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Schiavo Was Beyond Saving, Autopsy Finds

A medical examiner says no treatment could have reversed the woman's persistent vegetative state in her final days, despite contrary claims.

June 16, 2005|John-Thor Dahlburg and Karen Kaplan | Times Staff Writers

MIAMI — During Terri Schiavo's final days, when her fervent supporters said she was alert, responsive and trying to speak, she was massively and irreversibly brain-damaged, blind and oblivious to what surrounded her, a medical examiner's findings revealed Wednesday.

Schiavo died March 31 at a Pinellas Park, Fla., hospice after the plastic tube through which she had received food and water for 15 years was removed by a Florida judge's order, sought by her husband, who contended that she was in a persistent vegetative state.

Schiavo died of dehydration, said Dr. Jon R. Thogmartin, the chief medical examiner for Pinellas and Pasco counties, who announced the results of the autopsy at a news conference in Largo, Fla.

A battle over whether the Florida woman should be allowed to die had raged in Congress, the Florida Legislature and the state and federal courts, and President Bush signed a special law meant to help Schiavo's parents keep her alive.

Although experts said the findings upheld the medical consensus on Schiavo's condition, some opponents continued to object to the removal of her feeding tube. Senior Republican leaders, who had mobilized in vain to save Schiavo, had little reaction.

The parents, Bob and Mary Schindler of Gulfport, Fla., had contended their 41-year-old daughter could get better with care. But Thogmartin said the postmortem examination had shown an improvement would have been medically impossible, with her brain shrunken to less than half its normal size.

"The brain weighed 615 grams [about 1.36 pounds], roughly half of the expected weight of a human brain," Thogmartin said. "This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons."

Although the Schindlers had wanted to feed their daughter by mouth, the medical examiner said Schiavo never would have been able to eat or drink on her own. Thogmartin also said the incapacitated woman could not see "because the vision centers of her brain were dead."

The autopsy also found no evidence that Schiavo had been strangled, administered inappropriate medication or otherwise abused at the hands of her husband, Michael Schiavo.

In a lawsuit, Terri Schiavo's parents had alleged that their son-in-law had wanted their daughter dead for reasons of financial gain.

Terri Schiavo had a heart attack and collapsed in her home Feb. 25, 1990. Her breathing stopped for several minutes, resulting in brain damage. Afterward, she was able to breathe unassisted but could not speak, eat or drink. Michael Schiavo, a Clearwater, Fla., nurse, had maintained that his wife would not have wished to be kept alive in such a state, and the courts sided with him.

Thogmartin also said that if her feeding tube had remained connected, and ailments common to bedridden patients, such as pneumonia and urinary tract infections, had been properly tended to, she might have lived another 10 years. The finding that Schiavo had been under no threat of imminent demise was seized upon by advocates for her parents as proof that her death was unnecessary, as well as immoral.

The autopsy report was the result of 274 X-rays and photographs, the analysis of dissected tissue samples, a review of Schiavo's medical records, and reports from law enforcement and social service agencies. Its publication had been expected last month but it was delayed for a neuropathology report by an outside expert.

Independent medical specialists said the report should put to rest any lingering doubts that Schiavo was conscious when her feeding tube was disconnected March 18. They said they concurred that Thogmartin's findings were in line with the prevailing consensus among neurologists that Schiavo had fallen into a persistent vegetative state brought on by lack of oxygen, causing brain cells to die. Although the primitive parts of the brain that regulate breathing and sleeping continue to function, such patients lose their ability to interact with the world.

However, they do make random movements, which are often misinterpreted by family members as signs that the patients are responding to them, neurologists said.

That diagnosis was, and still is, bitterly contested by the Schindlers. For patients in such a state, chances for improvement are considered nil.

"I personally cannot imagine that there could be consciousness in that brain," said Dr. Martin A. Samuels, neurology department chairman at Brigham and Women's Hospital in Boston. "People can be assured that no matter what anybody had done, it would not have helped. There are just no neurons."

Michael Schiavo's lawyer hailed Thogmartin's report as supporting his client's contention that Terri Schiavo had no real hope of recovery, and said Michael Schiavo planned to release autopsy photographs of his wife's brain to prove how severe the damage was.

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