Posted on 06/15/2005 12:27:19 PM PDT by veronica
(1st Add: Includes comments from George Felos, Michael Schiavo's attorney.)
(CNSNews.com) - Terri Schiavo's body did not show any signs of trauma or other criminal activity that would explain her brain injury, nor was there evidence to support previous diagnoses of a heart attack or an eating disorder, the Florida medical examiner who conducted her autopsy said Wednesday. A representative of Terri's family complimented the report, but said it still leaves many questions unanswered.
"She died of dehydration," Dr. Jon Thogmartin, the Florida medical examiner for Pinellas and Pasco counties said, noting that the official cause of death would be listed as "complications of anoxic encephalopathy."
"That's the only diagnosis that I know for sure, is that her brain went without oxygen," he added. "Why? That is undetermined."
George Felos - attorney for Terri's husband, Michael Schiavo - said the report confirms what he has argued all along.
"The courts have found that there was no abuse of Terri, no evidence of abuse, and that's what the medical examiner found," Felos said.
Terri Schiavo collapsed under unknown circumstances in 1990. Michael Schiavo was awarded nearly $2 million in judgments and settlements in a medical malpractice lawsuit claiming that the collapse was caused by a heart attack triggered by a potassium imbalance, caused by an undiagnosed eating disorder, bulimia nervosa. Thogmartin challenged that determination.
"No one observed Mrs. Schiavo taking diet pills, binging and purging or consuming laxatives and she apparently never confessed to her family or friends about having an eating disorder," Thogmartin found. "Furthermore, many other signs of bulimia nervosa were not reported to be present."
Terri was "heavy" as a teenager, according to Thogmartin, and had lost more than 100 pounds after graduation. The eating disorder diagnosis was based on that fact and a low potassium level measured during a blood test about an hour after Terri was first hospitalized.
"Her low potassium level appears to be the main piece of evidence purporting to show that she had an eating disorder," Thogmartin said. But he noted that she received numerous medical treatments when she arrived at the hospital that would have lowered that measurement.
"Thus the main piece of evidence supporting the diagnosis of bulimia nervosa is suspect," he concluded.
"Once you eliminate the potassium problem, which is known in bulimics, you end up with a 26-year-old who used to be healthy, who now lost the weight, is reveling in her thinness now, enjoying her life and doesn't want to gain the weight back," Thogmartin said. "If that's a bulimic, there's a lot of bulimics out there. It's just not enough."
Thogmartin said that because he cannot, "with reasonable medical certainty," ascertain why or how the blood and oxygen to Terri's brain were interrupted, he cannot rule on what started the chain of events that led to her death.
"The manner of death is different from the cause of death. Manner of death is the circumstances of death or how the death came about," Thogmartin said. "Since I don't know the circumstances or can't tell, actually, what the underlying cause is, the manner of death has to be 'undetermined.'"
Other allegations and theories addressed
Thogmartin dismissed the theory that the oxygen depravation to Terri's brain might have been the result of a myocardial infarction, the medical term for a "heart attack," or death of heart muscle from coronary artery disease.
"Mrs. Schiavo's heart was anatomically normal without any areas of recent or remote infarction," he explained.
In response to the allegations that Terri's collapse was the result of a physical assault, Thogmartin noted that she received nearly 30 X-rays, CAT scans and ultrasound examinations during the medical examination that followed her collapse.
"Any fractures - including rib fractures, leg fractures, ankle fractures, skull fractures, spine fractures - that occurred concurrent with her initial collapse would almost certainly have been diagnosed in 1990, especially with the number of physical exams, radiographs and other evaluations she received during her initial hospitalization," Thogmartin said. "No fractures or trauma were reported or recorded."
There was also, Thogmartin said, "no evidence to support or the evidence did not support," various allegations that Terri was abused or neglected after her initial brain injury.
Was Terri in a Persistent Vegetative State?
Thogmartin brought in Dr. Stephen Nelson, an expert in pathology of the brain and central nervous system, as a consultant during the autopsy. Nelson stressed numerous times that the diagnosis of a "Persistent Vegetative State," which was used to justify the removal of the feeding tube that kept Terri alive, "is a clinical diagnosis, it's not a pathologic diagnosis that has precision associated with it." But he did not dispute the finding.
"There is nothing in her autopsy report, in her autopsy that is inconsistent with Persistent Vegetative State," Nelson said, adding that there was evidence to support the finding.
"A normal brain weight for somebody who is approximately 41 years of age ought to be somewhere in the neighborhood of 1,200 to 1,300 grams," Nelson explained. "Her brain is 615 grams and is largely reduced to what is termed granular atrophy ... associated with the loss of blood flow that happened many years prior.
"Those all are consistent with what is reported in the literature for Persistent Vegetative State," Nelson added. "We found nothing that is contrary to what has previously been reported for Persistent Vegetative State."
Nelson compared the physical condition of Terri's brain to that of Karen Ann Quinlan, the New Jersey woman who died in 1985 -- nine years after her parents won a court battle to remove her from a respirator.
"Her brain, Karen Ann Quinlan's, weighed more than Terri Schiavo's brain weighed," Nelson said. "The findings here are, perhaps, worse, even, than Karen Ann Quinlan."
Thogmartin also concluded that Terri's brain injury was irreversible.
"Her brain was profoundly atrophied," the medical examiner concluded. "This damage was irreversible and no amount of therapy or treatment would have regenerated the massive loss of neurons."
Michael Schiavo relied on the diagnosis of a Persistent Vegetative State when he sought permission from the Florida courts to remove Terri's feeding tube. He and two of his relatives testified that Terri had said she would not want to be kept alive in such a condition. Thogmartin discussed the contention by many right-to-life advocates that Terri's family should have been allowed to offer her food and water by mouth after that feeding tube was removed.
"She would not have been able to consume sustenance safely or in sufficient quantity by mouth," Thogmartin said. "Mrs. Schiavo was dependent, therefore, on nutrition and hydration by her feeding tube and removal of her feeding tube would have resulted in her death whether she was fed by mouth or not."
In layman's terms
After a technical explanation of his findings, laden with medical language, Thogmartin was asked to summarize his findings in an exchange with one unidentified reporter:
REPORTER: "In layman's terms, did Terri Schiavo starve to death?"
THOGMARTIN: "No."
REPORTER: "Did she suffer any neglect or abuse?"
THOGMARTIN: "No."
REPORTER: "Will we ever know what caused her death?"
THOGMARTIN: "I don't know."
Pamela Hennessy, spokeswoman for the Terri Schindler Schiavo Foundation and Terri's parents, Bob and Mary Schindler, complimented Thogmartin on his report.
"However, it does seem that the conclusions of his report leave as many unanswered questions as there were previously," Hennessy said. "For instance, if Terri did not suffer bulimia and she had as healthy a heart as Dr. Thogmartin proclaimed, what caused her collapse?
"It doesn't really bring much in the way of closure to [the Schindlers] as far as what happened to their daughter, why this happened in the first place and what could have been done for her," Hennessy concluded.
Thogmartin said he is open to answering those questions.
"It is the policy of this office that no case is ever closed, and that all determinations are to be reconsidered upon receipt of credible new information," he explained.
"In addition to fading memories, the 15-year survival of Mrs. Schiavo after her collapse resulted in the creation of a voluminous number of documents, many of which were lost or discarded over those years," he continued. "Receipt of additional credible information that clarifies any outstanding issues may, or shall cause an amendment to her cause and manner of death."
"You badmouth them all you want, but clearly Terri's parents and real family wanted to take care of her. And there's nothing wrong w/that."
Yeah and Norman Bates took care of his mom.
No, she wasn't a Ms. Bates but the extremes her parents were willing to go to were a bit extreme...
"Didn't George Felos come from Terri's room when she was dying and tell the public how peaceful she was? Well, if the dehydration was the worst the doctor had ever seen; that tells me George Felos lied to the public. What else has he lied about? "
Intellectualy vapid statement, void of any critical thought.
How could Felos see inside her body? That statement is not even right enough to be wrong.
Delusional.
Yes, your theory is delusional. Don't you think it's more likely that he just wanted her dead immediately, rather than have her in a PVS for 15 years?
Look, if most of a county is known to be corrupt, and Pinellas County is thoroughly corrupt, than why should I believe anything that comes out of there? This case is totally incestuous. Who is investigating this - the Sheriff's office? Mike Schiavo's now deceased mother in law (by his common law wife) worked there, and now he does. He got his job without an interview apparently. The nursing home director is under investigation for misuse of funds, and I believe the home is under federal investigation in general (again, I'm working from memory and there's a lot of detail). There were connections between the pro-Schiavo lawyers and the nursing home. Judge Greer has been accused of shady real estate deals prior to becoming a judge. THe former ME prior to this one was forced out because of changing her analysis under pressure.
With a whole pattern of wide spread corruption, incompetence and malfeasance that I have seen in Pinellas County, why on earth would I believe any one sided report that came out of there without independent corroboration? That would be foolhardy. The ME blew it by not having some independent party there are the autopsy to corroborate his findings. AS it is, he's just another Pinellas County official, who may or may not be honest, or may or may not be operating under HIS OWN BIAS. I'm not just automatically gonna believe him because he's the ME. No more than I would have automatically believed his predecessor.
"I wish I knew a pathologist who could point to the effect of starvation and dehydration regarding brain weight."
You might do better to read the report and look at the composition of her cranial cavity/head.
Note, she died of dehydration not starvation according to the autopsy.
Something along the lines of "I've never seen her look so beautiful" also.
I don't believe that for a minute. They've got too much invested in this whole thing to ever admit they were wrong.
No one's mind has been changed, nothing has been resolved.
That's correct, if you're talking about those who are prone to conspiracies and to wild speculation.
By the way has the judge held Michael in contempt for failing to tell the parents where she is buried yet???
Well, I think my point has been proven. Nothing has changed here. You believe what you want to believe, I believe what I want to believe, and everyone else does likewise. There is no new evidence here because this official HAS NO CREDIBILITY because he is too involved with the case because of his position. The only way an autopsy would have been relevant is if an independent party had been there, and/or a representative of the Schindlers as they requested. The fact that this ME would not allow this has now left him in this difficult position of LACKING CREDIBILITY. The same as his predecessor. There needs to be an outside investigation of this entire case by an objective party, if one can be found at this point.
The Schindlers wanted Cyril Wecht, a Medical Examiner from Pittsburgh who is, himself, under a federal probe.
Is this your idea of an "outside expert"?
"There is a precedent for incompetence in posting right here on FR, but I don't hold that against YOU."
!!!!!! TOUCHE !!!! game set match. LOL
There might be one or two minds that have been changed, but I would say the overwhelming majority of people still believe (on both sides) as they did previously.
As far as all these people go, I don't think the point is what data is presented, which all of these folks would have accumulated in various ways - I think the point is WHAT CONCLUSIONS ARE DRAWN, which is what the ME has done. And that is where the arguments lie. Interpretations and conclusions.
"Any fractures - including rib fractures, leg fractures, ankle fractures, skull fractures, spine fractures - that occurred concurrent with her initial collapse would almost certainly have been diagnosed in 1990, especially with the number of physical exams, radiographs and other evaluations she received during her initial hospitalization," Thogmartin said. "No fractures or trauma were reported or recorded."
Just the facts.
Call this question silly I suppose...but wasn't the multi-million dollar settlement against her ob/gyn for not discovering that she was bulimic? So is she wasn't, will he give them back the $$. Am I missing something here?
It doesn't matter so much what I think of Wecht - I understand he is highly regarded in his field, despite his current difficulties. The point is that the SCHINDLERS wanted him - and it would have been both a courtesy to them (one that is frequently if not commonly extended in autopsies) to do this and it would have been a highly intelligent thing to do politically as it would have created "balance" in the results. If both sides had reviewed the evidence and could state their agreements or disagreements, there might have been some progress here. What you are saying to me though, is that it was appropriate to exclude the Schindlers entirely from this case of their own daughter's autopsy and then we are supposed to rely solely on the word of this official from a thoroughly corrupt county. That's ridiculous.
Personally I would have liked to see several people at the autopsy - the ME, the Schindler's expert, and another disinterested party who could have been objective. That would have been the best and most logical (and kindest to the Schindlers) approach.
"And that is where the arguments lie. Interpretations and conclusions."
Hope you've read the report. There's lots of info there from a variety of sources and I'd say the cononer went out of the way to document and address every "questionable issue" that has been raised.
I was referring to brain atrophy, not broken bones.
Look. For the last time. IT DOESN"T MATTER what the ME says. It LITERALLY DOESN"T MATTER. The problem is that he LACKS CREDIBILITY because he is just another Pinellas County official and he would not allow anyone else into the autopsy with him. Even if what he is saying in the report is correct, there is no independent corroboration of it and that is essential. I'm not going to buy anything he says just because he's the ME. Dr. Joan Wood was the ME of Pinellas County as well and she bloody well lied under pressure and had to resign because of it. Maybe you would have believed her too, at one point.
I have personally witnessed the deaths of several people in the last few years. There was nothing peaceful about it. It's strange to sugar coat it, but what do you expect from Felos the deathman, the ghoul.
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