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Dr. Cranford's brain CT comparison of normal 25 yr (left) and Schiavo (right) |
CT of 75 yr old normal woman, who had 1 seizure |
Schiavo autopsy: click here
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Dr. Cranford's brain CT comparison of normal 25 yr (left) and Schiavo (right) |
CT of 75 yr old normal woman, who had 1 seizure |
Death by dehydration results in a further decrease in brain mass.
Before you read the Schiavo autopsy, note what medical examiner Jon R. Thogmartin said about the uselessness of an autopsy after a delayed death of only six days:
"But when there's a long delay in death, a lot of times an autopsy won't help you a whole lot," Thogmartin said.
archived article:
http://sptimes.com/News/072801/Sports/Doctors_approve_skipp.shtml
Doctors approve skipping autopsy
Medical examiners from around the state say little would be learned of what killed UF football player Eraste Autin.
By BRIAN LANDMAN nd STEPHEN HEGARTY
© St. Petersburg Times,
published July 28, 2001
Although an autopsy wasn't performed on Florida football player Eraste Autin, the medical examiner is awaiting toxicology results that could provide clues why a seemingly healthy 18-year-old freshman died after a workout.
"That's routine; it could help us rule out some things," said Albert Isaac of the Alachua County medical examiner's office. "We don't have any reason to believe it will show anything. But if he had been up to something in terms of drugs or medication, we'll know it."
Final lab results on blood and urine samples drawn July 19 when Autin was rushed to Shands at the University of Florida will not be available for as long as six weeks.
Autin died Wednesday afternoon, six days after collapsing as he walked from the practice field to the locker room.
Dr. William Hamilton, the Alachua County medical examiner, said the cause of death was "obvious" heat stroke and canceled a planned autopsy after a call from Autin's father, David, a urologist.
Normally an autopsy would have been performed, especially given that Autin appeared to be fit. But medical examiners around the state found nothing unusual or alarming about Hamilton's decision not to perform one in this case based on family wishes and medical reasons.
"There were strong family objections," Isaac said. "They were adamantly opposed to it."
Dr. Vernard Adams, the medical examiner in Hillsborough County, said it's "not uncommon" and is "acceptable" to consider the wishes of the next of kin as long as those are balanced with the circumstances.
Dr. Jon Thogmartin, the medical examiner for Pinellas and Pasco counties, said if Autin had died immediately after his collapse an autopsy would have been necessary, as in the case of Devaughn Darling, the Florida State freshman linebacker who died after an off-season workout in February.
"But when there's a long delay in death, a lot of times an autopsy won't help you a whole lot," Thogmartin said. "You can reasonably determine the cause of death without an autopsy. ... If the family had strong objections, I'd probably do the same thing, but only in particular cases."
He stressed that a key question in an autopsy is the condition of the heart and the possibility of a congenital defect. An autopsy also could shed light on whether any foreign substances contributed to Autin's death.
But since Autin's heart continued beating for six days, attending physicians might have logically ruled out a defect, doctors said.
"I would assume they did diagnostic tests to rule out (head) trauma, and the only reason the kid was down was, at least to the doctors' satisfaction, was the hyperthermia," Thogmartin said.
According to family friends, Autin's body temperature reached 108 degrees.
Dr. Stephen Nelson, the medical examiner in Bartow and the chairman of the state Medical Examiners Commission, agreed that with heat stroke the bottom line is temperature.
"That (108) is significant," he said. "When you've had somebody in the hospital for six days, with all their testing, they probably had a real good idea of what they were dealing with. An autopsy may not have much to add, if anything."
As for an autopsy determining the presence of substances, such as performance-enhancing supplements, anabolic steroids or drugs, doctors said the blood and urine analysis could serve that purpose while still respecting the family's wishes. The NCAA warns that something as innocuous as over-the-counter antihistamines can increase the risk of heat stroke.
Nelson said he and his staff make sure they obtain specimens from hospitals they can test later, "even if we're not going to autopsy the person." That was done in this case.
Hamilton, who in addition to his prime duties as medical examiner is an associate professor at Florida, was on vacation and could not be reached for comment Friday. He previously told the Times there was no "compelling public reason" to disregard the family's wishes. The family has not commented on why they did not want an autopsy performed.
"If we thought there were some issue, we could have contacted the medical examiner," Alachua County assistant state attorney Greg McMahon said. "We didn't even consider it."
- Staff writer Joanne Korth contributed to this report.
