NORTH KOREA - Otto Warmbier, 22, UV student, released from North Korea, June 2017, Deceased

[gitana1]

But, to be fair, we don't know how he acquired that damage to his brain. Some prisoners died in Gitmo too, while in US custody.

I think reasonable inferences can be made here. And while we have certainly committed atrocities against people suspected of terror, I think the only way one can equate us with North Korea is if he or she knows little about that monstrous nation.

Our country has failed at times and will continue to fail but we have a philosophy against human rights abuses, we strive to do better and we prosecute those accused f such abuses. We don't give them medals.

North Korea is easily the scariest nation on earth at the moment. It is a combination of the worst of Nazi Germany, Stalinist USSR, Caligula's Rome, and Huxley's Brave New World. It's a nightmarish hell hole.

And no one can tell me with a straight face that he intentionally committed
an act of treason, or and act of terrorn, or anything close. He was a young man in the wrong place at the wrong time.

 

[jjenny]

Note the feeding tube taped to his face. I wonder when the last time was he ate actual food. I don't know why, but that tube is becoming the symbol of what I hate about this whole situation, as well as the NoKo government.

He couldn't it or swallow in the PVS condition that he was in. That was the whole deal with Terry Schiavo. Feeding tube is considered life support. If she could eat food on her own she wouldn't have been considered on life support so her food couldn't have been discontinued. But she couldn't eat on her own.
If you try to feed a patient in PVS food they will not be able to swallow and choke to death.

 

[BetteDavisEyes]

Jun 20 2017, 9:11 am ET

What Killed Otto Warmbier? Maybe an Infection or Blood Clot

by Maggie Fox

Pneumonia, a blood clot, kidney failure or sepsis could have killed Otto Warmbier, but he almost certainly never had a chance of recovering, neurologists said Monday.

Warmbier’s family said he died Monday afternoon, just days after he was returned unconscious and unresponsive from North Korea.

North Korean officials said he had been in a coma for more than a year — right after he was sentenced to 15 years of hard labor in prison for allegedly having taken a propaganda poster off a wall. North Korean authorities said the strapping, 21-year-old college student had taken a sleeping pill after he fought a bout of botulism...

http://www.nbcnews.com/health/healt...armbier-maybe-infection-or-blood-clot-n774421

 

[Elainera]

We only heard from the Koreans that he had been in a coma since March last year. Is it possible that this is not true? Could the injury to his brain have been much more recent and that's why he had no bed sores and other complications from long immobility? If the injury happened recently that might be the reason why NK let him go, because they didn't want to have a prisoner who required medical care 24/7.

 

[JanetElaine]

We only heard from the Koreans that he had been in a coma since March last year. Is it possible that this is not true? Could the injury to his brain have been much more recent and that's why he had no bed sores and other complications from long immobility? If the injury happened recently that might be the reason why NK let him go, because they didn't want to have a prisoner who required medical care 24/7.

This went through my head as well, when K_Z described the care that would have been needed for him to be in this condition. I just don't see NK doing that.

 

[BetteDavisEyes]

Coroner probing death of student freed from N. Korea

Dan Sewell, Associated Press 9:40 a.m. ET June 20, 2017

Cincinnati — A coroner’s office in Ohio is investigating the death of a 22-year-old college student who died less than a week after his return to the U.S. after nearly a year and a half in North Korean detention, a spokesman said Tuesday.

The spokesman for Hamilton County Coroner Dr. Lakshmi Sammaraco said the office “accepted the case” of Otto Warmbier, who died Monday in a Cincinnati hospital. Justin Weber told The Associated Press a press conference is expected later to provide more information.

Wambier’s parents did not cite a specific cause of death, but cited “awful, torturous mistreatment” by North Korea. Doctors had described Warmbier’s condition as a state of “unresponsive wakefulness” and said he suffered a “severe neurological injury” of unknown cause...

http://www.detroitnews.com/story/news/nation/2017/06/20/obit-north-korea-detainee/103032120/

 

[dotr]

https://www.theguardian.com/world/2...ts-plight-of-foreigners-jailed-in-north-korea

[URL="https://www.theguardian.com/profile/justinmccurry"]Justin McCurry in Tokyo

[/URL] Tuesday 20 June 2017 [h=1]Otto Warmbier's death highlights plight of foreigners jailed in North Korea[/h] Calls grow to free three more Americans, six South Koreans, a Canadian and several Chinese nationals

While the mystery surrounding his death may never be resolved, experts voiced surprise that his incarceration – even in North Korea’s notorious prison system – had ended in his death.

“Foreign prisoners are held solely as bargaining chips for the North Korean regime, so there would be no advantage in mistreating them to the extent that they become dangerously ill or die of diseases caused by malnutrition,” said Jiro Ishimaru, of Asia Press, an Osaka-based organisation with a network of contacts in North Korea.

“North Korean prisoners are routinely tortured, but it’s unlikely that that happens to foreign detainees. They are also well-fed compared with North Korean inmates. They are going to get out eventually, and the regime does not want them to tell the world that they have been starved and beaten.

“The biggest problem is the toll incarceration in a place like North Korea takes on their mental health.”

North Korea’s explanation for Warmbier’s death – that he went into a coma after contracting botulism and taking a sleeping pill – appears as improbable as those given for the deaths of several Japanese citizens abducted by the state’s spies in the 1970s and 1980s.

Keiko Arimoto, who was tricked into flying to North Korea while studying English in London in 1983, was said to have died from carbon monoxide poisoning caused by a gas heater, while others had drowned or died in car accidents.

Young Pioneer Tours, which organised Warmbier’s 2016 trip, said on Tuesday it would stop taking US citizens into North Korea

Other tour operators, including Koryo Tours and Uri Tours, said they were reviewing their policy on accepting American citizens, amid reports that the US secretary of state, Rex Tillerson, is considering imposing a ban on travel to North Korea.

 

[K_Z]

We only heard from the Koreans that he had been in a coma since March last year. Is it possible that this is not true? Could the injury to his brain have been much more recent and that's why he had no bed sores and other complications from long immobility? If the injury happened recently that might be the reason why NK let him go, because they didn't want to have a prisoner who required medical care 24/7.

OW was evaluated at a tertiary care university medical center, with numerous high level neurological specialists available, as well as advanced imaging. Without a doubt, it is possible to determine what is "old" damage, versus what is more recent damage. Additionally, he had significant muscle wasting, as well as some contractures, which occur over time (months).

 

[K_Z]

Patients in vegetative states have little to no gag reflex, nor do they have effective airway protective mechanisms, such as a strong cough. As such, they are very vulnerable to serious lung dysfunction and repeated pneumonias.

When OW was carried off the plane, a very large nasogastric tube was visible taped to his cheek. IMO, this is a very "old fashioned" type of tube not commonly used anymore for feedings in more developed countries. If a nasogastric feeding tube is used (typically at the beginning of a period of disability like PVS), it is a very small bore/ diameter, very soft, weighted feeding tube, such as the Dobhoff brand. IMO, it would probably be rare for NK to have access to a lot of modern medical devices, such as commercial tube feeding solutions, modern tubes, and infusion pumps. It's likely, IMO, they were feeding him with some kind of homemade solution thru a gravity bag, or using a syringe to put the solution down the tube. It's remotely possible he had a percutaneous gastric tube, but I doubt it.

After no improvement for a period of time, like a few weeks, a permanent gastric feeding tube is typically placed, thru the skin of the abdomen. Having a nasogastric feeding tube long term is very detrimental. The tube often permits sugar rich feeding solutions to "track" up the tube into the lungs, where it provides a perfect medium for bacteria to grow, causing repeated pneumonias. Additionally, a rigid NG tube can cause perforations of the esophagus over time, as well as other problems such as nasal septum erosion.

We don't know if OW had a permanent gastrostomy tube placed, but we did see what appears to be a rigid NG tube.

 

[BetteDavisEyes]

Any discussion regarding retaliation towards NK for their role in Warmbier's death should probably be reserved for Politivent forum, but I hope the President takes action against the adversarial nation.

 

[K_Z]

From what as been announced in media conferences, OW was in reasonably good physical condition considering his level of disability, and that he was in the incarceration "care" of a brutally oppressive dictator regime.

The only way that his condition could have been this "good" (not suggesting at all that a vegetative state is "good", but focusing on the care of the body) is for OW to have been assigned caregivers 24/7. The care of a completely dependent patient in a vegetative state is never ending-- it is a constant struggle to prevent skin breakdown from incontinence (they can have runny diarrhea from the tube feed solution, etc), and from immobility. Fingers, limbs, and joints have to be massaged and range of motion exercises done daily, or more often. They have to be repositioned in bed with cushions and pillows every hour or two. They have to have oral secretions and phlegm suctioned out of their noses and mouths. Urinary care has to be done, either with diapers or managed by tubes. General bathing/ hair washing, etc. It's a very labor intensive job to care for a completely dependent bed bound patient.

As I wrote in earlier posts, we don't know why NK was willing to maintain his physical body this way, but clearly it was a priority they were willing to devote substantial resources to. It could be that his caregivers were scared to death that if OW died, they would be executed themselves. Or their loved ones. That would be a very potent incentive to make sure he received the *best* care they could give him in his vegetative condition, right?

 

[MicheleT]

Just catching up on this incident. I would suspect that NK did this on purpose thinking (maybe) they had found a cure and it didn't work. Maybe this was a slow process - moving him to this level of incapacitation.

 

[gitana1]

Patients in vegetative states have little to no gag reflex, nor do they have effective airway protective mechanisms, such as a strong cough. As such, they are very vulnerable to serious lung dysfunction and repeated pneumonias.

When OW was carried off the plane, a very large nasogastric tube was visible taped to his cheek. IMO, this is a very "old fashioned" type of tube not commonly used anymore for feedings in more developed countries. If a nasogastric feeding tube is used (typically at the beginning of a period of disability like PVS), it is a very small bore/ diameter, very soft, weighted feeding tube, such as the Dobhoff brand. IMO, it would probably be rare for NK to have access to a lot of modern medical devices, such as commercial tube feeding solutions, modern tubes, and infusion pumps. It's likely, IMO, they were feeding him with some kind of homemade solution thru a gravity bag, or using a syringe to put the solution down the tube. It's remotely possible he had a percutaneous gastric tube, but I doubt it.

After no improvement for a period of time, like a few weeks, a permanent gastric feeding tube is typically placed, thru the skin of the abdomen. Having a nasogastric feeding tube long term is very detrimental. The tube often permits sugar rich feeding solutions to "track" up the tube into the lungs, where it provides a perfect medium for bacteria to grow, causing repeated pneumonias. Additionally, a rigid NG tube can cause perforations of the esophagus over time, as well as other problems such as nasal septum erosion.

We don't know if OW had a permanent gastrostomy tube placed, but we did see what appears to be a rigid NG tube.

From what as been announced in media conferences, OW was in reasonably good physical condition considering his level of disability, and that he was in the incarceration "care" of a brutally oppressive dictator regime.

The only way that his condition could have been this "good" (not suggesting at all that a vegetative state is "good", but focusing on the care of the body) is for OW to have been assigned caregivers 24/7. The care of a completely dependent patient in a vegetative state is never ending-- it is a constant struggle to prevent skin breakdown from incontinence (they can have runny diarrhea from the tube feed solution, etc), and from immobility. Fingers, limbs, and joints have to be massaged and range of motion exercises done daily, or more often. They have to be repositioned in bed with cushions and pillows every hour or two. They have to have oral secretions and phlegm suctioned out of their noses and mouths. Urinary care has to be done, either with diapers or managed by tubes. General bathing/ hair washing, etc. It's a very labor intensive job to care for a completely dependent bed bound patient.

As I wrote in earlier posts, we don't know why NK was willing to maintain his physical body this way, but clearly it was a priority they were willing to devote substantial resources to. It could be that his caregivers were scared to death that if OW died, they would be executed themselves. Or their loved ones. That would be a very potent incentive to make sure he received the *best* care they could give him in his vegetative condition, right?

Thank you so much for all this detailed information. This is a horrific case. In your opinion, what kind of things can lead to this state?

 

[K_Z]

Thank you so much for all this detailed information. This is a horrific case. In your opinion, what kind of things can lead to this state?

Young healthy people in vegetative states usually have some kind of hypoxia event, that may or may not proceed to a full cardiac arrest. Presumably OW had a very strong, healthy heart (he was an athlete), and excellent medical care preceding his trip to NK.

It could have been something as simple as a drug administered to him that caused profound drowsiness that produced positional airway obstruction that went unrecognized for too long ( respiratory arrest, or near respiratory arrest). Could have been a pillow over his face if he was drugged, or a hand, or a piece of tape, etc. He had no fractures according to doc media report, and an mri would probably have revealed even a hyoid fracture ( though the hyoid calcifies close to age 30, so the autopsy will be more conclusive than MRI for any kind of strangulation event).

Basically, there are many, many possible scenarios where his breathing could have been impaired to the point of creating hypoxic encephalopathy. Depending on how severe the episode was, and how severe the brain swelling was, they may have had to maintain his breathing by bagging or mechanical ventilator for hours, days, or weeks after the event.

There's no real way to know what happened, beyond the fact that it was a severe hypoxic event. Could have been accidental, or mechanical, or assisted with inhaled or systemic neuro depressants, he could have vomited and aspirated, etc. There are thousands of scenarios.

I still don't think they intended to kill him. It would have been so easy to do so. To intentionally create a vegetative state would be nearly impossible to predict. The "line" between life and death, at the point of severe injury, taking into account the evolving neuro injury over days or weeks, as the brain swells and has further damage, would be rather impossible to predict, I'd think. If that makes sense.

That's why I don't think they intended to kill him.

 

[gitana1]

There are some fascinating documentaries about North Korea for those who want to know more. Vice did a great one: https://video.vice.com/en_us/video/vice-guide-to-north-korea/56815b6132382b833c2230ad

Another one that was incredible is the Red Chapel. It's a Swedish documentary about three comics who go there to satirize the place. All are Korean adoptees but North Korea makes a big deal about their choice to return "home" not to South Korea, but to the North.

What's remarkable about the film is that one of them has cerebral palsy and so while all tourists are spied on and bugged through surveillance, they can't translate what he's saying because his speech is affected by his disability so he is free to say what he really thinks. And then his buddies translate it into something else. So you hear the fake stuff they want the North Koreans to hear but see the reality of what he's saying which is frank and not charitable. It's funny.

Then it becomes not funny. The weight of the oppressive regime becomes too much and you see the slow breakdown of the comedic with disabilities as the farce of pretending all is wonderful becomes too much. He realizes people like him are probably killed there. Not one disabled person can be seen.

The fear they all feel during the scary fake military exercises and propaganda parades is palpable. I watched it on Netflix.

Another eye opening one is Lisa Ling's documentary. She goes with a team of charity doctors to do and teach cataract surgery. Cataracts happen there a lot due to extreme poverty/malnutrition and lack of medical care. This documentary is probably why her sister was later imprisoned there after she wandered too close to the border. It shows the extreme level of brain washing and/or fear of the people.

https://m.youtube.com/watch?v=AlJUGZPanB8

 

[gitana1]

I agree, that wasn't Otto. They just wanted to single out an American. In fact I believe the whole thing was a set up, a farce. It's so sickening. That evil regime needs to be destroyed.

The problem is that neither China nor South Korea want the regime destroyed. Because those nations will have to bear an influx of millions of unskilled migrants they will need to care for and absorb without anything good from the country they can take to make up for that, as pretty much all natural resources have been stripped from the country.

Dismantling the regime will cause a global crises of millions of poor migrants. Much worse than what we are seeing as a result of the war in Syria.

So both nations- one an ally of North Korea and one an enemy- will put pressure on to keep the nation intact. And China is under treaty to retaliate against any country that attacks North Korea. So aggression on our part could cause WWIII.

Its a complex and delicate situation.

 

[Elainera]

This went through my head as well, when K_Z described the care that would have been needed for him to be in this condition. I just don't see NK doing that.

Yes exactly.

 

[Elainera]

OW was evaluated at a tertiary care university medical center, with numerous high level neurological specialists available, as well as advanced imaging. Without a doubt, it is possible to determine what is "old" damage, versus what is more recent damage. Additionally, he had significant muscle wasting, as well as some contractures, which occur over time (months).

Oh I see. Thank you for explaining.

 

[gitana1]

Young healthy people in vegetative states usually have some kind of hypoxia event, that may or may not proceed to a full cardiac arrest. Presumably OW had a very strong, healthy heart (he was an athlete), and excellent medical care preceding his trip to NK.

It could have been something as simple as a drug administered to him that caused profound drowsiness that produced positional airway obstruction that went unrecognized for too long ( respiratory arrest, or near respiratory arrest). Could have been a pillow over his face if he was drugged, or a hand, or a piece of tape, etc. He had no fractures according to doc media report, and an mri would probably have revealed even a hyoid fracture ( though the hyoid calcifies close to age 30, so the autopsy will be more conclusive than MRI for any kind of strangulation event).

Basically, there are many, many possible scenarios where his breathing could have been impaired to the point of creating hypoxic encephalopathy. Depending on how severe the episode was, and how severe the brain swelling was, they may have had to maintain his breathing by bagging or mechanical ventilator for hours, days, or weeks after the event.

There's no real way to know what happened, beyond the fact that it was a severe hypoxic event. Could have been accidental, or mechanical, or assisted with inhaled or systemic neuro depressants, he could have vomited and aspirated, etc. There are thousands of scenarios.

I still don't think they intended to kill him. It would have been so easy to do so. To intentionally create a vegetative state would be nearly impossible to predict. The "line" between life and death, at the point of severe injury, taking into account the evolving neuro injury over days or weeks, as the brain swells and has further damage, would be rather impossible to predict, I'd think. If that makes sense.

That's why I don't think they intended to kill him.

Thanks for that. Yeah I think it's clear they didn't mean too either. Otherwise why not sentence him to death? And why try to keep him alive? Besides, they arrest these people for political purposes. Not to kill them but to use them
to bargain.

I did wonder about the possibility that he might have tried to take his life after being sentenced. But your explanation of the hyoid bone bone seems to eliminate hanging.

Is it possible they beat or tortured him in some way. Maybe hit him hard in the head? Too hard on accident? And then neglected his medical care?

Regardless, no matter what happened, it was murder IMO. They falsely arrested an innocent young man as a political pawn and he is now dead after going into that country as a very healthy young man.

 

[dotr]

http://www.ctvnews.ca/world/u-s-sen...n-show-of-force-against-north-korea-1.3467756

June 20, 2017 10:47AM EDT
SEOUL, Korea, Republic Of -- The United States flew two supersonic bombers over the Korean Peninsula on Tuesday in a show of force against North Korea, South Korean officials said.

The U.S. often sends powerful warplanes in times of heightened animosities with North Korea, and flew B-1B bombers several times this year as the North conducted a series of banned ballistic missile tests.

Tuesday's flights by B-1Bs came shortly after the death of a U.S. college student who was recently released by North Korea in a coma following more than 17 months of captivity.

The U.S. military said the bombers conducted two separate drills with the Japanese and South Korean air forces. It said the flights demonstrated solidarity among South Korea, Japan and the United States "to defend against provocative and destabilizing actions in the Pacific theatre."

Moon said in an interview with CBS television broadcast Tuesday that Warmbier's death showed "we must now have the perception that North Korea is an irrational regime," but that talks are still necessary because "we were unable to resolve the North Korean nuclear issue through only the sanctions and pressure."