EXCERPTS FROM THE SCHIAVO AUTOPSY

NOTE: Page numbers are from Acrobat Reader, not the document.

"Cause of Death: Complications of Anoxic Encephalopathy" (p. 2)

"There are no open and active decubitus ulcers." (p. 3)

"In the left chest wall is an implanted medical device with a wire extending through subcutaneous tissues of the left neck and into the left scalp. A wire then further extends into the cranial cavity." (p. 3)

"A 9 centimeter long implanted neurological thalamic stimulator wire extended outward from the right parietal bone and it was surrounded by a 1 centimeter bony nodule on the inner table. This wire was traced and its tip terminated in the right thalamus." (p. 12)

"At autopsy, the brain weighed 615 grams. A total of 645 milliliters of cereberospinal fluid (weighing 678 grams) were recovered upon opening the skull and exposing the brain." (p. 13)

"The granular neurons of the cerebral cortex were relatively preserved, while the larger pyramidal neurons were globally absent." (p. 15)

"Within the cerebellum there were no recognizable Purkinje cells found." (p. 15)

"d. Was she strangled?
No trauma was noted on any of the numerous physical exams or radiographs performed on Mrs. Schiavo on the day of, in the days after, or in the months after her initial collapse. Indeed, within an hour of her initial hospital admission, radiographic examination of her cervical spine was negative. Specifically, external signs of strangulation including cutaneous or deep neck injury, facial/conjunctival petechiae, and other blunt trauma were not observed or recorded during her initial hospital admission." (p. 31)

"e. Did she collapse due to other trauma?
Mrs. Schiavo had no traumatic injuries observed or recorded by her initial treating physicians despite numerous physical exams and radiographs." (pp.31-32)

"f. What other etiologies are possible?
Subtle trauma related to commotio cordis or nontraumatic asphyxia is also possible, but no evidence of these exists." (p. 32)

"The bone scan request form listed the history of Mrs. Schiavo as "closed head injury." This is clearly incorrect unless it was meant to imply that the hypoxia was the "injury." The phrase "The patient has a history of trauma" appears to have been derived solely from the erroneous history on the request form." (p. 32)

"3. Could Mrs. Schiavo eat by mouth?
The neuropathologic findings, oropharyngeal anatomic findings, and medical records clearly indicate the Mrs. Schiavo would not have been able to consume sustenance safely and/or in sufficient quantity by mouth. In fact, the records and findings are such that oral feedings in quantities sufficient to sustain life would have certainly resulted in aspiration." (p. 34)

"Claims from caregivers of past oral feedings are remarkable, and, based on the autopsy findings and medical records, these feedings were potentially harmful or, at least, extremely dangerous to Mrs. Schiavo's health and welfare." (p. 34)

"6. What diagnoses can be made in regards to the brain of Mrs. Schiavo? (See attached neuropathology report)
Mrs. Schiavo's brain showed marked global anoxic-ischemic encephalopathy resulting in massive cerebral atrophy. Her brain weight was approximately half of the expected weight. Of particular importance was the hypoxic damage and neuronal loss in her occipital lobes, which indicates cortical blindness. Her remaining brain regions also show severe hypoxic injury and neuronal atrophy/loss." (p. 35)

"8. What was the cause and manner of death?
Mrs. Schiavo suffered a severe anoxic brain injury. The cause of which cannot be determined with reasonable medical certainty. The manner of death will therefore be certified as undetermined." (p. 36)