Monday, March 28, 2005

CodeBlue CT Scan Thread - Excerpts

[Originally posted on CodeBlueBlogs]

For any visitors linking from mine or other Schiavo posts in defense of Terri's cognitive abilities or potential: the point is, this CT scan may not even be hers at all. (!) Dr. Martin finds at least two reasons for that conclusion. And if it is hers, CodeBlueMD finds reasons to doubt her diagnosis was accurate. I'm not a doctor ;) so I'm not voting - others will have to build a consensus - but I think it's time to consider the possibilities here...

Posted by: RD | March 24, 2005 08:48 PM

RD, I have major issues with the validity of the CT too.

Posted by: | March 24, 2005 08:55 PM

Yeah, WTF? What the heck is that thing on the CT? There's nothing in Terri's published medical record to indicate she ever had a shunt. Are we looking at falsified evidence?

Posted by: | March 24, 2005 09:22 PM
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So, here's the question:

Is the spot in the CT scan a shunt, or is it her implant? What do the doctors think? It is either one or the other. Is there a way to tell, or any identifying characteristics separating one from the other?

Also: It stands to reason that (1) if her type of implant does show up on a scan, they would attempt to find a patient with a "similar splotch" on the CT; or (2) if not, then they simply screwed up.

I'd like us to be right on this so that we aren't called "idiots" for "overlooking" her current implant.

Posted by: RD | March 25, 2005 02:34 PM

I was specifically addressing the following point from an earlier provocateur:

I hope someone here has posted that this isn't a SHUNT it's a thalamic stimulator implant. Which, incidentally, would have required surgery, which would have caused damage to Terri's skull. ... So, basically half this article is specious (and incorrect).

Is there a firm opinion on this before I go to press w/it?

Posted by: RD | March 25, 2005 02:51 PM

RD, if you look at CodeBlue's responses above, he feels it's a shunt, but cannot confirm from the one slice. If it is her implant, it's in the wrong place.

Posted by: | March 25, 2005 03:06 PM
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Look, first of all, there is no "scanning mistake" -- the scan is in radiological convention (left on right and right on left) as it is supposed to be. Second, the brain shown in this CT -- if it is, indeed, Schiavo's -- is very, very atrophied. There are almost no parietal lobes, very little frontal matter, nothing to speak of in the temporal lobes -- almost no cortex at all. Anyone looking at that scan and saying that it's "not that bad" hasn't seen a normal CT scan.

Posted by: Anna | March 25, 2005 05:41 PM

Anna, there is no confirmation that this is Schiavo's CT.
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Thanks for the thumbs-up on the shunt - I'm going w/it. Back to the subject of medical records fraud for a minute: If we assume this brain scan is not Terri's, that means either:

1. Terri had a CT scan performed, but someone else's records were substituted for hers (a switcheroo)
2. Terri never had a scan performed. The medical data just materialized on its own. (a phantom)

IMO it raises the following questions:
1. Was Terri taken out of & back to her care facility at the time the scan was allegedly performed? Or was there no 'trip'?
2. Were there any witnesses who saw Terri going to or from the lab?
3. Does the radiologist or operator remember Terri?
4. Do they remember what they saw on the scans? (long shot) Do they remember the circumstances surrounding her trip?
5. Were any copies sent to archival storage for safekeeping? Might those records be available to criminal investigators at some point?

6. Was Michael Schiavo far enough along in his nursing career by 1996 that he could manipulate the provenance (chain of evidence) of those scans?
7. Was Michael far enough along in his career that he could have had access to medical documents of other patients, or even had his pick of available substitutes?
8. Was Michael sufficiently well-connected by 1997 (the time they filed the death suit) to have others do the searching for him?
9. If there were duplicates made, were they purged or returned to Mr. Schiavo? Did Michael ask for them back? What was the argument used at the time? What was the outcome?

On incrimination: Realize that if no one was actively looking at Mr. Schiavo, it's possible he might have thought he could get away with it in the knowledge that no one would ever [be permitted by Judge Greer to] look at them.

Is there anyone in law enforcement or other relevant fields thinking along the same lines? Maybe there are ways to find independent corroborating information on the brain scan question. Either way it would clear up some questions - Thanks

Posted by: RD | March 25, 2005 07:51 PM


Posted by: | March 25, 2005 05:46 PM

Anna, we weren't discussing a "scanning mistake", we were discussing the nature of the artifact on the slice.

Posted by: | March 25, 2005 05:59 PM
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Any possibility that the scan picture isn't "Terri's"? Any reason to believe the Miami ethics site has the wrong scan? Just checking... 'cause that'll be the question from the other side. :)

Posted by: RD | March 26, 2005 06:58 AM
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I'm working on a post on that will be going on my site in the next 2-3 hours (or as soon as I can finish it). I'm going to need everyone's help to check the document and offer whatever suggestions are needed. But I think you're gonna like it. Back in a little while...

Posted by: RD | March 26, 2005 05:38 PM
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Finally done! Sorry for the delay. I have a post up on the site (LFT) arguing the thread's contention that "Exhibit A" - our scan - is a hoax. I'll need some help fixing any issues w/accuracy (or blurring the precision sufficiently ;) Also have an article on medical records fraud up on Schiavogate that also hints to why he may have picked Exhibit A instead of something less incriminating.

Next: There's a truly DEVASTATING indictment of the chain of evidence in the works. It should close all looopholes. I'd like to post it somewhere and have us be able to look at it (not a blog comment IOW). Any place on your site - or a free web host - you'd like me to put it? If not I'll find a place somewhere & post the link.

Thanks
RD

P.S. If there's something in the post that's patently absurd, let me know. It's not 100% logically consistent but that was kinda on purpose. The text file's got it whittled down to just the meat...

http://liberalsforterri.blogspot.com
http://schiavogate.blogspot.com

Posted by: RD | March 27, 2005 03:50 PM

RD, a good point of investigation would be to find out how the medical records were treated in the chain of evidence in this particular case. After the CT (did a radiologist read the CT? Is there a report available?)left the Imaging facility, how was it delivered to the court? Did the neurologists have access to the entire scan or just selected parts of it? Her medical records have been sealed by Judge Greer but (I assume) within those records there would have been a chain of events as the patient would have been moved to an Imaging facility, records as to the patients presence at the Imaging facility, who performed the scan, etc. Also, does the Imaging facility who performed the scan keep copies of such things?

Posted by: | March 27, 2005 04:41 PM

This is a crazy tin-foil thought.....but.....since Felos and Schiavo had control over at the Hospice, what would stop them from transporting a different patient to the Imaging facility but provide ID, at the facility, that it was Terri? I mean, I doubt that Terri has a recent picture ID or that a picture ID would be required for patient ID to perform the scan.

Posted by: | March 27, 2005 04:53 PM

Oh crud, more tin-foil thoughts.....maybe that's why Schiavo is adamant regarding immediate cremation with no autopsy. One look at Terri's brain could identify this CT as fraudulent.

Posted by: | March 27, 2005 04:57 PM

The portion of Dr. Cranford's report to the court dealing with CT scans, MRIs and EEGs:

Terri was in a coma for approximately one month, and then evolved into a vegetative state. Four board-certified neurologists in Florida consulting on her care (James H. Barnhill, Garcia J. Desousa, Thomas H. Harrison, and Jeffrey M. Karp) had repeatedly made a diagnosis of PVS over the years. The initial CT scan on the day of admission, February 25, 1990, was normal but further CT scans documented a progression of widespread cerebral hemisphere atrophy, eventually resulting in CT scans of 1996 and 2002 showing extreme atrophy (CT scans-1996, 2002: “diffuse encephalomalacia and infarction consistent with anoxia, hydrocephalus ex vacuo, neural stimulator present); prior to these most recent two CT scans, CT scans had been performed on February 25, 1990, February 27, 1990, and March 30, 1990, with an MRI scan on July 24, 1990.The two most recent EEG’s have demonstrated no electrical activity-on July 8, 2002: “no evidence of cerebral activity;” and October 4, 2002-“does not have any definite brain activity. However, most of the tracing is obscured by artifact from muscle and eye movement.” The clinical exams over the years were entirely consistent with diagnosis of permanent vegetative state secondary to hypoxic-ischemic encephalopathy. From the initial hospitalization in February, 1990, until the present time, there have been no significant changes in Terri’s neurological findings, and nothing in the medical records to suggest any disagreement whatsoever among Terri’s attending and consulting physicians about the underlying diagnosis and prognosis for recovery.

Posted by: neloho | March 27, 2005 09:48 PM

neloho, don't know if you figured this out but a few of us here don't put a lot of credence into what Cranford says as he is a euthanasia activist.

Posted by: | March 27, 2005 10:16 PM
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I just wanted to counter the often repeated, yet totally incorrect claim that no EEG had been done for over 10 years.

As the report from 2003 reports:

The two most recent EEG’s have demonstrated no electrical activity-on July 8, 2002: “no evidence of cerebral activity;” and October 4, 2002-“does not have any definite brain activity.

Posted by: neloho | March 27, 2005 10:42 PM

I've said all along that something is certain to be fishy about Shaivo. He seems adament alright. Too soon after the 'execution' process started by Greer and the so-called husband team, did he want to start talking about cremating poor Terri. He looks, acts, talks, and jestures like a man who had just gotten away with the murder plot of his wife. God have mercy! What would Ben Franklin say about his discovery of electricity not being put to the good use of human life sanctity? What would he and others from our history pages have to say about all this uproar? There is a final judge and He is Christ Jesus. Then what? I'd hate to see His courtroom filled with all the people in our judicial system who's fought against Terri's parents, with Terri's relatives and her two-bit husband in the same room with all these earthly judges who helped with this murderous plot. I rest my case!

Posted by: Betty J Taylor | March 27, 2005 11:01 PM

neloho, does that really matter? She should have had one done last week or last month.

Posted by: | March 27, 2005 11:05 PM

Posted by: | March 27, 2005 11:18 PM

There may have been more recent EEGs. The report I quoted is from back in 2003.

Posted by: neloho | March 28, 2005 12:24 AM

neloho,

"March 9, 2005… Judge Greer denies Schindlers' motion requesting new tests"

Why would they put in a new motion for tests if tests were being done?

Posted by: | March 28, 2005 12:34 AM

They were requesting additional tests as a delaying tactic. I suspect that had the motion been granted, they would have continued to request additional tests year after year after year.

Posted by: neloho | March 28, 2005 12:44 AM

neloho,

"They were requesting additional tests as a delaying tactic. I suspect that had the motion been granted, they would have continued to request additional tests year after year after year."

There has been no tests SUBMITTED INTO EVIDENCE since 2002 and you say that the motion is a "delaying tactic". You are a heartless, cruel, injust b*****d. I can tell that there will be no protesting when it's time to pull your plug.

Posted by: | March 28, 2005 12:54 AM

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In Cranfords diagnosis:

"diffuse encephalomalacia and infarction consistent with anoxia, hydrocephalus ex vacuo, neural stimulator present"

If you had "hydrocephalus ex vacuo" you wouldn't need a shunt because it would be NPH, right? Can you fluctuate between NPH and increased intracranial pressure? I guess these questions are for the docs because there is nothing in anyones notes about a shunt. If her "stimulator artifact" were in the wrong place, wouldn't that be noted on the neurolgist review of the scan or in the radiologists notes? If she does have a shunt doesn't she have to be tested for increased intracanial pressure? Because certainly, at one time, she had pressure or there wouldn't be a shunt. How can you tell if someone is NPH all the time unless you do testing? Otherwise, isn't it negligent?

Posted by: | March 28, 2005 03:35 AM

In Cranfords diagnosis:

"diffuse encephalomalacia and infarction consistent with anoxia, hydrocephalus ex vacuo, neural stimulator present"

Also, Cranfords diagnosis is wrong off the bat because she never was diagnosed as having a MI. Read the Humana discharge summary and Dr. Peter Bambakidis testimony.

Posted by: | March 28, 2005 03:47 AM

Dang, Cranfords diagnosis may just contain a litany of neglect to this patient. Infarct? Where's the infarct? When did this happen? How was she treated? It didn't happen at Humana, so when did it occur? How and where was the patient treated? Hydocephalus? Why no treatment? Shunt? Why? When? How? For what purpose? What was the patients after care in regards to the shunt? Is it NPH or no? He's supposed to be a neurologist but no mention that the "stimulator artifact" is floating somewhere it shouldn't be? Why not? It's an odd enough finding to put in your notes in any case.

Posted by: | March 28, 2005 04:35 AM

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