Neurologist discredits Schiavo autopsy report, says she died ‘horrific’ death

Chicago, Ill., Jun 26, 2005 / 22:00 pm

A neurology expert has discredited several aspects of Terri Schiavo’s autopsy report, released earlier this month, saying that the main cause of death listed in the report is inaccurate.

Dr. Thomas Zabiega, MD, has said the medical examiners’ claims that Schiavo died from anoxic-ischemic encephalopathy are wrong.

“She died of starvation and dehydration, plain and simple, although many of the ischemic and anoxic changes may have resulted from the chemical abnormalities caused by the starvation and dehydration,” he wrote.

The 41-year-old physically disabled and brain-damaged Florida woman died March 31, almost two weeks after her feeding tube was removed. She had fallen into this state after she suffered a heart attack in 1990 that left her without oxygen to her brain for several minutes. Her husband won a years-long court battle to remove her feeding tube, sparking an international right-to-life debate in the process.

“She did not die from the injuries that caused her to have brain damage, rather from the enforced starvation and dehydration,” said Zabiega. “The examiner only notes she died from dehydration in one of the last sentences of the report, but does not list it as the main cause of death.”

The neurologist and vice president for legislative affairs of the Chicago Physicians' Guild questioned whether medical examiners were making this claim in order to exonerate the issue of how she died.

 “If I have lung cancer and someone gives me cyanide, I died from the cyanide, not the lung cancer,” he said.

The neurologist added that osteoporosis, joint degeneration, and muscle atrophy that medical examiners found in Schiavo were not the result of anoxic-ischemic encephalopathy either, but “a direct result of lack of physical therapy and lack of activity that Terri Schiavo was not allowed to have due to her husband's orders.”

The report also indicated that Schiavo's heart, lungs, kidneys, liver, and gastrointestinal tract were “normal except for changes secondary to the dehydration/starvation process,” Zabiega noted.

He concluded, therefore, that Schiavo “would have probably lived for many more years without any major health problems” had she received proper food and hydration.

The autopsy report stated that Schiavo had no memory — because her hippocampus was damaged — and no cognitive ability. But Zabiega noted the "relative preservation" of the frontal and temporal lobes.

“Complex cognition and executive decisions as well as emotional output are often associated with the frontal lobe, while the temporal lobes are often associated with memory, as well as hearing,” he explained.

“Therefore Terri Schiavo's ability to think, react with appropriate emotions, memory, and hearing could have all be intact at the time the feeding tube was removed,” he stated. The same may have been true about her memory since damage to the hippocampus could have been caused by the dehydration and starvation, he added.

Schiavo may have been cortically blind, but there was no way of saying if the preserved occipital lobe had taken over and whether there was macular sparing, allowing her to see up close, the neurologist said. This would make it possible that Schiavo could indeed see her mother and react to her.

What Zabiega says is “most horrific” is that Schiavo had only acetaminophen (Tylenol) found in her blood. This means that she was not receiving appropriate amounts of morphine after her feeding tube was removed and that “she died a horrific, painful, excruciating death that would be worse than any form of execution used in modern times,” he said.