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."
It has a history of the entire legal case and it also has a copy of the Medical Examiner's report.
One could just as easily make the case that this is what you're position would entail -- the state stepping in and interfering with private family decisions.
Sorry...I was assuming you'd read the basic information on the case before posting, but I forgot what topic we were on....facts don't seem to matter to the I'm-On-A-First-Name-Basis-With-"Terri"-and-Know-Her-Better-Than-Her-Husband crowd... are you one of them?
In any case...read the big GAL's (Wolfson) report to Jeb Bush for info on the swallowing tests. She failed to swallow, despite repeating the testing twice trying to get a response. The results were so conclusive that there was no hope, that it was recommended that no more tests be done.
Wolfson recommended another swallowing test, if the parties could agree on what to do with the results, and he also noted that the Schindlers changed positions on the PVS diagnosis. For years and years they agreed she was in a PVS, but flip-flopped just prior to this report.
Regarding saliva, it takes conscious cerebral activity to move the food back to where the swallowing reflex (reflex=involuntary) takes over. For small amounts of saliva, the reflex can be triggered without conscious intervention, but for her to actually swallow food or drink, she would need the conscious voluntary input. That is, her neck angle wouldn't allow her to eat, but it did prevent her from drooling as the saliva could go back down her throat. IANAP.
Maybe that is because this whole thing is a great deal more serious than you pro-MS guys think it is.
What about Rush Limbaugh, Sean Hannity, Glenn Beck, Ann Coulter, Peggy Noonan, Jeb Bush, Pres. Bush, Tom DeLay?
Are they unreliable too?
I recall seeing "stoppage of breath" on some old death certs. Gotta love it.
Are you being tacky or do you always treat posters this way?
She never had, was said to have had by her doctors, or needed to have, a Heart Attack (MI).
She undoubtedly had a Cardiac Arrest, as her chart states, and the MI explained today
Ahhh, never had a Heart attack? But had Cardiac Arrest??
Definitions to help your confusion:
car·di·ac ar·rest (plural car·di·ac ar·rests)
noun
heart attack: the sudden stopping of the heartbeat and therefore of the pumping action of the heart. Cardiac arrest requires immediate treatment to prevent brain damage and death.
MI (also known as Myocardial Infarction):
my·o·car·di·al in·farc·tion (plural my·o·car·di·al in·farc·tions)
noun
heart attack
Thank you for posting this. I also think however, it's important to review things in addition to simple court documents as there is a lot of information they don't explain or even reveal. Information that might give us the "why" of a decision as well as the flat decision itself. For example, we might review the recent Michael Jackson court documents and note that he has been found "not guilty", but how many people actually believe he is not a child molester? Sometimes the law and justice are not only not equivalent - they are at odds.
Well, the terrisfight.org website or whatever it is/was had a lot of the documents, but then they began removing ones that disproved their claims so you can't find them all there anymore. :-(
Well, that's unfortunate - that's why I feel strongly that there needs to be independent reviewers of this case (if they can be found at this point). I hope that Mark Fuhrman might be one such. That was my initial point about the ME's report - that he should have allowed other observers in the room to support the credibility of his own report. I think nearly everyone has chosen a corner at this point, however.
I'm not sure I know what link you're referring to?
"Yes and he convinced one young woman that her father died of natural causes only to later be determined that her father was actually murdered by being shot behind the ear. He settled out of court, and this is not the only case where his work was sloppy."
Do you have documentary evidence of this?
My favorite was 'died of natural causes'. That left the doors open and closed them at the same time!
I will not get into word games with you malakhi so that you can switch the emphasis to one of technical laws.
You did not answer my questions. Is it right to rip a son/daughter from the arms of a parent and kill it?
No, it is not right.
All of this comes into play when the state starts killing citizens. It is not right to kill and it is not right to tromp over the rights of other citizens whose family members are being killed.
Explain it away all you want. You do not want this happening to you but you dare not say that.
Explain why you fight so hard for the right of a husband to put a wife to death? What if your husband was having an affair of years standing and when you fell into a coma (someway......), he claimed that you said many years ago that you would not want to live in a coma. Therefore, he gets a free murder. Do you think he has that right to kill?
Well, I don't. Every woman out there and every husband is at risk of being killed by a man/woman that does not wish to take care of an invalid, does not wish for money to be spent caring for them.
And, if you think that is good law. Then maybe we need to check and see what the laws are setting our people up for. Would be nice if the people knew about them.
Agreed!
What was very disturbing to me was when I said that I was hoping people could join me in wishing that whatever happened was what she would have wanted....and I found opposition to THAT, even!
There were so many "Damn-People's-Rights, Full-Speed-Ahead!" fanatics that scared the heck out of me and made me wonder where conservatism had gone! They didn't care about Mrs. Schiavo...she was just a pawn for their "Life-At-All-Costs" agendum...I realized that this Culture of DisrespectTM doesn't look at people as individuals with inherent rights, but rather as just "lives"...existing as a formless mass.
"The autopsy does not change that it was wrong to kill a non-dying woman."
This topic is about the autopsy and it's helpful when people stay on topic. IMHO
"For those of you that have an extremely hard time understanding why some of us care about what happened to Terri......"
I personally haven't seen anyone who "didn't care" what happened to her. I have seen a lot of people who can't separate facts and logic from their emotions.
While the law may be flawed and her treatment as being moral or ethical is open to debate, there remains that part of the matter that isn't open for debate.
Well, the ME's report is there. But some of the information on testimony and doctors' reports can be found there also. And really, what else do we have to go on? I don't think many of us, if any, were there. We didn't know the families involved. We can only try to learn from such documents. And just because the MJ jury came to the conclusion they did, doesn't mean we would have. I believe that the more we learn, the better and more credible our own judgment.
Where are the x-rays you claimed?
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