Rebecca and the 'rescue breaths'

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Time, you had posted your thoughts on the subject of Jonah's fateful phone call to Rebecca that night under #136, What One Thing? I believe your view is solid on why SDSO took Jonah's word. Here is your snipped post (hopefully you don't mind) as I believe it bears repeating:

"Makes it really laughable that during the first press conference they claimed hard science/facts told them this was a suicide for a couple of reasons - so much of it is not good science at all and every investigation looks at more than a few chosen facts to put forward for explanations - victimology, forensic psychology, MO of a perp, and so on. The later foci were almost totally excluded except for the attempt to throw a couple of things in there as to motive for a suicide. But if they were going to do that, then why wouldn't they have included Dina hatred for Rebecca and the suspicions floating around in Dina's family and with the Doctor? Because it made it look more like a murder than motive for a suicide."

No, SDSO did not want to get into the weirdness of the *advertiser censored*, bindings, Nina questioning and visiting the house that night, sightings of Dina, no alibis for many, Adam's weird 911 call, past mutual violent domestic abuse and stalking between Dina and Jonah, the death of a little boy that was misdiagnosed until autopsy and on and on."

Time, I think you are so right on.

Thanks for reporting that ... I see my mind hasn't changed over all this time (but I'm probably getting a little more mundane in my expressions!).

From what we know now, a lot of things just don't make sense as presented (or as withheld) ... you pointed out several good examples.

I hope there is some lawsuit eventually filed or cases get opened up because then we will see more of the evidence, including interviews and depositions. That will tell us more about possible motives. I think this 'rescue breath/CPR' thing was somehow twisted into something it wasn't and couldn't have been. And, why was that?
 
Thanks for reporting that ... I see my mind hasn't changed over all this time (but I'm probably getting a little more mundane in my expressions!).

From what we know now, a lot of things just don't make sense as presented (or as withheld) ... you pointed out several good examples.

I hope there is some lawsuit eventually filed or cases get opened up because then we will see more of the evidence, including interviews and depositions. That will tell us more about possible motives. I think this 'rescue breath/CPR' thing was somehow twisted into something it wasn't and couldn't have been. And, why was that?

Agree, and I'm also beginning to question the accusations of possible "suffocation" and Dr.'s report to LE 2 days after RZ died.

If it was such a pressing concern, why didn't the doctor say something to LE within the first 24 hrs. of MS's accident? I'm not accusing the doctor, but just wondering why it wasn't reported to LE until 4 days later. Of course, the suspicions became moot when the autopsy showed the extent of spinal cord damage, but by then the "suffocation" story had grown legs.
 
No, SDSO did not want to get into the weirdness of the *advertiser censored*, bindings, Nina questioning and visiting the house that night, sightings of Dina, no alibis for many, Adam's weird 911 call, past mutual violent domestic abuse and stalking between Dina and Jonah, the death of a little boy that was misdiagnosed until autopsy and on and on."

Time, I think you are so right on.

I'm not sure I agree that Max was misdiagnosed until autopsy. You see, the cord contusion he received would have been evident on MRI within about 2-12 hours post injury. His spinal cord top 2 cm was dead and crumbling at autopsy-- that surely would have been evident on his last MRI, in addition to the other severe head/ brain injuries. Max almost assuredly had more than one MRI while at Rady. All of that information, I am confident, is contained within his medical records-- which we may not see unless there is a civil suit in which the records are subpoened as evidence. Even then, the records can be suppressed from public disclosure.

IMO, Dina is well aware of this, and I believe this is a portion of why she has felt comfortable saying some of the things she has about his hospital course and her knowledge of his injuries. Jonah is not about to say anything publicly. Dina may not know how to read medical records, since she has no background in this area, but she can hire someone to interpret what is contained within them. She knows what is in Max's records, and if there were anything there that supported any of what she has claimed publicly, she would copy it and post it on her website (among other places), just as she did the EMS report. IMO, there is nothing in Max's records to support her version of events. She would have used it by now if there was.

I think it is VERY telling that Dina (and Jonah) are completely comfortable with the excellent care Max received from his team of professionals. Dina has had no criticism publicly for the paramedics, Coronado ER staff, or anyone at Rady. I very glad of that, because I believe these professionals gave Max the best care that they could, and the best care that was available. The ONLY criticism Dina has is for Rebecca and her sister.

What that tells me is that Dina was well aware of what Max's injuries were, what his prognosis was, and everything that was going on from the moment he arrived at Rady. If she were not, she would have VERY public criticism for the docs and hospital, IMO, as she certainly has accused anyone and everyone she can with some fairly outrageous claims. She would not hesitate to say so if she thought his condition was not properly represented to her, or if docs minimized his condition, or withheld information about his condition.

I don't think Max was misdiagnosed until autopsy. Not at all. I am confident docs knew exactly what was going on. I'm also confident that they shared everything about Max's condition and prognosis with Dina and Jonah, on an ongoing and daily basis. There was no "good" news to be had about Max's condition, from the moment of his admission. I'm confident the docs never presented Max's situation as "recoverable with a tutor", "missing soccer season, but recoverable", etc.

In the absence of any other information about his injuries, Max had a 99% prognosis of dying, simply because he had been in aysytole from a traumatic arrest for nearly 30 minutes. (Please reference the outcome studies of aystole and head trauma in the EMS Report thread which support this statement.)
 
Actually, I do know that Jonah was not there...
JMO

BBM

Actually you don't know if JS was not there unless you were somewhere else with him. Period.

AND we don't know if you were there if no hard proof...
 
BBM

Actually you don't know if JS was not there unless you were somewhere else with him. Period.

AND we don't know if you were there if no hard proof...

Jonah saying that he wasn't there, or that his kids weren't there is not proof. While there may be a statement in the SDSO report or the CPD report about this, it was prefaced with "we were told by Jonah that he was not at Spreckels".......that information should have been verified.......all good cops check and double check what they are told by people that they are questioning regarding any type of incident. And just because MyBelle says Jonah wasn't there, well, that does not make it so.
 
I'm not sure I agree that Max was misdiagnosed until autopsy. You see, the cord contusion he received would have been evident on MRI within about 2-12 hours post injury. His spinal cord top 2 cm was dead and crumbling at autopsy-- that surely would have been evident on his last MRI, in addition to the other severe head/ brain injuries. Max almost assuredly had more than one MRI while at Rady. All of that information, I am confident, is contained within his medical records-- which we may not see unless there is a civil suit in which the records are subpoened as evidence. Even then, the records can be suppressed from public disclosure. <respectfully snipped>

The whole long post was very informative and I remember now that you have said this before. Pardon my snipping above, but just doing so for brevity.

This brings up a question in my mind. Did the hospital just have to report the injury to CPS to be followed up, e.g., this is just protocal (someone said something like this before). Were they pushed to follow up?

Where did we hear that the doctor said Max suffocated? Would the doctor(s) use the term suffocated just to explain the blocked airways and was that just misconstrued?

I'm just wondering if, in fact, it's possible the whole 'suffocation' thing was never really even connected to the CPS report - am I making sense?
 
From trauma.org blog, with a topic of trauma patients who arrive to the ER in asystole. These are trauma surgeons commenting.

http://www.trauma.org/archive/archives/arres1.html

One comment:

Date: Sun, 25 May 1997 12:33:55 -0400 (EDT)
From: Ken Mattox [KMATTOX@aol.com]
The data is becoming quite clear. For a trauma patient, who is not intubated, I have not been able to find a survivor who has had pre hospital CPR for more than 5 minutes, including our own data going back to 1960 on our trauma registry. If the patient has been intubated and is a victim of trauma and has had prehospital CPR for more than 10 minutes, we have never had a survivor. If the initial pH is 6.8 or less, in a patient with a traumatic arrest, we have not ever had a survivor. ED resuscitations cost almost $5000.00/hr or more. I do not hesitate to spend this money if there is a chance for reversal, but I think we are irresponsible to pour a lot of money down the drain when everyone knows that this patient in front of us has NO chance of survival, and if we do coax the heart back the cost in the expensive care unit for a person with a dead brain, but a beating heart in an intubated patient is awsome. The family comes to begrudge the "wrongful life" and lawsuits have already been filed as wrongful life suits. Death is virtually always inevitable. We cannot and must not use these desparate and futile cases as "practice" either. That is disrespectful of the dead. What I have said here is for trauma patients, but I am not sure that cardiac patients are not far behind is successes.....

And another:

Date: Fri, 30 May 1997 02:35:42 +0100
From: Smith, J. Stanley, MD [JStanley.Smith@hmc.psu.edu]
Cardiac arrest from major trauma especially blunt means death. The survival rate is as close to zero as it can get. Only in penetrating trauma, is it worthwhile to try to resuscitate but it must be by thoracotomy.
 
Significant factors in predicting sustained ROSC (return of spontaneous circulation) in paediatric patients with traumatic out-of-hospital cardiac arrest (OHCA) admitted to the emergency department

This is a nice power point presentation. Very informative.

www.kmuh.org.tw/www/ed/traumameeting/paper20070710.ppt ·
 
This brings up a question in my mind. Did the hospital just have to report the injury to CPS to be followed up, e.g., this is just protocal (someone said something like this before). Were they pushed to follow up?

Where did we hear that the doctor said Max suffocated? Would the doctor(s) use the term suffocated just to explain the blocked airways and was that just misconstrued?

I'm just wondering if, in fact, it's possible the whole 'suffocation' thing was never really even connected to the CPS report - am I making sense?

I believe Dina, in an interview, was the original official source of the "suffocation" comment, IIRC. I'm sorry, I don't have a link for that, but perhaps someone else does. (Was it the "Boy, Interrupted" article where we first heard her discuss this?) The suffocation comments were discussed at length by anonymous posters at various sites on the web, along with other "leaked" theories and comments, so somtimes it's difficult to track back to the first "official" mention. The "Rebecca starving the kids with healthy meals" was another leaked meme, as was the "Rebecca was a secret ninja jiujitsu master"-- which was leaked/ floated well in advance of the first official mention of this in Dr. Melinek's report. There can be no doubt, imo, that there is a concerted effort to put information like this out to the public in sound bites and oft-repeated chunks that sound like campaign slogans. I think we have even seen that in these threads.

Back to the CPS report. Here is a link to the California "Mandated Reporter Training" guide:

http://mandatedreporterca.com/

It's my opinion that the source of the request for social work to place a CPS request/ report has more to do with the negligence aspect, than any suspicions of child abuse. Max suffered what was to be an ultimately fatal fall that was UNWITNESSED, from a residential staircase, that appeared to involve the use of a dangerous outside riding toy. The fall was so severe that it produced cardiac arrest at the scene. It is this confluence of circumstances that I believe triggered the request for report. I sincerely doubt any of his ER or ICU doctors thought Max was suffocated and thrown over the railing.

As we have seen in other threads (reference the scooter thread), fatal injuries related to toys are "reportable" to several agencies (CPSC, etc). I believe the negligence aspect was what was concerning, not any suspiscions of child abuse. The oft-repeated comment that Dr. Peterson did not feel that Max's injuries matched the story of how he fell fits that thought process for me.

I also keep coming back to Dina's comment at the Coronado City council that she was NOT to be notified about this report. I still think that is VERY curious. Perhaps she was not a target for investigation, but LE didn't want to precipitate an altercation or angst between Dina and Jonah (divorced parents, new girlfriend involved) while Max lay dying in ICU.

However, using only small snippets of repeated conversations allows anyone to manipulate those sound bites into whatever they want. What we need to see are Max's hospital records, which contain answers to many of the questions surrounding his death, as well as very pertinent information that could point to a likely motive for Rebecca's murder.

I'm rather hopeful that if (when!) the first civil suits are filed that the defendants will be reluctant to settle out of court, and bring the information to a civil trial. I believe that a lot of this information should see the light of day, to quell speculation, and get closer to the truth of what happened in both deaths.

It has been commented here and else where that XZ "will be forced to testify under oath" when civil suits are filed. She is not the only one that will be "forced to testify under oath". There are a great many people who can be subpoenaed to testify in civil proceedings filed either by RZ's surviving family, OR Dina and/ or Jonah Shacknai.

My bet is on Dina to file the first suits.
 
K_Z ... thanks for the post because when I got to thinking about all this, I realized the whole suffocation thing is pretty darn hazy as is the whole CPS thing. Did Melinek also claims the doctors said something about this? I'll have to go dig her report up. Thanks also for reminding us in this thread about what has been released and what hasn't.
 
Dr. Melinek and CPS -

Dr. Melinek Report - snip of material reviewed.

14 . On March 16, 2012 we visited the Coronado Police Department and reviewed in the
presence of Commander Michael T. Lawton all the scene photographs in the case
file, as well as photographs of the hospitalízed Maxfield Shacknai. I also reviewed
several police interviews and reports not included in the above files including a child
protective services report and an interview of XZ conducted after the death of the
Rebecca Zahau.
Included in the materials was a drawn diagram by the first responder
indicating the positions of Max, Rebecca and the chandelier prior to them being
moved by emergency personnel for access.

Dr. Melinek Report - snip from her opinion.

10 . According to Sharp Coronado Hospital records 3 mg Versed was given in the
emergency room at 1146 on7l22l2o01 following endotracheal intubation. Hospital
records indicate an unknown down time and the radiological scans are negative for
cervical spinal fracture. Radiological scans of the head describe a left frontal non-
depressed fracture. Hospital physicians believed the injuries were inconsistent with
the report of an accidental fall and reported the case to Child Protective Services.
The subsequent report relied on the Medical Examiner's conclusion of the manner of
death that this was an accidental fall and the case was closed.


http://media.utsandiego.com/news/documents/2012/08/06/Dr.Melinek_Report.txt
 
This thread was created to discuss the CPR story/theories. What I find interesting is Dina's focus on whether or not RZ gave Max CPR. I understand what lies beneath her focus is the theory that RZ lied. RZ did not lie to the responding officers as it was stated in the EMS no CPR was given prior to arrival. Where the story of CPR begins after the EMS report is basically unknown except for what Nina has told us. However, if there was a lie, it did not influence the care Max received. Max did not die because CPR was not administered prior to the arrival of EMS. In my opinion, the whole CPR story is only being used to support theories that RZ was a liar. Until and if ever Jonah speaks, we do not know what RZ actually said to Jonah. It is quite possible it was a mistake in words by Jonah or a lie put forth by Jonah. It is unfortunate RZ is being fingered as a liar when so little information available to us. In my opinion, Jonah's credibility is just as questionable. Yet it appears Jonah gets a free pass and blaming the dead woman is the theory being pushed with nonexistent facts. Is it too much to ask to get all sides of the story before pointing fingers? Shouldn't we hear from Jonah before calling RZ a liar? Would that not be fair and respectful?


BBM

*Lash*, you have made an important point. We do not know exactly what time Jonah claimed to have left the house to go to the gym and how that time cooresponded with Max's fall. We are told that Max fell at approximately 10:00 AM but we are not given an exact time.

I would like to know exactly what time Jonah left the house and if Max's fall occured before or after 10:00 AM.
 
[/B]

BBM

*Lash*, you have made an important point. We do not know exactly what time Jonah claimed to have left the house to go to the gym and how that time cooresponded with Max's fall. We are told that Max fell at approximately 10:00 AM but we are not given an exact time.

I would like to know exactly what time Jonah left the house and if Max's fall occured before or after 10:00 AM.

And we do not know when Jonah arrived at Rady Children's Hospital......that is also an important detail.
 
Dr. Melinek and CPS -

Dr. Melinek Report - snip of material reviewed.

14 . On March 16, 2012 we visited the Coronado Police Department and reviewed in the presence of Commander Michael T. Lawton all the scene photographs in the case file, as well as photographs of the hospitalízed Maxfield Shacknai. I also reviewed several police interviews and reports not included in the above files including a child protective services report and an interview of XZ conducted after the death of the Rebecca Zahau. Included in the materials was a drawn diagram by the first responder indicating the positions of Max, Rebecca and the chandelier prior to them being moved by emergency personnel for access.

Dr. Melinek Report - snip from her opinion.

10 . According to Sharp Coronado Hospital records 3 mg Versed was given in the emergency room at 1146 on7l22l2o01 following endotracheal intubation. Hospital records indicate an unknown down time and the radiological scans are negative for cervical spinal fracture. Radiological scans of the head describe a left frontal non-depressed fracture. Hospital physicians believed the injuries were inconsistent with the report of an accidental fall and reported the case to Child Protective Services. The subsequent report relied on the Medical Examiner's conclusion of the manner of death that this was an accidental fall and the case was closed.
PURPLE - I sure wish we had some concrete evidence that this is what the doctors thought/reported/recorded and when (as far as we know, it could have been in the first two hours).

Is it strange, the wording in the last sentence? It somehow seems to obscure the possible problem here which is Cause of Death. It is because of the Cause of Death and other info that it was concluded to be an accidental fall, the Manner of Death.

My opinion of Dr. Melinek's report is that, although it appears to be precise when you first read it, it is actually phrased in very imprecisely upon analysis.
 
Dr. Melinek and CPS -

Dr. Melinek Report - snip of material reviewed.


PURPLE - I sure wish we had some concrete evidence that this is what the doctors thought/reported/recorded and when (as far as we know, it could have been in the first two hours).

Is it strange, the wording in the last sentence? It somehow seems to obscure the possible problem here which is Cause of Death. It is because of the Cause of Death and other info that it was concluded to be an accidental fall, the Manner of Death.

My opinion of Dr. Melinek's report is that, although it appears to be precise when you first read it, it is actually phrased in very imprecisely upon analysis.

With all due respect i have noted many, many inconsistencies, imprecise 'details' and typos within Dr. melinek's report. For example did any one notice the date and what she wrote here, 'According to Sharp Coronado Hospital records 3 mg Versed was given in the emergency room at 1146 on7l22l2o01 following endotracheal intubation.'

Was that her typo or the hospital's? Did the intubation occur on 7/22/2001? Was versed given before or after the intubation? I highly doubt that a MD would write that versed was given after intubation. Considering Max was unconscious would versed even be necessary? Idk, K_Z?
 
With all due respect i have noted many, many inconsistencies, imprecise 'details' and typos within Dr. melinek's report. For example did any one notice the date and what she wrote here, 'According to Sharp Coronado Hospital records 3 mg Versed was given in the emergency room at 1146 on7l22l2o01 following endotracheal intubation.'

Was that her typo or the hospital's? Did the intubation occur on 7/22/2001? Was versed given before or after the intubation? I highly doubt that a MD would write that versed was given after intubation. Considering Max was unconscious would versed even be necessary? Idk, K_Z?

It is my understanding that Max remained at Sharp Coronado Hospital for approximately 1 hour, having arrived around 10:30am.........I have had a few dealings with the ER staff there, in particular one of the attendings, whom has made some critical mistakes regarding patient diagnosis and care. That being said, not sure who was on duty at that time, but I will agree that the report does not reflect reality, and obviously some one was not double checking details........could have been Dr. Melinek, or the ER staff. Without seeing the actual patient records, we just don't know.
 
It is my understanding that Max remained at Sharp Coronado Hospital for approximately 1 hour, having arrived around 10:30am.........I have had a few dealings with the ER staff there, in particular one of the attendings, whom has made some critical mistakes regarding patient diagnosis and care. That being said, not sure who was on duty at that time, but I will agree that the report does not reflect reality, and obviously some one was not double checking details........could have been Dr. Melinek, or the ER staff. Without seeing the actual patient records, we just don't know.

With all due respect, why would Dr. Melinek repeat the error instead of noting it in her report?

Imo, the report is unprofesionally written. I question whether it was co-authored?
 
With all due respect i have noted many, many inconsistencies, imprecise 'details' and typos within Dr. melinek's report. For example did any one notice the date and what she wrote here, 'According to Sharp Coronado Hospital records 3 mg Versed was given in the emergency room at 1146 on7l22l2o01 following endotracheal intubation.'

Was that her typo or the hospital's? Did the intubation occur on 7/22/2001? Was versed given before or after the intubation? I highly doubt that a MD would write that versed was given after intubation. Considering Max was unconscious would versed even be necessary? Idk, K_Z?

Hi FreeSpeech! I reviewed a PDF that was not linked from the UTSanDiego article. The PDF is from the Max Shacknai website. Dr. Melinek did use the date 7/22/2001. This is an obvious error since Max had passed by then. I have noticed the discrepancies as well. They appear on Melinek's report that is directly linked on the Max Shacknai website.
 
I would also like to add, an important document DS put forth 'Summary of Reports' is not authored. In my opinion, you could say the same for the material Dr. Melinek used in her report from the Left Handed Kitten forum.
 
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