According to TMZ.com, paramedics say pop icon Michael Jackson, 50, was already dead when they arrived and they failed to recognize him after working on him for 15 minutes.

When paramedics arrived at a rented Bel Aire mansion, they found an unresponsive “frail, old, sickly looking man” who whose heart rhythm was flatlined when they hooked him up to an EKG monitor.

Sources told TMZ that “there was no electrical activity in his heart and Jackson showed no sign of life.” Sources also say paramedics wanted to pronounce Jackson dead at the scene, but Jackson’s friend and personal physician, Dr. Conrad Murray, insisted that they transport the body to the hospital.

But that doesn’t jibe with established medical protocol. Paramedics can’t pronounce anyone dead in the field. They must transport the body to a hospital where the ER doctor (or the patient’s doctor) calls the time of death.

In the case of hospice patients who die at home, a nurse can pronounce the patient dead.