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University Hospitals’ man in the (medical) mirror in the Michael Jackson case

Dr. Howard Nearman has been popping up a lot — more than 1,600 times at last count — right next to the belated King of Pop. Media outlets have talked to Nearman, chairman in the anesthesia department at University Hospitals Case Medical Center, about the diprivan, which is used to sedate patients in an intensive care unit or as an anesthetic in the operating room.

CLEVELAND, Ohio — Dr. Howard Nearman has been popping up a lot — more than 1,600 times at last count — right next to the belated King of Pop.

Media outlets have talked to Nearman, chairman of the anesthesia department at University Hospitals Case Medical Center, about the Diprivan, generically known as propofol, which is used to sedate patients in intensive care units or anesthetize them in operating rooms. In the Jackson case, there are reports the late pop icon was using it at home to get over insomnia.

Media organizations have been quoting Nearman — sometimes, they’ve built entire stories solely on his quotes — about the proper use of Diprivan and its potential use in the home of Jackson. Nearman primarily appeared on FOX News, MSNBC and ABC News, but those appearances have spun into media reports in celebrity gossip blogs to a New Zealand newspaper.

In what has become on often quoted-phrase, Nearman told FOX: “When I heard it last night, I just did a double-take. Using this drug for insomnia is sort of like using a shotgun to kill an ant. How someone could get a hold of this medication — and use it for the purpose that he allegedly used it for — is just incredible.”

Nearman has been at University Hospitals and Case Western Reserve University since 1981,and took over the anesthesiology department in 2000, according CWRU’s Web site. He got his medical degree from the school in 1976, but he also holds a bachelor’s degree in engineering, a master’s in biomedical engineering and an MBA from CWRU.

He did a general surgery internship in Philadelphia, but did both his residency and an anesthesiology fellowship at University Hospitals. He’s been published on topics including the organization of intensive care units and transferring post-operative patients to the ICU.

As I mentioned, Nearman has been quoted almost exclusively in some media cases. Here’s the rest of  a section from the FOX article:

If Jackson had this drug in his home, it would be against FDA guidelines. And if it was used in conjunction with any other painkiller or sedative that Jackson was taking — the combination could have ultimately led to his cardiac arrest and death.

“It should not be used out of an ICU or an operating room setting,” Nearman said. “Here at University Hospitals Case Medical Center … Diprivan can only be used by anesthesiologists or intensivists … and these people, who by virtues of training and experience, can handle this drug and manage any adverse side-effect should they arise.”

It doesn’t take a large dose of propofol to cause respiratory depression, which basically means a person will stop breathing, Nearman said, calling it a “slippery slope.”

“Once the breathing is slowed down or the blood pressure drops, eventually the heart won’t be able to sustain itself.”

Nearman said it’s imperative that propofol be used only in a controlled setting where doctors can monitor the heart rate, blood pressure and breathing, and where if anything goes wrong, there is equipment in place to resuscitate a patient.

Because propofol is used only in hospital settings, this begs the question of how it could end up in the hands of someone like Jackson.

“One can only hypothesize,” Nearman said. “But it had to be taken from a hospital pharmacy or an outpatient surgery center perhaps — because you cannot walk into a drugstore and get it.”