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."
This exchange:
HIM: LOL, why don't you sue me?
ME: I'm not the one being libelled.
might have tipped you off.
Nonsense.
The main thing here is it calls into question his - and his interested siblings/cousins/in-laws - intentions.
What right do parents have to impose their wishes upon their adult children?
"You're implying their real desire was to kill her off themselves?"
I'm implying nothing.
"Anything you or I might say about his motives is sheer speculation."
Correct.
"You think he had venal reasons for acting so."
As you're always admonishing, don't ASS-U-ME here. I don't know anything about Michael for certain. I've said many times - esp. during the whole nitemare - that there is apparently no solid evidence he did anything bad (per se). He may have totally had her interests at heart.
I've always said the ultimate thing that makes me sick is the poor judgement by the judge on likewise FLIMSY evidence. That led to Terri's neglect and death.
"An alternative explanation is that it took him several years to become convinced that her state really was unrecoverable."
Yes, possible, but wouldn't that make him "terrible" according to the "rite-to-die" people to put her thru all that agony for years? Wasn't Terri in pretty bad shape from the get-go and showed little change?
The judge should've thought it queer that the man would apparently work hard on a woman who was apparently in a bad state for some years, then finally declare she wanted to die.
Maybe Michael is totally innocent, and LIKE the Schindlers, at 1st he didn't want to obey his wife and tried to get her better rather than let her wither away. Then maybe he just gave up, unlike the Schindlers, and decided he'd go along w/her wishes.
That all doesn't erase the fact that the evidence either way was flimsy, and supporting death on flimsy evidence seems very poor judgement and rule of law to me.
"""It is amazing to me that they will not find de-hydration/starvation as the manner of death."""
It is amazing to me that they will not find "de-hydration" as the manner of death.
Nobody but nobody ever died of starvation when both, water & food, were witheld at the same time. NOBODY!!
And you can take that to the bank!
By what NATURAL right does a *spouse* have to impose his wishes?
Again, in English, his was hearsay "he-said" evidence - WAY AFTER the fact.
It is no more their business than it is the business of those on the "right-to-life" side. Private. Family. Decisions.
Wasn't Terri in pretty bad shape from the get-go and showed little change?
Yes. I could understand, however, why someone might hang onto hope for years.
The judge should've thought it queer that the man would apparently work hard on a woman who was apparently in a bad state for some years, then finally declare she wanted to die.
Perhaps, perhaps not. Once MS accepted that she was not going to recover, then it seems reasonable that he would seek to act upon her wish not be remain in such a condition.
That all doesn't erase the fact that the evidence either way was flimsy, and supporting death on flimsy evidence seems very poor judgement and rule of law to me.
I'm not completely comfortable with the law in Florida, either, but as far as I can see it was followed in this case.
The spouse, under both natural and civil law, is automatically his spouse's legal guardian.
Marvin, I found a little- but not as much as I thought I would... part of the problem was the sheer volume of information- my 300+ replies within my post had multiple links, which led to more links often with hundreds of replies to them.
I found a little about the ME, nothing about the video of Terri by the lake, but one video ( above the double line ) that I had seen but forgotten about.
I tried searching FR for "Thogmartin" and got only a few returns- possibly a search engine different from Yahoo! would yield more results?
Anyway, here's what I found:
"'but wouldn't that make him "terrible" according to the "rite-to-die" people to put her thru all that agony for years?'
"It is no more their business than it is the business of those on the "right-to-life" side. Private. Family. Decisions."
But you were calling Schindlers on the carpet for the same. If they all still agreed, wouldn't you be disgusted by them ALL for "ignoring her wishes"?
The question was, "does XXXX have a right to impose *HIS* wishes....", not, who the GUARDIAN is. (And I stated NATURAL rights so there is no question or confusion w/made-up "rights" which are really privileges.) And there is no such thing as a "natural law" regarding "guardians".
There is NO NATURAL right to kill ANYone (and indeed, I'm assuming here that MS brought up the "Terri wanted to die" for his convenience, not cuz she actually said it). Murder is a violation of natural rights, regardless of your relationship.
"If you choose not to see that - fine. That does not stop me from seeing it."
I see a lot of things and strive to put them into context. For example, just because Cheney is Pres. of the Senate does not make him one in cahoots with Reid.
"What on earth are you talking about? lol And you call me confused?"
I have a vision... it's a woman in TX banging her head against the wall. ROFLMAO
Hang in there.
"The manner of death is different from the cause of death.
I don't see the difference. Can you explain?"
In more explicit terms:
What is the CAUSE and MANNER of death on the death certificate?
The cause of death is the specific reason that a person dies, for example a stab wound to the abdomen, gunshot wound to the head, asthma, atherosclerotic heart disease, blunt impacts to the head and torso, hanging, drug intoxication or AIDS. These are only several examples. The manner of death falls under one of several categories: homicide, accident, suicide, natural or undetermined. Some jurisdictions utilize another category, therapeutic complication. The cause and manner of death are always listed on the death certificate.
What is the MECHANISM of death?
The mechanism of death is the physiologic reason for a person's death. Etiologically, it is nonspecific, and does not specify the underlying or proximate cause of death. It is generally not placed on the death certificate. Examples are sepsis, shock, electrical irritability of the heart or brain, seizures, exsanguination, cardiac tamponade, pulmonary thromboemboli, and asphyxia.
http://www.forensiconline.com/generallink.htm#a27
Great FAQ post by a "Joseph I. Cohen, M.D., Forensic Pathologist"
"Terri was alive and healthy"
How do you define healthy?
"So that argument is moot."
No it begs for common sense in the face of reality.
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