know how they're planning on using it. Some of the stuff that's in here is not
appropriate to show to the jury, and I just don't want to cause the witness to accidentally talk about or show
something --
Judge. We can mark it, but it's not going to be admitted into evidence.
Mr. Koskoff. No, no, no.
Mr. Panish. Not yet.
Judge. All right. We'll mark it. Give me a number of what you want. Do you want to collectively mark the
folder?
Mr. Panish. No. We don't need the whole folder. It's got the slides. 1113.
Judge. 1113?
Ms. Cahan. What are you marking?
Mr. Panish. I'll show you. These two.
Ms. Cahan. So that's the footnotes to the demonstrative? I'm just trying to see what you have because you're
holding them up from across the table. Okay.
Q. Doctor, showing you exhibit 1113 for identification -- and is this an exhibit that you prepared, or did the
lawyers prepare that exhibit?
Mr. Putnam. Objection, your honor. It's not an exhibit.
Ms. Cahan. And as to that, your honor --
Mr. Koskoff. Exhibit for identification.
Ms. Cahan. -- there's two pages. One page relates to the thing that we're not showing the jury, so I just want to
be careful that we're not causing any issues here.

Mr. Panish. That's fine. We're not showing that.

A. Just the first page here?
Mr. Koskoff. Yes.
A. This is one of the things that we worked together in collaboration with the lawyers.
Mr. Koskoff. Okay. So you worked on that in collaboration with the lawyers?
A. Yes.
Q. And then 1114, is that another collaboration?
A. Yes, it is.
Q. And when you say a collaboration --
A. Can I have those back?
Judge. You're taking his file, counsel. He needs it.
Mr. Koskoff. Well, I'll stay here.
Q. 1114, did you have any part of really doing 1114, or did counsel do it all?
A. No. I certainly had a part to it.
Q. Okay. And the same with 1113?
A. Yes.
Q. Okay. So did you tell counsel who the doctors were in the case, or did they tell you who the doctors were in
the case?
Ms. Cahan. Objection; vague.
Judge. Overruled.
A. Some of them, I knew who the doctors were; some of them, I wasn't sure; so that's why it is through
collaboration between the two.
Q. So you asked them?
A. Yes.
Q. And they told you?
A. Some of them, yes.
Q. And you based some of your testimony on what the lawyers told you rather than your own research; is that
correct?

Ms. Cahan. Objection; misstates his testimony.

Judge. Sustained.
Q. Did you base some of your testimony on what the lawyers told you rather than on information you learned
yourself?
A. There was some things in these records here that the lawyers provided, and I did not double check myself to
see. For example, where this --
Q. Okay. You have to understand that when I ask a question that calls for a simple answer -- were there some
things that were in the file that the lawyers told you that you did not get yourself?
Ms. Cahan. Objection; vague as to "the file."
Mr. Koskoff. Just say yes or no.
Judge. You know what? I can't hear the objection if you're talking over counsel.
Mr. Koskoff. I'm sorry, your honor.
Judge. Vague --
Ms. Cahan. -- as to "the file." I'm just confused as to what he's talking about.
Judge. I'm a little confused, too; so I'm going to sustain the objection.
Q. Exhibit 1114, is there some of the information in that exhibit that the lawyers told you that you did not have
yourself?
A. Yes.
Q. And some of your testimony in this case is based upon information the lawyers told you rather than
information that you yourself found from examining the file; is that correct?
Ms. Cahan. Objection; misstates the testimony.
Mr. Koskoff. Well, he can just say -- it's a question. It's cross-examination.
Judge. Overruled. Is that the case?
A. No. Up until now, I haven't really referred to this table here, which is the one that contains the information
you're referring to.
Mr. Koskoff. Well, let's talk about what you did since you got here on Friday night.
A. Yes.
Q. Did you stay here in Los Angeles, downtown?
A. Yes.

Q. And did you meet with counsel Saturday morning?

A. Yes.
Q. And with whom did you meet Saturday morning?
Mr. Putnam. Asked and answered.
Judge. Sustained, asked and answered.
Q. Was that the same counsel that you talked about earlier?
A. Yes.
Q. And what did you do with counsel Saturday morning?
A. Reviewed materials for the case.
Q. What materials did you review?
A. Depositions, medical records. We also worked on possible questions that you may be asking me.
Q. Did counsel tell you the questions I might be asking you?
A. The suggested areas that maybe I would be asked during this trial, yes.
Q. And did they suggest ways in which you might answer those questions?
A. No.
Q. Did you go over some of your answers with them?
A. Yes.
Q. And was that -- that discussion was Saturday morning. Do you remember which particular witnesses you
discussed Saturday morning?
A. No.
Q. Do you remember if there were any of the treating doctors?
A. Yes.
Q. Was Dr. Klein discussed?
A. Yes.
Q. And did you review anything of Dr. Klein's?
A. I reviewed his medical records. Can I clarify something to him?

Judge. Yes.
A. I made a mistake earlier in the cross-examination when I said about Dr. Klein when I actually meant to say
Dr. Metzger.
Q. Did your lawyer tell you that at the break?
A. No, they did not.
Q. Did you ask the lawyer at the break who it was?
A. No, I did not.
Q. It just came to you?
A. It came to me, absolutely.
Q. And you got Klein and Metzger confused?
A. For a moment, I did.
Q. And what's Dr. Metzger's specialty?
A. Dr. Metzger is a general physician and worked in that capacity, maybe an internist. Let me review my
records here, then.
Q. I just want to ask you do you remember who Dr. Metzger is --
A. Of course I do.
Q. -- and what is his specialty? Can you tell what his specialty is without looking at your notes? If not, you can
go to your notes and refresh your recollection.
A. He is a general physician. He specializes in rheumatology, but he acted primarily as a general physician.
Q. Is he practicing now?
Ms. Cahan. Objection; calls for speculation, assumes facts not in evidence.
Mr. Koskoff. It's --
Judge. Overruled.
A. I'm not sure if he practices right now.
Q. He's a rheumatologist?
A. I believe that's his training.
Q. Isn't that a specialty?
A. Yes.

Q. Why did he see Michael Jackson?

A. A lot of people who specialize in rheumatology may very well be seeing patients in a general practice, so I
suspect that may be the connection. He did see Michael Jackson for a number of general medicine issues,
including some musculoskeletal problems.
Q. That's your impression that that's why he saw Michael Jackson, right?
Ms. Cahan. Objection; argumentative.
Judge. Overruled.
A. Yes.
Q. And just like your impression that he had an addiction?
Ms. Cahan. Objection; argumentative.
Judge. Overruled.
A. No. They're very, very different kind of impressions.
Q. In fact, you're willing -- are you willing to speculate when you give answers, sir?
A. No.
Q. Okay. But what you said about Dr. Metzger, that was just speculation, wasn't it?
A. That was an overall impression that I had from the review of the records. I've been reviewing volumes and
volumes of materials; and at this moment, as I stand here, that's the best I could come up with.
Q. Could you answer my question, please? I asked you are you willing to speculate in that answer?
A. No.
Q. So that is why Dr. Metzger saw Michael Jackson, that's why he went to Dr. Metzger? That's what you're
saying; is that right?
Ms. Cahan. Objection; vague.
Judge. Overruled.
A. Are you asking me about the very first time that Dr. Metzger saw Michael Jackson?
Q. Well, what did he -- do you know what happened in that time, what that was for?
A. I do not recall that, no. I know that it was long time ago, it was something like 1983 or so; but I can't
remember the specifics.
Q. And how did he -- how did he get to Dr. Metzger? How did Michael Jackson get to Dr. Metzger?

A. I believe that he was introduced by Dr. Klein.

Q. And what was his -- what was -- isn't it true, sir, that he didn't go to Dr. Metzger as a general doctor, he went
to him initially for an opinion regarding whether or not Michael had lupus?
A. I don't recall this particular incident. I'd be happy to review it if you want to show it to me.
Q. You got that answer when you talked with counsel, about, "I'd be happy to review it," that answer?
Ms. Cahan. Objection; argumentative.
Judge. Overruled.
Q. Let me ask you, isn't that an answer that counsel gave you to say -- an answer for you to say? When
somebody asks you if you remember something, you would say, "I'd be happy to review it if you would like"?
Weren't you told by counsel to say that?
A. This is something that I own and something that I fully stand behind.
Q. I see. But you saw -- did you read Dr. Green's deposition?
A. Dr. Green's deposition? I can't recall right now Dr. Green's deposition.
Q. Who was Dr. Green?
A. I can't recall right now who is Dr. Green. I can possibly look at some of my records here.
Q. Did you read Dr. Czeisler's deposition?
A. Dr. Czeisler's, yes.
Q. Now, so Saturday morning, you met with the lawyers?
A. Yes.
Q. And you went over some of the questions I was going to ask and over some materials, and then -- did you go
out to lunch with them?
A. Lunch was brought in.
Q. I see. So you worked all day? Did you work all day?
A. Until 4:00, I believe, or 5:00.
Q. And was it the same lawyers all day long?
A. Yes.
Q. And did you go over -- did they go over with you the questions that they were going to ask you?
A. We did go over questions that they would ask me, yes.

Q. And they showed you deposition sections, correct?

A. Deposition sections -- we worked on deposition sections together.
Q. When you say "we worked," did they show you portions of depositions that you might want to refer to?
A. Yes, and I showed them portions of depositions that I felt were relevant.
Q. Okay. And then Saturday night, you left, went home, went to sleep. Sunday, when did you start?
A. Around 10:00 o'clock.
Q. And same lawyers?
A. Yes.
Q. Same scenario?
A. Yes.
Q. You went over -- and when was it that you actually made up those slides that -- that counsel showed to the
jury?
A. It was all three days, Saturday, Sunday --
Q. Were they drafts? Did you go through several drafts of the slides?
A. We went through a few corrections of the slides and a few drafts, yes.
Q. And a few drafts. And do you have copies of the earlier drafts?
A. No, I don't.
Q. And then -- and that -- how long did you work on -- on Sunday?
A. About the same time period.
Q. That's about -- you started from about 10:00 and you ended about when?
A. I believe 4:00 or 5:00.
Q. And then Monday, did you meet with them again?
A. Yes.
Q. And, again, how long did you meet with them to go over what you were going to say?
A. About the same time.
Q. 10:00 to 5:00?
A. I think we end up earlier, around 4:00.

Q. Now, in the last day, is there anything that you read -- any deposition that you read over?
A. I did read some of the depositions later by myself to refresh my memory.
Q. Which one?
A. Certainly Dr. Van Valin. I believe Dr. Saunders, as well.
Q. Anyone else?
A. I did look through the materials again trying to remember as much as I can about preparation for today.
Q. And did you go through a mock cross-examination?
A. I'm not sure exactly what that means; but yes, we did go through questions that you may be asking me and
answers that I may be offering.
Q. Now, who was it who -- who did that part of the examination?
A. Sometimes Dr. -- Mr. -- I'm sorry mrs. -- sometimes Ms. Kleindienst, sometimes Ms. Cahan.
Q. Okay. You said that you've spent about 25 hours since your deposition. All right. You've told us about Friday,
Saturday -- I'm sorry -- Saturday, Sunday and Monday, the time you spent.
A. Yes.
Q. Is that included in the 25 hours since your deposition?
A. I tried to include that. The entire time would be something more -- I may have to revise that more to 30 to 35
hours to include the telephone calls and the other review of materials.
Q. So there were 20, but those -- that's 24 hours of work you did Saturday, Sunday and Monday?
A. I believe it was a little less than that, but somewhere there.
Q. Okay. And you said now you're going to revise the amount of time you spent to 30 hours?
A. Come to think of it, if you add the number of hours that I've worked on the case between the deposition and
the -- that's the first time I'm calculating these kind of numbers, but it would be something like that.
Q. Well, you haven't sent a bill to GL. Whatever?
A. I've sent the bill to GLG. Not for these three past days, no.
Q. And do you keep hours?
A. I do keep hours, yeah.
Q. Where do you keep the hours?
A. My computer.

Q. And so you know how many hours you spent?

A. Not off the top of my head, no. I have a general feeling, and that's what I'm trying to convey to you.
Q. I'm sorry. I interrupted you.
A. I'm saying I have a general idea and that's why I'm trying to be as correct as possible here.
Q. And -- but before you came out here to California and since your deposition, have you billed GLG. For any
hours?
A. Yes.
Q. How many hours did you bill GLG. For?
A. Maybe 15.
Q. So you billed them for 15 hours before you came to California?
A. Yes.
Q. And do you charge for the time you're on the plane?
A. No.
Q. Okay. So you billed them for 15 hours, and then you've been here for -- you described about 24 hours.
A. If you think about six to eight hours, that would be more like 20 hours, and perhaps another 10, 15 -- maybe
the grand total would be anywhere between 30 and 35 hours.
Q. How much of the time before you got here did you actually spend carefully reviewing the medical evidence?
A. Occurring before the deposition, or --
Q. Well, that's a fair question. Let's say since the deposition.
A. Maybe five, six hours. I don't -- I don't really remember exactly how many hours, but it's somewhere there.
Q. And you -- you came -- did you feel, sir, that in a case of this importance -- you believe this is an important
case?
A. Yes.
Q. Do you feel that in a case of this importance, you have given the kind of careful consideration that an expert
should give to an opinion as important as this?
A. Yes, I do.
Q. You called a man in your slide an addict, didn't you?
A. Yes.

Q. And you know, don't you, sir, that the word "addict," rightly or wrongly, has a very negative connotation,
doesn't it?
A. All of mental illness has a negative connotation, including the word "addict," "schizophrenic," a number of
mental illnesses. There's no question that there is a lot of stigma in mental illness, yes.
Q. People feel sorry for schizophrenics, don't they?
A. Some people do.
Q. People feel sorry for a person who has cancer, don't they?
A. A lot of people do, yes.
Q. But when the term "addict" is used, that brings to mind certain visual concepts, doesn't it? You understand
that?
A. Yes.
Mr. Putnam. Vague, your honor.
Judge. Sustained. I think it is vague.
Mr. Koskoff. He said he understood it, your honor; and I think he does, too.
Mr. Putnam. Move to strike, your honor.
Judge. Motion granted, the answer is stricken.
Q. Does it have a negative connotation?
A. The word "addict"?
Q. Yes.
A. Not in my mind.
Q. No, not in your mind. But you know as part of your job as an addiction specialist that in society in general,
there is a negative perception of addicts?
A. Yes, it's a specialty that's full of negative connotations.
Q. Now, and that's one of the reasons, sir -- question withdrawn. You referred in that slide -- let me get the slide
here. Do you remember that you showed a slide to us that talked about addiction -- it was labeled "addiction"?
Ms. Cahan. Objection --
A.. Which number?
Mr. Koskoff. That's what I'm trying to find. Okay. I'll come back to this. You know, sir, that -- I'm going to talk
a little bit about what you were referring to earlier as the DSM IV. Okay?

Q. The DSM. IV is the manual that is produced by the American psychiatric association; is that correct?
A. That's correct.
Q. And the DSM. Stands for diagnostic statistical manual, correct?
A. Correct, and statistical manual.
Mr. Koskoff. Diagnostic and statistical manual. And I have slide number 13550. Can you put that up?
Mr. Panish. Hold on. Just -- oh, there it is.
Q. what you testified, sir, under oath earlier today was that the criteria for determining drug addiction that you
listed there were from the DSM. IV; is that correct?
Ms. Cahan. Objection; misstates the testimony.
Judge. Overruled.
A. It was based on the DSM. IV criteria, yes.
Q. But the DSM. IV doesn't use the word "addiction," does it?
A. Of course not. I said that already.
Q. Where did you say that, sir?
A. Earlier when I was speaking with Ms. Cahan.
Q. Maybe, but you didn't -- but you didn't say that in court here, did you?
A. Yes, I did.
Mr. Putnam. Objection, your honor; misstates his prior testimony. He said exactly --
Q. So you're saying, then --
Judge. Wait a minute. Is that what you said in court today?
A. I said that it is not in the DSM. -- the word "addiction" is not in the DSM. IV.
Judge. Sustained.
Q. So the word "addiction" is not anywhere in the DSM IV, is it?
A. Correct.
Q. They took it out of the diagnostic manual for psychiatrists because it was of uncertain meaning?
A. No.

Q. And because it had negative connotations; isn't that correct?

A. Would you like me to explain why they took it out?
Mr. Koskoff. You can say yes or no.
Judge. Just answer the question.
Mr. Koskoff. You can answer my question yes or no.
A. Okay. No.
Q. And you chose, though, rather than using the term -- what is the term that the DSM. Does -- IV does use?
A. "dependence."
Q. "dependence." the DSM. IV says that the criteria that you listed there are criteria for establishing
dependence, correct?
A. Correct.
Q. Not -- and they don't say they're the criteria for establishing addiction?
Ms. Cahan. Objection; asked and answered.
Judge. Overruled.
A. That's correct.
Q. And you chose to use the word "addiction" in the slide, didn't you?
A. Yes.
Q. Did you discuss it with attorney Cahan?
A. No.
Q. That was your decision?
A. 100 percent.
Q. Now, the DSM. IV has been changed. In fact, it's obsolete now, isn't it? Withdraw the question. It's been
superseded?
A. That's correct.
Q. That it was in effect for many years; is that right?
A. Correct.
Q. And then the American psychiatric association felt -- or decided to change the criteria for various reasons; is
that right?

A. Yes.
Q. And so now they do not -- they've changed the whole manual. It's now called DSM. 5; is that correct?
A. Correct.
Q. And DSM. 5 is -- one of the other things they changed is they no longer use a roman numeral for iv, now
they just go right to a number 5, right?
A. Correct.
Q. And didn't -- doesn't the DSM. 5 specifically say that most people link dependence with addiction when, in
fact, it can be a normal body response to a substance?
A. I don't quite understand the question the way it's phrased.
Q. Okay. Well, I'll ask it a different way. The DSM. 5 is the one that is the -- the manual that is currently in
effect?
A. Correct.
Q. And DSM. 5 says that the word "addiction" is not applied as a diagnostic term; isn't that correct?
A. It's on the title of the chapter.
Q. Does it say that the word "addiction" is not applied as a diagnostic term -- as a diagnostic term?
A. After a lot of debate, the word "addiction" was not really included in the body of the diagnosis.
Q. Sir, would you answer my question yes or no, please?
A. It's not included in the diagnosis, correct.
Q. And the reason it's not included as a diagnostic term is because of its uncertain definition and potentially
negative connotation; isn't that so, sir?
A. That's correct.
Q. And in spite of the fact that the American psychiatric association took the word "addiction" out of the
diagnosis, you still used it in your slide to this jury; isn't that so?
Mr. Putnam. Objection; asked and answered and argumentative, your honor.
Judge. Overruled.
A. First of all, the word "addiction" --
Q. Did you, sir? I'm sorry, I don't want to interrupt you, but I know what -- you have to answer yes or no, if you
can; and if not, just tell me you can't and I'll decide if I want to pursue it further.
A. I have to say more than yes or no to this question.

Q. Did you say something, sir?

A. I have to say more than yes or no as an answer to this question that you asked me.
Q. Now, the American psychiatric association took the word "addiction" out and substituted what they
considered to be a neutral term; isn't that right?
A. No.
Q. Substance abuse disorder?
A. That's wrong.
Q. Excuse me?
A. That's wrong.
Q. They didn't -- they didn't change it to substance -- substance use disorder?
A. That's correct.
Q. That's correct. So they changed it to substance use disorder; isn't that right?
A. Retaining the word "addiction" in the chapter.
Mr. Koskoff. I ask that that be stricken.
Mr. Putnam. Your honor, it's an answer.
Mr. Koskoff. I asked about the diagnosis and -- he just insists on volunteering.
Mr. Putnam. Your honor, what his question was is they changed it to substance use disorder; isn't that right?
And because it's an entire chapter, he said no, they left "addiction" in the title.
Mr. Koskoff. Substance use -- let me go back, sir.
Judge. All right.
Q. Substance use disorder is the diagnosis?
A. That's correct.
Q. It's not addiction, according to the American psychiatric association; is that right?
A. There are several disorders that are called substance use disorders, that's correct.
Q. And they -- you did it to describe disorders that can be from mild to severe; is that right?
A. That's very correct.

Q. So that if we think of substance use disorder on the one side, there are people who have a mild disorder, and
at the other end of the scale, there are people who have a serious substance use disorder?
A. Correct.
Q. And a person can fall anywhere along that spectrum?
A. Yes.
Mr. Koskoff. What time are we going to, your honor?
Judge. Is this a good place to stop?
Mr. Koskoff. Yes.
Judge. Let me find a time for you to return. Okay. 9:30 tomorrow. Thank you.
(the following proceedings were held in open court, outside the presence of the jurors:)
Judge. Just a reminder. Please, if you object, please just state your grounds for your objections.
Mr. Putnam. Yes, your honor. Could I ask how much longer he's going to be tomorrow so we can determine
whether or not to have the additional witnesses cued up?
Mr. Koskoff. Ms. Cahan asked me earlier and I said I thought I would probably go most of the morning.
Anytime you want to ask me, you can ask me directly.
Mr. Putnam. I like to ask the court. So that means they'll be most of the morning so we won't need someone
tomorrow morning?
Mr. Koskoff. If we're starting at 9:30, I think I will -- I will definitely go to 11:00.
Judge. Redirect, right?
Ms. Cahan. At this point, I have very little; so we'll have someone here for late morning.
Mr. Panish. I would say to be safe have someone that you could call at 11:00 to be here.
Mr. Putnam. I'll have them here at 11:00.
Judge. Who are we having at 11:00?
Ms. Cahan. Dr. Quinn and then Cherilyn Lee after that.
Judge. All right.
Mr. Panish. Thank you.
(proceedings adjourned to Wednesday, august 28, 2013, at 9:30 a.m.)