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."
The court did rule that Michael was to inform the parents of her burial place.
The only thing that would make these people believe the ME is if he reported he found a video tape of Michael beating Terri in her abdominal cavity.
Quite a gal Terri was. She was the most severe case of dehydration the examiner has ever seen. Gambone was right, she had a strong will to live.
http://66.195.16.55/bio945.html
As you can see the courts ordered that he was to inform them. What are you suggesting? That the parents go to court to make the judge enforce his ruling? I thought that was the judges responsibility.
I think you are right. The stipulation was 'when' she was interned. Dreadful...
From my understanding there were other examiners present. Wasn't that covered during the presser?
The ME is a state employee.
Honestly, would you accept any report which came back with a result you didn't like?
Read page 2 of pdf. file of the report. Look right above Dr. Thogmartin's signature. It says:
Manner of death: undetermined.
Also look further on pg. 36
"8. What was the cause and manner of death?
Mrs. Schiavo suffered a severe anoxic brain injury. The cause of which cannot be determined wtih reasonable medical certainty. The manner of death will therefore be certified as undetermined."
I don't think I'm missing anything.
The manner of death is actually removal of her hydration/nutrition. They are trying to assert the manner of her death as being whatever happened to her years ago. In essence they are saying she actually died as a result of her collapse 15 years ago, but cannot determine the manner in which it occurred. What happened to her 15 years ago may have horribly injured her, but she did not die because of those injuries. She died because the court ordered removal of her feeding tube.
The report also finishes by saying that
"Receipt of additional information that clarifies outstanding issues may or shall cause an amendment of her cause and manner of death."
I haven't seen reports of any others that were not associated with the state of Florida's payroll.
Well, all of Florida's payroll cannot be suspect. Next you'll be saying all of the citizens of that state are suspect, too.
Good point. Terri's previously posted brain scans reported that she did not have more than 80% of her brain left. Now, they dehydrated her and they only report the weight of the brain. Needless to say, I can't figure the math.
I am well aware of that.
As I stated earlier, I do not expect judges in this country to rule based on media reports alone. If the parents have a complaint about one of his orders not being complied with then they need to file with his court and then the judge would be in a postion to address the matter.
The Schindler's requested that an examiner representing them be at the autopsy.
The request was denied.
The autopsy does not change that it was wrong to kill a non-dying woman. It was wrong to not allow the federal review of the case with new eyes.
For those of you that have an extremely hard time understanding why some of us care about what happened to Terri......
We have learned that laws are being written to allow non-dying people to be killed. If you don't agree with this - check your state laws and get busy.
We have learned that food and water were changed to be extraordinary medical treatment. Check to see what else has been changed in your state.
We have learned that someone, somewhere has the authority to write laws about when each of us can be killed and we know nothing about it. Who takes on that authority and is that what we want?
We have learned that in Florida - hearsay evidence can be used to kill. In other words - in Florida a neighbor has more right to state your last wishes than a distant relative in another state, because the neighbor said you wanted .........
We have learned that there is a large part of this population and some on FR that support the state writing laws that allow some to kill others.
So, apparently we have many in America that want the right to get rid of an invalid spouse when they decide they suddenly remember an undocumented statement of wish for death. And, we have many that want the option to kill off unneeded relatives to save the victims money being spent on their own care or to receive the estate when they desire rather than when a natural death occurs.
We have learned that there is a strong euthanasia/death culture movement on the march against each of us in America and are going to be supported by those desiring the option to kill for their personal profit.
We over-react? I think not. But, Terri has shown us the beast and therefore she will be the awakening call.
May Terri rest in peace.
Honestly, would you expect the report to say that her brain was not too bad, and that everyone made a mistake in killing her? Give me a break.
Why don't you skip the wise cracks and post a link that there were independent examiners present?
AMEN.
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