I wanted to review the EMS timeline from their pre-hospital report, because it may put to rest some speculation about the scene being "staged". Particularly if we add in some thoughts about how hearts in cardiac arrest (specifically, asystole) respond to ACLS efforts after time has passed. Asystole is typically not so much a rhythm to be treated, but more often a confirmation of death, unless the asystole was witnessed and secondary to a treatable underlying cause. Electrical defibrillation is not indicated in asystole.
Asystole - Wikipedia, the free encyclopedia
From the Pre-Hospital Care Report:
10:12 911 called and EMS dispatched
10:16 EMS arrived on scene at mansion
10:18 EMS began CPR and ACLS interventions
10:30 EMS leaves the scene **CPR/ ACLS in progress (we know this because....
10:36 EMS arrives at destination (Sharp Coronado hospital) **EMT states compressions suspended due to ROSC and NSR in the ED-- so we know Max did not regain a pulse or rhythm at the scene or enroute.
Having reviewed that, I strongly believe we can assume that at 10:12 when 911 was called, it is very likely Max was already in cardiac arrest. Despite the comment about "initial dispatch was for SOB due to a fall", we know for certain Max was in aystole at 10:18 when EMT's put him on the monitor and confirmed it.
So, from 10:12 to ROSC in the ED at Sharp Coronado at 10:36 is 24 minutes of asystole. (18 minutes if we use 10:18 as the confirmation of aystole.)
Although we cannot confirm how long Max was down before 911 was called, I believe that this amount of time would be extremely short. Far too short, for example, to "stage" the scene, lower or crash a chandelier, etc. Because if Max had been asystolic for much longer than the 18 or 24 minutes (and I lean more toward 24+ minutes), I don't believe that any amount of ACLS would have been able to restart his heart in these circumstances. Cardiac resuscitations for aysytole are very rarely successful beyond 24+ minutes, except in cases such as drownings and hypothermia.
IMO, the evidence that we have strongly supports that Max had cardiac arrest secondary to the head trauma (as opposed to a deteriorating cardiac rhythm that becomes aystolic from hypoxia, which is a completely different electrical process in the heart.)
I don't think he could have been assaulted in any manner that would leave him in cardiac arrest, and then add time for the scene to be "staged", and then his heart be able to still respond to ACLS with ROSC, after
ANOTHER 18 to 24 min of asystole.
What I'm saying is that the evidence, IMO, and knowledge of the physiology of cardiac arrest makes it very likely that the 911 call was made VERY promptly after discovering Max. If much more time had passed, I sincerely doubt that paramedics could have been able to get his heart restarted. I hope that makes sense.
Added: I think it's possible that the dispatch indication of "sob due to a fall" would be clearer if we were able to hear the entire 911 call. The minor sounded very scared and upset on the snippet of call we heard on the Dr. Phil show-- we didn't hear the beginning of the call, so we don't know exactly how it was phrased. It's also possible that Rebecca DID initiate the call, and handed the phone off to her minor sister-- we just don't know without hearing the whole call.
I hope that the 911 call will eventually be released in its entirety, particularly if the authorities continue to decline to reopen the cases. 911 calls should be available under FOIA, IIRC, with some personal info redacted, etc. Perhaps one of the major news agencies will petition for release of the 911 call.
