Max's Death - Dina's Independent Experts Summary Reports

[i.b.nora]

I was wondering too.

Melinek says it in her report:
"... Suggesting a pattern: configured roughly in a figure "7" as the back is viewed in an upright position. ..."

However, I can find nothing about it being "an exact impression mirroring it to a portion of the railing" etc. More made up 'scientific' stuff, IMO.

Dr. Melinek describes a figure "7" in her report.

 

[time]

Dr. Melinek describes a figure "7" in her report.

I guess she references it more than once, but I still don't see anything validating actually matches the post. And, as I said before, I sure didn't see that shape when the pictures of Max's back were shown.

 

[i.b.nora]

I guess she references it more than once, but I still don't see anything validating actually matches the post. And, as I said before, I sure didn't see that shape when the pictures of Max's back were shown.

I am glad between the two of us we managed to capture all her references to it. I had only seen the previous one that I posted earlier. Plus, it's a drag to have to type out stuff from her report. It looks like it was scanned by an optical reader. And, I didn't see or notice that either but my view of the pictures was very abbreviated.

 

[time]

I am glad between the two of us we managed to capture all her references to it. I had only seen the previous one that I posted earlier. Plus, it's a drag to have to type out stuff from her report. It looks like it was scanned by an optical reader. And, I didn't see or notice that either but my view of the pictures was very abbreviated.

Maybe the show was taped...I'll look tomorrow.

 

[K_Z]

Has it been established with certainty who put together/ authored the "Summary of Reports"?

Angela Hallier?

 

[bourne]

I honestly don't know why Dr. Melinek would do this, she went beyond what they needed to do to get the case reopened. I think Dina is sinking her own boat by claiming this was an assault and a murder. It obviously means more media coverage because it wouldn't be as sensational if they just claimed a major injury on the head had to happen differently than what the original report claimed.

Motive for Dina? I don't know and can only speculate. My first thought is that because of the evidence she should be a suspect in Rebbecca's death. It is not an uncommon strategy to try and preempt efforts of blame by doing your own blaming. The recent headlines do sort of exact empathy for Dina and possibly dislike or hatred toward a woman who is now purported to have killed a child. I believe Dina is also trying to implicitly promote the idea that this is more evidence for why Rebecca would have committed suicide (god knows, something has to counteract the bizarre facts of that in the public's mind) - because she is claiming Rebecca had guilt and was in a situation she couldn't get out of.

This also has provided Dina with national media coverage where she can get away with vague innuendo's about Rebeca's character - saying she was concerned because of a 'feeling' about her, claiming she is a criminal (but not even saying it was for shoplifting), claiming Rebecca didn't give her her real name in this country (whatever that means), and so on. What the public hears is really blown out of proportion in relation to what the truth actually is or might be.

This is a planned media blitz including the announcement of the nonprofit. I think she was unwise to do that because it could be interpreted as just using the media to get donations or as too concerned abut her own image.

I'm off track of the thread theme now, but I do believe there was more motivation in all this than simply getting the SDSD to reexamine the evidence based on the 'science' presented. If you want to base it on good science, you don't start muddying the waters with a lot of other possibly erroneous, nefarious, vague or unsupported and sensational claims.

I agree with everything you've written here. Dina is making a preemptive strike.

 

[time]

Has it been established with certainty who put together/ authored the "Summary of Reports"?

Angela Hallier?

IDK if Hallier or colleagues have claimed that in the media... the "Summary of Reports" itself is not signed/authored.

I was surprised to find out the other day that she is actually a divorce attorney, not a criminal attorney. I also think she and Dina admitted she was Dina's attorney for her divorce. Maybe everyone else already knew this.

 

[time]

I am glad between the two of us we managed to capture all her references to it. I had only seen the previous one that I posted earlier. Plus, it's a drag to have to type out stuff from her report. It looks like it was scanned by an optical reader. And, I didn't see or notice that either but my view of the pictures was very abbreviated.

I found the video with the pics of his back (start at about 6:15 minutes in to the video)

http://www.hlntv.com/video/2012/08/07/death-san-diego-execs-son-foul-play-or-accident

I can see a sort of 7 shape if you include a general area that is just red to one side. I'd have to look again to see if I could make sense of this matching the post - and trying to see what measurements were given.

 

[arielilane]

I hope it's ok that I post this photo. Please remove if need be. The seven mark is seen with the top of the "seven" beginning at the top right side.

Sort of a seven laying on its side.

 

[freespeech]

I don't think I understand how Max got the linear abrasions to his back. None of the explanations really make sense to me at this point. However, that may change with more information. At this point I tend to think his back came into contact with the chandelier during the fall. Was the chandelier ever tested for blood or DNA? That could certainly shed some light on this question.

OT but here is a very informative article on spinal cord injury/contusion with cardiac arrest in children over a year old. The title is 'A critical analysis of outcome for children sustaining cardiac arrest after blunt trauma'. Below is an excerpt. Below that is the link.

"Injury is the leading cause of cardiac arrest in children older than 1 year. Previous findings suggest that children who require cardiopulmonary resuscitation (CPR) administered by paramedics for any reason rarely survive to hospital discharge. The authors evaluated the outcome of children sustaining cardiac arrest after blunt trauma in a Regional Pediatric Trauma Center."

http://www.ncbi.nlm.nih.gov/pubmed/11819195

 

[Mrs. Holmes]

The 7 mark as I have written earlier this week..... could it have come from the Scooter? If it went over the railing with MS it could have landed on his back. The scooter could have been resting against the newel post at the top of the stairs if MS tripped while running he may have reach out to grab the railing but instead got the scooter.. gripping it he would have dragged it over the railing with him.. making the marks on the newel post... the scooter could have gotten caught in the chandelier with MS holding it... causing him to swing out and hit the middle level railing... then the boy, scooter and chandelier crash to the ground in that order... once the chandelier gives way...?

Those marks look like the scooter to me... you can even see what could be the marks from the wheels.. at the top of the seven...?

 

[time]

The 7 mark as I have written earlier this week..... could it have come from the Scooter? If it went over the railing with MS it could have landed on his back. The scooter could have been resting against the newel post at the top of the stairs if MS tripped while running he may have reach out to grab the railing but instead got the scooter.. gripping it he would have dragged it over the railing with him.. making the marks on the newel post... the scooter could have gotten caught in the chandelier with MS holding it... causing him to swing out and hit the middle level railing... then the boy, scooter and chandelier crash to the ground in that order... once the chandelier gives way...?

Those marks look like the scooter to me... you can even see what could be the marks from the wheels.. at the top of the seven...?

I think the scooter making the mark could be entirely possible if the dimensions match. I'm looking at our scooter here and it does have about the same angle, e.g., they do not open to a 90 degree angle but a slanted angle.

I am not sure how the post/railing could make that slanted angle?

 

[freespeech]

The 7 mark as I have written earlier this week..... could it have come from the Scooter? If it went over the railing with MS it could have landed on his back. The scooter could have been resting against the newel post at the top of the stairs if MS tripped while running he may have reach out to grab the railing but instead got the scooter.. gripping it he would have dragged it over the railing with him.. making the marks on the newel post... the scooter could have gotten caught in the chandelier with MS holding it... causing him to swing out and hit the middle level railing... then the boy, scooter and chandelier crash to the ground in that order... once the chandelier gives way...?

Those marks look like the scooter to me... you can even see what could be the marks from the wheels.. at the top of the seven...?

Thank you Mrs. Holmes for your analysis. It makes sense. Your scenario is the first that I've read that I can actually visualize happening.

Your scenario would explain the marks to the back and also the newel post. I also believe that Max and the scooter together could bring down the chandelier.

This seems to have been a tragically freak accident and certainly every parent's nightmare. I don't know how preventable something this freakish would be. Unfortunately accidents are the number one cause of childhood mortality in this country. . .

 

[K_Z]

As part of her review of Max Shacknai's death, Dr. Melinek was provided with what appears to be Max's entire medical records, including his outpatient pediatric visits (which she quoted). So, I am assuming she spent a considerable amount of time reviewing Max's medical records, particularly the records that begin with the paramedics arriving at the scene of the accident, the enroute care Max received on the way to the Coronado hospital, care at the Coronado hospital, transfer to Rady Children's, and continuing until Max's death.

That is a considerable amount of information, with many different levels of providers documenting care and assessments, as well as all of the diagnostic procedures and results, and opinions about prognosis. I think it is very noteworthy that Dr. Melinek made no comments at all about any aspect of Max's care-- noteworthy in a very good way. Dr. Melinek had no criticism of any aspect of the care Max received, nor any of the documentation. Perhaps it is a leap of logic, but to me, that indicates that she believes Max received the highest level of care that was possible, given his injuries, and the excellent resources available at Rady Children's Hospital.

I have said before that I have absolutely no doubt that Max received superb care from a very professional, experienced, and dedicated group of professionals-- and that includes everyone from the paramedics, to the Rady doctors and nurses and staff who cared for Max. Any time a child is injured this gravely, it is a tremendously emotional experience for medical providers, also, who truly want nothing more than to be able to fix the injuries and return a small child to the energetic, vivacious child they were before the injuries. Health care providers are deeply saddened, too, for the loss of a beautiful child's life, and sometimes angry for what has been lost. Parents look to them for all of the answers. They cling to their every word that could possibly indicate hope for their child, even when the overwhelming circumstances lead ever closer to the inevitable outcome of the child's death. In their anger and grief, it isn't uncommon to search for blame, particularly in the cases of accident and trauma. "How could this happen" is probably the most common question every parent asks over and over.

I don't believe any provider ever held out real hope to Dina or Jonah that Max could survive, from nearly the moment he was admitted. I don't believe anyone persuaded them Max had a condition where he would fully recover, and return to his typical activities in a few months. I believe Dina and Jonah had many, many conversations with the staff at Rady, as Max lay dying.

Sharing a devastating prognosis with the parents of a previously healthy child is difficult, under any circumstances. The time when the extent of the injuries is being determined is excruciating for parents, as each piece of information that comes to them is less hopeful. Conversations about beginning the process of establishing brain death are painful to the core, and further add to the realization that the outlook is so grim, that any real hope of any level of recovery is pretty much gone. I'm confident all of this is well documented in Max's medical records.

In cases like Max's, this isn't a situation where a doc comes by once or twice a day for a 30 second conversation, and the rest of the time the parent is left to sit there while nurses provide care-- quite the opposite. Intensivists (like Brad Peterson and his excellent colleagues) are working, visible, and personally available in the unit 24/7-- that's what an intensivist does. They are available on a minute to minute basis right in the ICU, coordinating care, ordering tests and meds, doing procedures, consulting with other specialists, and that also includes ongoing, nearly continuous communication with parents and family members. When parents are present, staff are constantly asking if they need anything, do they have questions, can something be explained. Many parents are in nearly constant communication with caregivers-- asking about equipment, what does "this" mean, how does it work, what does it do, and most importantly, questions about whether or not their child is showing signs of improvement.

Which makes it all the more puzzling that Dr. Melinek chose to overlook any documented comments about Max potentially being anything but a victim of a tragic accident. In fact, her comment about the original autopsy is that she AGREES with the cause of death documented by the ME, Lucas. She quantifies this agreement in the same paragraph that she addresses the presumptive positive benzodiazepine result (attributed to versed at the first hospital, and not a factor in Max's death). She goes on to say in the same paragraph that it would have required intact upper cervical cord neurons to articulate the word "Ocean"-- and Max's upper cervical cord neurons were not intact. She stops short of clearly stating that this injury also would produce cardiac arrest, which Dr. Lucus did state in his report-- although she clearly states she agrees with Lucas' cause of death.

Why did she not state that cardiac arrest would be attributed to this upper cervical cord injury? Because that would counter the negative comments about Rebecca not performing CPR well enough, or that somehow Rebecca delayed initiating CPR. Hmmm.

So after what I hope was an exhaustive study of ALL of Max's diagnostic studies and hospital course, she agrees that the original cause of death was accurate. And to review, that was documented as a massive skull fracture, a spinal cord contusion that lead to a cardiac arrest, a prolonged cardiac arrest, eventual heart resuscitation by paramedics, and subsequent global hypoxic encephalopathy. So that is why I think it is very interesting to look at a few very pertinent things that Dr. Melinek did NOT say in her report to Dina Shacknai.

What Dr. Melinek did NOT say is:

1. That Max suffered injuries that could have been recoverable.

2. That ANY level of care, from Rebecca finding Max, through the paramedics care, the Coronado hospital care, and the Rady Children's Hospital care, would have saved Max. I think that this effectively puts to rest any speculation that somehow Rebecca's efforts would have saved Max "if only" she had done them differently, better, faster, or more skillfully. Because if Dr. Melinek had valid criticism about Rebecca's efforts impeding Max's ability to recover, I have every confidence she would have documented that extensively and critically in her report.

3. Dr. Melinek makes no comments at all about the remarks of Dr. Brad Peterson. None. She neither states she agrees with whatever he said or documented, nor does she disagree with anything said or documented by Dr. Peterson. And over and over, Dr. Peterson is the one who has been named as initially stating concerns about how Max's accident occurred.

Now, that is VERY curious. Because Dr. Melinek has concluded that Max was assaulted. Further, she has concluded that a specific person was heavily involved in this speculative assault. Many reports now state that she collaborated and directed Dr. Bove to conduct an analysis that not only seeks to disprove Dr. Gomez' analysis of the fall, but further seeks to attempt to explain that an assault "could have" occurred.

Dr. Bove refuses to speculate as to whether this speculative assault could have been intentional. I think that was very ethical on his part-- he stands his ground as to making accusations against ANY person in particular, or making speculative accusations about intent. That is huge, imo.

Getting back to Dr. Peterson's speculation, we first learned of his concerns when the search warrants were unsealed back in September 23, 2011. This was right after Jonah asked the California AG to review the SDSO's findings. As we know, the AG declined (which was not unexpected, from comments in the media).

http://www.10news.com/news/29268087/detail.html

Among the information presented is a potential factor in the death of Max Shacknai suggested by Dr. Brad Peterson, the head of the Intensive Care Unit at Rady Children's Hospital, that hadn't been made public previously.
Det. Thomas Atkins of the Coronado Police Department wrote, "... Dr. Peterson did not feel the visible injuries were consistent with the cardiac arrest and brain swelling experienced by Shacknai. Dr. Peterson expressed concerns made based on the -- the above factors, suffocation may have occurred prior to Shacknai’s fall."

Peterson's conclusion was a possibility given the young man’s outward appearance and was consistent with the medical examiner's findings.

When reviewing the autopsy report, the medical examiner's findings explained why Peterson thought suffocation was the cause of death. The autopsy said: "A spinal cord injury at this level can cause cardio-respiratory arrest (cessation of heart activity and/or breathing)," which would explain the suffocation theory suggested by Peterson.

Now, what WE do not know is when and how Dr. Peterson first communicated this to Dina and Jonah, and documented this in Max's records. But, Dr. Melinek DOES know, since she performed an exhaustive review of Max's records. We also know that this was an opinion Dr. Peterson documented in Max's medical records as part of the rationale for forwarding Max's case to social services. A social services referral in the case of an unwitnessed accident that leads to grave injury, and death, is a mandatory report by hospital, and is a separate issue from his suspicions of suffocation. We don't know when Dr. Peterson and his colleagues referred Max's case to social services, but Dina has indicated that this occurred very early on in Max's admission at Rady. I think it is also extremely likely that Dr. Peterson's comments and suspicions about suffocation occurred within minutes or hours of Max's admission-- not several days after admission. In fact, I think it is highly likely that Dr. Peterson's suffocation comments to Dina and Jonah, and whatever documentation exists to support his conversation/s, occurred in this same time frame-- minutes to hours after admission, before the extensive diagnostic studies had been completed. And before the extent of the high spinal cord contusion was known. Spinal cord injuries evolve over time, with both a primary and secondary injury pattern. I have asked both a radiologist and a neurologist who specializes in head and spinal cord injuries to comment on the earliest time that a high spinal cord contusion like Max's would be evident on diagnostic studies, and when I receive their answers, I will post here.

But getting back to Dr. Melinek's complete omission of any comments about Dr. Peterson's suspicions, I think that this is because there is nothing that Dr. Peterson's comments would bring to benefit the assault scenario put forth by Dina and Dr. Melinek. Dr. Peterson would definitely be named as a witness in any civil or criminal trial that might occur after reinvestigation of EITHER Max's OR Rebecca's deaths. Dr. Peterson is on the record with, at a minimum, a police interview about his suspicions of suffocation. (Comments from Det. Thomas Atkins of Coronado PD.)

Dr. Peterson is on record with 2 items that would be highly interesting:

1. He believed Max's injuries were not "consistent with the cardiac arrest and brain swelling".
2. "Dr. Peterson expressed concerns made based on -- the above factors, suffocation may have occurred prior to Shacknai's fall".

http://www.10news.com/news/29268087/detail.html

And deposition of Dr. Peterson, by either side, will focus on those 2 issues. And that is very problematic for supporters of having either Max or Rebecca's death reopened. His testimony would be damaging to either side.

Dr. Melinek did not look to Dr. Peterson's comments in Max's records to lend support to her scenario, because I believe that what she discovered is that the evidence documented in Max's hospitalization AFTER those comments were made, combined with the evidence at autopsy, demonstrate that suffocation was clearly NOT the cause of Max's death-- either accidental suffocation, OR suffocation by another person. For whatever reason, professional camaraderie or otherwise, Dr. Melinek was very reluctant, imo, to criticize Dr. Peterson's comments, which have been widely quoted and circulated in the media. Now, Dr. Melinek COULD HAVE criticized his interpretation of suffocation, and cut him slack because it was too early in the clinical picture to be making that kind of determination when the child had suffered an out-of hospital arrest in excess of 30 min. She could have focused on how Dr. Peterson (and any others who expressed this) were correct to refer the case to social services, because the evidence indicated the situation was more complicated than an accidental fall. But she didn't do that, either. Curiously. She ignores Dr. Peterson all together. Could that be because Dr. Peterson's comments would ultimately not be able to support the assault scenario? I think so.

Dr. Peterson's comments, ignored by Dr. Melinek, are problematic because he can very likely be shown by other experts to have made an error in speculating about suffocation, as well as the very real concern that his comments could have been the the motive for murdering Rebecca. That's why, IMO, Dr. Peterson has been silent in support of Dina's petition to reopen the case. That's why Dr. Melinek could not use his concerns and police interview to her advantage and support in her written report. Certainly attorneys for the hospital have urged him to remain out of the media, which he has done. It is virtually a certainty that he would be called as a witness in any litigation or criminal charges, for EITHER Max or Rebecca's deaths.

The suffocation theory has been largely put to rest by Dr. Melinek agreeing with Dr. Lucas, the ME, as to cause of death, based on review of the medical records. What Dr. Melinek has stated is she disagrees with the MANNER of death. She doesn't believe in the suffocation theory-- she has advanced a NEW theory that someone caused Max to go over the railing, and that this represents homicide-- "death at the hands of another." She stops JUST short of overtly accusing Rebecca of homicide in HER report, but instead states "support Rebecca Zahau's direct involvement." Who exactly is she accusing of the assault, then? I think anyone familiar with the case can figure that out-- she is not accusing Rebecca of assaulting Max, but holding her responsible for the actions of some OTHER unnamed person. It is only in the SUMMARY OF REPORTS, which is unsigned, and quotes both Dr. Melinek and Dr. Bove in the 3rd person, that Rebecca is named 12 times. Twelve times in the last 2 pages of narrative of the Summary. Six times by name, and 6 times by pronoun. Twelve times-- and Rebecca is dead, so going "after" Rebecca solves nothing.

So WHO exactly authored the Summary of Reports, and why? This document was released FIRST, in advance of the 2 actual reports from Bove and Melinek. Widely circulated, with focus on the accusations against Rebecca. Released by the Martz PR agency retained by Dina (the same agency that represents her publicity for the nonprofit she started)-- which initially stated that media could only receive the original reports and photographs by contacting them.

So WHO exactly authored the Summary of Reports? The PR aqency? Angela Hallier, Dina's attorney? Dina? Dr. Melinek or Dr. Bove?-- that's unlikely. This document should be completely discredited by any LE or media agency. None of us need a "Summary" of reports that are brief in length, that attempts to say something the original reports did not say-- by saying it multiple times. Page 11 of the summary repeats the same statement 3 time in a row in the outline format. The Summary of Reports goes far beyond what either Dr. Bove or Dr. Melinek stated in their reports. The summary would not be admitted as evidence in any legal proceeding-- yet it is the summary, written anonymously, that was shopped around FIRST.

I do hope Max's investigation is reopened, in parallel with reopening Rebecca's investigation. The 2 deaths are forever intertwined, and one cannot be examined without looking at the entire situation of both deaths. I hope they will be reopened, but I am very doubtful that either one will be.

Thanks to anyone who read this all the way through!

 

[time]

K_Z ... thank you for taking the time and effort to post.

I think it's strange to say the least that the "Summary of Reports' has no stated author and that the actual reports were withheld. For myself, I was surprised when I saw both reports. It also seems that some of what was contained in Dr. Bove's report was hidden in the "Summary of Reports" and int he media appearances.

 

[time]

Reposting htis here from Trisha's Radio show with Rudoy as a guest

Interesting, Zahau's attorneys had a report on Center of Gravity six months ago (Max?) but it doesn't agree with Dr. Bove's report?

 

[*Lash*]

KZ - Thank you so much for your detailed research. I agree Dr. Melinek leaving out Dr. Peterson's thoughts and reporting is very interesting.

 

[Jessica2012]

It is my understanding that the medical information which may prove Maxie did not die the way Rebecca said he did belongs in court, not in a request to re open the investigation. In the present request, they would concentrate on the discrepencies in the original investigation. After they obtain permission for a reinvestigation, if it is proven that the manner of death was not as concluded, then they would move to reclassify the death as homicide. It is during this time that medical experts would testify on what they believe caused Maxie's death. I also think the information made public is very limited. All my opinion.

 

[katydid23]

The 7 mark as I have written earlier this week..... could it have come from the Scooter? If it went over the railing with MS it could have landed on his back. The scooter could have been resting against the newel post at the top of the stairs if MS tripped while running he may have reach out to grab the railing but instead got the scooter.. gripping it he would have dragged it over the railing with him.. making the marks on the newel post... the scooter could have gotten caught in the chandelier with MS holding it... causing him to swing out and hit the middle level railing... then the boy, scooter and chandelier crash to the ground in that order... once the chandelier gives way...?

Those marks look like the scooter to me... you can even see what could be the marks from the wheels.. at the top of the seven...?

I agree that the marks on his back look like they came from the scooter. But I disagree that a falling boy could 'drag' a scooter over the balcony rail with him. Scooters are very bottom heavy.

Imo, it was thrown or dropped over the railing after the boy fall. Maybe as a staging ploy. Or perhaps in anger.

 

[time]

It is my understanding that the medical information (and there is ALOT) which proves Maxie did not die the way Rebecca said he did belongs in court, not in a request to re open the investigation. In the present request, they would concentrate on the discrepencies in the original investigation. After they obtain permission for a reinvestigation, if it is proven that the manner of death was not as concluded, then they would move to reclassify the death as homicide. It is during this time that medical experts would testify on what caused Maxie's death. I also think the information made public is very limited. All my opinion.

What medical information is that? You are stating it as if it is a fact.