If you are going to convict Michael Jackson's doctor for homicide for using propofol as colonoscopy anesthesia at home without anesthesiology support you will have to convict gastroenterologists and general practitioners for using colonoscopy anesthesia without anesthesiology support, if a patient dies on the table. in their outpatient endoscopy suites.
If you don't want to blame the propofol colonoscopy anesthesia use in an out of hospital setting as the basis of the "gross negligence", but rather the off label indication for Dr. Conrad's use, then you will be convicting millions of doctors for using off label medications every day they go to work and cause the death of patients for such things as treatment of ascites with lasix when the patient dies of acute renal failure.
The Cochrane Review indicates that only one study compared the administration of propopfol by anesthesiologists compared to non-anesthesiologists with no difference in procedure time or patient satisfaction.
Another big study suggested the safety of propofol when administered by general practitioners in free standing endoscopy suites, over thousands of patients. It appears colonoscopy anesthesia can be safely administered in non ICU settings by non anesthesiologists.
Gastroenterologists are no more likely than general practitioners who are no more likely to be adequately trained to administer colonoscopy anesthesia than say a cardiologist. Yet the evidence, while limited, suggests colonsocopy anesthesia can be done safely by non anesthesiologists.
Performing bad CPR does not equate to homicide. If that was the case, I would recommend many of Happy's hospital RNs be charged with murder for bad providing bad compression technique.
Rules of administration for conscious sedation( such as for colonsocopy anesthesia) vary from hospital to hospital and no such standard exists for out of hospital administration. The administration of propofol outside of hospitals is quite common. For off label uses such as colonoscopy anesthesia.
You can substitute insomnia for colonoscopy and the endoscopy suite with MJs mini ICU and the result is criminal homicide prosecution for every gastroenterologist or general practitioner that performs screening colonoscopies with colonoscopy anesthesia that result in a bad outcome.
The mob mentality wants to send Dr Conrad to jail for homicide. A ridiculous assertion given that this medicine is used in outpatient settings by nonanesthesiologists in off label indications all the time to perform screening colonoscopies. The evidence suggests that propofol can be administered as colonoscopy anesthesia for routine colonoscopies, by non anesthesiologists. You cannot convict a man for administering a medication that the data suggests can be done safely in an out of hospital setting. Unless of course you are the mob. Which is exactly why this man will get a vigorous defense in the court of law. As he should.
