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."
However, there's nothing wrong with someone posting his CV. We're all here to learn and discuss, right? I appreciate it when someone posts something informative. It's then up to me to read it and take it for what it's worth. :)
Next time you see your doctor ask him/her if they have a living will. I'll bet it's a "no" or the will is so all inclusive of life saving procedures that it might as well not exist.
You are slandering a man with no proof. And, if you'll look around, nobody believes you.
I am a court reporter; you are DEAD wrong about that. Nowhere in this country is a PUBLIC OFFICIAL SUED IN A COURT OF LAW and it's kept from the PUBLIC.
Now, the more you keep repeating that, the less credible, if possible, you become.
Different nurses, they gave depositions which Greer would not allow into evidence.
"feelings.........nothing more than ..Feelings"
Why bother? They can just stay on this thread.
Is it just me, or are you mistaken as to whom was on Terri's side of Life? Terri's name was Terri Schindler Schiavo. Her then husband's name was Michael Schiavo. Her parents (and brother and sister) are named Schindler.
As I've said before, it is totally irrelevant to me what the report says or how Thogmartin presents it. He made a critical error in not allowing other parties to witness the autopsy as there is no independent corroboration of his observations. In a situation like this with 2 warring factions fighting over each detail, that was a BIG error, as it renders the autopsy virtually useless. Each side will just view it as they wish. In fact, I literally just heard a radio report as I'm typing this saying that neither side's view has been changed by the autopsy report. That's true, and he might have avoided this conclusion if he had included other parties in the autopsy.
Moreover, I don't care what the autopsy said, one way or another as this is a moral issue to me. It was wrong to starve and dehydrate this woman. Period. You can go back and review more of my comments if you wish. I'm going to call it a night.
" Misdiagnosis of Karen Ann Quinlan's injury may have led her doctors and her parents to not even try giving her therapy ""
Excellent post with valid points.
No - it is fraud and everyone wanting to skirt their own responsibilities that is ruining the medicare/medicaid benefits.
And, the answer is NEVER killing as is the undercurrent here.
How do the young who don't want to pay the price for the seniors - expect that suddenly when they are old, someone will change their minds and pay for them? The young will have turned themselves into ghouls because they were spoiled rotten by indulgent parents teaching them that life owes them what they want - no matter what it means to others.
The answer has to lie in better care to keep seniors self-sufficient. Our medical community could find ways to improve physical health to allow people independence.
Abuse of the system must be stopped. For all.
We also have to stop the "if you do it for one - you do for all". Why are we paying for school lunches, breakfast? This is just an example.
The answer is never that a society chooses to kill some. That is the death of society.
This is a major problem that will have to be dealt with. But, it will not be solved by killing.
We have to stop the greed - that is the problem. Our legislators are the top greed partakers. We do not need to provide lifetime salaries for legislators. We do not need to pay for security for judges. We do not need to pay for perks at the taxpayer expense. On and on - greed and corruption are the problem - not the elderly that have worked their entire lives to pay into the system and when they need it, the system fails them.
That is feeding off the weak.
I'm aware of a person, let's call them, "BB" who likes to post slanderous stuff on the internet, claiming to work at different well respected universities, but only likes to gossip in an evil way. Do you believe ME? WHY? Because I said so? Or, because you believe I have PROOF?
It isn't just you. I'm pretty stunned by what I seeing.
Absolutely perfect!
Those depositions were not even taken until this latest round of court antics - The Schaivo's ignored and never called these nurses who supposedly talked to them many years and appeals ago. Check the dates - ( if they haven't disappeared from the sites allready )
I don't mind his CV being posted, it's informative certainly. I just don't like seeing it being used as an answer to an argument, when it really can't serve that purpose. A CV can tell you what someone has accomplished, but it doesn't tell you what they're like. There's a lot that is necessarily omitted.
I believe you :)
Read my posts in their entirety, the records are sealed and have confidentiality clauses. If you are part of the medical community you will know his record, if you are not a part of that circle you will know and find nothing. It is not a matter of public record therefore the public at large would not know about it. I am simply sharing my knowledge having worked in the medical circles in Central Florida for a more balanced sharing of information.
So you're on record as disagreeing with Mark Furhman, right?
He thinks this guy did a bang up job and will be "hailed" for his fairness, thoroughness, and fact finding in the future.
"Is it just me, or are you mistaken as to whom was on Terri's side of Life? " Shindlers - Schievos , Someone is burying the "evidence" as more and more holes appear in it.
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