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."
If she didn't starve to death, then how did she die?
It does and it doesn't. Try "tortious interference". ;)
Wow - great catch. On FR someone always see through to the truth behind the stupidity.
Her years of being cared for and no one ever mentioned she was blind. And the diagnosis of PVS was based not even knowing this primary fact.
Lets not forget that it was the declaration of her being PVS that made it legal to kill her. So of the two declarations the declaration the SHE WAS PVS was key.
"Do you think that just the marriage contract can be broken with impunity or any ole contract?"
You can violate the terms of ANY contract with impunity, as long as the other party to it does not complain, and even then, the contract is not broken until the court says so.
If this were not true, there would be people who are now single because their spouse cheated, many who never knew it.
Imagine a widow who finds out she's been living in sin with
a "husband" who "broke their contract" 40 years ago - and now she can't get his Social Security.
"... and the link showing that this was based on her lack of visual cues is where ? "
"Her years of being cared for and no one ever mentioned she was blind. And the diagnosis of PVS was based not even knowing this primary fact. "
Actually, it was the people saying she was NOT PVS were the ones trying to do so based on her supposed response to visual stimuli. Right?
It was the people who believed she WAS indeed PVS that had said from the beginning that she DOES NOT RESPOND to visual stimuli.
Lets not get it backwards.
Exactly.
You'll have to enlighten me. I can see how the person who interferes in the contract may incur liability but I can't see how the contractor eludes liability. Remember I am but an egg where the law is concerned. Now golf is another matter.
It does have bearing, though, since the Schindlers encouraged him to 'break the contract', and then tried to use his 'breaking of the contract' as a reason to claim he was conflicted and thus should not have the right to make medical decisions on Terri's behalf.
And I have a kid who's starting golf lessons, so maybe you're available on weekends this summer? ;)
Not quite. Killing your spouse violates the contract even though the spouse can never complain. And you will lose your spousal rights to control your spouses estate because you violated the marriage contract. But there are those who think violtaing contracts is a trivial matter, you one of those?
If this were not true, there would be people who are now single because their spouse cheated, many who never knew it.
Your statement was not true, period, cheating and forgiving spouses not withstanding.
Imagine a widow who finds out she's been living in sin with a "husband" who "broke their contract" 40 years ago - and now she can't get his Social Security.
Imagine a husband who attempts to murder his wife, he fails at the attempt to murder but succeeds in damaging his wife to the point she can not remember or relate the attack. He takes up with another woman and starts a family. He eyeballs the assets of the old wife and petitions the state to put her out of her misery to access those assets and get on with his new life.. The state complies. Imagine that.
The manner of death is different from the cause of death. The manner of death is unknown. The cause of death is dehydration.
Because she is dead - wake up.
"It does have bearing, though, since the Schindlers encouraged him to 'break the contract', and then tried to use his 'breaking of the contract' as a reason to claim he was conflicted and thus should not have the right to make medical decisions on Terri's behalf."
Good point, especially in light of the "benefit" they would receive by him violating the contract, and possibly having it broken.
I hope your son enjoys it, I know I do and I say that as an ex jock who used to ridicule the sport until I got hooked at the age of 46.
The 2nd DCA said the Schindlers, the parents, were conflicted as well. Seems to me that according to Florida law the next in line for guardianship is TS's brother and sister, not the state.
In this country you have to be PROVEN guilty, which is why accusations and suspicions brought up a decade later by people who would stand to benefit are simply not given a lot of credence.
Good post. Hope some can understand the simple thing of love that wishes to help rather than allow a man to freely kill their daughter BASED ON HIS MEMORY OF A STATEMENT SUPPOSEDLY MADE BY TERRI. Only remembered AFTER he received the malpractice settlement which was intended to care for Terri the rest of her life - not to pay for efforts to kill her. Another point that the judge just skirted over in his efforts to help Michael.
Thought judges were to be impartial. Thought both sides were to be treated equally - but that is another point in this 15 year tragedy.
Imagine somebody making such a claim too explicitly and getting sued for libel.
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