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 seem to be glad Terri Schiavo was murdered. Good for you.
Anyone who cares that much about human life is much worse than a "twit." What you are I cannot say in open threads without being banned.
She has no right to do that! YOU have no right to do that!
You must be kept alive at all costs -- even if it drives your spouse into bankruptcy. Your spouse must suffer the financial and emotional burden of caring for your hopelessly brain damaged body, despite your wishes to the contrary.
Besides, we all know that she's after your money and we must look to your best interests to make sure that only the hospital and the lawyers get that money (by filing lawsuits insisting on repetitive and costly MRI and PET scans, separate reviews by 15 doctors, useless therapy, and the like).
And here you thought you had a right to privacy.
I think we can all agree with that. And I certainly appreciate that this thread did not get out of hand, and that adults debated an important issue calmly and rationally.
I couldn't have said it better!
Animal people consider injections much more humane than letting the animal wilt away over time. And for some centuries, indeed, shooting a horse was more humane than just letting him gradually die.
Yes, by God, I would prefer it that way, if I HAD to choose how to execute an innocent person.
But the real choice was between letting her die (by neglecting her, no less) and letting her be cared for by her family.
In which the latter is ALWAYS my choice.
You're implying their real desire was to kill her off themselves? How absurd a comparison (fictional as it is) is that? Ridiculous.
Don't be ridiculous. That isn't even the point; their desire to care for her rather than kill her off is. But if "their manner of care" were - what makes you think they'd always be insisting on stuffing things down her throat thru her mouth?
Do you think a man who supposedly loves his wife would ask nurses, "When is that bitch going to die?" and engage in unusual behavior (e.g., forbid his wife to have even the most basic care)?
This case had red flags all over it from the word go. At the very least, Michael should have had his guardianship permanently withdrawn and Terri's care placed in that of someone impartial. The fact you and others here chose to ignore that speaks volumes about how you measure humanity and compassion.
What if Terri had put her wish "not to live that way" on paper instead of orally? Still morally wrong?
True judgement has been used for ages, esp. understood in the long-past days of the Republic. Concern about the SPIRIT even above the LETTER of the law should be paramount. Otherwise, you'll start behaving like Clinton. "I didn't lie when I said I never inhaled." The ass knew the concern is using drugs at all, never mind exactly what he did w/them!
Ah! I see. YOU get to say when man can kill you, but not Terri.
Why is that?
I agree; I think the ME must've done a good job. I don't see off hand anything wrong w/what he's done. If anything, it puts both parties into question depending on which aspect you're discussing.
That's a pretty sweeping statement on your part. Care to back that up?
Untrue. She had intense therapy, and repeated testing. Her condition was determined to be unrecoverable.
When? By whom? Was it before or after the malpractice settlement?
The one group of people during this whole case that were consistently dishonest and consistently told us things that we now know were not, and could not have been, the truth, were the Schindlers and their mini-armi of lawyers and Randal Terrys.
"Hopefully, the rest of us can agree to disagree without resorting to threatening hate filled posts."
That tends to be the last resort of somebone who has lost the argument.
That is an outrageous thing to say. Why do you think they would do something like that? Because they felt their daughter was still alive and they wanted to take care of her? What in the hell is so wrong with that? Do you have even the slightest idea what the hell you are talking about?
Nothings changed. There are those of us who oppose the state ordered killing of American citizens who have committed no crime and then there are those that support it.
Amen.
I stated this much earlier, but it seems to me the judge way back lacked judgement and let MS continue his path w/no solid evidence himself about even any "wish to die". So not only was this all morally wrong, but it was legally questionable from way back.
Oooooh. That's going to leave a mark.
Hey, ClancyJ, better put some ice on that.
Oh good grief. The 'manner of death' was purposeful starvation and dehydration.
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