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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: Howlin

Your attempt at being subtle landed with a resounding thud, ha.


501 posted on 06/15/2005 10:03:26 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: A Citizen Reporter

Well, there was plenty of ugliness to go around; both sides were equally involved.



502 posted on 06/15/2005 10:03:35 PM PDT by Howlin
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To: tertiary01

I would expect you are correct.

The medical profession is in the process of destroying itself.

Once confidence in them is lost, the people will not pay to see them. Why should they?

And the same with nursing homes. If they become killing places, there will be no patients and the homes will shut does. Afterall, someone can die without care at all and avoid all the trouble of chasing after doctors, moving to nursing homes.


503 posted on 06/15/2005 10:04:49 PM PDT by ClancyJ (McCain: "As far as the criticism is concerned, none of us care about public opinion.")
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To: ClancyJ

Starting at 201, and then reading through, you find her negatively portraying the ME, with NO documentation to back up her facts. I consider that slander.


504 posted on 06/15/2005 10:05:36 PM PDT by Pan_Yans Wife ("Death is better, a milder fate than tyranny. "--Aeschylus)
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To: blueblazes

"I think you misunderstood me. When I refererred to "evidence of some type" I mean if someone is making allegations about another individual. THey should have some kind of evidence or material they are referring to that they can openly share with us."

Yes, I must have misunderstood that part. I agree that people should not make allegations about other individuals that they cannot back up. I don't mind people saying that they "believe" someone is "blah blah blah", but we shouldn't say we "know" someone is "blah blah blah" unless we know it for a fact, and can back it up with facts.


505 posted on 06/15/2005 10:05:47 PM PDT by Chena (I'm not young enough to know everything)
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To: Howlin
Getting kinda hot around here Im off for a ride on my bike....


506 posted on 06/15/2005 10:06:21 PM PDT by woofie ("Plunk your magic twanger, Froggy!!")
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To: ClancyJ

The medical profession is in the process of destroying itself.




How so? Mighty broad brush.


507 posted on 06/15/2005 10:06:34 PM PDT by onyx (Pope John Paul II - May 18, 1920 - April 2, 2005 = SANTO SUBITO!)
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To: Howlin
Sorry I don't equivocate here. I've taken note of who on what side has come back to this issue, AGAIN, and AGAIN.
508 posted on 06/15/2005 10:07:02 PM PDT by A Citizen Reporter
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To: blueblazes; sinkspur; eagle mama; Chen; bonfire
When I refererred to "evidence of some type" I mean if someone is making allegations about another individual. THey should have some kind of evidence or material they are referring to that they can openly share with us.

You need to take that up with eagle mama.

509 posted on 06/15/2005 10:08:15 PM PDT by Howlin
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To: blueblazes

Forget trying to explain anything to them. Afterall, he justifies their stand that Terri was nothing, and that Michael had full justification morally and legally to kill her based on a sudden memory after 7 years and getting the malpractice award to care for her the rest of her life.

Now they have to win you know because they want their husband to be able to kill them. It is far too hard to just have a Living Will stating such - they must have the whole country agree that it is ok for a husband with two wives to have life and death decision power over both.

Whoopee. We can kill.


510 posted on 06/15/2005 10:09:02 PM PDT by ClancyJ (McCain: "As far as the criticism is concerned, none of us care about public opinion.")
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To: A Citizen Reporter

It sounds like you're carrying a grudge.


511 posted on 06/15/2005 10:09:29 PM PDT by Howlin
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To: blueblazes; eagle mama
if someone is making allegations about another individual. THey should have some kind of evidence or material they are referring to that they can openly share with us.

You need two need to talk.

512 posted on 06/15/2005 10:09:33 PM PDT by unbalanced but fair
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To: unbalanced but fair

They need eachother's phone numbers.


513 posted on 06/15/2005 10:10:19 PM PDT by bonfire (dwindler)
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To: bonfire
"feelings.........nothing more than ..Feelings"

So what? You have none I guess.

514 posted on 06/15/2005 10:10:51 PM PDT by ClancyJ (McCain: "As far as the criticism is concerned, none of us care about public opinion.")
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To: Howlin
You need to take that up with eagle mama.

Beat me to it. See my post #512.

515 posted on 06/15/2005 10:12:20 PM PDT by unbalanced but fair
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To: ClancyJ

Gosh, correct me if I'm wrong -- but I don't think I am -- weren't you one of the ones decrying the nastiness not too very long ago?


516 posted on 06/15/2005 10:12:50 PM PDT by Howlin
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To: ClancyJ

And you expressed many of the reasons why I'm retired from nursing. I did not learn to kill my patients in nursing school and I sure am not going to change with the times.

I for one will never have a living will.


517 posted on 06/15/2005 10:13:11 PM PDT by tertiary01 (Getting tired of the Culture of Killing.)
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To: bonfire

Well, they could always find a chat room.


518 posted on 06/15/2005 10:14:13 PM PDT by unbalanced but fair
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To: ClancyJ

I try not to let them obscure facts.


519 posted on 06/15/2005 10:14:39 PM PDT by bonfire (dwindler)
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To: A Citizen Reporter
do take note of those who seem to be obsessed with this topic. It's time for it to end

Not obsessed - awake. And, of course, there are many end-of-life panel "experts" and lawmakers that hope it will end.

I just do not enjoy the fact that end-of-life laws are being made by "someone" that determine when I have to die or when a family member is to be killed.

In fact, it scares the dickens out of me. So nice that you do not have those fears.

But, I am no fool and I'm afraid that Terri has shown us the dirty underbelly of what is going on in our government.

520 posted on 06/15/2005 10:15:14 PM PDT by ClancyJ (McCain: "As far as the criticism is concerned, none of us care about public opinion.")
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