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 made those accusations in three different posts up the thread, and you've yet to provide any evidence that supports what you said.
You should not be flamed for ANYTHING. I don't approve of flaming, or of trying to get rid of posters I don't agree with. These seem to be immature practices to me.
I think the concern here is with that old slippery slope of setting a monetary value on human life and at what point granny becomes too expensive to keep alive. A lot of people would think that might be right after she's eligible for AARP if it would increase the estate, and they wouldn't hesitate to use the government to enforce their greed, if they can.
you would have prefered euthanasia by something quicker? controlled morphine OD? Lethal injection? taken out back and shot?
Actually causing someones death by direct action rather than by withholding life support (including artificial feeding) is considered as a different class of actions legaly and ethically.
what I meant was, "isn't 1992 about the time of her barium tests?"
I believe this is a moral issue and that the technicalities actually are irrelevant. The bottom line to me (as I've stated before) is that it is morally wrong to starve and dehydrate a woman just because we don't like or understand her existence, or she disgusts or frightens us, and her estranged husband with a common law wife and children wants her dead. That to me is simply wrong, and there is nothing that can make it right.
Was his original lawsuit based on the fact that the doctor failed to diagnose her eating disorder? Does the insurance company have any recourse now that it has been shown she didn't in the autopsy?
This is the same coroner that was sued (numerous times and settled out of court) for ruling many deaths as natural causes, such as the man who was found to have been murdered execution style with a bullet to the head, ole Doc T ruled his death as being due to Natural causes.
I agree with you about the need for living wills. But they are useless if we have a society that doesn't value people's rights and wishes.
I can't find the link you posted to support that claim about the execution-style murder being mis-ruled. Would you please post it again?
Or are you yet again making a claim without any evidence?
I was wondering exactly the same thing. It was settled out of court, I noted from the autopsy.
One of the problems with living wills that people don't consider is that they don't ALLOW YOU TO CHANGE YOUR MIND. Many people simply don't consider that, while they might find a certain condition repugnant at this point and would never want to live in a certain way viewed now as a young and healthy person, if they actually were to BECOME that way, they might feel very differently. How many of us would actually want to be paralyzed in a car accident, or blinded, or live like Stephen Hawking? But people do adjust to these things and that's what Living Wills don't take into consideration. You may want to live when you actually have the condition but you may be deemed legally as not being able to make that decision. So, you lose. I for one, would never have a Living Will. If they pull out my feeding tubes I'm coming back and haunting them :)
This is a lie. There is nothing in google about this incident, or in Yahoo search.
In fact, there is nothing untoward in any source about Thogmartin.
You are prevaricating.
I worked in one of many hospitals that would not permit him in their morgue because of his sloppiness and bad rep, these cases were settled out of court with confidentiality clauses. Therefore you will not find documentation due to the records being sealed. The medical circles are hush, hush to the public but not within their own circles. He is notoriously known within the medical community for his screw ups.
How convenient.
I don't think the autopsy showed such a 'fact' ... the ME didn't opine regarding eating disorder and in fact didn't assert cause for her cardiac event. He couldn't/wouldn't make such a determination and insurance company wouldn't try such a trick either.
http://www.apfn.org/apfn/Terri_bonescan.htm
The radiologists report and interpretation of the Bone Scan.
I am just joining the post now, but I can imagine what has transpired, based upon your attack here, demanding a withdrawal or a retraction.
I for one, believe in LIFE, and will stand against the culture of death and forces of evil which exist in Florida and elsewhere, whether you reside there or not.
Rhetoric such as yours is just that: words but without actions bearing fruit. If you are so 'gifted' with having assumed the the 'correct' position regarding life vs death, why am I not convinced by you or by others of your ilk,and your hollow reasoning?
Convince me that withdrawing hydration from Terri leading to death somehow was in the best interest of mankind. How did I benefit by it?
Hitler tried similar eradication tactics, but now there are those who deny that 6 million people really did die as a result.
Maybe 60 or so years from now, people will deny that Terri really lived, and died under excruciating circumstances, and that this present-day argument is about a person who never really existed? I would imagine her parents would challenge that belief, and that her 'husband' might remember this past year as being the one he most wants to forget.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.