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."
So starving someone to death is now known as a 'complication' - that's interesting.
Thanks, it's aways been one of my favorites.
It's over? Not by a long shot. The managed care/ long term care insurance companies need to speed up the dying process a la Schiavo or they will go bankrupt. Too many old folks on the horizon. The baby boomers will sink them if they can't find a way to get rid of them. With the help of the Florida legislature and courts they found a very good way.
There is nothing about the human condition that the Bard didn't understand and write about brilliantly.
You bet. I would like to see analyze these Xrays like many freepers did with Ron Brown.
That was some good analysis back in the day. Any old timers remember?
"I doubt it's common practice for a medical examiner to take x-rays of an entire body"
247 images according to the autopsy report.
I should add, allowing to euthanize when there were even direct relatives willing to care for her.
This was a true lack of JUDGEMENT by a "judge", likely sticking solely to "the letter of the law" and not the spirit, recognizing that erring on the side of caution - life - would have been perfectly acceptable and harmless to "the rule of law".
Actually it sounds to me that the ME did a good job, and an unbiased 1. I could be wrong, but it seems so.
My freeper page and links give more detail, if that isn't clear enough. I'm outta here. ; )
"Meanness?"...was it mean to tell people she could see and follow a balloon, that she could swallow that she could recover, when in fact, according to the autopsy, she couldn't?
I KNOW the REPORT said she didn't have 1.
As I clearly stated, MICHAEL apparently claimed she had a HR.
So, the hitch is that the report contradicts MS's claims she had a HR!
I stand corrected. All the more reason for those making false allegations of abuse to stop their slander (before they get sued).
Incidentally, I find this blindness/balloon part confounding.
What the heck was Terri doing if not eyeing the balloon as it crossed in front of her?
David Brown of the Washington Post writes...
"Terri Schiavo died of the effects of a profound and prolonged lack of oxygen to her brain on a day in 1990, but what caused that event isn't known and may never be, the physician who performed her autopsy said today."
and...
"She died of marked dehydration. She did not starve to death," Thogmartin said. As measured by the balance of salt and water in her body fluids, the dehydration was the most severe he had ever seen. This attested to Schiavo's robust underlying health, and in particular the strength of her heart, the pathologist said.
http://www.washingtonpost.com/wp-dyn/content/article/2005/06/15/AR2005061500512_pf.html
THE DEHYDRATION WAS THE MOST SEVERE HE HAD EVER SEEN. MAY THOSE WHO WANTED TO SEE TERRI SCHIAVO DEAD GET ON THEIR KNEES AND THANK GOD FOR THE GIFT OF LIFE.
MIchael's new wife-to-be wants a Catholic wedding, so Michael needs to be a widower, not a divorcee. The Bishop down in St. Pete never lifted a finger to help Terri.
Michael is a huge guy -- all he needed to do was put his forearm across her throat and push until she couldn't breathe any more. No finger prints, no bruises. But there was a bone scan done, and the doc noted a fractured neck (C-3?). Why didn't the ME reference that report?
I guess Michael needs to pay that money back then...
Maybe the ME should confer with the previous Pinellas ME, Dr. Joan Wood, and see what they can come up with between them.
If you watch that video, you will see a slight lag in time...while he mother moves the balloon in front of Terri's face as Terri moves her head back and forth.
Terri had electrodes left in her brain from some test Michael had her go through out in California. The doc wanted to take out the electrodes when it was obviously not helping. Michael refused to let him do it. The net result was that Terri would never be able to have a MRI because this test is done in a huge cylinder surrounded by extremely strong magnets. These magnets would have pulled the electrodes right out of Terri's head. So, no definitive MRI tests could be done due to that ever thoughtful Michael.
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