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."
A lot of that going around today.
"If we can get the link up, you might find the videos made in 1992 or 1993 in Michael's presence (he's in the vids also) where Terri is in a wheelcahir, neck brace, swallows, follows commands to transfer her gaze to things Michael points to on the lake before them, and licks her lips repeatedly. "
Ping me if this ever gets found, you would think this would have been played over and over again, but this is the first I've ever heard of it.
You are 'da links man' ... we have a need for links to the data regarding the ME when he was assigned in the Schiavo case (his history that was posted on FR) and for the link to the videos of Terri from 1992/1993 beside the lake. Please help us if you can ... I don't have current access to my links list or timeline of Terri's medical history. Thank you ...
Whatever happened to "slander"?
No, I don't want any living will - it gives the government too much leeway to get rid of me if I prove too expensive (whatever that is) or inconvenient to keep around. I'm staying and I'll go when God calls me, and only then. I don't want the government to be involved in issuing execution orders for non-criminals as Judge Greer did for Terri Schiavo. Money or the convenience of others should not be the determinant of whether someone lives or dies, as none of us would be safe eventually.
I've had to deal with relatives and the Do Not Resuscitate order and feeding tubes. I had the damndest time getting the doctors to explain what the actually MEANT by DNR - under what circumstances they would not resuscitate. THey hemmed and hawed and eventually told me that it meant they if my relative had a cardiac attack they wouldnt use the paddles to resuscitate her. So I said the hell with that- I'm not signing any DNR order because I don't trust you SOBs. And after having worked in a hospital for the past few years, it's only confirmed my opinion about doctors. I'm not thrilled with most of them frankly, and I'd rather take my chances with God.
As for feeding tubes, I've gone through that with a relative too. I don't want to go into it in detail, but frankly many people live for years if not decades with feeding tubes. There is nothing extraordinary about having a feeding tube - people with severe stomach problems have them. The law in Florida was changed SPECIFICALLY to include feeding tubes so that Schiavo could succeed in killing his wife. Felos helped push the law through around 2000 if I remember right.
Oh really? Why don't you try reading the thread first before you comment. Then you won't have to 'imagine' it.
based upon your attack here, demanding a withdrawal or a retraction.
The other party made an unwarranted claim, and I called him on it. If that bothers you, tough.
Oddly enough, the video was played in pieces on CNN and on Fox at various lead ins for discussion bits they did. Larry King had it twice that I recall, once when MS and Felos were on his program, with emphasis on MS attending to Terri as shown in the video.
Yeah, he's a real lightweight; DUH.
Scheduled speaker for the July 26 membership luncheon at the Harborview Center is Jon R. Thogmartin, M.D., District Medical Examiner for District 6, Pinellas and Pasco Counties, since December 2000. Dr. Thogmartin was born in Wellington, Texas, and received his doctorate in medicine in 1990 from University of Texas Health Science Center at San Antonio, and his bachelor of science in biology from Southern Methodist University in Dallas in 1986, magna cum laude.
Dr. Thogmartin was Associate Medical Examiner in Broward County and Dade County before becoming District 15 Medical Examiner in Palm Beach County in April 1999, a position he left in November 1999 to accept the position in Pinellas and Pasco. Licensed in both Florida and Texas, Mr. Thogmartin is also certified in Anatomic, Clinical and Forensic Pathology by the American Board of Pathology.
Jon Thogmartin has been honored by the Alpha Omega Alpha Medical Honor Society (1989), Phi Beta Kappa (1986), and Robert Stewart Hyer Society (1985). He also received the Silver Medal of Valor from the Metro-Dade Police Department in November 1996. Jon Thogmartin has been accepted as an expert in the field of Forensic Pathology in U.S. Federal Court and in the Circuit Courts of Dade, Broward, Palm Beach County and the State of Michigan. His major fields of interest are wound ballistics, firearms, infant deaths, child abuse, asphyxia, and forensic toxicology.
Thogmartin has also done his share of teaching. In Texas, beginning in 1984, he was a teaching assistant at Southern Methodist in the Department of Chemistry, and at the University of Health Science Center at San Antonio in the Departments of Cellular and Structural Biology and Pathology. More recently, in Miami, at the Dade County Medical Examiner Office and IACP Seminar, he taught a course on Strangulation and Other Compressions.
Jon Thogmartin has been published in the Journal of Forensic Science, American Journal for Medical Pathology, and Journal of Pediatrics, in addition to the Palm Beach Post and Medical Examiner Annual Report.
Another lie. Court filings are public record, even if all the information isn't.
A lawsuit against an ME is headline-stuff, in any county.
I've seen the video. They even showed portions of it today on one of the networks. Yes, Terri's eyes move. but I don't recall they moved to any command. To me she seemed more unaware than aware. But other people may see it differently. Since I'm not a doctor I wouldn't be qualified to interpret and diagnose. I do have a colleague who is totally blind. Her eyes still move and sometimes you think they're following you, but she's quick to tell you she isn't.
Slandering a man's name because you don't like the results. Sad and unreal that this is acceptable here on FR with no PROOF.
Hi Howlin. That's all very impressive and I'm sure he's a fine guy. I don't know anything about him personally. However , I'm reminded of a professor - in fact several professors I worked with at MIT. They were all extremely well known men and if you were to look up their bios on line you'd see their education and the honors they've received, and the work they've accomplished, blah blah. What you wouldn't see, and what I know, because I worked for them, is that they 3 of them were rotten bastards. One was an outright and well known liar within the Institute, another one was considered autistic at best and actually insane at the worst, and the third was considered as having extremely bizarre views by his peers. However, all of these things were known informally, but of course, no one says anything publicly as its an old boys network and no one rocks the boat.
So all of this may be true about Dr. Thogmartin, and then again, there may be things we don't know either. We can't just look at the surface of things.
I have looked all day long and haven't seen ONE thing detrimental to this doctor.
In fact, Mark Furhman said he was a well respected ME, that his report was excellent, that Mark agrees with it, and he even went so far to say that the ME would be "hailed" for his fairness and accuracy.
You wrote-> "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.""
Today I heard President Bush say it was WRONG to kill Terri, too. I agree with you and our President. :)
If there were doctors who supposedly did not support the findings of Dr. Campbell (and so far as I know the bone scan was never allowed into evidence much less the radiologist who wrote the interpretation, therefore if this was not allowed there would have been no examination or cross), since this is your contention would you not provide the link to this. I don't believe there is one since the bone scan was never allowed into evidence.
I find this really questionable - from your link
"Dr. Hammesfahr confirmed that Terri could talk and was improving in the very first year when she was getting some rehabilitation (BEFORE Michael got the money), and that the medical records confirm, that after Michael got the money, rehabilitation was completely stopped!"
Since Hammesfahr never saw Terri until 2002, just how can he CONFIRM anything that happened 10 years before that ?
Well, by all means, slander this man if you need it to prop up your arguments!
It's a free country, after all.
Oh, I just thought of another prof I worked with at Harvard. Same thing - if you looked up his name on line, you'd see his honors, his achievements, his societies, blah blah. What you wouldn't see is his obsession with sex and sexual talk in the work place, his grabbing of the interns' breasts in the elevators, his attempts to fire all the women over 30 and any gay men, etc. I was there and saw all of this. I had to console the interns and I went to Personnel to complain (they did nothing by the way, which is how they would generally respond to complaints about professors.) However, you'd never know about any of it if all you went by was what you see on the Net. Sometimes there's more to the story, and sometimes there isn't.
There's not. eagle mama is slandering him. Nobody believes her.
"Oddly enough, ..." Very odd indeed - why do you think the Schievo's would have buried these videos ?
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