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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; Gondring

"And that's the end of the discussion for me."

You could have saved yourself a lot of time by saying that in the beginning.

Now - is it MORALLY WRONG to accuse people of being corrupt when you have no evidence of it ?


241 posted on 06/15/2005 6:55:38 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: Gondring
I think it had to do with her neck angle. IANAP, but you can do some searching and find it, I'm sure. Even Hammesfahr admitted it.

I see, her neck angle would of allowed to eat. You seem sparse on your facts or any links to facts.

242 posted on 06/15/2005 6:58:23 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: ClancyJ
You have no problem with the state killing a non-dying woman. Veeerrrrrry interesting..........

I never said that at all!

This was between Mrs. Schiavo and her husband. The government didn't have to get involved that way at all, but that the Schindlers insisted. I'd rather they have stayed out...or at least once they'd decided, let it rest at that.

But if I were in the condition Mrs. Schiavo were in, and nobody else would intervene and fulfil my wishes, then yes, I'd like the government to do so. I don't like the government to intervene unbidden and stomp rights, but to protect a person's rights and to allow them to be exercised, then that's a government's purpose.

243 posted on 06/15/2005 6:59:05 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: RS

If you want to review evidence, go read Empire Journal.com. They have amassed plenty of information about Pinellas County and it's not pretty.

As far as morality goes, I think it's much worse to starve and dehydrate a woman to death than it is to accuse any official of possible corruption especially when his department has a history of it. I think on the moral richter scale murder trumps accusations of corruption or bias.


244 posted on 06/15/2005 7:02:33 PM PDT by blueblazes
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To: Smartaleck

Thanks Smartie, your post saves me from posting it!


245 posted on 06/15/2005 7:03:16 PM PDT by MilspecRob (Most people don't act stupid, they really are.)
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To: Halls

PING


246 posted on 06/15/2005 7:04:48 PM PDT by Halls
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To: Gondring; Hildy
Hopefully hidden away from her wacky parents...after the nasty accusations against her husband, I would guess he's being very careful.

Even Hildy gave me a better answer than that. Thanks Hildy.

247 posted on 06/15/2005 7:08:29 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

What about Milton, the neuropathology expert? Wasn't he present at the press conference?


248 posted on 06/15/2005 7:11:11 PM PDT by Pan_Yans Wife ("Death is better, a milder fate than tyranny. "--Aeschylus)
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To: eagle mama
Since you've posted zero links backing up your contention that Dr. Thogmartin has been sued and settled out of court, or that he is involved in corruption, I am left to conclude that you don't have any, and that you made all those accusations up.
249 posted on 06/15/2005 7:14:06 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: veronica
"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."

Yep Dr Jon, ya got it partly right... She died of dehydration, but to list the official cause of death as "complications of anoxic encephalopathy" is a stretch even in the wildest imagination!!! This lady was starved and dehydrated to death, pure and simple. With people like you, and Judge Greer, and lawyer Felos, I don't think that I will be wintering over in your sunny state! Maybe the new 'fruits and nuts' state is now Florida???????

250 posted on 06/15/2005 7:17:00 PM PDT by eeriegeno
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To: Gondring
but to protect a person's rights and to allow them to be exercised, then that's a government's purpose.

Exactly my point - the government is not to be in the business of killing non-dying people - Terri, you, me - anyone. It is not the business of government to kill citizens.

And a parent has a little more claim on a human than the government. Michael could have turned her over to loving parents and been done with it. The whole point is there is a 50% chance she wanted to die. We should err on the side of life - not death.

And - I want to know how these laws are being put in place. I will not stand for euthanasists deciding when I must die, when my husband must die, when my children must die. They do not have the authority and are not entitled to take away the constitutional rights of me and my family.

PERIOD. And for any of you out there thinking this is no problem - wake up. There will always be somebody that eyes your "goods" and would find you worthless to live.

The government has no right to be in the killing business as that over-rides the constitutional protections of those being killed.

251 posted on 06/15/2005 7:17:44 PM PDT by ClancyJ (McCain: "As far as the criticism is concerned, none of us care about public opinion.")
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To: blueblazes
Go to Empire Journal.com

A source completely lacking in credibility.

252 posted on 06/15/2005 7:20:50 PM PDT by malakhi
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To: malakhi

Well - just prove that it is unreliable. I have never seen anything about that.


253 posted on 06/15/2005 7:21:40 PM PDT by ClancyJ (McCain: "As far as the criticism is concerned, none of us care about public opinion.")
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To: malakhi

Well, that's a matter of opinion. Why don't you give me a site that you think is better?


254 posted on 06/15/2005 7:21:47 PM PDT by blueblazes
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To: veronica
"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."

Of course the condition of Terri's brain was "even worse" than that of Karen Ann Quinlan!

That's because upon autopsy, it was discovered that Karen Ann Quinlan's brain was hardly damaged at all --except for one small area, the thalamus:

Karen’s autopsy became an important aspect of her case because it did not confirm the doctor’s reasoning for her vegetative state. Instead of severe damage to the cerebral cortex, as the physicians had expected, Karen’s brain had extensive damage to the thalamus, and the cerebral cortex was only minimally damaged. [emphasis mine]

-- Creighton University School of Medicine: Autopsy Results for Karen Ann Quinlan

So what is this doctors' statement comparing Terri to Karen Ann Quinlan supposed to prove?

Misdiagnosis of Karen Ann Quinlan's injury may have led her doctors and her parents to not even try giving her therapy.

255 posted on 06/15/2005 7:22:10 PM PDT by shhrubbery! (The 'right to choose' = The right to choose death --for somebody else.)
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To: blueblazes
I don't give a damn what you think.

Oh, I'm crushed. However, you have re-stimulated my desire to engineer a "ignore poster" code when reading posts here.

So thanks again, the feeling is mutual, and by the way welcome to Free Republic blue.

256 posted on 06/15/2005 7:23:01 PM PDT by MilspecRob (Most people don't act stupid, they really are.)
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To: Smartaleck

How about the bone scan (not x-rays) where the doctor said someone worked her over good.

The following are links to the bone scan results and other very interesting information.

http://www.apfn.org/apfn/Terri_bonescan.htm

http://www.apfn.org/apfn/terri.htm


257 posted on 06/15/2005 7:24:26 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: ClancyJ
But, you have no problem with the government stomping all over the rights of parents wishing to keep a daughter that the government wants to kill.

Can you elucidate the rights parents have concerning their married adult children?

258 posted on 06/15/2005 7:25:06 PM PDT by malakhi
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To: ClancyJ

We should err on the side of rights, not ignoring them?

We should err on the side of law, rather than lawlessness?


259 posted on 06/15/2005 7:26:09 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: sinkspur
and that you made all those accusations up.

More likely someone else make those accusations up, and she's just parroting them.

260 posted on 06/15/2005 7:26:47 PM PDT by malakhi
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