Replies

From Karen K...To Cheryl F,
An avid Supporter of Terri asks Cheryl 2 questions:

Can she CONSISTENTLY swallow WITH no choking at all for an extended period of time?

First off Karen, I cannot respond to your question as to whether she can consistently do anything, nevertheless swallow.. because I have never personally seen Terri, Nor, have I ever had the opportunity to do a nursing physical assessment on her.

However, I can tell you this.
I asked her Dad last week if she was in need of suctioning because of inability to handle her own secretions and he replied, "No!"

I will also refer you to a couple of affidavits.
One by Heidi Law and one by Dr. Haffesfahr.

If you refer back to the affidavit signed by CNA Heidi Law on 8/30/2003, Heidi states on page 3 (paragraph 10) that in 1997 when she cared for Terri she would give Terri a wet washcloth filled with ice chips, to keep her mouth moistened. Heidi stated,
that she personally saw Terri swallow the ice water and never saw her gag. Heidi also states in her affidavit that she and another aid by the name of Olga frequently put orange juice or apple juice in her washcloth to give her something nice to taste. Heidi states that
she personally fed Terri small mouthfuls of jello, which she was able to swallow and enjoyed immensely.

On September 12th, 2002...Dr. Hammesfahr states in his affidavit that in spring of 2000, three physicians, including Dr. Jay Carpenter, who is former Chief of Medicine at Morton Plant Hospital, filed affidavits after observing Ms. Schiavo. All three physicians stated that it was visually apparent that Terri was able to swallow and in fact, swallowed her own saliva.

Dr. Hammesfahr on September 3, 2002 spent from 11 AM until
4 PM examining Terri and then returned the following day to observe Dr Maxfield do his exam and complete other portions of the exam himself.
Dr. Haffesfahr reports on page 11 of 14 in his affidavit after extensive neurological exam under
Impression:
The patient is not in a coma.
She is alert and responsive to her environment.
She responds to specific people.
She tries to please others by doing activities for which she gets verbal praise.
She responds negatively to poor tone of voice.
She responds to music.
She differentiates sounds from voices.
She differentiates specific people's voices from others.
She differentiates music from stray sound.
She attempts to verbalize.
She has voluntary control over multiple extremities.
SHE CAN SWALLOW!
She is partially blind.
She is probably aphasic and has a degree of receptive aphasia.
She can feel PAIN!

On the last point, he notes..."it is interesting to observe that the records from Hospice show frequent medication administered for pain by staff!
* So there you have it!

Now one has to wonder...
1. If she is in a PVS (a vegetable as Michael likes to portray) then why is he allowing Terri "pain" medication? Hmmmm!
A. Is it because Terri really has "pain" and is not a wasted vegetable as he claims?
B. Or, is he using the pain medication to make her appear like she is a zombied vegetable for some reason?
C. Or, is he attempting to do a slow narcotic overdose?

Let's see....between my Paramedic training and my nursing degree, I spent a total of 7 years in school studying medicine alone.

I was taught that as a Nurse, if a patient is in pain... you administered "pain" medication only to those who exhibited pain either audibly or by body language/facial gestures.

I often wonder if I slept through a class where the nursing professor told us it was okay to randomly administer pain medication to those who were sound asleep or were indeed in a PVS truly demonstrating no ability to react to painful stimuli!??
Hmmmmmmmmmmmmm!

One also has to wonder just how many nurses have been and are in conflict and violations with regard to what they are charting? How are they explaining administering Terri pain medication when she SUPPOSEDLY is reported as a VEGETABLE with no ability to feel pain?

HHmmmmmm Again!

I also wonder how they have made a nursing care plan (something all patient's by law must have) and what they are writing in their progress notes to support the administration of pain medication?

Let's STOP and think about this for a moment.

S.O.A.P charting is standardize Nursing charting....and in some cases we do a narrative charting. In either case....what we chart about a patient has to be substantiated by how we as nurses carry out a nursing action.

So let's take for an example the S.O.A. P charting I mentioned above. Assuming Terri is a VEGETABLE as Michael states she is;
what are her nurses charting in her progress notes and medication log?

S= Subjective O= Observation A= Assessment P= Plan

S= No charting would be here if Terri is like Michael states because there would be supposedly no sound or verbal of any kind coming from Terri.
O= Patient non-responsive, pupils non reactive to light/ pt. not alert to person place or time..lying in bed eyes closed, mouth open, no movement, no response to painful stimuli.
A = Patient noted in persistent vegetative state
P = Administering pain medication per doctors orders.

Do you see the blatant conflict in this nursing PLAN of Care and Action?

Okay...on to the next question...
Sorry to get off track and elaborate about what this case appears like to a Registered Nurse! Not to mention how angry it can make one feel knowing all the medical discrepancies there has to be!

Next Question"
Do you feel she is likely to PASS swallow test?
In answer to your second question, I am going to first refer you to a link that will define for all of you what a swallow evaluation is...why it is done, and what we do with the outcome after a patient has one.

Swallowing Disorders, Dysphagia, Sw allowing Disorders Center,Rusk Institute of Rehabilitation Medicine, NYC

Please note that when you are perusing the site...there is
NO Pass/Fail per say in a swallow evaluation.
It is simply a diagnostic tool used to evaluate either fluoroscopically, or without. The type of diet a patient is safely capable of ingesting. And there are several types of diet to treat dysphagic patient's depending upon their ability.

Periodic swallow evaluations need to be done and are done on patient's like Terri in an effort to advance their diets according to their ability to safely swallow.

Sadly, Michael Schiavo of course has not allowed Terri the medical technology that we have available to help people like her. Consequently, Terri never has been given the opportunity to determine if she can safely swallow food, be it 5 years ago, today, tomorrow, or 6 months from now.
His mission is so obvious to even the ignorant...to KILL her and cremate any remains.

And one then has to wonder just what part of this entire CLEAR medical picture is so complex and difficult for supposedly educated men like Wolfson, McCabe, Greer, and Felos to comprehend?

Scarey ....isn't it? Especially knowing there are thousands of USF (University of South Florida) students under the tutelage of Professor Wolfson ! Yikes!

Cheryl F.

PLEASE MEGA FREEP: GLOBAL DISTRIBUTION, ETC.

To ALL: PLEASE PICK UP YOUR TORCH, INCORPORATE, SHARE, SEND THIS OUT TO THE OFFICIALS LISTED AND OTHERS AND PAPER THE INTERNET, MEDIA, ETC.
LOOK AT HIS WEBPAGE FOR FURTHER REFERENCE: http://statty.co.pinellas.fl.us

IF BERNIE HAS A CONFLICT OF INTEREST A SPECIAL PROSECUTOR MAY HAVE TO BE APPOINTED.

To:

State Attorney Bernie McCabe (727-464-6221), BMcCabe@co.Pinellas.Fl.us,
BERNIEMCCABE@FDLE.STATE.FL.US

12-15-2003

Dear State Attorney McCabe,

On 11-15-2003 I sent you a letter urgently requesting that you
begin a comprehensive investigation into past and ongoing violations
of Florida law under the mandate of Florida Statute 415.104.

I brought to your attention serious breaches of Florida laws by
Mr. Michael Schiavo in connection with his guardianship of Terri
Schindler-Schiavo, a disabled Florida adult. In my letter I asked
for a speedy transmittal of my report to all appropriate law
enforcement agencies. My reading of the law confirmed that FS 415.104
mandates that you begin investigating allegations within a 24-hour
period.

To date, I have not had a response from you. I will alert you once
more to the high probability of these felony crimes before looking
into remedies against your apparent refusal to act in accord with
the directives provided by the law.

All of the following allegations concern past and ongoing abuse
and neglect of vulnerable Florida adult, Theresa Schindler-Schiavo
by her estranged husband and guardian, Michael Schiavo. Specific
prosecutorial guidelines are provided in the Statutes under
pertinent sections titled "punishable under".

By unlawful guardianship commissions and omissions, Mr. Schiavo
denied Terri the retained right to be restored to capacity at the
earliest possible time. This failure to allow guaranteed services
is further aggravated by related denials of rights protected under
the Americans with Disabilities Act.

For ten years up to the present time Mr. Schiavo explicitly forbade
medical personnel to provide therapy for Terri that could accomplish
speedy restoration to which the law entitles her. By this he
knowingly and willfully contravened Section 744.3215(1)(c) of
the 2003 Florida Statutes.

Mr. Schiavo also denied his disabled adult ward essential
rehabilitative therapy enumerated along with other services as
retained rights in the 2003 Florida. By this he knowingly and
willfully contravened Section 744.3215(1)(i), which states that
"The right to receive necessary services and rehabilitation is
a retained right."

Regardless of the current medical debate regarding Terri's
precise diagnosis, the law states that retained rights, including
the right to necessary rehabilitative therapy may not be delegated
to the guardian (Section 744.3215(3)), because the ward retains
these rights for the duration of guardianship. The law is furthermore
clear in extending no authority to the court to waive, remove or
delegate the retained right to receive necessary services and
rehabilitation.

Section 765.401 pertaining to termination of life-prolonging
procedures does not permit the guardianship court to prohibit such
therapy, or to convey authority to do so to the guardian. By seizing
such unconveyable authority and by actively prohibiting such therapy,
Mr. Schiavo proved himself delinquent in the lawful exercise of
guardianship and stands in violation of Florida law.

Mr. Schiavo's violations include but are not limited to
obstructing Terri's retained right to the service necessary for
rehabilitating her swallowing function. The need for this
rehabilitation is underscored by the guardianship court's recent
order to have Terri's feeding tube removed. Without adequate use
of swallowing muscles Terri is in danger of death. By this unlawful
act, Mr. Schiavo additionally violated and continues to violate
Terri's Constitutional right to life.

The guardianship court's deferral to Mr. Schiavo's claims
that his wife wished to remain free of artificial life support
cannot be construed to indicate her wish to die from lack of the
basic necessities of food and water. At the time of her alleged
expression of an aversion to artificial life support, feeding tubes
were not included under that definition. That inclusion did not occur
until the passage of an amendment to the Florida Statutes in 1999.
As you well know, new legal definitions cannot be retroactively
applied to prior situations.

Nothing in the court's findings indicates that Terri would
consider oral feeding or the necessary therapy to facilitate it
a violation of her privacy. If that is not the case, then the
withdrawal of food and water and the therapy necessary to facilitate
oral feeding must be regarded as an invasion of her privacy and an
assault against her person.

By no interpretation of the law can Terri be said to have
relinquished her right to receive necessary rehabilitative therapy.
Therefore Mr. Schiavo's refusal to honor these rights is in
direct contravention of Florida law and constitutes a punishable
felony under Section 744.3215(1)(i).

In contravention of 2003 FS 825.102(3)2., Mr. Schiavo failed to
request an investigation indicated when a bone scan of Terri's
body revealed multiple fractures and head trauma. In defiance of a
court order, he then failed to inform Terri's family of the
discovery and proceeded to have the record of these injuries
sealed for over ten years. By these acts, Mr. Schiavo additionally
raised suspicions of his possible complicity in the causation of
Terri's injuries. This possibility must be investigated under
criminal statutes in addition to those pertaining to neglect,
abuse and aggravated abuse of a disabled adult.

In contravention of 2003 FS 744.3215(1)(a) (The right of persons
determined incapacitated to have an annual review of the guardianship
report and plan), Mr. Schiavo failed to provide the mandatory
guardianship report and plan for the past three years.

In contravention of 2003 FS 744.3215(f), Mr. Schiavo moved Terri
into hospice three years ago without the mandatory certification by
two physicians, thereby falsely imprisoning her and preventing her
from being in a more health-supporting environment such as the one
Terri's family is willing to provide for her. He forbade free and
unsupervised visits to Terri by her parents and siblings, despite
evidence that their presence provides warmth and comfort to her.

In contravention of 2003 F S 744.3215(l) (The right of persons
determined incapacitated to counsel and 2003 FS 744.3215(k) (The
right of persons determined incapacitated to have access to the
courts), Mr. Schiavo caused the dismissal of and failed to replace
Terri's Guardian ad Litem, thereby depriving her of her retained
rights to counsel and access to the courts.

Mr. Schiavo has been and is in the process of committing class 3 and
class 2 felonies under Sections 825.102(1), (2) and (3) pertaining to
abuse, aggravated abuse and neglect of an elderly person or disabled
adult.

In contravention of 2003 FS 825.102(1), Mr. Schiavo forbade the
rendering of basic oral hygiene to Terri, thereby increasing the
possibility of dental disfigurement and loss. He forbade the
application of standard joint mobilization movements, and by thus
impacting Terri's lymphatic activity and suppressing her immune
system put her at risk of disease, loss and disfigurement.

Upon the Governor's issue in October of this year of a specific
executive order to replace Terri's feeding tube, Mr. Schiavo
endangered her life by instructing his lawyer Barbara Bushnell to
threaten medical personnel with lawsuits, should they obey the law
by reinserting Terri's feeding tube.

During the period immediately preceding the executive order,
he forbade the administration of the Last Rites of Terri's faith,
in particular the spiritual comfort of Holy Communion, thereby
causing spiritual anguish and loss of salvatory hope. By this act,
Mr. Schiavo additionally violated Terri's civil right to the
exercise of her religion.

In contravention of 2003 F S 825.102(2)(b), Mr. Schiavo forbade the
placing of a washcloth to prevent Terri's fingernails from
cutting into her palms, thereby increasing the risk of painful,
disfiguring lacerations and health-threatening infections. He
failed to repair or permit the replacement of a broken wheel chair
that would allow Terri to be taken outdoors, thereby depriving her
of the comfort and the health-giving effects of fresh air,
sunshine and auditory stimulation.

He reduced the possibility of beneficial therapy by illicitly holding
Terri in a death-oriented hospice for three years, despite the fact
that she showed no signs of impending physical death. By this act,
Mr. Schiavo additionally violated Federal Statutes mandating a
diagnosis of "terminal" by two independent physicians prior to
placement in hospice.

In contravention of 2003 FS 825.102(2)(c) Mr. Schiavo endangered
Terri's life by seeking to prevent the realization of an
executive order by Governor Bush to replace Terri's feeding tube,
despite the fact that the Florida Legislature had empowered the
Governor through passage of a specific law.

In contravention of 2003 FS 825.102(3)(a)1., Mr. Schiavo forbade the
administration of standard antibiotics for infections resulting in
pain, possible disfigurement and potentially fatal sepsis. He refused
to allow Terri's examination by neurology specialists, thereby
diminishing Terri's opportunities to benefit from new therapies
discovered during the ten years that he had deprived her of therapy
altogether.

He failed to allow Terri to receive treatment by a speech therapist,
thereby depriving Terri of opportunities to demonstrate consciousness
and communication facility. He ordered the removal from Terri's
room of faith inspiring and comforting symbols of her religion,
thereby neglecting Terri's spiritual well being. He ordered the
removal from Terri's room of pictures of her loved ones, comfort-
giving items from her past and objects that could provide beneficial
sensory stimulation, thereby diminishing Terri's opportunity for
gaining responsiveness.

The above and other felony offenses by Mr. Schiavo are punishable as
provided in s. 775.082, s. 775.083, or s. 775.084 and other sections
of the criminal statutes. In light of these alleged multiple felony
violations by Mr. Schiavo I urgently request that you investigate his
behavior and make the necessary reports to law enforcement within the
specified time frame. It is of the utmost urgency that you carry out
your mandate as State Attorney of the State of Florida and protect
Terri Schindler-Schiavo against further neglect, abuse and other
harm from Mr. Schiavo.

Please contact me at the earliest possible time to inform me of the
course of action you are taking in this matter of grave concern. I
specifically request that you inform me in case there are additional
steps I should take to ensure that my allegations are followed by you
in the spirit of Florida Statute 415.104 and all applicable Florida
laws. Please be aware that I will consider an absence of additional
instructions from you as your agreement that my report to you
followed proper protocol and that you will treat it with all
diligence described in Florida law.

Sincerely,

..............

Cc.: jeb@jeb.org,remote-
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