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."
Surface abrasions only. :o)
"Would you agree that a conflicted spouse who has broken the marriage contract should not be making those decisions?"
If I personally agree or disagree dosen't matter. Was any court ever petitioned to remove this right ?
"... You have bought every bit of rumor and speculation hook, line and sinker. All contradictory data, therefore, must be due to human evil and a vast conspiracy." What was your minor insulting phrase?... 'irresponsible rhetoric'? You having any success trying to inflame this thread this AM?
The doctors had been telling him for some time that her condition was unrecoverable.
through any type of artifcial means, even though he had absolutely nothing to back up his claim?
There were several other witnesses who 'backed up his claim'.
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)?
And your source for this is??
At the very least, Michael should have had his guardianship permanently withdrawn
On what basis?
and Terri's care placed in that of someone impartial.
She had THREE guardians ad litem.
You might want to read your own post #654 ... by your own words, convicted!
Have you read Pavone's comments? Did you find them credible?
When? By whom? Was it before or after the malpractice settlement?
Why don't you read the reports of the guardians ad litem? You might find them more edifying than the sort of unsubstantiated rumormongering peddled by the likes of Empire Journal.
Do you believe people have the right to make end-of-life decisions and reject medical treatment?
Obviously, they showed the 4 hours of video enough that you, someone not personally involved with the situation, knew there was 4 hours of video. Of COURSE the media, websites, et al cut the length of the video down. None of the above shows 4 hours of video of anything (unless it's something they're charging for).
Which we know know was impossible anyway and could have never happened.
Are you under the delusion that doctors know everything about how the human brain operates? It seems you are.
Also, if you look at the video, you will see that the person holding the balloon is following the movement of her eyes, not the other way around. But don't take my word for it, watch the video.
I have watched it and I don't agree with you. (Note that I am not calling you a liar because we don't agree. It's a shame you can't extend the same courtesy to her parents.)
Exactly what accusations did he make against the Schindlers?
Perhaps you do not recall that he claimed they were only fighting him because he wouldn't give them any money. Or perhaps you chose to forget that little tidbit.
The "poor saps" I referred to are people who bought into all the lies told by "experts" who never gave a damn about Terri, but only wanted to squeeze some cash out of the Schindlers during a time they were extremely vulnerable and willing to try anything to hold on to hope, rather than accept what is unfortunately true. Feeding their delusion that she could respond and be helped for their own benefit, knowing it was very likely not true.
The human brain is still a great mystery to science. Stranger things have happened than to have someone like Terri, with some effort, begin to do things they hadn't done in years. Christopher Reeve was an example of that. After many years and with much work, he learned to breathe on his own again.
Whether Terri would have improved or not has nothing to do with the legal oddity and immorality of executing an innocent person in a most heinous way based on hearsay evidence.
Absolutely.
"Or a nobody politician writes a letter that you should get the Nobel prize!"
The nobody politician who wrote the letter as a favor to a less then nobody retired cop who suggested it in the first place.
Then, don't offer any more opinions because it "doesn't matter".
Was any court ever petitioned to remove this right ?
The 2nd DCA in Florida acknowledged Mr Schiavo was conflicted, that was part of their basis for their decision to enable Judge Greer, as a representative of the state, order the death of Terri Schiavo.
Should states have that power?
Never mind, I forgot.
The Schindlers encouraged him to date and move on with his life.
You are playing a game of semantics. The fact is if she was blind her eyes did not function and she therefore could not SEE. So declaring her PVS based on her lack of ability to visually connect to the world is a complete sham.
If I encourage you to break a contract, any contract, and you break it the fact that I encouraged you to break it has no bearing on the fact that you have liability for breaking a contract.
Do you think that just the marriage contract can be broken with impunity or any ole contract?
I am not claiming to be a neurosurgeon here. But I am reasonable astute person. I am not a meteorologist, but I can tell you when it's raining.
The cerebral cortex, which is responsible for things like thinking, reasoning, remembering, and things like math and language, was severaly damaged with very little grey mater present and most of the structure atrophied. The cerebral cortex makes you "you".
The thalamus was also extremely damaged, indicitive of a total loss of cognitive function. This area controls purposeful movement and well as processing of senses, and severe damage to this area would prevent many meaningful brain activities.
Also, she had severe damage to the nerve pathways that carry information to the cortex, the CPU.
Also, severe loss of specialized cells in the basal ganglea which helps control purposeful movement, as well as the hippocampus being atrophied which is responsible for short term memory.
As for her inability to see, nearly complete destruction of the occipital lobe, with most neurons gone. This is what processes visual information.
Loss of cells in the cerebellum which also coordinates the actions of voluntary muscles, which would make things like walking or eating impossible even if this was the only part damaged.
The brain stem, very little damage in this area.. responsible for all lower, basic breain functions such as breathing and heartbeat. Pretty much all she had left.
I assure you, if you were to meet Terri in the afterlife and ask her what happened. She would tell you that the very last conscious thought or awareness she had of ANY KIND was of the moment of her collapse or very shortly after.
Deprivation of oxygen to the brain causes such utter devastation, that it's pretty hard to put words to.
See post 698 below, and see what I mean.
"So declaring her PVS based on her lack of ability to visually connect to the world is a complete sham."
... as much as sham as declaring her NOT PVS based on watching selected videos of her following objects with those blind eyes ?
( Oh, and WAS she declared PVS based on sight ? )
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