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CNN Live Today
Pets & Planes; Oil Man; Terri Schiavo's Autopsy Released
Aired June 15, 2005 - 10:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DARYN KAGAN, CNN ANCHOR: We may soon have answers to lingering questions about Terri Schiavo's health. Schiavo's autopsy report is scheduled to be released at the top of the hour. Most doctors said Schiavo was in a persistent vegetative state before she died on March 31st. Her parents said she was minimally conscious.
We'll have live coverage of the news conference from Florida in the next hour.
The parents of a 13-year-old girl with cancer return to court next hour to try to regain custody. Texas child protective services took custody of Katie Warnicke (ph) 11 days ago. Official thought the family was risking her life by refusing radiation treatment. On Friday, a judge said treatments should begin as soon as possible.
Right now on Capitol Hill, the Senate Judiciary Committee is taking a closer look at Guantanamo Bay and the alleged abuse of terror suspects held there. The charges and the international backlash have stoked heated debate in Washington and a new effort to polish Guantanamo's tainted image.
Our congressional correspondent Ed Henry is on Capitol Hill.
Ed, good morning.
ED HENRY, CNN CORRESPONDENT: Good morning, Daryn.
That's right, some fireworks at a Senate Judiciary Committee hearing this morning on the handling of detainees. Democrats charging that in fact the prison at Guantanamo Bay is a gulag, a legal black hole, in their words, where detainees are ruthlessly abused. Top Democrats on the Senate Judiciary Committee have been called for that prison to be shut down completely. They say that the damage has been so excessive to the American image around the world that the prison has to be closed.
Here's Democratic Senator Patrick Leahy.
(BEGIN VIDEO CLIP)
SEN. PATRICK LEAHY (D), VERMONT: This idea of changing, changing the focus producing, producing props of chicken dinners and such, seeing to argue this is more a club med than a prison. Let's get real. These people have been locked up for three years, no end in sight and no process to lead us out of there. Guantanamo Bay is causing immeasurable major damage to our reputation as a defender of democracy and a beacon of human rights around the world. (END VIDEO CLIP)
HENRY: Senator Leahy was referring to the fact that some Republicans have said that, in fact, the detainees have been treated humanely, and in fact yesterday Defense Secretary Donald Rumsfeld insisted that the U.S. government has gotten very valuable information from some of these detainees who are suspected terrorists. They could be major threats to the United States.
(BEGIN VIDEO CLIP)
DONALD RUMSFELD, SECY. OF DEFENSE: They are not common car thieves. They are believed to be determined killers. Arguably, no detention facility in the history of warfare has been more transparent or received more scrutiny than Guantanamo.
(END VIDEO CLIP)
HENRY: Secretary Rumsfeld also said there's no alternative to this prison at Guantanamo, suggesting that it makes no sense to simply dump these prisoners back out around the world who could potentially do damage to the United States. Democrats insist that's not what they're advocating. They say instead if some of these detainees are, in fact, terrorists, they should be charged with crimes. Democrats point out that some of these detainees have been languishing for up to three years without charges.
You also heard Senator Leahy there referring to the club med idea. He was referring, in part, to the fact that Republican Congressman Duncan Hunter the other day brought out the menu that some of these detainees have been enjoying, the chicken dinners, fish dinners, vegetables, various props that have been brought out on the Republican side to suggest that, in fact, the detainees are being handled humanely.
But Democrats at this hearing pointing out this "Time" magazine story this week that shows confidential logs suggesting that one of the detainees was not allowed to use the bathroom, was also forced to act like a dog. Democrats say that's where the focus is. And, in fact, one Republican senator, Mel Martinez of Florida, has said perhaps this prison should be shut down -- Daryn.
KAGAN: How much power does the Senate Judiciary Committee, or even the Senate, have in what would happen to Guantanamo? Is it just a suggestion?
HENRY: Absolutely. The bottom line, it's going to be decision made by the president of the United States. There has been a little bit of confusion because President Bush in the last few days has left the door open to the possibility of shutting this prison down. But you heard Secretary Rumsfeld there, he clearly does not think that, in fact, the prison will be shut down. Vice president Cheney has also come out strongly in the last couple days saying this prison should not be shutdown.
But as Secretary Rumsfeld himself pointed out in his briefing with reporters, this decision ultimately is made by the president of the United States, not by the defense secretary. And if this continues to be a public relations problem, that's a decision the president may ultimately make. But at this point, a top administration official is insisting no plans to shut it down -- Daryn.
KAGAN: Ed Henry on Capitol Hill. Ed, thank you.
Later this hour, President Bush will stump for his energy plan, and before that, some leading Democrats are also laying out their rival plan today. Both plans do share the same goal, creating domestic programs to wean the U.S. off of foreign oil. We'll hear from both the president and the Senate Democrats a little bit later in the newscast.
If you're an air traveler who also brings your pet along with your PJs, you'll want to know which airline is safest for Fido or Fluffy. Beginning today, Congress is requiring airlines to divulge how many pets are killed, lost or injured on their flights.
CNN's Sumi Das is at Reagan's National Airport, just outside Washington, with the latest.
Any pets along with you today, Sumi.
SUMI DAS, CNN CORRESPONDENT: We haven't seen any pets, only one seeing eye dog thus far, but we are on the lookout for them. But we all know how devoted pet owners can be to their pets, basically treating them as one of the family. Well, there's good news for them now. Thanks to the efforts of the ASPCA, the American Society for the Prevention of Cruelty to Animals, travelers can soon find out which airline has the best record when it comes to transporting the estimated two million animals that are flown commercially every year.
(BEGIN VIDEOTAPE)
DAS (voice over): Meet furry frequent flier Eloise. Luckily, Eloise can sit underneath the seat in an airplane cabin. Her owner refuses to check her into the cargo hold.
UNIDENTIFIED FEMALE: I do not want to be the one standing there with the empty leash.
DAS: She's not alone.
UNIDENTIFIED FEMALE: I would never allow her in cargo. She's not cargo. She's my baby.
DAS: No one knows how many pets die traveling. Estimates from the ASPCA range, but start at 5,000 a year, enough to concern pet owners. A new law required airlines to report pet injuries, losses and deaths occurring on their flights to the U.S. Department of Transportation. If a mishap occurs, the airline must try to prevent the same mistake from happening again.
The ASPCA says it would like airlines to do more. LISA WEISBERG, ASPCA: What it also hopefully will do is make airlines a little bit more responsible and accountable for the animals that are in their care.
DAS: Airlines fought unsuccessfully against the law. Now, some airlines fear the reports will be used competitively. Others wonder if airlines will follow Southwest's lead and choose not to carry pets. The ASPCA says the law presents a marketing opportunity.
WEISBERG: We're waiting for that airline to truly become pet- friendly and to either have the newer cargo holds that are temperature controlled or perhaps, even better, to make a place available on the airplane in the cabin itself.
(END VIDEOTAPE)
KAGAN: Airlines will begin reporting to the department of transportation today, but those figures aren't going to be available to the public until the first or second week in July, where they'll be published in the department's monthly report.
Live at Reagan National Airport, I'm Sumi Das -- Daryn.
KAGAN: Sumi, thank you.
A check of the markets is just ahead. Plus, when are rising energy prices a good thing. We'll tell you when you're the one collecting the money, of course.
Coming up, a man who thinks the price of oil is just about right.
KAGAN: And it's back to the beginning for Batman. The film opens today. Reviews by Mr. Moviefone ahead on CNN LIVE TODAY.
(COMMERCIAL BREAK)
(STOCK MARKET REPORT)
KAGAN: Two sides to everything. Rising energy costs for instance. You might gripe about prices at the pump, but it's a boom for a Kentucky oilman.
CNN's Alan Chernoff has his rags to riches story.
(BEGIN VIDEOTAPE)
ALAN CHERNOFF, CNN SR. FINANCE CORRESPONDENT (voice-over): As soon as Bill Daugherty launched his energy company in 1984, oil prices started to fall.
BILL DAUGHERTY, OIL & GAS EXECUTIVE: Little did I know that's probably the worst time in the history of oil and gas to start a company.
CHERNOFF: Bill put everything he had into the company, and, at first, got nothing in return. DAUGHERTY: My wife was expecting. We hadn't had a paycheck in about six months. Zero inspiration and 100 percent desperation.
CHERNOFF: Desperate no more, today, oil prices are above $50 a barrel, and Bill's one-man firm, NGAS Resources, is 66 employees strong. He's president and CEO, and he took the company public in 1993.
But it wasn't until oil prices began to rise in the late '90s that things really picked up. NGAS stock has jumped 1,500 percent since 1999. The company is searching for oil at a breakneck pace.
In '98, Bill drilled only five wells. Last year, 155. Recently, he bought two helicopters so now he can get from his offices in Lexington to the wells in eastern Kentucky in under an hour.
DAUGHERTY: I think the biggest thing is that, you know, I don't have to worry about money. It's given us an opportunity to grow the company. And that's an immense amount of fun.
CHERNOFF: Married 32 years, Bill and his wife Zella remember the early days, when he worked from home with a part-time secretary and no salary.
Along with watching the company grow, Zella has seen her own life change, too.
ZELLA DAUGHERTY, BILL'S WIFE: It was a lot different than it is now. I think the greatest thing is we got to take a vacation this past year.
Cheers to our new home.
We both grew up on a farm. We always have worked really hard. And it's kind of fun to be able to have a few toys.
CHERNOFF: Bill and Zella's two sons also are riding the wave of rising oil prices.
B. DAUGHERTY: It's given them the ability to have more fun and go to the schools they want to go to. My 20-year-old son William is at Center College. And, you know, he was there when there just was no money.
CHERNOFF: Just like day one, Bill has everything he owns in the company. Ninety percent of his investments are in company stock. And his salary, which has risen considerably since '99, is tied to the stock and, consequently, to the price of oil.
So what if prices fall again?
B. DAUGHERTY: We just batten down the hatch and keep on producing, because I will guarantee you one thing, if oil drops to $10 a barrel, it will go back up.
CHERNOFF: Alan Chernoff, CNN, New York. (END VIDEOTAPE)
KAGAN: Here's another story for you. Batman, he's back. But will he able to climb to the top of the box office? We brought Mr. Moviefone in a couple days early to give you a review of the new Batman movie. That's coming up next.
(COMMERCIAL BREAK)
KAGAN: Bruce Wayne takes a spin in the original Batmobile. Christian Bale plays a younger caped crusader in "Batman Begins." The prequel opens in theaters nationwide today.
Russ Leatherman, Mr. Moviefone, our own kind of movie superhero, is here with a review of the latest in the Batman series. Hi, Russ.
RUSS LEATHERMAN, MR. MOVIEFONE: I love Batman!
KAGAN: So you like this movie?
LEATHERMAN: I did. I thought that this was one of the best Batman movies we have seen in years. Christian Bale makes a terrific Batman. It's badder, it's better than any Batman we've seen in a long time. And the reason is, we get to see the back story. We see, really, a kid watch his parents get murdered right in front of his eyes.
KAGAN: Well, that's cool.
LEATHERMAN: Well, -- but yes, I know. But then we get to watch why he becomes this sort of cape crusader who takes on the entire town of Gotham City. This movie's got an amazing cast. It's got Liam Neeson, Morgan Freeman, Michael Caine, Ken Watanabe, Gary Oldman and Katie Holmes, as you see right there.
KAGAN: Yes. How is she in this movie? She's been getting a lot of publicity as Tom Cruise's squeeze.
LEATHERMAN: Yes, not so good, Daryn. She really -- she doesn't add much to the movie at all. And if there's any downside to the movie, I would say it's that you really don't see even the bat uniform until an hour into the movie. The movie takes a while to get cooking because it is dealing with a lot of this back story.
But the director, Christopher Nolan, who did "Memento," he definitely knows how to do a movie like this. I really thought that the movie is about as good as a comic book movie can be. So you can't miss "Batman Begins."
KAGAN: What about the Batmobile?
LEATHERMAN: The Batmobile is wicked, Daryn. I would love to take you for a spin in that thing.
KAGAN: I bet you would. LEATHERMAN: That is fantastic. And the nice thing about the movie, honestly, is it takes the material seriously. It's not campy, it's not goofy. You have an A-plus director, A-plus actors and a really good story. So I would say if you're inclined to see these kinds of comic book movies at all, do not miss "Batman Begins."
KAGAN: All right. Well that pretty much says it all. Mr. Moviefone, Russ Leatherman, thanks for coming in early this week.
LEATHERMAN: My pleasure. And by the way, Daryn...
KAGAN: Yes.
LEATHERMAN: There's a little movie called "The Perfect Man" that opens on Friday.
KAGAN: Where do you find one of those?
LEATHERMAN: Right here, my dear, right here.
KAGAN: No, really, what movie is that?
LEATHERMAN: Well, it's Hilary Duff and Heather Locklear.
KAGAN: Oh, yes, that one. OK, I've seen -- yes.
LEATHERMAN: Yes. She moves from town to town, is looking for love and can't find it. That's really an awful movie right there, Daryn.
KAGAN: Yes, because it has love and girls and all that stuff that's just...
LEATHERMAN: I hate that stuff.
KAGAN: ... too icky for you. I know.
LEATHERMAN: Go Batman, go Batman!
KAGAN: Thank you.
LEATHERMAN: See you later.
KAGAN: Let's check the time. 10:53 in Washington, D.C., 7:53 in Crescent City, California. And Jacqui Jeras has your weather forecast coming up. We're also awaiting a press conference detailing the autopsy results on Terri Schiavo. We'll bring that to you when it happens.
(COMMERCIAL BREAK)
KAGAN: President Bush is calling on the Senate to pass his energy plan before Congress recesses in August. The president is pitching his plan in the speech in Washington, D.C. this morning. A live picture there from the Reagan building, where he will be speaking. Mr. Bush wants to reduce U.S. dependence on foreign oil. The House passed an energy bill in April. That legislation includes $8 billion in tax incentives.
The Senate is now considering a proposal that would double the cost of those tax incentives. The president originally sent his energy plan to Congress four years ago. It's been stalled by disputes over tax breaks, arctic oil drilling and other issues.
(WEATHER REPORT)
KAGAN: A lot to get to this morning, including President Bush pushing his energy plan today. He's urging the Senate to pass a bill before August.
And Florida medical examiners are expected to announce the results of Terri Schiavo's autopsy report. We could learn more about her mental state. We'll bring that to you live as the second hour of CNN LIVE TODAY begins right now.
Want to go live now to Florida. This is the news conference. That's -- there we go. The new conference about Terri Schiavo's autopsy report.
(JOINED IN PROGRESS)
JON THOGMARTIN, MEDICAL EXAMINER: He's also board certified in neuropathology. He is the consulting neuropathology -- neuropathologist on this case. The medical examiner is charged pursuant to Florida chapter 406 with determining the cause and manner of death of persons who die under certain circumstances. The circumstances surrounding the death of Mrs. Schiavo necessitated medical examiner involvement by law.
On March 31, 2005, the district six medical examiner began a death examination of Mrs. Schiavo. The chain of events leading to this death investigation began 15 years ago, in the....
DARYN KAGAN, CNN ANCHOR: We still have a lot to get to this morning, including President Bush pushing his energy plan today. He's urging the Senate to pass a bill before August.
And Florida medical examiners are expected to announce results of Terri Schiavo's autopsy report. We could learn more about her mental state. We'll bring that to you live as the second hour of CNN LIVE TODAY begins right now. And we go live now to Florida. This is the news conference -- there we go -- the news conference about Terri Schiavo's autopsy report.
(JOINED IN PROGRESS)
JON THOGMARTIN, MEDICAL EXAMINER: He's also board certified in neuropathology. He is the consulting neuropathology -- neuropathologist on this case.
The medical examiner is charged pursuant to Florida Chapter 406 with determining the cause and manner of death of persons who die under certain circumstances. The circumstances surrounding the death of Mrs. Schiavo necessitated medical examiner involvement by law.
On March 31, 2005, the District 6 medical examiner began a death investigation of Mrs. Schiavo. The chain of events leading to this death investigation began 15 years ago in the early morning hours of February 25, 1990, when her husband reportedly found her unconscious.
This incident began the chain of events that led to her hospitalization, illness and death. Thus, the determination of her cause and manner of death would include events and records subsequent to that date and preceding that date. The focus of the investigation was the ideology of her initial collapse and other allegations made by her families members and others during the last 15 years.
On April 1, at 8:40 in the morning, a complete autopsy was performed, including external and internal examinations with 72 external photographs and 116 internal photographs. A radiologic survey of her entire body was performed using a digital fluoroscope x- ray with 58 pre-autopsy imagines captured.
During and after the autopsy, a second radiologic examination was performed, capturing an additional 28 imagines, including multiple views of her anterior neck structures, torso and pelvis. A total of 274 images were recorded during this examination.
Detailed dissections were performed on Mrs. Schiavo's anterior and posterior neck, spine and brain. Multiple microscopic samples were taken and examined. Dr. Nelson was present at the autopsy and examined her central nervous system.
A board certified anatomic clinical forensic pathologist with special expertise in cardiovascular pathology examined her cardiac tissue. Genetic testing for cardiac ion channel mutations was performed by Familian (ph) in New Haven, Connecticut, to detect markers for Long QT Syndrome. Complete toxicology testing was also performed.
The vitreous humorous chemistry was examined. Court, medical and other records, including public and confidential Department of Children Family -- Children and Family's records and law enforcement documents were reviewed as part of the death investigation.
Now, certain issues have repeatedly surfaced during this investigation. And these issues have been presented to the Department of Children and Families in the past, law enforcement, and have been presented in the media. I will attempt to address these here, but I have covered them in greater detail in the documents you have received today. I have also included references from appropriate medical literature as part of your packet.
First, what was the cause of Theresa Schiavo's collapse in 1990? Did she suffer from an eating disorder?
Mrs. Schiavo was heavy as a teenager. And after high school, she did lose over 100 pounds. No one observed her taking diet pills, bingeing and purging, or consuming laxatives. And she apparently never confessed to her family or friends about having an eating disorder. And, furthermore, many other signs and symptoms of bulimia nervosa were not reported to be present.
After her resuscitation from her initial cardiac arrest, the first blood draw at Human Hospital Northside, which was her admitting hospital, showed a low potassium level. Several other blood components were also at abnormal levels.
Her low potassium level and the eating disorder it appeared to indicate were the focus of a malpractice suit filed by her husband. Witnesses at trial -- at the malpractice trial -- offered no testimony to witness purging and experts. Although they favored bulimia nervosa, offered other possibilities for the low potassium level.
Both plaintiffs and defendant in the malpractice trial generally accepted the theory that her low potassium level was due to bulimia nervosa. And therefore, during the trial, the veracity of this diagnosis was not challenged.
Her low potassium level appears to be the main piece of evidence purported to show that she had han eating disorder. What caused this hypokalemia, or low potassium? Mrs. Schiavo was near death and critical for over one hour prior to that initial blood sampling. This blood sampling showed a potassium level of 2.0 millimoles per liter, while normal is 3.5 to 5.
She received approximately 1,250 ccs, or over a quart and a half of intravenous fluid prior to that blood draw. She received five doses of Epinefrin and suffered a period of ventricular fibrillation, all of which are known to cause factitious lowering of blood potassium. In fact, similar circumstances have brought about drastic potassium reductions, and these have been documented experimentally and during patient care.
Thus, it is reasonable to conclude that her potassium level of 2 measured after a period of ventricular fibrillation, Epinefrin and fluid administration, was an unreliable measure of her pre-arrest potassium level. Thus, the main piece of evidence supporting a diagnosis of bulimia nervosa is suspect.
If the diagnosis of bulimia is reduced to a mere possibility, then other ideologies for her collapse become more plausible. The hospital toxicology screen on her urine was negative, but this screening technique is not in any way to be considered a comprehensive screen.
Thus, diet pill or other drug toxicity cannot be ruled out. But again, no evidence indicates she used or was given drugs.
Reportedly, she was a habitual user or consumer of large amounts of tea and may have consumed as much as one gram of caffeine per day. And therefore, her tea-drinking habits may have also played a role in her death.
Caffeine was not tested for in the initial hospital toxicology. Caffeine has been somewhat associate with cardiac arrhythmias and hypokalemia. However, considering her activities on the night prior to her collapse, and the time of day of her collapse, being the early morning hours, caffeine toxicity is unlikely unless some type of pill or supplement containing caffeine was consumed.
Did she have a heart attack? The common term "heart attack" is generally reserved to describe the medical condition of myocardial infarction. In other words, death of heart muscle from Coronary Artery Disease.
Mrs. Schiavo's heart was anatomically normal without any areas of recent or remote infarction. Mutations associated with the heart defect known as Long QT Syndrome were not detected.
Next, what she strangled? No trauma was noted on any of the numerous physical examines or radiographs performed on Mrs. Schiavo on the day of, in the days after, or in the months after her initial collapse.
Indeed, within one hour of her initial hospital admission, she received a radiograph of her cervical spine which was negative for trauma. So the doctors were thinking at that time of neck trauma and ruled it out by radiograph.
Autopsy examination of her neck structures 15 years after her initial collapse did not detect any signs of remote trauma, but with such a delay, the exam was unlikely to show any residual neck findings. No evidence of strangulation was found. No evidence of trauma whatsoever was noted by the physicians during her initial hospitalization.
A bone -- now, next, a bone scan was performed on March 5, 1991, while Mrs. Schiavo was a patient at a rehabilitation center in Manatee County. The bone scan results which had been reported as indicating trauma have received much attention in the last year. This bone was performed, remember, over one year after Mrs. Schiavo's initial collapse.
Why was the bone scan performed, and what did the results indicate? Mrs. Schiavo had trouble with her right knee during her initial admission in the hospital in 1990. She had trouble with both knees in 1991, during -- and both of these areas of trouble with her knees occurred during times of physical therapy.
During both instances, her knees were x-rayed and showed no trauma, no fractures. But the 1991 x-ray did have additional findings of degenerative changes in her knee joints and osteopenia or osteoporosis.
Her rehabilitation doctors ordered a bone scan to primarily rule out heterotopic ossification. Heterotopic ossification, what is it? It's an abnormal extraskeletal growth of bone often found in patients with paralysis such as Mrs. Schiavo.
Her doctors made a diagnosis of heterotopic ossification from the bone scan, from the results, and began medical treatment with Didrinal (ph) for that condition. The bone scan results do not indicate fractures apart from the compression fracture diagnosed of her first lumbar vertebral body.
Spinal compression fractures such as this are common in patients with severe osteoporosis. Her doctors at the time already knew she had osteoporosis, and such a diagnosis is almost expected of someone in her clinical condition.
Postmortem -- postmortem findings include -- including radiographs and histology, support the diagnosis of heterotopic ossification and marked osteoporosis. Postmortem examination evidence of heterotopic ossification were seen in numerous areas of her bones and body.
Tissue sampling confirmed the presence of heterotopic ossification. Degenerative and/or fusion of other joints were also seen. Her bones were palpably soft from severe osteoporosis. These findings are typical of patients with long-term paralysis. She also had a normal bone growth on the inner surface of her skull known as Hyperostosis Frontalis Interna, unrelated to trauma or her illness.
In summary, any fractures, including rib fractures, leg fractures, ankle fractures, skull fractures, spine fractures that occurred, concurrent with her initial collapse, would almost certainly been diagnosed in 1990, especially with the number of physical exams, radiographs and other evaluations she received during her initial hospitalization. To be clear, during that hospitalization, she received 23 chest x-rays, three brain CT scans, two abdominal radiographs, two echocardiograms, one abdominal ultrasound, the previously mentioned cervical spine radiograph taken within an hour of her admission, one radiograph of her right knee.
No fractures or trauma were reported or recorded. By far, the most likely explanation for the bone scan findings in Mrs. Schiavo are prolonged immobility, induced osteoporosis and complicating heterotopic ossification in an environment of intense physical therapy. Without the original bone scan and radiographs from that period, no other conclusions can reasonably be made.
Next, could Mrs. Schiavo eat by mouth? The neuropathologic findings, oral forengal (ph) anatomic findings and medical records clearly indicate that she would not have been able to consume sustenance safely or in sufficient quantity by mouth. The records and findings are such that oral feedings in quantities sufficient to sustain life would have certainly resulted in aspiration. Swallowing evaluations and speech pathology evaluations repeatedly record that she was a high risk for aspiration and not a candidate for oral nutrition or hydration. Thus, that's why she had the feeding tube in the first place.
According to medical records, she had been treated in the past for aspiration pneumonia. At autopsy, the lungs had findings that could be considered to be consistent with aspiration of secretions. However, Mrs. Schiavo's decline in dehydration over almost two weeks could also have played a role in these findings. 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 and hydrated by mouth or not.
After her initial collapse, was Mrs. Schiavo given substances to speed her demise or otherwise alter her medical condition? There are basically three incidents involving these types of complaints.
The first was in 2003, when a former employee of Palm Garden of Largo filed an affidavit with the court regarding a 1996 incident or incidents at that facility. The affidavit detailed incidents the employee reportedly witnessed regarding the care of Mrs. Schiavo involving alleged poisoning by Michael Schiavo, along with other adverse behavior on his part.
On March 29, 2004, a hospice nurse noted apparent injection sites on Mrs. Schiavo's arm -- arms, and what appeared to be a plastic needle cap was also found in her room. Reportedly, these were discovered by hospice shortly after a visit by her parents.
There is no evidence to support, or the evidence does not support, that Mrs. Schiavo was given harmful substances related to either of these incidents.
In late March, 2005, it was alleged in the press that Mrs. Schiavo was being given a morphine drip or otherwise being drugged with morphine to expedite or otherwise ease the dying process while she was at hospice. Orders were written, and Mrs. Schiavo received two five-milligram morphine sulfate suppositories, one on March 19, one on March 26. Remember, her date of death was March 31.
Her postmortem toxicology showed no trace of morphine in her body. Acetaminophen was detected in her postmortem blood samples at what would be considered therapeutic levels. And this was a drug that was written and ordered in the medical chart.
However, this drug played no role in her demise. Therefore, no drugs were reported in the medical records other than these, nor were any other drugs detected in postmortem toxicology. No drugs or other substances given to Mrs. Schiavo caused her to die or accelerated the dying process.
Was Mrs. Schiavo in a persistent vegetative state? Persistent vegetative state is a clinical diagnosis arrived at through physical examination of living patients. Postmortem correlations to the persistent vegetative state have been recorded in the literature, and pathologic findings described. However, the findings vary with the ideology or the cause of the adverse neurological event.
What diagnosis can be made though in regards to the brain of Mrs. Schiavo? Her brain was profoundly atrophied. The brain weighed 615 grams, roughly half of the expected weight of a human brain.
This was due to diffuse hypoxic ischemic damage. There was massive neuronal loss, or death. This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons.
Of note, there was severe occipital lobe necrosis. Her vision centers of her brain were dead. Therefore, Mrs. Schiavo had what's called cortical blindness. She was blind, could not see. No evidence of direct skull or brain trauma was seen.
By what mechanism did Theresa Schiavo die? Postmortem findings, including the state of the body and laboratory testing, showed that she died of marked dehydration.
The state of her fatty tissue, and also the laboratory findings, indicate that she did not starve to death. She died of dehydration.
What was the cause and manner of death? Mrs. Schiavo suffered a severe anoxic brain injury. In other words, her brain suffered damage from lack of blood flow and oxygen, the cause of which cannot be determined without reasonable medical certainly. The manner of death will, therefore, be certified as undetermined.
Lastly, let me say 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 information. 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. Receipt of additional credible information that clarifies any outstanding issue may or shall cause an amendment to her cause and manner of death.
And that's all I have. Dr. Nelson and I will now entertain questions.
QUESTION: Dr. Thogmartin, if you could just sum it up for laymen, because it is kind of difficult to understand, so in laymen's terms, did Terri Schiavo starve to death?
THOGMARTIN: No.
QUESTION: Did she suffer any neglect or abuse?
THOGMARTIN: No.
QUESTION: Will we ever know what caused her death?
THOGMARTIN: I don't know. QUESTION: Just to clarify, you said she died from dehydration, but the cause of death is unknown. That's because the precipitating reason for the removal of her tube? I mean, I'm trying to clarify it.
THOGMARTIN: Well, her manner of death is different from cause of death. Manner of death is the circumstances of death or how the death came about. 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.
QUESTION: So cause of death is...
THOGMARTIN: It's going to be listed as complications of anoxic encephalopathy. That's the only diagnosis that I know for sure, is that her brain went without oxygen. Why? That is undetermined.
QUESTION: Dr. Thogmartin, what abilities did Terri have? You said she was blind. In those -- near the end of her life, what would she have been able to do, feel, whatever?
THOGMARTIN: I think it would be best if Dr. Nelson fields that question.
UNIDENTIFIED MALE: The -- again, it's important to remember this is -- persistent vegetative state is a clinical diagnosis. It's not a pathologic diagnosis. The findings of Terri Schiavo are very consistent with persistent vegetative state.
I made the comparison in my report to Karen Ann Quinlan. Karen Ann Quinlan died 10 years after being in a persistent vegetative state. Her brain, Karen Ann Quinlan, weighed more than Terri Schiavo's brain weighed.
The typical things associated with persistent vegetative state are those normal functions of beating heart and breathing and no other types of cognitive function that occurs in the higher portions of the brain.
QUESTION: So there's no evidence that she had any kind of an eating disorder by the findings that you guys -- from her initial collapse in 1990?
THOGMARTIN: Yes, I went back and interviewed as many people as I could contact, coworkers, obviously her husband, her family. Basically, what I'm left with is the impression that the potassium level of 2 was met with just belief, no skepticism, from day one, and actually presented at trial as being a fact.
And even though the medical literature even at that time showed that Epinefrin, ventricular fibrillation, people with any sort of arrest, can have their potassium level drop precipitously. And since 1990, that has been confirmed repeated in several larger studies.
So once you eliminate the potassium problem, which is known in bulimics, you end up with a 26-year-old that used to be heavy, that now lost the weight, is reveling in her thinness now, enjoying her life, and doesn't want to gain the weight back. And if that's a bulimic, there's a lot of bulimics out there. It's just not enough.
QUESTION: So what are the other things that could have led, if it wasn't that -- what could have led to her collapse?
THOGMARTIN: I pretty much laid those out. And in the document you have in your possession, it's much more detailed.
There's numerous possibilities, but I've ruled out overt trauma. I don't think drugs were sufficiently ruled out.
One thing, that she did have a toxicology screen, but it's a very specific screen, mostly for large classes of drugs. The sensitivity is there; however, she received a large fluid bolus prior to that blood draw. You know, a quart and a half of IV fluid, and she did have a relatively -- later on, a relatively dilute urine.
And it is known that if you dilute your urine for these types of amino (INAUDIBLE), you can fall below what's called the cutoff for positively. So, again, I'm thinking that the tox screen was nonspecific. Certainly wouldn't have detected many of the diet pills. And they didn't test for caffeine.
QUESTION: Is there anything in this postmortem that raised an eyebrow, that surprised you, or was it all pretty much what you could expect given these circumstances?
THOGMARTIN: There were some remarkable findings. I think the most remarkable was the degree of dehydration.
You can't measure sodium levels in postmortem blood, but we were able to measure the sodium level, and it reflects the blood level if you measure it from the eye fluid or the vitreous humour. Her sodium level in her vitreous humour upper eye was 207, and that was the highest I've ever seen.
QUESTION: Try to sum it up again in layman's terms. I mean, she had a high sodium or salt content?
THOGMARTIN: Correct. High sodium, low water content. Her skin was dry, her organs were dry. Her eyes were sunken.
She was very, very dry. And the fact that she was able to maintain her life functions when she's that dehydrated, again, argue for the strength, the underlying strength, the anatomical strength of her heart.
QUESTION: Doctor, her family had said repeatedly that she believed that -- they believed that she interacted with them. Are you saying that's impossible?
THOGMARTIN: I'll let Dr. Nelson deal with that.
UNIDENTIFIED MALE: We're certainly not saying that's impossible. But we're saying based on what we know, and what is in the literature with regard to persistent vegetative state, again, that is a clinical diagnosis. It's not a pathologic diagnosis that has precision associated with it.
The clinicians who made the diagnosis of persistent vegetative state, there's nothing in her autopsy report, in her autopsy that is inconsistent with persistent vegetative state. And again, drawing a correlation with Karen Ann Quinlan, the findings here are perhaps worse even than Karen Ann Quinlan.
KAGAN: We've been listening in to the medical examiner in Florida talking about the autopsy results from Terri Schiavo. Some interesting things that they say they've come up with after an extensive review of Terri Schiavo's body after her death earlier this year.
They say there are no -- there is no evidence that she suffered any kind of abuse either at the time of her collapse 15 years ago or afterwards. They also said there's no sign that she actually had han eating disorder, and very few clues as to what would have led to her initial collapse in the first place after 15 years ago.
They said she was in a persistent vegetative state. The weight of her brain, they said, it was profoundly atrophied. The weight only one half of what you would expect for a normal human brain.
They said that Terri Schiavo as blind at the time of her death, that that part of her brain had atrophied as well. But the bottom line, what she actually died of, they say she died in the manner of dehydration, in not having enough water, but that she did not starve to death, and that the exact cause of her death, what actually caused her to collapse 15 years ago, at this point still has not been determined.
They say this case will stay open if they get any additional information.
Let's go ahead and bring our Susan Candiotti in. She's covered this story quite a bit and joins us now from Largo, Florida -- Susan.
SUSAN CANDIOTTI, CNN NATIONAL CORRESPONDENT: Hello, Daryn.
Naturally, you'd want to know some reaction, first of all, from Michael Schiavo, the husband of Terri, and his family. And just before this press conference began -- naturally, we haven't spoken with them just yet -- they told us that they were convinced that this report would indeed prove that there was no abuse of Terri Schiavo, no physical abuse, no trauma, and that would have seem to have been borne out by what the medical examiner has said.
All along, the Schiavo family has said that he did not hurt his wife in any way that would have led to her collapse back in 1990, 15 years ago. That indeed, according to the family, she had heart failure. This, of course, is contrary to what the Schindler family had maintained, allegations that Michael Schiavo had abused his wife.
Again, they medical examiner said quite bluntly, "Did she suffer neglect or abuse?" And he said, "No." And he also indicated that there were no signs of physical trauma at all. Naturally, we will be hearing from -- the Schindler family has told us that they will tell us what they have to say about these findings. It will be interesting to know after all of this time what they have to say, as well as, remember, over the years, we see videotape that they made themselves of them interacting with their daughter.
Now we have learned that Terri Schiavo could not see, that indeed she was blind, which doesn't necessarily mean, according to these doctors, that they couldn't have had some interaction with their daughter in some way. They stopped short of saying that -- Daryn.
KAGAN: Yes. And one thing -- the one thing the autopsy report cannot tell us, and that's the basic premise of the dispute between the Schiavo and Schindler families of what was Terri Schiavo's final wish, to be kept alive or not. Because you also heard in the autopsy report how strong these doctors said this woman's heart was, and basically how hard her body fought to keep going.
CANDIOTTI: It would seem that the original cause of her collapse 15 years ago, if you were expecting an answer from this news conference, you weren't going to get it, and you're not going to get it, as well as a determination as to whether she was in a persistent vegetative state.
We knew from the beginning -- doctors and experts have said consistently that's something that you cannot determine in an autopsy. But you can determine the extent of brain damage, and that's what these doctors talked about.
And you'll remember, over the course of 15 years, Daryn, everyone weighed in on this from the president to the pope. The president saying let's err on the side of life and continue to let her live. But you will recall that Michael Schiavo continued to maintain that it was not in his wife's wishes to live in this kind of condition.
And that is why ultimately -- and the courts bore him out after years of hearing evidence in trials and hearings, and the like, that they agreed with Michael Schiavo that that was his wife's wishes -- Daryn.
KAGAN: Susan Candiotti, live in Largo, Florida. Thank you.
Let's get some more medical insight on this and bring in Dr. Dan Barrow. He is chairman of neurosurgery at Emory University School of Medicine here in Atlanta.
Dr. Barrow, good morning. Thank you for being with us.
DR. DAN BARROW, EMORY UNIVERSITY SCHOOL OF MEDICINE: Good morning. My pleasure.
KAGAN: Were you able to hear what the medical examiners in Florida were saying and listen in on that report?
BARROW: I did hear most of it. I missed the very first part of it, but I think I got the high points.
KAGAN: And for you, what would that be?
BARROW: Well, I think to underscore what has already been said by others, an autopsy, particular of the brain, the human nervous system, the brain and the spinal cord, doesn't make a clinical diagnosis. Many of the issues surrounding this case had to do with her clinical condition, which is not going to be verified by an autopsy. But certainly the evidence from the autopsy at least supports the clinical picture that was presented to the -- to the public.
KAGAN: When Terri Schiavo was still alive, there was this group of five or six doctors that examined her. She was alive, they have access to all her records. And they each came away with a different interpretation. So would you expect anything of that to change, now that there would be an autopsy? That this an interpretative science and it's not black and white?
BARROW: No, I wouldn't expect physicians to change their opinions. Medicine is not a pure science. There is some art to it and it's not uncommon for physicians to look at same problem and come up with slightly different interpretations. I think what the autopsy demonstrated, as you pointed out, was that there was marked atrophy or shrinkage of the brain. And that really serves, I think, as a surrogate for determining the amount of brain damage.
There is not a clear correlation at all between the size of a human brain and its function, certainly, demonstrating the profound atrophy and the diffuse damage to the brain, I think it supports the clinical impression of those who felt that she was in a persistent vegetative state, but it certainly does not prove that.
KAGAN: And, as a neurosurgeon, these issues of life and death and who is alive and who does go on, and what is a functioning brain, this is something that you deal with everybody. Did you learn anything from the Terri Schiavo case or is this just -- was that just a little slice of what your practice is about?
BARROW: Well, fortunately, I don't have to deal with this everyday, but it certainly is common in my profession. And I would point that in the overwhelming majority of cases, this is a much more clear-cut issue. There are clear and unequivocal criteria for determining brain death in this state and every state in the United States, where if -- where patients meet certain clinical criteria, we can ethically, morally and legally pronounce them dead.
It's the patient who doesn't meet those criteria, in whom there is some evidence of brain function, that it becomes an issue. And I think what I have learned from this case and what I think the public should learn is the importance of advance directives, of all of us having some type of durable power of attorney or living will that allows one of our loved ones to make those decisions for us if we're unable to in the future. KAGAN: Very well said. Put it in writing and don't put your family through this kind of torture that they went through. Dan Barrow, chairman of neurosurgery here at Emory University in Atlanta. Thank you, Dr. Barrow.
BARROW: Thank you very much.
KAGAN: We're also giving word that George Felos -- he is the attorney for Michael Schiavo -- he plans to hold a news conference in about two and a half hours -- or actually about three hours. 2:30 p.m. Eastern from Dunedin, Florida. And you'll see that live right here on CNN. And of course, if the Schindler family has anything to say, or their representatives, we'll bring that to you, as well.
Right now a quick break. We're back after this.
(COMMERCIAL BREAK)
KAGAN: Let's take a look at what's happening "Now in the News."
President Bush pushes his plan for fueling America's future. The president is urging the Senate to pass its energy plan. He wants a bill to sign before the August recess. The legislation has been stalled by disputes over tax breaks, Arctic oil drilling and other issues.
A major earthquake causes a tsunami scare in California. The magnitude seven earthquake struck off the Northern California coast. It triggered a brief tsunami warning, but scientists say the quake's movement was sideways instead of the thrusting movement that caused the tsunami in South Asia.
An Australian contractor who was taken hostage in Iraq is free this morning. Douglas Wood was kidnapped six weeks ago. A U.S. military official says Iraqi forces stumbled on Wood during a security sweep in northwestern Baghdad. He's said to be in good condition. Wood is married to an American and lives in California.
A new search turns up no sign of Natalee Holloway, the Alabama teen missing in Aruba. Police and FBI agents combed a swampy area near the Marriott hotel. A government spokesman says searchers found some woman's underwear, but it's believes the garment belongs to an older woman. The search ended last night.
In Florida, NASA readies the Space Shuttle Discovery for a return to space. The revamped vessel went on a slow crawl to the launchpad. It takes about ten hours to make that trip. Scheduled to launch in July. That would be the first flight since the Space Shuttle Columbia disaster in 2003 that killed seven crew members.
President Bush wants to energize Congress. He's pushing the Senate to approve his energy plan before the August recess.
Elaine Quijano joins us from the White House with more on the president's speech this morning. Elaine, good morning.
ELAINE QUIJANO, CNN CORRESPONDENT: Good morning to you, Daryn.
That's right, President Bush called America's dependence on foreign sources of energy, quote, "a foreign tax on the American dream." And today he called on Congress to pass legislation to reduce that dependence. That essentially was his message today as he went before the annual Energy Efficiency Forum, a gathering of industry officials from the public and private sectors.
Now, the U.S. House has passed a bill and with the Senate now taking up the issue, the president is hammering home that he wants an energy bill on his desk in the coming weeks.
(BEGIN VIDEO CLIP)
GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES: Summer's here, temperatures are rising and tempers will really rise if Congress doesn't pass an energy bill.
The American people know that an energy bill will not change the price of gas immediately. But they're not going to tolerate inaction in Washington as they watch the underlying problems grow worse.
(END VIDEO CLIP)
QUIJANO: The president there acknowledging, as he has done in the past, that higher gas prices are something that Americans and that American businesses are certainly feeling the president acknowledging that people are feeling the pinch from those high prices. But at the same time, they're making clear that the proposals he is behind would not have any immediate impact on those prices. But the president's saying that other factors, like increased global demand, are part of the reason why it is so difficult to bring down those prices.
Meantime, Democrats, for their part, are bringing up their own energy ideas. Specifically, Democratic Senator Maria Cantwell of Washington state talking about a proposal aimed at reducing America's daily oil dependency or oil demand, I should say, by some 7.5 million barrels per day by the year 2025. And today, she talked about her reasons for getting behind that proposal and urged her colleagues to do the same.
(BEGIN VIDEO CLIP)
SEN. MARIA CANTWELL, (D) WASHINGTON: If my colleagues believe in the underlying measures of this bill, and they believe that they can go to the floor and talk about our overdependence on foreign oil, then they ought to be brave enough to set a goal for the American people and say that our country is serious about our overdependence on foreign oil.
(END VIDEO CLIP)
QUIJANO: But the Bush administration has signaled opposition to even more modest reductions in the oil demand. The Bush administration effectively saying that that would require a rapid -- what they call a rapid increase in federal fuel mileage requirements for cars, trucks and other vehicles.
Meantime, President Bush reiterating some of the themes that we've heard him talk about before, including using advanced technology to promote greater conservation. But the overriding message to Congress, get a bill to my desk before August -- Daryn.
KAGAN: Elaine Quijano. Elaine, live at the White House. Thank you.
On Capitol Hill right now, a Senate Judiciary Committee meeting, holding a hearing on the treatment of terrorist detainees being held at Guantanamo Bay. A live picture there for you. The committee's senior Democrat told the committee his opinion.
(BEGIN VIDEO CLIP)
SEN. PATRICK LEAHY, (D) JUDICIARY COMMITTEE: The administration says that these detainees post a threat to the safety of Americans. The vice president said that the other day. If that's a true, if they pose a threat to us, then there has to be evidence to support that, or our administration would not tell the world that. If there's evidence, then let's prosecute them; let's bring the evidence forward.
(END VIDEO CLIP)
KAGAN; Meanwhile, Republican Arlen Specter, the committee's chair, says any talk of releasing prisoners should we approached with extreme caution.
(BEGIN VIDEO CLIP)
SEN. ARLEN SPECTER (R), COMMITTEE CHAIRMAN: While procedural due process is obviously important, we ought to be as sure as we can what steps are being taken so that we do not detainees from Guantanamo who turn up on battlefields killing Americans. And what's the value of a promise not to bear arms against the United States.
(END VIDEO CLIP)
KAGAN: Much more on this story coming up later today. "INSIDE POLITICS," 3:30 p.m. Eastern, 12:30 p.m. Pacific.
An unwanted side effect of becoming a father. Gaining weight? Next in our "Daily Dose" segment, advice on avoiding the extra pounds for new dads.
(COMMERCIAL BREAK)
(STOCK MARKET REPORT)
KAGAN: I want to go ahead and recap our top story for you, the autopsy report on Terri Schiavo. The medical examiner in Florida says no amount of treatment would have reversed the massive brain damage that Schiavo suffered following her 1990 collapse.
(BEGIN VIDEO CLIP) THOGMARTIN: Her brain was profoundly atrophied. The brain weighed 615 grams, roughly half of the expected weight of a human brain. This was due to diffused hypoxic ischemic damage. There was massive neuronal loss or damage. This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons.
Of note, there was severe occipital (ph) lobe necrosis (ph). Her vision centers of her brain were dead. Therefore, Mrs. Schiavo had what's called cortical blindness. She was blind, could not see.
(END VIDEO CLIP)
KAGAN: Schiavo died on March 31st, almost two weeks after her feeding tube was removed. She had been at the center of a bitter legal fight between her husband and parents. The medical examiner says the cause of Schiavo's initial collapse remains undetermined and he says there was no evidence of any kind of trauma.
Gaining weight. It is an expected part of pregnancy for mothers- to-be, but some new fathers find their waistlines expanding along with their wives. Senior medical correspondent Dr. Sanjay Gupta looks at sympathy weight gain in today's "Just for Dad" segment.
(BEGIN VIDEOTAPE)
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT (voice-over): Even though it was his wife who gave birth to these twin boys, it was David Feldman's weight that went up and down like a swing.
DAVID FELDMAN, NEW DAD: Before my wife got pregnant, I weighed 190 pounds, then during the pregnancy, peaked about 235. Now I'm down to 209, you know, and I plan to get back down under 200, hopefully, in a month or so.
We ate everything, you know, lots of carbs, lots of pizza, lots of Chinese food, a lot of ice cream, bacon cheeseburgers. One of my biggest cravings was bacon cheeseburgers.
GUPTA: While she grew out in front, he grew a little on the sides. Yes, love handles. Diagnosis: sympathy weight gain.
FELDMAN: She was very queasy, so I kept encouraging her to eat. And while she was eating, while I was encouraging her to eat, I ate with her.
GUPTA: Another common reason for the extra baggage, stress, about providing financially, getting the house ready, and taking on a new daunting role.
PATTY ONDARKO, EDITOR, "BABYTALK" MAGAZINE: It's just something that people don't talk about too often. It's not given that much attention. You know, during pregnancy, all the attention goes to the woman, so no one really is focusing on the man or noticing whether or not he's gaining weight. GUPTA: Putting on the pounds is part of a greater condition known as Couvade Syndrome. That's a French word for "hatching." Studies on Couvade Syndrome show about 90 percent of men experience at least one pregnancy-like symptom, anything from nausea to vomiting, food cravings, and most commonly, yes, weight gain.
There may be more than a psychological explanation behind the syndrome.
HEIDI MURKOFF, AUTHOR: Men actually experience a surge in female hormones during pregnancy and in the postpartum period, and it's not enough to grow breasts or anything, but it's enough so they actually experience many of the same symptoms that women are experiencing.
GUPTA: David's wife, Sloan, actually welcomed the weight gain.
FELDMAN: One of the running jokes we had throughout the pregnancy is that, even with twins, she did not want to weigh more than I did. And throughout the pregnancy, she never did. So she was ecstatic.
GUPTA: David's post-pregnancy diet helped him lose more than half the weight that he gained. Most fathers are better off trying to avoid the added pounds in the first place, by being conscious of their eating habits, encouraging exercise for both mom and dad, and talking openly to their partners about their own anxieties of becoming a father.
FELDMAN: You like that.
GUPTA: No longer worried about the ups and downs of becoming a dad, David can now concentrate on the ups and downs of being a dad.
Dr. Sanjay Gupta, CNN, reporting.
(END VIDEOTAPE)
KAGAN: Your daily dose of health news is always just a click away. Log on to CNN.com/health for the latest medical news. You'll also find special reports and a health library.
In California this morning, a big sigh of relief. A powerful earthquake rattled nerves in the northern part of the state last night. It also -- well, it caused no damage or injury, but the magnitude 7.0 tremor struck some 90 miles off the coast, triggering a tsumani warning. It was lifted about an hour later. One expert explained why the tsunami did not happen.
(BEGIN VIDEO CLIP)
KATE HUTTON, USGS SEISMOLOGIST: It was a strike slip earthquake, which means one side slid horizontally past the other. This is very good because that means it didn't raise or lower the ocean floor. And a tsumani would be very unlikely in a situation.
(END VIDEO CLIP)
KAGAN: And yet, that town, ready to go.
(WEATHER REPORT)
KAGAN: All right. Looking forward to that. Thank you so much. I'm Daryn Kagan. That's going to do it for me. International news is up next. Stay tuned for "YOUR WORLD TODAY" with Jim Clancy and Zain Verjee, after q a quick break. I'll see you right back here tomorrow morning.
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DARYN KAGAN, CNN ANCHOR: We may soon have answers to lingering questions about Terri Schiavo's health. Schiavo's autopsy report is scheduled to be released at the top of the hour. Most doctors said Schiavo was in a persistent vegetative state before she died on March 31st. Her parents said she was minimally conscious.
We'll have live coverage of the news conference from Florida in the next hour.
The parents of a 13-year-old girl with cancer return to court next hour to try to regain custody. Texas child protective services took custody of Katie Warnicke (ph) 11 days ago. Official thought the family was risking her life by refusing radiation treatment. On Friday, a judge said treatments should begin as soon as possible.
Right now on Capitol Hill, the Senate Judiciary Committee is taking a closer look at Guantanamo Bay and the alleged abuse of terror suspects held there. The charges and the international backlash have stoked heated debate in Washington and a new effort to polish Guantanamo's tainted image.
Our congressional correspondent Ed Henry is on Capitol Hill.
Ed, good morning.
ED HENRY, CNN CORRESPONDENT: Good morning, Daryn.
That's right, some fireworks at a Senate Judiciary Committee hearing this morning on the handling of detainees. Democrats charging that in fact the prison at Guantanamo Bay is a gulag, a legal black hole, in their words, where detainees are ruthlessly abused. Top Democrats on the Senate Judiciary Committee have been called for that prison to be shut down completely. They say that the damage has been so excessive to the American image around the world that the prison has to be closed.
Here's Democratic Senator Patrick Leahy.
(BEGIN VIDEO CLIP)
SEN. PATRICK LEAHY (D), VERMONT: This idea of changing, changing the focus producing, producing props of chicken dinners and such, seeing to argue this is more a club med than a prison. Let's get real. These people have been locked up for three years, no end in sight and no process to lead us out of there. Guantanamo Bay is causing immeasurable major damage to our reputation as a defender of democracy and a beacon of human rights around the world. (END VIDEO CLIP)
HENRY: Senator Leahy was referring to the fact that some Republicans have said that, in fact, the detainees have been treated humanely, and in fact yesterday Defense Secretary Donald Rumsfeld insisted that the U.S. government has gotten very valuable information from some of these detainees who are suspected terrorists. They could be major threats to the United States.
(BEGIN VIDEO CLIP)
DONALD RUMSFELD, SECY. OF DEFENSE: They are not common car thieves. They are believed to be determined killers. Arguably, no detention facility in the history of warfare has been more transparent or received more scrutiny than Guantanamo.
(END VIDEO CLIP)
HENRY: Secretary Rumsfeld also said there's no alternative to this prison at Guantanamo, suggesting that it makes no sense to simply dump these prisoners back out around the world who could potentially do damage to the United States. Democrats insist that's not what they're advocating. They say instead if some of these detainees are, in fact, terrorists, they should be charged with crimes. Democrats point out that some of these detainees have been languishing for up to three years without charges.
You also heard Senator Leahy there referring to the club med idea. He was referring, in part, to the fact that Republican Congressman Duncan Hunter the other day brought out the menu that some of these detainees have been enjoying, the chicken dinners, fish dinners, vegetables, various props that have been brought out on the Republican side to suggest that, in fact, the detainees are being handled humanely.
But Democrats at this hearing pointing out this "Time" magazine story this week that shows confidential logs suggesting that one of the detainees was not allowed to use the bathroom, was also forced to act like a dog. Democrats say that's where the focus is. And, in fact, one Republican senator, Mel Martinez of Florida, has said perhaps this prison should be shut down -- Daryn.
KAGAN: How much power does the Senate Judiciary Committee, or even the Senate, have in what would happen to Guantanamo? Is it just a suggestion?
HENRY: Absolutely. The bottom line, it's going to be decision made by the president of the United States. There has been a little bit of confusion because President Bush in the last few days has left the door open to the possibility of shutting this prison down. But you heard Secretary Rumsfeld there, he clearly does not think that, in fact, the prison will be shut down. Vice president Cheney has also come out strongly in the last couple days saying this prison should not be shutdown.
But as Secretary Rumsfeld himself pointed out in his briefing with reporters, this decision ultimately is made by the president of the United States, not by the defense secretary. And if this continues to be a public relations problem, that's a decision the president may ultimately make. But at this point, a top administration official is insisting no plans to shut it down -- Daryn.
KAGAN: Ed Henry on Capitol Hill. Ed, thank you.
Later this hour, President Bush will stump for his energy plan, and before that, some leading Democrats are also laying out their rival plan today. Both plans do share the same goal, creating domestic programs to wean the U.S. off of foreign oil. We'll hear from both the president and the Senate Democrats a little bit later in the newscast.
If you're an air traveler who also brings your pet along with your PJs, you'll want to know which airline is safest for Fido or Fluffy. Beginning today, Congress is requiring airlines to divulge how many pets are killed, lost or injured on their flights.
CNN's Sumi Das is at Reagan's National Airport, just outside Washington, with the latest.
Any pets along with you today, Sumi.
SUMI DAS, CNN CORRESPONDENT: We haven't seen any pets, only one seeing eye dog thus far, but we are on the lookout for them. But we all know how devoted pet owners can be to their pets, basically treating them as one of the family. Well, there's good news for them now. Thanks to the efforts of the ASPCA, the American Society for the Prevention of Cruelty to Animals, travelers can soon find out which airline has the best record when it comes to transporting the estimated two million animals that are flown commercially every year.
(BEGIN VIDEOTAPE)
DAS (voice over): Meet furry frequent flier Eloise. Luckily, Eloise can sit underneath the seat in an airplane cabin. Her owner refuses to check her into the cargo hold.
UNIDENTIFIED FEMALE: I do not want to be the one standing there with the empty leash.
DAS: She's not alone.
UNIDENTIFIED FEMALE: I would never allow her in cargo. She's not cargo. She's my baby.
DAS: No one knows how many pets die traveling. Estimates from the ASPCA range, but start at 5,000 a year, enough to concern pet owners. A new law required airlines to report pet injuries, losses and deaths occurring on their flights to the U.S. Department of Transportation. If a mishap occurs, the airline must try to prevent the same mistake from happening again.
The ASPCA says it would like airlines to do more. LISA WEISBERG, ASPCA: What it also hopefully will do is make airlines a little bit more responsible and accountable for the animals that are in their care.
DAS: Airlines fought unsuccessfully against the law. Now, some airlines fear the reports will be used competitively. Others wonder if airlines will follow Southwest's lead and choose not to carry pets. The ASPCA says the law presents a marketing opportunity.
WEISBERG: We're waiting for that airline to truly become pet- friendly and to either have the newer cargo holds that are temperature controlled or perhaps, even better, to make a place available on the airplane in the cabin itself.
(END VIDEOTAPE)
KAGAN: Airlines will begin reporting to the department of transportation today, but those figures aren't going to be available to the public until the first or second week in July, where they'll be published in the department's monthly report.
Live at Reagan National Airport, I'm Sumi Das -- Daryn.
KAGAN: Sumi, thank you.
A check of the markets is just ahead. Plus, when are rising energy prices a good thing. We'll tell you when you're the one collecting the money, of course.
Coming up, a man who thinks the price of oil is just about right.
KAGAN: And it's back to the beginning for Batman. The film opens today. Reviews by Mr. Moviefone ahead on CNN LIVE TODAY.
(COMMERCIAL BREAK)
(STOCK MARKET REPORT)
KAGAN: Two sides to everything. Rising energy costs for instance. You might gripe about prices at the pump, but it's a boom for a Kentucky oilman.
CNN's Alan Chernoff has his rags to riches story.
(BEGIN VIDEOTAPE)
ALAN CHERNOFF, CNN SR. FINANCE CORRESPONDENT (voice-over): As soon as Bill Daugherty launched his energy company in 1984, oil prices started to fall.
BILL DAUGHERTY, OIL & GAS EXECUTIVE: Little did I know that's probably the worst time in the history of oil and gas to start a company.
CHERNOFF: Bill put everything he had into the company, and, at first, got nothing in return. DAUGHERTY: My wife was expecting. We hadn't had a paycheck in about six months. Zero inspiration and 100 percent desperation.
CHERNOFF: Desperate no more, today, oil prices are above $50 a barrel, and Bill's one-man firm, NGAS Resources, is 66 employees strong. He's president and CEO, and he took the company public in 1993.
But it wasn't until oil prices began to rise in the late '90s that things really picked up. NGAS stock has jumped 1,500 percent since 1999. The company is searching for oil at a breakneck pace.
In '98, Bill drilled only five wells. Last year, 155. Recently, he bought two helicopters so now he can get from his offices in Lexington to the wells in eastern Kentucky in under an hour.
DAUGHERTY: I think the biggest thing is that, you know, I don't have to worry about money. It's given us an opportunity to grow the company. And that's an immense amount of fun.
CHERNOFF: Married 32 years, Bill and his wife Zella remember the early days, when he worked from home with a part-time secretary and no salary.
Along with watching the company grow, Zella has seen her own life change, too.
ZELLA DAUGHERTY, BILL'S WIFE: It was a lot different than it is now. I think the greatest thing is we got to take a vacation this past year.
Cheers to our new home.
We both grew up on a farm. We always have worked really hard. And it's kind of fun to be able to have a few toys.
CHERNOFF: Bill and Zella's two sons also are riding the wave of rising oil prices.
B. DAUGHERTY: It's given them the ability to have more fun and go to the schools they want to go to. My 20-year-old son William is at Center College. And, you know, he was there when there just was no money.
CHERNOFF: Just like day one, Bill has everything he owns in the company. Ninety percent of his investments are in company stock. And his salary, which has risen considerably since '99, is tied to the stock and, consequently, to the price of oil.
So what if prices fall again?
B. DAUGHERTY: We just batten down the hatch and keep on producing, because I will guarantee you one thing, if oil drops to $10 a barrel, it will go back up.
CHERNOFF: Alan Chernoff, CNN, New York. (END VIDEOTAPE)
KAGAN: Here's another story for you. Batman, he's back. But will he able to climb to the top of the box office? We brought Mr. Moviefone in a couple days early to give you a review of the new Batman movie. That's coming up next.
(COMMERCIAL BREAK)
KAGAN: Bruce Wayne takes a spin in the original Batmobile. Christian Bale plays a younger caped crusader in "Batman Begins." The prequel opens in theaters nationwide today.
Russ Leatherman, Mr. Moviefone, our own kind of movie superhero, is here with a review of the latest in the Batman series. Hi, Russ.
RUSS LEATHERMAN, MR. MOVIEFONE: I love Batman!
KAGAN: So you like this movie?
LEATHERMAN: I did. I thought that this was one of the best Batman movies we have seen in years. Christian Bale makes a terrific Batman. It's badder, it's better than any Batman we've seen in a long time. And the reason is, we get to see the back story. We see, really, a kid watch his parents get murdered right in front of his eyes.
KAGAN: Well, that's cool.
LEATHERMAN: Well, -- but yes, I know. But then we get to watch why he becomes this sort of cape crusader who takes on the entire town of Gotham City. This movie's got an amazing cast. It's got Liam Neeson, Morgan Freeman, Michael Caine, Ken Watanabe, Gary Oldman and Katie Holmes, as you see right there.
KAGAN: Yes. How is she in this movie? She's been getting a lot of publicity as Tom Cruise's squeeze.
LEATHERMAN: Yes, not so good, Daryn. She really -- she doesn't add much to the movie at all. And if there's any downside to the movie, I would say it's that you really don't see even the bat uniform until an hour into the movie. The movie takes a while to get cooking because it is dealing with a lot of this back story.
But the director, Christopher Nolan, who did "Memento," he definitely knows how to do a movie like this. I really thought that the movie is about as good as a comic book movie can be. So you can't miss "Batman Begins."
KAGAN: What about the Batmobile?
LEATHERMAN: The Batmobile is wicked, Daryn. I would love to take you for a spin in that thing.
KAGAN: I bet you would. LEATHERMAN: That is fantastic. And the nice thing about the movie, honestly, is it takes the material seriously. It's not campy, it's not goofy. You have an A-plus director, A-plus actors and a really good story. So I would say if you're inclined to see these kinds of comic book movies at all, do not miss "Batman Begins."
KAGAN: All right. Well that pretty much says it all. Mr. Moviefone, Russ Leatherman, thanks for coming in early this week.
LEATHERMAN: My pleasure. And by the way, Daryn...
KAGAN: Yes.
LEATHERMAN: There's a little movie called "The Perfect Man" that opens on Friday.
KAGAN: Where do you find one of those?
LEATHERMAN: Right here, my dear, right here.
KAGAN: No, really, what movie is that?
LEATHERMAN: Well, it's Hilary Duff and Heather Locklear.
KAGAN: Oh, yes, that one. OK, I've seen -- yes.
LEATHERMAN: Yes. She moves from town to town, is looking for love and can't find it. That's really an awful movie right there, Daryn.
KAGAN: Yes, because it has love and girls and all that stuff that's just...
LEATHERMAN: I hate that stuff.
KAGAN: ... too icky for you. I know.
LEATHERMAN: Go Batman, go Batman!
KAGAN: Thank you.
LEATHERMAN: See you later.
KAGAN: Let's check the time. 10:53 in Washington, D.C., 7:53 in Crescent City, California. And Jacqui Jeras has your weather forecast coming up. We're also awaiting a press conference detailing the autopsy results on Terri Schiavo. We'll bring that to you when it happens.
(COMMERCIAL BREAK)
KAGAN: President Bush is calling on the Senate to pass his energy plan before Congress recesses in August. The president is pitching his plan in the speech in Washington, D.C. this morning. A live picture there from the Reagan building, where he will be speaking. Mr. Bush wants to reduce U.S. dependence on foreign oil. The House passed an energy bill in April. That legislation includes $8 billion in tax incentives.
The Senate is now considering a proposal that would double the cost of those tax incentives. The president originally sent his energy plan to Congress four years ago. It's been stalled by disputes over tax breaks, arctic oil drilling and other issues.
(WEATHER REPORT)
KAGAN: A lot to get to this morning, including President Bush pushing his energy plan today. He's urging the Senate to pass a bill before August.
And Florida medical examiners are expected to announce the results of Terri Schiavo's autopsy report. We could learn more about her mental state. We'll bring that to you live as the second hour of CNN LIVE TODAY begins right now.
Want to go live now to Florida. This is the news conference. That's -- there we go. The new conference about Terri Schiavo's autopsy report.
(JOINED IN PROGRESS)
JON THOGMARTIN, MEDICAL EXAMINER: He's also board certified in neuropathology. He is the consulting neuropathology -- neuropathologist on this case. The medical examiner is charged pursuant to Florida chapter 406 with determining the cause and manner of death of persons who die under certain circumstances. The circumstances surrounding the death of Mrs. Schiavo necessitated medical examiner involvement by law.
On March 31, 2005, the district six medical examiner began a death examination of Mrs. Schiavo. The chain of events leading to this death investigation began 15 years ago, in the....
DARYN KAGAN, CNN ANCHOR: We still have a lot to get to this morning, including President Bush pushing his energy plan today. He's urging the Senate to pass a bill before August.
And Florida medical examiners are expected to announce results of Terri Schiavo's autopsy report. We could learn more about her mental state. We'll bring that to you live as the second hour of CNN LIVE TODAY begins right now. And we go live now to Florida. This is the news conference -- there we go -- the news conference about Terri Schiavo's autopsy report.
(JOINED IN PROGRESS)
JON THOGMARTIN, MEDICAL EXAMINER: He's also board certified in neuropathology. He is the consulting neuropathology -- neuropathologist on this case.
The medical examiner is charged pursuant to Florida Chapter 406 with determining the cause and manner of death of persons who die under certain circumstances. The circumstances surrounding the death of Mrs. Schiavo necessitated medical examiner involvement by law.
On March 31, 2005, the District 6 medical examiner began a death investigation of Mrs. Schiavo. The chain of events leading to this death investigation began 15 years ago in the early morning hours of February 25, 1990, when her husband reportedly found her unconscious.
This incident began the chain of events that led to her hospitalization, illness and death. Thus, the determination of her cause and manner of death would include events and records subsequent to that date and preceding that date. The focus of the investigation was the ideology of her initial collapse and other allegations made by her families members and others during the last 15 years.
On April 1, at 8:40 in the morning, a complete autopsy was performed, including external and internal examinations with 72 external photographs and 116 internal photographs. A radiologic survey of her entire body was performed using a digital fluoroscope x- ray with 58 pre-autopsy imagines captured.
During and after the autopsy, a second radiologic examination was performed, capturing an additional 28 imagines, including multiple views of her anterior neck structures, torso and pelvis. A total of 274 images were recorded during this examination.
Detailed dissections were performed on Mrs. Schiavo's anterior and posterior neck, spine and brain. Multiple microscopic samples were taken and examined. Dr. Nelson was present at the autopsy and examined her central nervous system.
A board certified anatomic clinical forensic pathologist with special expertise in cardiovascular pathology examined her cardiac tissue. Genetic testing for cardiac ion channel mutations was performed by Familian (ph) in New Haven, Connecticut, to detect markers for Long QT Syndrome. Complete toxicology testing was also performed.
The vitreous humorous chemistry was examined. Court, medical and other records, including public and confidential Department of Children Family -- Children and Family's records and law enforcement documents were reviewed as part of the death investigation.
Now, certain issues have repeatedly surfaced during this investigation. And these issues have been presented to the Department of Children and Families in the past, law enforcement, and have been presented in the media. I will attempt to address these here, but I have covered them in greater detail in the documents you have received today. I have also included references from appropriate medical literature as part of your packet.
First, what was the cause of Theresa Schiavo's collapse in 1990? Did she suffer from an eating disorder?
Mrs. Schiavo was heavy as a teenager. And after high school, she did lose over 100 pounds. No one observed her taking diet pills, bingeing and purging, or consuming laxatives. And she apparently never confessed to her family or friends about having an eating disorder. And, furthermore, many other signs and symptoms of bulimia nervosa were not reported to be present.
After her resuscitation from her initial cardiac arrest, the first blood draw at Human Hospital Northside, which was her admitting hospital, showed a low potassium level. Several other blood components were also at abnormal levels.
Her low potassium level and the eating disorder it appeared to indicate were the focus of a malpractice suit filed by her husband. Witnesses at trial -- at the malpractice trial -- offered no testimony to witness purging and experts. Although they favored bulimia nervosa, offered other possibilities for the low potassium level.
Both plaintiffs and defendant in the malpractice trial generally accepted the theory that her low potassium level was due to bulimia nervosa. And therefore, during the trial, the veracity of this diagnosis was not challenged.
Her low potassium level appears to be the main piece of evidence purported to show that she had han eating disorder. What caused this hypokalemia, or low potassium? Mrs. Schiavo was near death and critical for over one hour prior to that initial blood sampling. This blood sampling showed a potassium level of 2.0 millimoles per liter, while normal is 3.5 to 5.
She received approximately 1,250 ccs, or over a quart and a half of intravenous fluid prior to that blood draw. She received five doses of Epinefrin and suffered a period of ventricular fibrillation, all of which are known to cause factitious lowering of blood potassium. In fact, similar circumstances have brought about drastic potassium reductions, and these have been documented experimentally and during patient care.
Thus, it is reasonable to conclude that her potassium level of 2 measured after a period of ventricular fibrillation, Epinefrin and fluid administration, was an unreliable measure of her pre-arrest potassium level. Thus, the main piece of evidence supporting a diagnosis of bulimia nervosa is suspect.
If the diagnosis of bulimia is reduced to a mere possibility, then other ideologies for her collapse become more plausible. The hospital toxicology screen on her urine was negative, but this screening technique is not in any way to be considered a comprehensive screen.
Thus, diet pill or other drug toxicity cannot be ruled out. But again, no evidence indicates she used or was given drugs.
Reportedly, she was a habitual user or consumer of large amounts of tea and may have consumed as much as one gram of caffeine per day. And therefore, her tea-drinking habits may have also played a role in her death.
Caffeine was not tested for in the initial hospital toxicology. Caffeine has been somewhat associate with cardiac arrhythmias and hypokalemia. However, considering her activities on the night prior to her collapse, and the time of day of her collapse, being the early morning hours, caffeine toxicity is unlikely unless some type of pill or supplement containing caffeine was consumed.
Did she have a heart attack? The common term "heart attack" is generally reserved to describe the medical condition of myocardial infarction. In other words, death of heart muscle from Coronary Artery Disease.
Mrs. Schiavo's heart was anatomically normal without any areas of recent or remote infarction. Mutations associated with the heart defect known as Long QT Syndrome were not detected.
Next, what she strangled? No trauma was noted on any of the numerous physical examines or radiographs performed on Mrs. Schiavo on the day of, in the days after, or in the months after her initial collapse.
Indeed, within one hour of her initial hospital admission, she received a radiograph of her cervical spine which was negative for trauma. So the doctors were thinking at that time of neck trauma and ruled it out by radiograph.
Autopsy examination of her neck structures 15 years after her initial collapse did not detect any signs of remote trauma, but with such a delay, the exam was unlikely to show any residual neck findings. No evidence of strangulation was found. No evidence of trauma whatsoever was noted by the physicians during her initial hospitalization.
A bone -- now, next, a bone scan was performed on March 5, 1991, while Mrs. Schiavo was a patient at a rehabilitation center in Manatee County. The bone scan results which had been reported as indicating trauma have received much attention in the last year. This bone was performed, remember, over one year after Mrs. Schiavo's initial collapse.
Why was the bone scan performed, and what did the results indicate? Mrs. Schiavo had trouble with her right knee during her initial admission in the hospital in 1990. She had trouble with both knees in 1991, during -- and both of these areas of trouble with her knees occurred during times of physical therapy.
During both instances, her knees were x-rayed and showed no trauma, no fractures. But the 1991 x-ray did have additional findings of degenerative changes in her knee joints and osteopenia or osteoporosis.
Her rehabilitation doctors ordered a bone scan to primarily rule out heterotopic ossification. Heterotopic ossification, what is it? It's an abnormal extraskeletal growth of bone often found in patients with paralysis such as Mrs. Schiavo.
Her doctors made a diagnosis of heterotopic ossification from the bone scan, from the results, and began medical treatment with Didrinal (ph) for that condition. The bone scan results do not indicate fractures apart from the compression fracture diagnosed of her first lumbar vertebral body.
Spinal compression fractures such as this are common in patients with severe osteoporosis. Her doctors at the time already knew she had osteoporosis, and such a diagnosis is almost expected of someone in her clinical condition.
Postmortem -- postmortem findings include -- including radiographs and histology, support the diagnosis of heterotopic ossification and marked osteoporosis. Postmortem examination evidence of heterotopic ossification were seen in numerous areas of her bones and body.
Tissue sampling confirmed the presence of heterotopic ossification. Degenerative and/or fusion of other joints were also seen. Her bones were palpably soft from severe osteoporosis. These findings are typical of patients with long-term paralysis. She also had a normal bone growth on the inner surface of her skull known as Hyperostosis Frontalis Interna, unrelated to trauma or her illness.
In summary, any fractures, including rib fractures, leg fractures, ankle fractures, skull fractures, spine fractures that occurred, concurrent with her initial collapse, would almost certainly been diagnosed in 1990, especially with the number of physical exams, radiographs and other evaluations she received during her initial hospitalization. To be clear, during that hospitalization, she received 23 chest x-rays, three brain CT scans, two abdominal radiographs, two echocardiograms, one abdominal ultrasound, the previously mentioned cervical spine radiograph taken within an hour of her admission, one radiograph of her right knee.
No fractures or trauma were reported or recorded. By far, the most likely explanation for the bone scan findings in Mrs. Schiavo are prolonged immobility, induced osteoporosis and complicating heterotopic ossification in an environment of intense physical therapy. Without the original bone scan and radiographs from that period, no other conclusions can reasonably be made.
Next, could Mrs. Schiavo eat by mouth? The neuropathologic findings, oral forengal (ph) anatomic findings and medical records clearly indicate that she would not have been able to consume sustenance safely or in sufficient quantity by mouth. The records and findings are such that oral feedings in quantities sufficient to sustain life would have certainly resulted in aspiration. Swallowing evaluations and speech pathology evaluations repeatedly record that she was a high risk for aspiration and not a candidate for oral nutrition or hydration. Thus, that's why she had the feeding tube in the first place.
According to medical records, she had been treated in the past for aspiration pneumonia. At autopsy, the lungs had findings that could be considered to be consistent with aspiration of secretions. However, Mrs. Schiavo's decline in dehydration over almost two weeks could also have played a role in these findings. 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 and hydrated by mouth or not.
After her initial collapse, was Mrs. Schiavo given substances to speed her demise or otherwise alter her medical condition? There are basically three incidents involving these types of complaints.
The first was in 2003, when a former employee of Palm Garden of Largo filed an affidavit with the court regarding a 1996 incident or incidents at that facility. The affidavit detailed incidents the employee reportedly witnessed regarding the care of Mrs. Schiavo involving alleged poisoning by Michael Schiavo, along with other adverse behavior on his part.
On March 29, 2004, a hospice nurse noted apparent injection sites on Mrs. Schiavo's arm -- arms, and what appeared to be a plastic needle cap was also found in her room. Reportedly, these were discovered by hospice shortly after a visit by her parents.
There is no evidence to support, or the evidence does not support, that Mrs. Schiavo was given harmful substances related to either of these incidents.
In late March, 2005, it was alleged in the press that Mrs. Schiavo was being given a morphine drip or otherwise being drugged with morphine to expedite or otherwise ease the dying process while she was at hospice. Orders were written, and Mrs. Schiavo received two five-milligram morphine sulfate suppositories, one on March 19, one on March 26. Remember, her date of death was March 31.
Her postmortem toxicology showed no trace of morphine in her body. Acetaminophen was detected in her postmortem blood samples at what would be considered therapeutic levels. And this was a drug that was written and ordered in the medical chart.
However, this drug played no role in her demise. Therefore, no drugs were reported in the medical records other than these, nor were any other drugs detected in postmortem toxicology. No drugs or other substances given to Mrs. Schiavo caused her to die or accelerated the dying process.
Was Mrs. Schiavo in a persistent vegetative state? Persistent vegetative state is a clinical diagnosis arrived at through physical examination of living patients. Postmortem correlations to the persistent vegetative state have been recorded in the literature, and pathologic findings described. However, the findings vary with the ideology or the cause of the adverse neurological event.
What diagnosis can be made though in regards to the brain of Mrs. Schiavo? Her brain was profoundly atrophied. The brain weighed 615 grams, roughly half of the expected weight of a human brain.
This was due to diffuse hypoxic ischemic damage. There was massive neuronal loss, or death. This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons.
Of note, there was severe occipital lobe necrosis. Her vision centers of her brain were dead. Therefore, Mrs. Schiavo had what's called cortical blindness. She was blind, could not see. No evidence of direct skull or brain trauma was seen.
By what mechanism did Theresa Schiavo die? Postmortem findings, including the state of the body and laboratory testing, showed that she died of marked dehydration.
The state of her fatty tissue, and also the laboratory findings, indicate that she did not starve to death. She died of dehydration.
What was the cause and manner of death? Mrs. Schiavo suffered a severe anoxic brain injury. In other words, her brain suffered damage from lack of blood flow and oxygen, the cause of which cannot be determined without reasonable medical certainly. The manner of death will, therefore, be certified as undetermined.
Lastly, let me say 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 information. 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. Receipt of additional credible information that clarifies any outstanding issue may or shall cause an amendment to her cause and manner of death.
And that's all I have. Dr. Nelson and I will now entertain questions.
QUESTION: Dr. Thogmartin, if you could just sum it up for laymen, because it is kind of difficult to understand, so in laymen's terms, did Terri Schiavo starve to death?
THOGMARTIN: No.
QUESTION: Did she suffer any neglect or abuse?
THOGMARTIN: No.
QUESTION: Will we ever know what caused her death?
THOGMARTIN: I don't know. QUESTION: Just to clarify, you said she died from dehydration, but the cause of death is unknown. That's because the precipitating reason for the removal of her tube? I mean, I'm trying to clarify it.
THOGMARTIN: Well, her manner of death is different from cause of death. Manner of death is the circumstances of death or how the death came about. 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.
QUESTION: So cause of death is...
THOGMARTIN: It's going to be listed as complications of anoxic encephalopathy. That's the only diagnosis that I know for sure, is that her brain went without oxygen. Why? That is undetermined.
QUESTION: Dr. Thogmartin, what abilities did Terri have? You said she was blind. In those -- near the end of her life, what would she have been able to do, feel, whatever?
THOGMARTIN: I think it would be best if Dr. Nelson fields that question.
UNIDENTIFIED MALE: The -- again, it's important to remember this is -- persistent vegetative state is a clinical diagnosis. It's not a pathologic diagnosis. The findings of Terri Schiavo are very consistent with persistent vegetative state.
I made the comparison in my report to Karen Ann Quinlan. Karen Ann Quinlan died 10 years after being in a persistent vegetative state. Her brain, Karen Ann Quinlan, weighed more than Terri Schiavo's brain weighed.
The typical things associated with persistent vegetative state are those normal functions of beating heart and breathing and no other types of cognitive function that occurs in the higher portions of the brain.
QUESTION: So there's no evidence that she had any kind of an eating disorder by the findings that you guys -- from her initial collapse in 1990?
THOGMARTIN: Yes, I went back and interviewed as many people as I could contact, coworkers, obviously her husband, her family. Basically, what I'm left with is the impression that the potassium level of 2 was met with just belief, no skepticism, from day one, and actually presented at trial as being a fact.
And even though the medical literature even at that time showed that Epinefrin, ventricular fibrillation, people with any sort of arrest, can have their potassium level drop precipitously. And since 1990, that has been confirmed repeated in several larger studies.
So once you eliminate the potassium problem, which is known in bulimics, you end up with a 26-year-old that used to be heavy, that now lost the weight, is reveling in her thinness now, enjoying her life, and doesn't want to gain the weight back. And if that's a bulimic, there's a lot of bulimics out there. It's just not enough.
QUESTION: So what are the other things that could have led, if it wasn't that -- what could have led to her collapse?
THOGMARTIN: I pretty much laid those out. And in the document you have in your possession, it's much more detailed.
There's numerous possibilities, but I've ruled out overt trauma. I don't think drugs were sufficiently ruled out.
One thing, that she did have a toxicology screen, but it's a very specific screen, mostly for large classes of drugs. The sensitivity is there; however, she received a large fluid bolus prior to that blood draw. You know, a quart and a half of IV fluid, and she did have a relatively -- later on, a relatively dilute urine.
And it is known that if you dilute your urine for these types of amino (INAUDIBLE), you can fall below what's called the cutoff for positively. So, again, I'm thinking that the tox screen was nonspecific. Certainly wouldn't have detected many of the diet pills. And they didn't test for caffeine.
QUESTION: Is there anything in this postmortem that raised an eyebrow, that surprised you, or was it all pretty much what you could expect given these circumstances?
THOGMARTIN: There were some remarkable findings. I think the most remarkable was the degree of dehydration.
You can't measure sodium levels in postmortem blood, but we were able to measure the sodium level, and it reflects the blood level if you measure it from the eye fluid or the vitreous humour. Her sodium level in her vitreous humour upper eye was 207, and that was the highest I've ever seen.
QUESTION: Try to sum it up again in layman's terms. I mean, she had a high sodium or salt content?
THOGMARTIN: Correct. High sodium, low water content. Her skin was dry, her organs were dry. Her eyes were sunken.
She was very, very dry. And the fact that she was able to maintain her life functions when she's that dehydrated, again, argue for the strength, the underlying strength, the anatomical strength of her heart.
QUESTION: Doctor, her family had said repeatedly that she believed that -- they believed that she interacted with them. Are you saying that's impossible?
THOGMARTIN: I'll let Dr. Nelson deal with that.
UNIDENTIFIED MALE: We're certainly not saying that's impossible. But we're saying based on what we know, and what is in the literature with regard to persistent vegetative state, again, that is a clinical diagnosis. It's not a pathologic diagnosis that has precision associated with it.
The clinicians who made the diagnosis of persistent vegetative state, there's nothing in her autopsy report, in her autopsy that is inconsistent with persistent vegetative state. And again, drawing a correlation with Karen Ann Quinlan, the findings here are perhaps worse even than Karen Ann Quinlan.
KAGAN: We've been listening in to the medical examiner in Florida talking about the autopsy results from Terri Schiavo. Some interesting things that they say they've come up with after an extensive review of Terri Schiavo's body after her death earlier this year.
They say there are no -- there is no evidence that she suffered any kind of abuse either at the time of her collapse 15 years ago or afterwards. They also said there's no sign that she actually had han eating disorder, and very few clues as to what would have led to her initial collapse in the first place after 15 years ago.
They said she was in a persistent vegetative state. The weight of her brain, they said, it was profoundly atrophied. The weight only one half of what you would expect for a normal human brain.
They said that Terri Schiavo as blind at the time of her death, that that part of her brain had atrophied as well. But the bottom line, what she actually died of, they say she died in the manner of dehydration, in not having enough water, but that she did not starve to death, and that the exact cause of her death, what actually caused her to collapse 15 years ago, at this point still has not been determined.
They say this case will stay open if they get any additional information.
Let's go ahead and bring our Susan Candiotti in. She's covered this story quite a bit and joins us now from Largo, Florida -- Susan.
SUSAN CANDIOTTI, CNN NATIONAL CORRESPONDENT: Hello, Daryn.
Naturally, you'd want to know some reaction, first of all, from Michael Schiavo, the husband of Terri, and his family. And just before this press conference began -- naturally, we haven't spoken with them just yet -- they told us that they were convinced that this report would indeed prove that there was no abuse of Terri Schiavo, no physical abuse, no trauma, and that would have seem to have been borne out by what the medical examiner has said.
All along, the Schiavo family has said that he did not hurt his wife in any way that would have led to her collapse back in 1990, 15 years ago. That indeed, according to the family, she had heart failure. This, of course, is contrary to what the Schindler family had maintained, allegations that Michael Schiavo had abused his wife.
Again, they medical examiner said quite bluntly, "Did she suffer neglect or abuse?" And he said, "No." And he also indicated that there were no signs of physical trauma at all. Naturally, we will be hearing from -- the Schindler family has told us that they will tell us what they have to say about these findings. It will be interesting to know after all of this time what they have to say, as well as, remember, over the years, we see videotape that they made themselves of them interacting with their daughter.
Now we have learned that Terri Schiavo could not see, that indeed she was blind, which doesn't necessarily mean, according to these doctors, that they couldn't have had some interaction with their daughter in some way. They stopped short of saying that -- Daryn.
KAGAN: Yes. And one thing -- the one thing the autopsy report cannot tell us, and that's the basic premise of the dispute between the Schiavo and Schindler families of what was Terri Schiavo's final wish, to be kept alive or not. Because you also heard in the autopsy report how strong these doctors said this woman's heart was, and basically how hard her body fought to keep going.
CANDIOTTI: It would seem that the original cause of her collapse 15 years ago, if you were expecting an answer from this news conference, you weren't going to get it, and you're not going to get it, as well as a determination as to whether she was in a persistent vegetative state.
We knew from the beginning -- doctors and experts have said consistently that's something that you cannot determine in an autopsy. But you can determine the extent of brain damage, and that's what these doctors talked about.
And you'll remember, over the course of 15 years, Daryn, everyone weighed in on this from the president to the pope. The president saying let's err on the side of life and continue to let her live. But you will recall that Michael Schiavo continued to maintain that it was not in his wife's wishes to live in this kind of condition.
And that is why ultimately -- and the courts bore him out after years of hearing evidence in trials and hearings, and the like, that they agreed with Michael Schiavo that that was his wife's wishes -- Daryn.
KAGAN: Susan Candiotti, live in Largo, Florida. Thank you.
Let's get some more medical insight on this and bring in Dr. Dan Barrow. He is chairman of neurosurgery at Emory University School of Medicine here in Atlanta.
Dr. Barrow, good morning. Thank you for being with us.
DR. DAN BARROW, EMORY UNIVERSITY SCHOOL OF MEDICINE: Good morning. My pleasure.
KAGAN: Were you able to hear what the medical examiners in Florida were saying and listen in on that report?
BARROW: I did hear most of it. I missed the very first part of it, but I think I got the high points.
KAGAN: And for you, what would that be?
BARROW: Well, I think to underscore what has already been said by others, an autopsy, particular of the brain, the human nervous system, the brain and the spinal cord, doesn't make a clinical diagnosis. Many of the issues surrounding this case had to do with her clinical condition, which is not going to be verified by an autopsy. But certainly the evidence from the autopsy at least supports the clinical picture that was presented to the -- to the public.
KAGAN: When Terri Schiavo was still alive, there was this group of five or six doctors that examined her. She was alive, they have access to all her records. And they each came away with a different interpretation. So would you expect anything of that to change, now that there would be an autopsy? That this an interpretative science and it's not black and white?
BARROW: No, I wouldn't expect physicians to change their opinions. Medicine is not a pure science. There is some art to it and it's not uncommon for physicians to look at same problem and come up with slightly different interpretations. I think what the autopsy demonstrated, as you pointed out, was that there was marked atrophy or shrinkage of the brain. And that really serves, I think, as a surrogate for determining the amount of brain damage.
There is not a clear correlation at all between the size of a human brain and its function, certainly, demonstrating the profound atrophy and the diffuse damage to the brain, I think it supports the clinical impression of those who felt that she was in a persistent vegetative state, but it certainly does not prove that.
KAGAN: And, as a neurosurgeon, these issues of life and death and who is alive and who does go on, and what is a functioning brain, this is something that you deal with everybody. Did you learn anything from the Terri Schiavo case or is this just -- was that just a little slice of what your practice is about?
BARROW: Well, fortunately, I don't have to deal with this everyday, but it certainly is common in my profession. And I would point that in the overwhelming majority of cases, this is a much more clear-cut issue. There are clear and unequivocal criteria for determining brain death in this state and every state in the United States, where if -- where patients meet certain clinical criteria, we can ethically, morally and legally pronounce them dead.
It's the patient who doesn't meet those criteria, in whom there is some evidence of brain function, that it becomes an issue. And I think what I have learned from this case and what I think the public should learn is the importance of advance directives, of all of us having some type of durable power of attorney or living will that allows one of our loved ones to make those decisions for us if we're unable to in the future. KAGAN: Very well said. Put it in writing and don't put your family through this kind of torture that they went through. Dan Barrow, chairman of neurosurgery here at Emory University in Atlanta. Thank you, Dr. Barrow.
BARROW: Thank you very much.
KAGAN: We're also giving word that George Felos -- he is the attorney for Michael Schiavo -- he plans to hold a news conference in about two and a half hours -- or actually about three hours. 2:30 p.m. Eastern from Dunedin, Florida. And you'll see that live right here on CNN. And of course, if the Schindler family has anything to say, or their representatives, we'll bring that to you, as well.
Right now a quick break. We're back after this.
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KAGAN: Let's take a look at what's happening "Now in the News."
President Bush pushes his plan for fueling America's future. The president is urging the Senate to pass its energy plan. He wants a bill to sign before the August recess. The legislation has been stalled by disputes over tax breaks, Arctic oil drilling and other issues.
A major earthquake causes a tsunami scare in California. The magnitude seven earthquake struck off the Northern California coast. It triggered a brief tsunami warning, but scientists say the quake's movement was sideways instead of the thrusting movement that caused the tsunami in South Asia.
An Australian contractor who was taken hostage in Iraq is free this morning. Douglas Wood was kidnapped six weeks ago. A U.S. military official says Iraqi forces stumbled on Wood during a security sweep in northwestern Baghdad. He's said to be in good condition. Wood is married to an American and lives in California.
A new search turns up no sign of Natalee Holloway, the Alabama teen missing in Aruba. Police and FBI agents combed a swampy area near the Marriott hotel. A government spokesman says searchers found some woman's underwear, but it's believes the garment belongs to an older woman. The search ended last night.
In Florida, NASA readies the Space Shuttle Discovery for a return to space. The revamped vessel went on a slow crawl to the launchpad. It takes about ten hours to make that trip. Scheduled to launch in July. That would be the first flight since the Space Shuttle Columbia disaster in 2003 that killed seven crew members.
President Bush wants to energize Congress. He's pushing the Senate to approve his energy plan before the August recess.
Elaine Quijano joins us from the White House with more on the president's speech this morning. Elaine, good morning.
ELAINE QUIJANO, CNN CORRESPONDENT: Good morning to you, Daryn.
That's right, President Bush called America's dependence on foreign sources of energy, quote, "a foreign tax on the American dream." And today he called on Congress to pass legislation to reduce that dependence. That essentially was his message today as he went before the annual Energy Efficiency Forum, a gathering of industry officials from the public and private sectors.
Now, the U.S. House has passed a bill and with the Senate now taking up the issue, the president is hammering home that he wants an energy bill on his desk in the coming weeks.
(BEGIN VIDEO CLIP)
GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES: Summer's here, temperatures are rising and tempers will really rise if Congress doesn't pass an energy bill.
The American people know that an energy bill will not change the price of gas immediately. But they're not going to tolerate inaction in Washington as they watch the underlying problems grow worse.
(END VIDEO CLIP)
QUIJANO: The president there acknowledging, as he has done in the past, that higher gas prices are something that Americans and that American businesses are certainly feeling the president acknowledging that people are feeling the pinch from those high prices. But at the same time, they're making clear that the proposals he is behind would not have any immediate impact on those prices. But the president's saying that other factors, like increased global demand, are part of the reason why it is so difficult to bring down those prices.
Meantime, Democrats, for their part, are bringing up their own energy ideas. Specifically, Democratic Senator Maria Cantwell of Washington state talking about a proposal aimed at reducing America's daily oil dependency or oil demand, I should say, by some 7.5 million barrels per day by the year 2025. And today, she talked about her reasons for getting behind that proposal and urged her colleagues to do the same.
(BEGIN VIDEO CLIP)
SEN. MARIA CANTWELL, (D) WASHINGTON: If my colleagues believe in the underlying measures of this bill, and they believe that they can go to the floor and talk about our overdependence on foreign oil, then they ought to be brave enough to set a goal for the American people and say that our country is serious about our overdependence on foreign oil.
(END VIDEO CLIP)
QUIJANO: But the Bush administration has signaled opposition to even more modest reductions in the oil demand. The Bush administration effectively saying that that would require a rapid -- what they call a rapid increase in federal fuel mileage requirements for cars, trucks and other vehicles.
Meantime, President Bush reiterating some of the themes that we've heard him talk about before, including using advanced technology to promote greater conservation. But the overriding message to Congress, get a bill to my desk before August -- Daryn.
KAGAN: Elaine Quijano. Elaine, live at the White House. Thank you.
On Capitol Hill right now, a Senate Judiciary Committee meeting, holding a hearing on the treatment of terrorist detainees being held at Guantanamo Bay. A live picture there for you. The committee's senior Democrat told the committee his opinion.
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SEN. PATRICK LEAHY, (D) JUDICIARY COMMITTEE: The administration says that these detainees post a threat to the safety of Americans. The vice president said that the other day. If that's a true, if they pose a threat to us, then there has to be evidence to support that, or our administration would not tell the world that. If there's evidence, then let's prosecute them; let's bring the evidence forward.
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KAGAN; Meanwhile, Republican Arlen Specter, the committee's chair, says any talk of releasing prisoners should we approached with extreme caution.
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SEN. ARLEN SPECTER (R), COMMITTEE CHAIRMAN: While procedural due process is obviously important, we ought to be as sure as we can what steps are being taken so that we do not detainees from Guantanamo who turn up on battlefields killing Americans. And what's the value of a promise not to bear arms against the United States.
(END VIDEO CLIP)
KAGAN: Much more on this story coming up later today. "INSIDE POLITICS," 3:30 p.m. Eastern, 12:30 p.m. Pacific.
An unwanted side effect of becoming a father. Gaining weight? Next in our "Daily Dose" segment, advice on avoiding the extra pounds for new dads.
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KAGAN: I want to go ahead and recap our top story for you, the autopsy report on Terri Schiavo. The medical examiner in Florida says no amount of treatment would have reversed the massive brain damage that Schiavo suffered following her 1990 collapse.
(BEGIN VIDEO CLIP) THOGMARTIN: Her brain was profoundly atrophied. The brain weighed 615 grams, roughly half of the expected weight of a human brain. This was due to diffused hypoxic ischemic damage. There was massive neuronal loss or damage. This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons.
Of note, there was severe occipital (ph) lobe necrosis (ph). Her vision centers of her brain were dead. Therefore, Mrs. Schiavo had what's called cortical blindness. She was blind, could not see.
(END VIDEO CLIP)
KAGAN: Schiavo died on March 31st, almost two weeks after her feeding tube was removed. She had been at the center of a bitter legal fight between her husband and parents. The medical examiner says the cause of Schiavo's initial collapse remains undetermined and he says there was no evidence of any kind of trauma.
Gaining weight. It is an expected part of pregnancy for mothers- to-be, but some new fathers find their waistlines expanding along with their wives. Senior medical correspondent Dr. Sanjay Gupta looks at sympathy weight gain in today's "Just for Dad" segment.
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DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT (voice-over): Even though it was his wife who gave birth to these twin boys, it was David Feldman's weight that went up and down like a swing.
DAVID FELDMAN, NEW DAD: Before my wife got pregnant, I weighed 190 pounds, then during the pregnancy, peaked about 235. Now I'm down to 209, you know, and I plan to get back down under 200, hopefully, in a month or so.
We ate everything, you know, lots of carbs, lots of pizza, lots of Chinese food, a lot of ice cream, bacon cheeseburgers. One of my biggest cravings was bacon cheeseburgers.
GUPTA: While she grew out in front, he grew a little on the sides. Yes, love handles. Diagnosis: sympathy weight gain.
FELDMAN: She was very queasy, so I kept encouraging her to eat. And while she was eating, while I was encouraging her to eat, I ate with her.
GUPTA: Another common reason for the extra baggage, stress, about providing financially, getting the house ready, and taking on a new daunting role.
PATTY ONDARKO, EDITOR, "BABYTALK" MAGAZINE: It's just something that people don't talk about too often. It's not given that much attention. You know, during pregnancy, all the attention goes to the woman, so no one really is focusing on the man or noticing whether or not he's gaining weight. GUPTA: Putting on the pounds is part of a greater condition known as Couvade Syndrome. That's a French word for "hatching." Studies on Couvade Syndrome show about 90 percent of men experience at least one pregnancy-like symptom, anything from nausea to vomiting, food cravings, and most commonly, yes, weight gain.
There may be more than a psychological explanation behind the syndrome.
HEIDI MURKOFF, AUTHOR: Men actually experience a surge in female hormones during pregnancy and in the postpartum period, and it's not enough to grow breasts or anything, but it's enough so they actually experience many of the same symptoms that women are experiencing.
GUPTA: David's wife, Sloan, actually welcomed the weight gain.
FELDMAN: One of the running jokes we had throughout the pregnancy is that, even with twins, she did not want to weigh more than I did. And throughout the pregnancy, she never did. So she was ecstatic.
GUPTA: David's post-pregnancy diet helped him lose more than half the weight that he gained. Most fathers are better off trying to avoid the added pounds in the first place, by being conscious of their eating habits, encouraging exercise for both mom and dad, and talking openly to their partners about their own anxieties of becoming a father.
FELDMAN: You like that.
GUPTA: No longer worried about the ups and downs of becoming a dad, David can now concentrate on the ups and downs of being a dad.
Dr. Sanjay Gupta, CNN, reporting.
(END VIDEOTAPE)
KAGAN: Your daily dose of health news is always just a click away. Log on to CNN.com/health for the latest medical news. You'll also find special reports and a health library.
In California this morning, a big sigh of relief. A powerful earthquake rattled nerves in the northern part of the state last night. It also -- well, it caused no damage or injury, but the magnitude 7.0 tremor struck some 90 miles off the coast, triggering a tsumani warning. It was lifted about an hour later. One expert explained why the tsunami did not happen.
(BEGIN VIDEO CLIP)
KATE HUTTON, USGS SEISMOLOGIST: It was a strike slip earthquake, which means one side slid horizontally past the other. This is very good because that means it didn't raise or lower the ocean floor. And a tsumani would be very unlikely in a situation.
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KAGAN: And yet, that town, ready to go.
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KAGAN: All right. Looking forward to that. Thank you so much. I'm Daryn Kagan. That's going to do it for me. International news is up next. Stay tuned for "YOUR WORLD TODAY" with Jim Clancy and Zain Verjee, after q a quick break. I'll see you right back here tomorrow morning.
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