Milk of Amnesia

More than Mother’s little helper…

Tomorrow marks one month until the status hearing with Judge Weisberg to review the status of evidence testing of the 3-4 cc’s of Robert Wone’s blood specimen remaining from the autopsy. The status of other forensic testing is also anticipated.

At the May 22, 2009 status hearing the prosecution and defense agreed that the remaining blood would be used to test for additional drugs. Both sides concurred that these tests would consume all of what remains. The government and defense were told to agree upon the limited number of drugs that would be screened given the size of the remaining sample, paralytics included. Weisberg suggested, “… and anything that ends in -caine.”

Much has been discussed regarding the possible use of ketamine to incapacitate Robert. After all, ketamine is readily available on the street or the back doors of unscrupulous veterinarians or physicians. Recently, another anesthetic has been making headlines in the Michael Jackson investigation – propofol.

Propofol

Propofol

Propofol is a short-acting, intravenous agent used extensively in anesthesia and intensive care medicine to provide dose-dependent sedation and hypnosis. It is characterized by a short onset, a short duration of action, low toxicity, ability to control sedation, and ease of administration. Thus, it quickly found general acceptance amongst anesthesiologists after its introduction into the market in the mid- 1980s. Other advantages to propofol are its anti-nausea properties and rapid metabolism, eliminating undesirable side-effects of its popular predecessor, sodium pentothal.

The New York Times recently featured a front page story propofol’s potential for abuse and addiction . Detailed in an article from Anesthesia & Analgesia:

Although its clinical properties are well known to anesthesia providers, knowledge concerning its abuse potential and more complex issues, such as its use in suicide, are less commonly appreciated. Before 1992, clinicians and the manufacturer were convinced that such abuse was rare to nonexistent. Since 1992, however, reports have been published (largely in forensic medical journals) concerning abuse, accidental overdose and suicide.

The Drug Enforcement Administration in Drugs and Chemicals of Concern states:

Propofol is mostly abused by health care staff including anesthetists, practitioners, nurses and technicians…Propofol has a narrow window of safety. Induction of anesthesia with propofol is associated with cessation of breathing in some adults and children. Prolonged high dose infusions of propofol for sedation in adults and children have been associated with cessation of breathing, breakdown of heart muscle, heart and kidney failure leading to death in some cases, referred as “Propofol Infusion Syndrome.” Propofol abuse may also cause fluid in lungs, cardio-respiratory depression and death. There is no antagonist or reversal medication for propofol.

Propofol is an unlikely street drug, given its narrow window of safety, usually managed skillfully through proper administration and monitoring of vital signs by anesthesiologists and nurse anesthetists. Euphoria, sexual hallucinations and dis-inhibition have been described on recovery of propofol anesthesia. These effects could explain the recreational use of the drug. That does not preclude obtaining the drug through seemingly legitimate channels. One case of propofol abuse involved a 25 year old man who obtained prescriptions for propofol from various veterinarians whom he told that he was a tropical fish enthusiast and he needed propofol to anesthetize his fish.

Did the government and defense team agree to include propofol in the list of drugs to be tested in Robert Wone’s blood? Perhaps we will learn at the September 11th status hearing.

– posted by Michael

51 comments for “Milk of Amnesia

  1. CDinDC
    08/10/2009 at 11:04 AM

    Hmm….I’m not ready to jump on propofol bandwagon, guys.

    I’m still going with Ketamine. Propofol has been, pretty much, an unknown drug until Michael Jackson died. And there’s really no connection between propofol and the gay community. Not to mention it’s primarily an iv. drug.

    I need more on that one.

    • CDinDC
      08/10/2009 at 11:05 AM

      Not to mention Mr. Culuket dropped a dime on himself with that cute little moniker of his.

      • David
        08/10/2009 at 11:37 AM

        CD,

        When Lance was an active commenter on the site, he was particularly upset with any definition of culuket without further information. Yes, someone suggested that it was a combination of the spanish word “Culu” and the shortened “ket” for ketamine, but there are also many other definitions that could fit the word. I think our best bet is to go with likely definitions based on what we know, but with the full understanding that we certainly don’t know a lot, and the origins of “culuket” is definitely one of them.

        David, co-ed.

        • CDinDC
          08/10/2009 at 11:50 AM

          Noted, David.

          I certainly don’t mind looking at all angles.

          • Craig
            08/10/2009 at 12:16 PM

            Didn’t we learn recently that the slate of drug tests performed on Robert would’ve turned up Ketamine yet the results were negative?

            With so many injections sites found on his body, is it possible someone was looking to tap a vein? Especially at the hand & foot sites? Just wonderin’.

            • CDinDC
              08/10/2009 at 1:08 PM

              Is this Craig the ed?

              I thought the only drug test done to date was the basic tox screen that was done post autopsy.

              “Tap a vein”…..why the willy nilly when flipping over his arm would have sufficed? A lot of people think he was pre-drugged and if he was finding a vein would have been easy.

              • Craig
                08/10/2009 at 1:34 PM

                Yeah, it’s me the editor guy. “X” marks the spot.

                I’ll have to track down where but I recall seeing that Ket would’ve shown up in Robert’s blood test.

                Maybe from the May status hearing – which we’ve had a hard time getting hold of the transcript.

                • Doug
                  08/10/2009 at 3:00 PM

                  Ketamine can be tested for two to four days following use, depending on the amount used. It can be detected in blood, urine, and hair; however after several days it would not be detectable.
                  A Medical Examiner we spoke with earlier particularly found the puncture wounds – their number and location – immediately suspect, saying he would have ordered testing on samples taken from the punctures. That, however, wasn’t done in this case.

                  • des
                    08/10/2009 at 3:22 PM

                    “Ketamine can be tested for two to four days following use, depending on the amount used. It can be detected in blood, urine, and hair; however after several days it would not be detectable.”

                    would that be in someone who is alive and metabolizing the drug? or is that for a deceased person too?

    • corgivet
      08/10/2009 at 2:06 PM

      Agreed…propofol is really a “lights out” drug…it MUST go IV in a defined bolus dose for induction and entubation with maintainance on gas and oxygen….or a controlled drip administration…
      Although not controlled…and I am sure the Jackson case will bring this under scrutiny…it’s potential for abuse IMHO is far less than say ketamine….
      Do we know if the 3 to 4 cc of blood is whole blood, serum or plasma…?

  2. JusticeForRobert
    08/10/2009 at 11:47 AM

    Many months ago, when I visited this site for the first time and read Roberts autopsy report, one question came to my mind immediately. Who in that house had a medical background? It would not be long until I learned that Dylan’s father was not only a doctor but a cardiologist. It is not uncommon for the child of a medical practitioner to have access to many medical journals, training materials and exposure to medical scenarios that the average person would not ever come into contact with growing up. I am not saying that having a doctor for a father makes you a murderer. It could however give you a very keen insight into a world that few others may ever know that much about.

    • Clio
      08/10/2009 at 3:27 PM

      JFR, I also believe that Dylan probably gained a familiarity with drugs and medical procedures via his father Needham, but, unfortunately, we need to know more about that father-son relationship before making any firm connections. It has been assumed that Dr. Ward is underwriting at least part of his son’s expenses, but how close were/are Needham and Dylan? No one has come forward to share that family narrative. Dylan’s choices of career seem to point away from any formal or informal “apprenticeship” under Needham, but one could argue that massage therapy is a form of preventative/holistic medicine? Did Dylan want a “Big Daddy” such as Needham in DC — seeking out the structure, security, and order provided by Joe? Who knows? So many questions.

      • David
        08/10/2009 at 4:03 PM

        Clio,

        It is not assumed that Dylan Ward’s parents are paying for their son’s defense, but rather has been directly mentioned by the defense. On page 14 of the Motion for Pre-Trial Release it states, “The brunt of [Ward’s] defense costs are being born by his parents.”

        David, co-ed.

        • Clio
          08/10/2009 at 4:49 PM

          So noted. Thank you, David.

        • Craig
          08/10/2009 at 4:59 PM

          Good point. But did Needam sign on for his son’s defense when it was only David Schertler billing on this?

          I wonder what happened, especially to the hours, when Spagnoletti was added to the team.

  3. WH
    08/10/2009 at 1:26 PM

    Interesting post guys, but propofol is definitely an unlikely candidate for use in Robert’s case. It not only has a narrow therapeutic window requiring close monitoring (i.e. not much dosing difference between sedation and death), and must be given IV, but it also has a VERY short half-life. This means that you’d have to infuse it continously to keep a victim sedated. If it was used by someone as a date-rape drug, death would almost certainly be the guaranteed result since the dose required to keep someone unconscious long enough to rape them, given as a bolus rather than continous infusion, would be very likely to kill them. The short half-life is the reason why this drug is a favorite in ORs and ICUs–patients can wake up quickly from their sedation when the need for it has passed.

    Although one could argue that death WAS the result in Robert’s case, and therefore propofol could have been used, I think it much more likely the murderers would have used a drug they were familiar and experienced with, and propofol is not a likely candidate for Joe and Dylan’s recreational use based on the above.

  4. AnnaZed
    08/10/2009 at 1:27 PM

    Just casting about here, but wouldn’t Propofol or a similar agent (if there is such a thing) additionally have an effect that from Joe and Dylan’s point of view would be advantageous; ie: amnesia. Though you use the word amnesia in the title of this post I’m not seeing (or being obtuse and not seeing) the suggestion that Joe and or Dylan maybe initially banked on the amnesiatic (I am not sure if that is the correct form of that word, but “causing memory loss” is what I am talking about) properties of any of these drugs.

    I think that in their delusion and malevolence these two men sought to incapacitate and sexually assault Robert and that they initially believed that the incapacitating drug would also produce amnesia in Robert. To the mentally disturbed and disinhibited by drug abuse and alcohol abuse this might seem like a good plan.

    I remind all on this site that sexual crimes of this nature against women and girls are so commonplace that they aren’t even mentioned in the mainstream press except as compiled statistics numbering in the thousands per annum. I think that it is important for the participants on this site to attempt to put into perspective the sheer number of drug facilitated sexual assaults on any persons that take place in our society literally daily.

    In a very real sense Joe and Dylan aren’t that extraordinary. They are just garden variety criminals.

    Too much, I think, is made of what might seem on the face of it to be extreme sexual deviation (it isn’t really) on the part of Dylan and Joe. I am concerned that the police have become too focused on, too distracted by the silly props of what is after all S&M ordinaire, predictable and commonplace stuff, boring really after a while.

    I doubt that the police understand that in a relationship like the one described between Joe and Dylan the sexual “slave” is almost always the dominant one in real life. This doesn’t make either of them criminals or even make them all that special. The deviant behavior was first the incapacitating and assaulting of Robert and then the easy escalation to murder and mendacity that followed.

    Like all sexual crimes this was primarily a crime of violence, the sex itself is almost secondary. Again, I return to the idea of who in that house would most likely have unsuspecting Robert in his cross-hairs and I still see Joe in that role. Dylan with his various talents had already shown himself willing to, in effect, prostitute himself to do Joe’s will. Dylan’s agreeing to participate in the sexual crime doesn’t even seem like much of a leap to me.

    • WH
      08/10/2009 at 1:35 PM

      AnnaZed, the word you want is “amnestic.”

      Many drugs have amnestic effects, and any sedating drug is likely to have such. The best known ones, are benzodiazepines (such as Versed in particular), which are often used for short procedures. It is desirable for its ability to produce an amnestic effect even in the absence of complete sedation (i.e. the patient remains somewhat conscious but does not remember the procedure later). This is called “conscious sedation” and is used for procedures such as colonoscopies and others.

      The opposite case is paralytic drugs, which paralyze the patient (or victim) without producing any sedation or amnesia. These drugs (such as vecuronium) will complete incapacitate you (including make you unable to breathe) while leaving you fully conscious. They are used primarily to aid in airway management (such as endotracheal intubation). An unpleasant thing to go through without sedation, from someone who’s been there!

      • AnnaZed
        08/10/2009 at 1:59 PM

        Thank you for your clarification WH.

        I hope you’re not the ghost of Auden or my appalling typing will be even more embarrassing than it already is. Wasn’t he originally a biologist or botanist or something?

        • WH
          08/10/2009 at 2:04 PM

          Your typing is fine! I would not expect someone outside of a medical field to know the word “amnestic”–your suggestion of “amnesiatic” is endearingly creative.

          On another note, I just read the interesting NYT article–thanks to the editors for providing the link. Should have read it before my posts above, as it opened my eyes to the potential for abuse of propofol. However, I would emphasize that nearly all abusers of this drug are medical professionals with ready access, and it still seems exceedingly rarely used as a recreational drug by others. Now that I know about this, however, I’m going to have to check whether this drug is open-access at my hospital… (just kidding)

  5. CDinDC
    08/10/2009 at 1:44 PM

    If you want to consider other drugs (other than ketamine), you could look at the same family of drugs, from which comes tiletamine and zolazepam. They are both veterinary dissociative anaesthetics, similar to ketamine. All three of these drugs come from the PCP family. (PCP can be injected, but intraveneously.) This family of drugs is used specifically to render animals (especially large animials in the wild) immobile in order to conduct medical procedures.

    Re the -caine meds (as the judge suggested), they are local anaesthetics. They don’t “paralyze.” someone.

    • WH
      08/10/2009 at 2:12 PM

      Good point, CD. I would clarify that the “-caines” are indeed local anesthetics, but also potent cardioactive drugs (i.e. lidocaine is used to numb your teeth, but also intravenously as an antiarrhythmic ). These drugs can easily stop your heart in overdose. Some are potent vasoconstrictors as well and can result in heart attacks (i.e. the original “-caine,” cocaine, whose effects everyone is already familiar with.) I would guess this is why the judge suggested testing for these agents, although I agree with you that they are less likely than ketamine to have been used on Robert.

      • CDinDC
        08/10/2009 at 2:26 PM

        Maybe, as Craig mentioned earlier, no traces will/were found. Perhaps we’ll never know what was used.

        But given these 3 factors (gay men, intramuscular injection, no defensive wounds) I’ll go with ketamine.

        K is easily obtained in the gay community (by those that partake), it can be intramuscularly injected, and it has paralytic qualities (without hendering the respiratory system).

    • AnnaZed
      08/10/2009 at 3:21 PM

      So the judge should have said, ” … anything ending in “mine” or “pam” instead”!

  6. AnnaZed
    08/10/2009 at 2:04 PM

    “….Re the -caine meds (as the judge suggested), they are local anaesthetics. They don’t “paralyze.” someone.”

    I know that much as well, and I noted when I read Judge Weisberg’s quote that he is clueless. That could be a real problem at some point in the proceedings.

  7. former crackho
    08/11/2009 at 8:54 AM

    I think we need to be careful not to give these bozos too much credit. Pretty sure it was K or G, or a combo of both. Drugs these guys were familiar with and probably had easy access too, I’m sure.

    • former crackho
      08/11/2009 at 8:56 AM

      Ooops. God, I wish we could edit . Don’t shoot, grammar police :-).

      I’m also bummed – the former crew club worker I knew doesn’t seem to be around the area any longer, or at least isn’t out during the light of day.

      • CDinDC
        08/11/2009 at 9:38 AM

        Facebook? LOL

        • CDinDC
          08/12/2009 at 10:54 PM

          FC….believe it not, there is a Crew Club listing on Facebook! LOL It has 65 members.

      • Bea
        08/11/2009 at 12:03 PM

        I tend to agree about the boys using drugs they likely have “on hand”. And maybe the crew club guy will surface (CD-do love FB reference!).

    • AnnaZed
      08/11/2009 at 12:43 PM

      I think so too former crackho. In fact I think that it is possible to think of this crime and give these assholes way too much credit all the way across the board.

      Rather than being masterminds they appear to me to have been the beneficiaries of a series of astonishing strokes of luck (so far) in that the police seem to me to have made errors so egregious that the District Attorney’s office may be unable to recover from these errors and ever make the obvious case for murder that the evidence calls for.

      That doesn’t make Joe the super in control uber-villain that we on this site sometimes seem tempted to characterize him as being. I think that is possible that some of us (I have this tendency and I don’t even watch TV, ever ~ seriously), are unduly influenced by cultural depictions of murderers as cold calculating articulate quasi-superior beings. They are not. The Mayo Clinic even did extensive research on this phenomenon:

      http://www.mayoclinic.org/news2009-rst/5276.html

      Most violent crimes take place when perpetrators are inebriated or high and lose inhibition. To me Joe and Dylan are nothing but mutton dressed up as lamb, ie: long term substance abusers in nice clothes. I don’t think that they got hold of some obscure and undetectable drug and administered it with Dylan’s special knowledge from being the child of a medical man. I think that they used the materials that they had at hand and got results that went out of their control (as they were bound to) very quickly. Think of the pattern of injection sites on Robert’s body. Does that seem like the work of a skilled or methodical assailant? I think that the forensics labs just fucked up, and that now it’s too late on that front. I think they incapacitated him with whatever crap street drugs they were abusing at the time and that the window of opportunity for detecting them has passed, unfortunately.

      Little rant over now.

      what is “G” exactly?

      • CDinDC
        08/11/2009 at 1:07 PM

        AnnaZed says: “That doesn’t make Joe the super in control uber-villain that we on this site sometimes seem tempted to characterize him as being. I think that is possible that some of us (I have this tendency and I don’t even watch TV, ever ~ seriously), are unduly influenced by cultural depictions of murderers as cold calculating articulate quasi-superior beings.”

        IN control? No. Controlling? I think so. Just based on characterizations from people that know/knew Joe that have posted on the board. Joe wants his world the way Joe wants it. How many people to you know that have a boyfriend in bed and one living in the guest room? Zero for me.

        “Quasi-superior being”……..in his own mind.

        He’s a piss ant. And as you so perfectly said “nothing but mutton dressed up as lamb.”

      • former crackho
        08/12/2009 at 8:36 AM

        From Wiki)

        GHB (Gama Hydroxybutyric Acid) is a synthetic depressant produced in clandestine labs. While available as a prescription for sleep disorders in some other countries GHB was banned (in the U.S.) by the FDA in 1990 because of the dangers associated with its use. However, on July 17th, 2002, GHB was approved for treatment of a rare form of narcolepsy. Most of the GHB used in the U.S. is illegally manufactured within its borders. Like Rohypnol, GHB and its analogs are considered “date rape” drugs because they can be mixed with liquids (even water) and a victim wouldn’t notice by smelling or looking at it. GHB, by itself, has a soapy or salty taste–but when mixed in a drink it may be difficult to detect.

        Its very popular in the gay “party n play” arena and often used in combination with crystal met in that context.

  8. Craig
    08/11/2009 at 12:40 PM

    We dined again last week with our pals who were the Crew Club patrons and claim Dylan Ward in their history. That’s as far as we’ve gotten.

    I still find it curious that they immediately recognized Ward from his mug shot when it was released last year. I wonder if they’d recognize him now.

    • CDinDC
      08/11/2009 at 12:57 PM

      The “history” remains shrouded, however?

      • Clio
        08/11/2009 at 2:01 PM

        What a shame! We do need those details! Any oral history project does take time to blossom, however.

        On a broader, historiographical note, it is curious that, while the late, notorious O Street corridor of flesh and flash has gotten its own collective biography in Craig Seymour’s All I Can Bare, the Crew Club has yet to receive its proper treatment from scholars.

        • CDinDC
          08/11/2009 at 2:31 PM

          Clio, if you want to relive any sordid memories, go to this National’s website. It shows the many buildings they razed for the new stadium. In daylight, no less.

          http://www.jdland.com/dc/stadium.cfm?tab=no3&filter=demos

          But I digress.

          • former crackho
            08/12/2009 at 9:43 AM

            *sob* … God, you are making me so homesick! I’m afraid that may be my car parked outside of club washington
            😉

            • CDinDC
              08/12/2009 at 12:39 PM

              LOL, FC.

              I remember going to the Pier when I was a youngster in the late 70’s / early 80’s. I suppose they gobbled that building up, as well. Not to mention, L&F.

              • former crackho
                08/12/2009 at 3:01 PM

                Believe it or not, the old Pier is now where Ziegfields reopened, on the other side of the freeway – still within a stone’s throw of the stadium, but safe from the first round of the pillage.

                • CDinDC
                  08/12/2009 at 3:57 PM

                  At least something survived from imminent domain.

      • Craig
        08/11/2009 at 3:02 PM

        Clouded, not shrouded. The boys have little to add. Don’t think we haven’t pressed them. Repeatedly.

        It mustn’t have been a night worth remembering.

        • CDinDC
          08/11/2009 at 3:40 PM

          Ouch. LOL

          • CDinDC
            08/11/2009 at 3:43 PM

            Actually, was this pre-Joe or during-Joe?

            And if during, does that mean Dylan would venture out on his own? Or was Joe part of the circus?

            • Craig
              08/11/2009 at 4:15 PM

              Good point CD – We’ll try and time stamp the romp, but I’m nearly certain it was within the last several years, eg. during-Joe, but before the murder. We’ll find out as best we can.

              • David
                08/11/2009 at 6:04 PM

                CD,

                I can confirm it was definitely during Joe. The harder question is was pre-murder Joe, and post murder Joe when the romp took place.

                David, co-ed

                • CDinDC
                  08/11/2009 at 6:50 PM

                  Boy, would love to know specifics (I’m sure you do, as well!)

                  Can you at least tell us if your dinner chums are…..vanilla?

                  • Craig
                    08/12/2009 at 10:22 AM

                    CD – I get the impression they are, but I could be wrong.

                    David ?

                    • CDinDC
                      08/12/2009 at 12:42 PM

                      so, if they are, it goes along with my thought that Dylan goes S&M for his sugar daddy. anything to please his keeper.

  9. AnnaZed
    08/11/2009 at 12:50 PM

    Sorry, make that:

    “…District Attorney’s office may NEVER be unable to recover.”

    My own self copy editing is appalling sometimes.

    • AnnaZed
      08/11/2009 at 12:52 PM

      Oh for Pete’s sake, it was right the first time. I need to go ride my bike and clear my head.

      Many apologies.

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