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Terri Schiavo Autopsy: Manner of Death 'Undetermined'
CNSNews.com ^ | June 15, 2005 | Jeff Johnson

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."


TOPICS: Extended News; News/Current Events
KEYWORDS: autopsy; facts; schiavo; schiavoautopsy; terrischiavo
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To: blueblazes
I am saying that there is a history of corruption throughout various departments and offices of Pinellas County and that as far as I know, it's still thoroughly corrupt.

You've produced no evidence to corroborate your contention.

It's likely one of your "I've got a feeling" moments.

201 posted on 06/15/2005 6:00:58 PM PDT by sinkspur (If you want unconditional love with skin, and hair and a warm nose, get a shelter dog.)
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To: apackof2; bjs1779
Read carefully....

The subjects lost between 2.1 % and 2.6 % of their body mass due to water loss through sweating.

Not brain mass. Not brain volume. They are simply quantifying the degree of dehydration. Pay the fee and read the paper for the brain mass loss. :-)

202 posted on 06/15/2005 6:02:03 PM PDT by Gondring (The can have my Bill of Rights when they pry it from my cold dead hands.)
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To: blueblazes

"Now you death cultists - those of you who could not bear to see this woman alive and who seem so passionately attached to killing her, post until your fingers break. I don't give a damn what you think. You were wrong then, you're wrong now, and you will be wrong 500 years from now."

Pure nutiness. Myself, actually, I had no problem with her parents being allowed to take care of her, for their sake. (Since she would never have known the difference)

But it was not their decision, by law, nor is it mine or yours. That's something alot of people have a difficult time with.

The problem I have is with the blatant intellectual dishonesty exhibted by the Terri militia. They don't even realize it but it so exactly resembles what goes on at DU. It just does. Exactly to a T. It's like normally intelligent people completely lose their mind when it comes to this issue. I have never seen such blatant pillaging and plundering of logic and common sense.

Judicial activist? Bad! Government sticking their nose in people's lives? Bad! Politicians grandstanding? Bad.. oh, except for when something happens that I don't agree with. Then.. "The Judge has to do something!"... "The Govnernor needs to send in the National Guard and abduct her and take her to another state!!" Please.

A death cultist, am I? Jeez, I am embarassed for you.


203 posted on 06/15/2005 6:03:13 PM PDT by Bones75
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To: blueblazes
Now you death cultists - those of you who could not bear to see this woman alive and who seem so passionately attached to killing her, post until your fingers break. I don't give a damn what you think.

You're doing your part to drag Free Republic into the gutter.

204 posted on 06/15/2005 6:04:33 PM PDT by sinkspur (If you want unconditional love with skin, and hair and a warm nose, get a shelter dog.)
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To: sinkspur

You need to do some research then as it has been well documented that there is or has been corruption in the nursing home, in the ME's office, in the Sheriff's office. Judge Greer has been accused of corruption in his real estate dealings, among other things. I can't recount this whole case for you - if you are unaware of these things, then you simply haven't done any research.

Moreover, the bottom line is: it was MORALLY WRONG AND EVIL to allow this severely handicapped woman to be starved and dehydrated to death by an estranged husband who has a common law wife for years and children by her. That truly is the bottom line for me, and all this nonsense about weighing brains and the rest of it is simply irrelevant. It was WRONG to kill her. PERIOD. END OF STORY. END OF DISCUSSION.


205 posted on 06/15/2005 6:05:03 PM PDT by blueblazes
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To: blueblazes
Where is the corruption in the current ME's office?

Be specific, with sources and links? Otherwise, your guilt-by-association smear demonstrates your bias.

206 posted on 06/15/2005 6:07:03 PM PDT by sinkspur (If you want unconditional love with skin, and hair and a warm nose, get a shelter dog.)
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To: blueriver
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.

No, I wouldn't expect that, because every indication previously was that she was PVS and had suffered significant deterioration of brain tissue.

I'm not the one attributing all evidence which disagrees with my view to some vast conspiracy.

207 posted on 06/15/2005 6:08:31 PM PDT by malakhi
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To: sinkspur

You obviously didn't get the point of my last post. I'm not going to argue these little factoids with you folks anymore as it's pointless. You can do the research yourself if you are so inclined. It's out there. Go to Empire Journal.com for one site that has thoroughly documented much of this corruption in Pinellas County. I am NOT going to continue arguing factoids with you when the bottom line and the only thing that matters is: IT was MORALLY WRONG to dehydrate and starve a severely handicapped woman by court order because her estranged husband with a common law wife and children of several years wanted it. It was WRONG. PERIOD. That's the only real issue, and all the facts, opinions, evidence and analyses don't change the baseline moral equation.


208 posted on 06/15/2005 6:11:15 PM PDT by blueblazes
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To: Gondring
I see, the brain is exempt. Water weight stays in the brain no mattter what? Still, I think my point was that the purported scans of Terri's brain showed 80 % missing, and now it is only 50% gone by weight after severe dehydration. I haven't got a lot a clear answers about that.
209 posted on 06/15/2005 6:12:11 PM PDT by bjs1779 ("I don’t want anyone trying to feed that GIRL" Greer thundered from the bench in 2001)
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To: bjs1779

"I see, the brain is exempt. Water weight stays in the brain no mattter what? Still, I think my point was that the purported scans of Terri's brain showed 80 % missing, and now it is only 50% gone by weight after severe dehydration. I haven't got a lot a clear answers about that."

It's a moot point, in a way. At issue is not the mass or volume of her brain, at issue is the atrophy of the cerebral cortex which appears to have been complete and irrevocable.


210 posted on 06/15/2005 6:14:31 PM PDT by Bones75
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To: Bones75
It's a moot point, in a way. At issue is not the mass or volume of her brain, at issue is the atrophy of the cerebral cortex which appears to have been complete and irrevocable.

That is what they say. But, I ask you how she could swallow her own saliva if she could not sallow as the M.E. said she could not of done?

211 posted on 06/15/2005 6:19:32 PM PDT by bjs1779 ("I don’t want anyone trying to feed that GIRL" Greer thundered from the bench in 2001)
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To: bjs1779
...if she could not sallow as the M.E. said she could not of done?

Or the barium swallowing-tests they gave her confirmed.

212 posted on 06/15/2005 6:24:10 PM PDT by Gondring (The can have my Bill of Rights when they pry it from my cold dead hands.)
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To: Gondring
Or the barium swallowing-tests they gave her confirmed.

What date?

213 posted on 06/15/2005 6:26:20 PM PDT by bjs1779 ("I don’t want anyone trying to feed that GIRL" Greer thundered from the bench in 2001)
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To: Gondring

The symptoms of dehydration
That headachy feeling you may be experiencing at the end of the day may very well be a sign of dehydration. Because the brain is made up of 75% water, moderate dehydration can often cause lightheadedness, dizziness, headaches and nausea. More severe dehydration may also raise the body's core temperature, effect muscle strength, endurance and coordination as well as increase the risk of cramps, heat exhaustion and life-threatening heat stroke. One of the best ways to recognize dehydration is to pay close attention to the color of your urine - ideally, light to clear urine indicates proper water intake.


214 posted on 06/15/2005 6:27:30 PM PDT by mware ("God is dead" -- Nietzsche........ "Nope, you are"-- GOD)
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To: bjs1779

...and didn't Hammesfahr even admit on the stand that swallowing of saliva is common with PVS patients?


215 posted on 06/15/2005 6:28:58 PM PDT by Gondring (The can have my Bill of Rights when they pry it from my cold dead hands.)
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To: BubbaJunebug

Just so you are aware, this medical examiner doesn't have a spectacular record, his credentials, credibility and ethics ARE currently under scruitiny. He is not permitted in the morgues of many area hospitals, even the hospitals known for giving less than acceptable care. He has been sued and settled out of court on several cases. For example the autopsy findings on one man was listed as natural causes. During the wake, this man's daughter leaned over the coffin to give her father a kiss, in doing so she cupped his head in her hand and felt what appeared to be a hole just behind his right ear. Upon further investigation it was determined that this man was murdered having been shot execution style. Yes the fix is in and the fix has been in place for some time. It will never be over for Terri's family. And what happened to the bone scan where the doctor in the hospital stated "someone worked her over good"?


216 posted on 06/15/2005 6:29:34 PM PDT by eagle mama (If you are of the opinion that things don't add up, it doesn't mean you are a conspiracy theorist.)
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To: bjs1779

Back when she was receiving intensive therapy. She still failed them all.


217 posted on 06/15/2005 6:29:46 PM PDT by Gondring (The can have my Bill of Rights when they pry it from my cold dead hands.)
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To: blueblazes

Your basic premise is still flawed...

"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."

So because he does not come up with conlusions that satify YOU --- he's corrupt also. Come up with some kind of plausible explaination of WHY all of these people would risk their careers and freedom.


218 posted on 06/15/2005 6:30:46 PM PDT by RS (Just because they are out to get him, it doesn't mean he's not guilty.)
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To: mountaineer

You are correct, x-rays are not commonplace in an autopsy, let alone a bone scan, which is what would be necessary to determine abuse.


219 posted on 06/15/2005 6:31:45 PM PDT by eagle mama (If you are of the opinion that things don't add up, it doesn't mean you are a conspiracy theorist.)
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To: RS

Because they are ALL Scientologists. (snicker)


220 posted on 06/15/2005 6:34:03 PM PDT by bonfire (dwindler)
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