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."
An essay entitled, "Why the Law Worked in the Terri Schiavo Case", by Robert Tracinsky (incidentally, registered under that name on FR), website http://www.tiadaily.com
The article isn't currently available at the link, but I found it doing a google search.
I'm sorry you've not known loving men who would fulfil wishes of their spouses.
</sarc>
I'm going to start selling Nobel prize nominations. Like my slogan? "Just as valid as Hammesfahr's!"
Want one?
..... paging Dr. Jordan Cavenaugh....
You keep assuming she had this wish to die. Not only is it based on (English) hearsay, it is claimed way after the fact and even if she stated such a thing off the cuff, it is not in truth a bound, sealed statement of belief. As if she was in deep thought about it. People state such things glibly all the time - then when it comes down to it, "change their minds" (as if they really thought about it at all). Or they change their minds through their lives, anyway.
1 glib off-the-cuff statement does not constitute a viable intention to me. Never mind the questionable existence of it.
The court ruled this to be the case, and was upheld at every level of the state and federal judiciary.
Not only is it based on (English) hearsay
No, it was based on testimony.
Hearsay is hearsay, in real life, no matter what FL rules are. It's a "he said & he said" situation. The victim here was not asked for her testimony - which would have been truly direct, not any1 else's.
As for the "upheld" smoke&mirrors - the procedures of the lower court were upheld, not necessarily the lower-court opinion that Terri truly wanted to die.
BTW: And OJ is innocent!
No, I don't. I'm on record here with doubts about his claims of what she said. (and how all this came down)
My point about the Schindlers remains, as their determination remained, whether she did wish to die, or did not.
They actually petitioned the court not to *allow her* to "put her immortal soul in danger" by making the choice. Many freepers have taken that position, too. That's what I despise.
But then, as another poster indicated, it is not "her" right to force her family to go along w/her wishes when it is against their beliefs and feelings. (Esp. since we have absolutely no proof it WAS her wish!)
You apparently do not understand the legal distinction between 'hearsay' and 'testimony'. 'Hearsay' is, "John told me that Jim said X". 'Testimony' is, "I personally heard Jim say X". What MS and the corroborating witnesses told the court was not hearsay.
the procedures of the lower court were upheld, not necessarily the lower-court opinion that Terri truly wanted to die.
Of course, that's what appeals courts do. It was ruled on appeal that Greer did not abuse his discretion.
What a ridiculous argument. An adult does not need permission from his family to exercise his legal rights.
"Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive.
It may be better to live under robber barons than under omnipotent moral busybodies.
The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience."
-C. S. Lewis
I don't see the difference. Can you explain?
If someone is shot and is in the hospital for six months, finally dying of an infection, then the manner of death would be homicide and the cause of death would be the infection.
That is an appalling statement! Is this what you truly believe? The individual's rights must give way to others' beliefs? So then her family has the right to force their beliefs on her? Perhaps this is at the heart of all this disagreement. It is a very revealing statement.
Oh you all give me a break!
You all didn't get so up in arms about the man earlier posting that he told his MIL he wouldn't have anything to do w/carrying out her "wishes" to die if you put out a written document, e.g., DNR. It's her right to die, but not her right to expect him to sign up to it and "enforce" it.
That is the exact point I was reiterating! Maybe I'm not great at writing, but that's all it was about.
I have said a million times that hearsay is an English word that means anything coming from the mouths of any1 BUT the 1st party. I've also shown I KNOW about the (silly) legal definition which extends it to 2nd parties. Hence my ref's to "English" and here, "real life".
Just cuz I tell you my cube-mate told me he got a bonus at work, doesn't make it so that he actually said this. My "testimony" in court is hearsay in real life.
I don't mean to single you out, Oilreb. If I'd read that in isolation, it wouldn't bother me so much.
I understand if *you* didn't mean it the way it came out, but that kind of thinking is far too common, and was what I was condemning her parents for.
WRT the earlier poster, there's a big difference between asking someone to carry out your wishes, and asking them not to fight your wishes.
That is hardly the same thing as sign up to it and "enforce"it. That is saying it was okay for them to interfere with her wishes. I have no problem if some one douesn't want to honor another's final wishes. But, as long as the wishes are legal, they have no right to interfere or stop them from being carried out.
And I would have responded to the other poster you referred to, if I knew who they were.
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