Posted on 03/22/2005 5:17:15 PM PST by atomic_dog
Trial focuses on role of malnutrition in death
Doctor says victim not fed enough
By GEORGE B. SANCHEZ
Herald Salinas Bureau
The care of a developmentally disabled Prunedale man before his death was the underlying topic during witness testimony Monday in the case against a couple accused of allowing Junji Grubbs to starve to death under their supervision.
The prosecution used expert witnesses to identify the role malnutrition played in Grubbs' demise and alleged that Grubbs' death could have been prevented. Defense attorneys countered the allegations with facts entered as proof during trial last week.
Shinji Grubbs and his wife, Angela, are charged with felony abuse in the death of Shinji's brother Junji Grubbs, who was 33 when he died in 2003.
Monday morning began with testimony from Dr. John Hain, a pathologist for the Monterey County Coroner's Office. He said the immediate cause for the death of Junji Grubbs was pneumonia, while the underlying condition was severe malnutrition.
"Death wouldn't have occurred at the time it did without the man developing malnutrition," Hain said. "Death wouldn't have occurred at the time it did without developing pneumonia. In that respect, we've got two equally weighty conditions going on."
He said when he examined Junji Grubbs' body, it appeared normally developed, though "extreme emaciation" was apparent.
Evidence of this, he said, was the near absence of body fat, the way the skin was "draped" over the man's bones, and the appearance of malnourishment. Grubbs suffered from shingles, Hain said, a virus that causes chicken pox and usually occurs in adults with weakened immune systems. Autopsy tests revealed Grubbs did not die from a chronic illness or disease, nor from poisoning, dehydration or drug abuse, Hain said. Organs like the liver, spleen, kidneys, and heart were all smaller then expected, he said.
"There was obvious atrophy of all the muscles from the external and internal exam," Hain said.
During cross examination, Hain explained malnutrition as the absence of nourishment to the body. Someone can be malnourished, but not starved, he said.
Frank Dice, attorney for Shinji Grubbs, responded by asking if all Hain could say about the body of Junji Grubbs is that he wasn't getting enough calories. The doctor replied affirmatively and said Junji was not getting enough to eat.
Steve Rease returned to an explanation offered by his client, Angela Grubbs, to the police at the time of the arrest, and asked Hain if it's possible that a parasite could cause malnutrition but "resolve itself" before he examined the body. Hain said it was possible.
Dr. Mumtaz Tabba, a nutritionist, said Grubbs' malnutrition could have been prevented. He said 5 percent change in the body's weight is normal, assuming the body is at its ideal weight and not fat. A 20 percent weight loss requires medical attention and a 30 percent weight loss would likely impair walking, he said. The effects of malnutrition cannot be reversed if more than 40 percent of a person's ideal weight is lost, the doctor said.
According to the timetable presented by prosecutors, between 2000 and 2003, Shinji Grubbs' weight loss could have been treated. Grubbs weighed 68 pounds at his death in March 2003, though in 1999, friends and family said he weighed close to 180 pounds.
Rease asked Tabba if a person who lost as much weight as Junji Grubbs would be able to walk, do yard work and feed himself in a public restaurant. The doctor said it was possible, though it would place the man among less than 5 percent of people who could do that in such a physical state. Rease's questions alluded to defense testimony he plans to introduce.
Dr. Diana Koin, an expert on elder abuse, took the witness stand in the midafternoon. She admitted during prosecutor Arnie Klein's direct examination that she would be paid $500 an hour for her testimony and earned $300 an hour for reviewing records related to the case. She explained to Rease and Dice that she didn't want to speak with defense attorneys about the case before trial because she "didn't want to talk across sides" and lose control of her role in the case.
She said caregivers should fill in the gaps when disabled or elderly persons can't care for themselves. Going through the case against the Grubbs, she said Junji's shingles should have been treated, his broken glasses replaced, and his weight loss, no matter the cause, should have been examined by a doctor.
"I do believe he did not receive what he justly should have received from his caregivers," Koin said.
The defense attorneys pointed out that an investigation by Adult Protective Services found inconclusive evidence of elder abuse. Koin said she disagreed with the report. Then Dice reminded Koin that Junji Grubbs' application to a local program for disabled people was denied.
"If the help wasn't forthcoming, one would have to take additional steps," she replied.
The case against Angela and Shinji Grubbs continues today in Salinas.
When will starvation become the method of state executions since it is so painless?
How ironic. SCOTUS needs to sort this out -- quickly.
I can already see the outcome.
"It's a states-rights issue and it is not the pervue of the United State Supreme Court to injects itself in matters of this sort."
Can't you see it, too?
""When will starvation become the method of state executions since it is so painless?""
i was thinking the exact same thing
imagine That! It's illegal to starve someone!
Not only is it painless, it's not even execution. It's just letting nature take it's course, doncha know.
Yeah, well Junji Grubbs told Shinji and Angela that he wouldn't want to live like this. Don't know what the fuss is about. CA should get with the program here. < / sarc >
What do think they're doing forcing food on someone? No one should have to be forced to accept the medical treatment of nutrition and hydration.
I'm really saddened by the fact people don't understand (that) for some of us, heaven is a place where we think he will go. And we think, as good ardent Christians, that heaven is a better thing than anything we have experienced here on earth.
I can't understand why anybody would try, particularly staunch Christian advocates, would try to deny him the opportunity to have what has always been described to us as the promised land.
Yeah, let's see how that plays.
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