Anna Nicole Smith's Autopsy

    On Monday evening, Larry King interviewed Joshua Perper, the medical examiner from Broward County, Florida, on the autopsy results of Anna Nicole Smith.

   Here is a partial transcript of the interview.

CNN LARRY KING LIVE

Accidental Overdose Killed Anna Nicole

Aired March 26, 2007     Entire Transcript

  We begin in West Palm Beach, Florida with Dr. Joseph Perper, a frequent guest on this program, the Broward County medical examiner, who performed the autopsy on Anna Nicole Smith.
You found the cause, Dr. Perper, to be -- of the death -- to be combined drug intoxication.
What does that mean?

PERPER: It means that the cause of death was a combination of chloral hydrate, which was the major component, plus four other drugs which were in therapeutic levels. And they were basically intended primarily for control of depression and anxiety. KING: When you call a death accidental, what leads to that conclusion? Like how do you know there wasn't any malfeasance involved?

KING: What do you make as a forensic physician and as a physician, of the amount of drugs she had in her system and the combinations itself?
PERPER: Well...
KING: Have you ever seen any like that prescribed?
PERPER: Yes, we have seen that and as a matter of fact this combination also points to accident because the therapeutic levels of the other prescribed drugs indicated that she did not really wanted to take her life because then we would have expected much higher levels from the other drugs -- of the anti-depression and anti-anxiety drugs.
And the only drug, basically, which was the major component was the chloral hydrate. By itself, it would could have caused the death, but perhaps not in a person who is used to the drug. But in combination with the other drugs, it definitely -- all of them together caused her unfortunate death.
KING: Any illegal drugs in the system?
PERPER: No, there were no illegal drugs at all. As a matter of fact, there was not even methadone in the blood, though it was in the bile -- that's a secretion of the liver -- indicating that some two or three days before her death, she used methadone.

KING: Could she have been saved if she were hospitalized sooner?
PERPER: Absolutely. And the reason is that she would have been hospitalized, she wouldn't have had the opportunity of taking the excess amount of chloral hydrate.
As a matter of fact, the antibiotic which we had given her for infection in the bottle (ph) were effective and basically cleaned the blood of the bacteria. But she still felt weak and unfortunately she had access to the chloral hydrate.
KING: Tamiflu was present, right?
Isn't Tamiflu an amazing drug?
PERPER: Well, it's reported to be quite effective in some cases and not so much in others.
KING: You have to get it early, though, when you have the flu?
PERPER: That's correct.
KING: Yes.
We have an e-mail question from Noni (ph) in Hammond, Indiana: "Why do you accept Howard K. Stern's account of events on the morning of Anna Nicole's death as bible oath? He says he didn't give her chloral hydrate or see her taking any medications. Why do you believe him?"
PERPER: You're asking me?
KING: Why do you believe the accounts of Howard K. Stern?
PERPER: Well, I believe -- I do not -- this is his statement. His statement is not contradicted by any other statement. The conglomerate of the facts indicated it was an accidental death. Even if she -- even assuming that he gave her the drug, it was obviously not against her wishes, because she liked the drug and she sometimes drank straight from the bottle.
KING: Another e-mail from Connie in Bedford, Virginia: "How can Anna Nicole's death be accidental when she had a doctor, a nurse, a bodyguard and a companion around her 24-7? Maybe negligence, but an accident?"
PERPER: Well, this doesn't make any sense because negligence can lead to an accident. I don't see how negligence excludes an accident. She had the ability to move and whether she took the chloral hydrate or somebody else, it was a non-intentional death. There is nothing to point to homicide. And, as I mentioned before, the police investigation reached the same conclusion.
KING: Is the case closed?
PERPER: The case is closed formally at this time. But any case can be opened if additional information which is credible and important surfaces.

 

Tags: Anna Nicole Smith drugs autopsy  Dr. Joseph Perper

 

Emerging Republican Minority

Crossposted from Truth Out

Go to Original

    By Paul Krugman
    The New York Times

    Monday 26 March 2007

    Remember how the 2004 election was supposed to have demonstrated, once and for all, that conservatism was the future of American politics? I do: early in 2005, some colleagues in the news media urged me, in effect, to give up. "The election settled some things," I was told.

    But at this point 2004 looks like an aberration, an election won with fear-and-smear tactics that have passed their sell-by date. Republicans no longer have a perceived edge over Democrats on national security - and without that edge, they stand revealed as ideologues out of step with an increasingly liberal American public.

    Right now the talk of the political chattering classes is a report from the Pew Research Center showing a precipitous decline in Republican support. In 2002 equal numbers of Americans identified themselves as Republicans and Democrats, but since then the Democrats have opened up a 15-point advantage.

    Part of the Republican collapse surely reflects public disgust with the Bush administration. The gap between the parties will probably get even wider when - not if - more and worse tales of corruption and abuse of power emerge.

    But polling data on the issues, from Pew and elsewhere, suggest that the G.O.P.'s problems lie as much with its ideology as with one man's disastrous reign.

    For the conservatives who run today's Republican Party are devoted, above all, to the proposition that government is always the problem, never the solution. For a while the American people seemed to agree; but lately they've concluded that sometimes government is the solution, after all, and they'd like to see more of it.

    Consider, for example, the question of whether the government should provide fewer services in order to cut spending, or provide more services even if this requires higher spending. According to the American National Election Studies, in 1994, the year the Republicans began their 12-year control of Congress, those who favored smaller government had the edge, by 36 to 27. By 2004, however, those in favor of bigger government had a 43-to-20 lead.

    And public opinion seems to have taken a particularly strong turn in favor of universal health care. Gallup reports that 69 percent of the public believes that "it is the responsibility of the federal government to make sure all Americans have health care coverage," up from 59 percent in 2000.

    The main force driving this shift to the left is probably rising income inequality. According to Pew, there has recently been a sharp increase in the percentage of Americans who agree with the statement that "the rich get richer while the poor get poorer." Interestingly, the big increase in disgruntlement over rising inequality has come among the relatively well off - those making more than $75,000 a year.

    Indeed, even the relatively well off have good reason to feel left behind in today's economy, because the big income gains have been going to a tiny, super-rich minority. It's not surprising, under those circumstances, that most people favor a stronger safety net - which they might need - even at the expense of higher taxes, much of which could be paid by the ever-richer elite.

    And in the case of health care, there's also the fact that the traditional system of employer-based coverage is gradually disintegrating. It's no wonder, then, that a bit of socialized medicine is looking good to most Americans.

    So what does this say about the political outlook? It's difficult to make predictions, especially about the future. But at this point it looks as if we're seeing an emerging Republican minority.

    After all, Democratic priorities - in particular, on health care, where John Edwards has set the standard for all the candidates with a specific proposal to finance universal coverage with higher taxes on the rich - seem to be more or less in line with what the public wants.

    Republicans, on the other hand, are still wallowing in nostalgia - nostalgia for the days when people thought they were heroic terrorism-fighters, nostalgia for the days when lots of Americans hated Big Government.

    Many Republicans still imagine that what their party needs is a return to the conservative legacy of Ronald Reagan. It will probably take quite a while in the political wilderness before they take on board the message of Arnold Schwarzenegger's comeback in California - which is that what they really need is a return to the moderate legacy of Dwight Eisenhower.

 

Tags: Pew Research Center Democrat Republican John Edwards