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."
Three of the five doctors testified that Terry Schiavo was in a persistent vegetative state, although Dr. Cranford felt it more appropriate to phrase it permanent vegetative state which meant that the condition was irreversible. Two of the doctors felt that she was not in a persistent vegetative state. These two sets of opinions had little in common. Those who felt she was not in a persistent vegetative state placed great emphasis upon her interaction with her mother during Dr. Maxfield's examination and the tracking of a balloon. Those who felt that she was in a persistent vegetative state felt that her actions were neither consistent nor reproducible but rather were random reflexes in response to stimuli. However, the court has not and will not make its decision or a simple head count but will instead consider all factors. At first blush, the video of Terry Schiavo appearing to smile and look lovingly at her mother seemed to represent cognition. This was also true for how she followed the Mickey Mouse balloon held by her father. The court has carefully viewed the videotapes as requested by counsel and does find that these actions were neither consistent nor reproducible. For instance, Terry Schiavo appeared to have the same look on her face when Dr. Cranford rubbed her neck. Dr. Greer testified she had a smile during his (non-videoed) examination. Also, Mr. Schlinder tried several more times to have her eyes follow the Mickey Mouse balloon but without success. Also, she clearly does not consistently respond to her mother. The court finds that based on the credible evidence, cognitive function would manifest itself in a constant response to stimuli. Dr. Hammesfahr testified that he felt that he was able to get Terry Schiavo to reproduce repeatedly to his commands. However, by the court's count, he gave 105 commands to Terry Schiavo and, at his direction, Mrs. Schindler gave an additional 6 commands. Again, by the court's count, he asked her 61 questions and Mrs. Schindler, at his direction, asked her an additional 11 questions. The court saw few actions that could be considered responsive to either those commands or those questions. The videographer focused on her hands when Dr. Hammesfahr was asking her to squeeze. While Dr. Hammesfahr testified that she squeezed his finger on command, the video would not appear to support that and his reaction on the video likewise would not appear to support that testimony. The record is replete with the doctors disagreeing over what the videotapes appeared to portray. For instance, was it a visual orienting reflex or was it tracking. Was it a cognitive focus of the eyes or was it a startle response looking to the sound. Perhaps the most compelling testimony was that of Dr. Bambakidis who explained to the court the agony and soul-searching which he underwent to arrive at his opinion that Terry Schiavo is in a persistent vegetative state. He concluded that all the data as a whole supports permanent vegetative state. While the others may have gone through such an analysis, their testimony does not indicate that.
We're supposed to believe this to be a false claim, because it was made seven years after the fact. But the claims that MS abused Terri, made TEN YEARS after the fact, we are supposed to believe to be true?
Once again (as in the posts around 400) you prove you don't actually know what the heck this case was about. It was not until 2000 that the Schindlers learned of Michael's liason with his new wife and the children fathered with her, when an obit listed 'survivors' in the Schiavo family. At that point the Schindlers tried to bring the conflict of intetrest up in Greer's court and Greer would not allow it into the record thus he could ignore it. When you play at agitprop your lack of knowledge regarding the thing you play at will come out, as it has with your postings. How old are you, by the way ... this might be a good case for you to study and remember in the decades ahead.
It is most likely to turn into a reality if this type of slander is allowed to continue against Michael..all in the name of God.
sw
I don't see the difference. Can you explain?
Where do you find in this that those supporting the diagnosis of PVS based their findings on the lack of visual stimulus ?
"He concluded that all the data as a whole supports permanent vegetative state."
"The court finds that based on the credible evidence, cognitive function would manifest itself in a constant response to stimuli."
NOT simply visual stimuli.
The Schindlers encouraged MS to date and to move on with his life. They even met some of the women he dated. The claim that they didn't find out about this until after the fact is therefore untenable.
All you have to do is sign a Living Will that you want to be killed and they will gladly do it.
But, you do not have the right to determine when me or my family have to die. You step on our constitutional rights as American citizens who are given the right to LIFE.
Don't think for a minute I will surrender that right without a dang good fight. That changes the America I grew up with and I do not intend to turn America into a country of constitutional rights of some or constitutional rights of the healthy only. What a legacy for my grandchildren - they have to fully document that they want food and water, they want treatment rather than be killed when their eyes close.
They get to die wondering if those hovering over them are there because they love them or there to make sure they die quick and release their monetary leavings to them.
So you and others that want to die, just sit down and write a living will and I will make the decision I want and my family will make the decision they want.
It appears now - we have no automatic right to life anymore because of the death culture that goes around seeing who they can kill off.
A good proportion was based on visual contact. To say otherwise is to disregard the statements made by the doctors. Don't you think it rather suspect that these doctors never diagnosed that she was blind, and yet can diagnose PVS. Makes them look rather unsuitable to make any determination.
Based on science's limited understanding of the brain. But we all know that science has been surprised multiple times when people being doing things doctors had said they'd never do again.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.
I see. . .so you are claiming to have all knowledge of the brain, while scientists readily admit they know little.
This is Florida you know. Look at the presidential election - the Supreme Court had to come in for a fair election.
You tend to forget Florida is a retirement state. There is a very strong Scientology lobby there, a very strong euthanasia society. There are also great assets of property and money in those elderly people. Also Florida is the test case of how to handle the elderly and infirm in our society.
Of course, it is really simpler to believe that Felos was not a proponent of euthanasia, that Felos was not on the board at one time of the hospice, that the euthansia proponents would never think of becoming members of the legislature or end-of-life panels or hospices.
But due to Terri's case, many of us are looking at what is going on and we are not buying it. We see it as a major step forward in being able to kill off the weak.
If you choose not to see that - fine. That does not stop me from seeing it.
If you have an issue with what pieces they showed, take it up with them. I'm not an apologist for the media or any particular website.
If there was truly a 4 hour video out there, the MSM would have wanted to find it. They were in favor of starving/dehydrating Terri to death. If you have knowledge of where this claimed video is and didn't bring it forward, that's your fault.
Think about it, college kids host dozens of full length movies, yet not one of them would post her full video?
Once again, if you had knowledge of this 4 hour video, why didn't you get a copy of it and post it on a website, or provide it to someone else?
"Don't you think it rather suspect that these doctors never diagnosed that she was blind, and yet can diagnose PVS."
Not respoding to visual stimuli is a good indication of blindness, is it not ? ( Just how are you to tell ? ) The PVS diagnosis seems to have been made by her NOT responding in ANY cognitive fashion to ANY stimuli.
Your post was of the court findings, what the judge felt was important to mention from the doctors reports, NOT from the doctors reports themselves.
"Once again, if you had knowledge of this 4 hour video, why didn't you get a copy of it and post it on a website, or provide it to someone else?"
The judge claimed to have watched hours of it. HIS decisions were not based on the MSM clips provided by the Schindlers.
Prove who guilty of what?
But you don't know Florida Law concerning conflict of interest. Doesn't surprise me.
LOL, why don't you sue me? I could use a good laugh and some more money for retirement.
Greer's decision not to remove MS as guardian was upheld. I assume he and the judges on the Florida appeals courts do know Florida law concerning conflict of interest.
The very next step by the euthanasia society. Watch for promotion of a better death "after death has been chosen".
Of course, so many just wish the right to get rid of the responsibility of ill ones of their family and it is so much easier if they can claim that the person "said" they did not wish to live like ........
Because, many times that ill one might change their minds and they would have to care for them wouldn't they? So much nicer to believe that they are already dead and their soul gone so that the killing can take place. The assets saved from medical care and given to them (the spoiled selfish ghouls that they are).
Of course, they have deprived the ill one of their consitutional rights - but what the heck - they are dead and just don't know it.(/sarcasm, of course. I believe in the sanctity of life, that God chooses our time of departure and that man is not to be trusted with the ability to kill others freely as man is full of greed, corruption, and selfishness as well as the good traits that many possess.)
I would never give the state/government the power of determining when man is no longer man but dead and therefore initiating a death to a non-dying person. It is not right and oversteps the bounds of government that protects the rights of ALL for LIFE, LIBERTY.
Thanks. Just reinforces my belief that somehow Michael Schiavo attempted to murder his wife in '90. The reason is greed. He met Jodi prior to the murder. Wouldn't surprise me one iota to find out that she helped plan Terri's murder. Just think. If you had a loved one that collapsed "for no apparent reason", first thing a normal, innocent person would do is grab the phone and dial 911, but ole Mikey waited 70 minutes. What was he cleaning up during that 70 minutes?
I'm not the one being libelled. And I doubt you have deep enough pockets to make a suit against you worthwhile.
I'd keep an eye on Sean Hannity and possibly Mark Fuhrman, though.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.