Dina Shacknai wants Max's death reopened; gives ICU pic to media

[time]

Couple points of clarification as I read thru the comments here. (I am a WS-verified health care professional):

- It's unlikely Max had a cardiac consult to determine if he could be a transplant candidate. Max had sustained a 30+ min cardiac arrest, and had (at a minimum) 2 rounds of epi in addition to whatever supportive meds (cardiac, pressors, etc) that he was receiving in ICU. Typically, a patient with that history would not be considered a candidate for heart donation.

-There is no evidence he was defibrillated at the scene by paramedics. The reports state he had ROSC after 2 rounds of epi and CPR. ROSC is "return of spontaneous circulation." If he was in aystole, or had an agonal rhythm, or electromechanical dissociation (any or all of which are the most likely scenario), electricity is not indicated. Paramedics would have treated him differently if he was in a shockable rhythm.

-The process of determining brain death is complex, multifactorial, and involves numerous tests and measures over time. Typically, if a patient has fairly stable cardiac and physiological function, the process will occur over 24-72 hours or so-- every situation is different. But it is seldom a situation when the patient is alive with some hopeful prognosis one minute, and brain dead the next. The prognosis was not hopeful for Max from admission to the first hospital, when his decorticate posturing demonstrated a very grave situation-- BEFORE he was even transferred to Rady. Medical records, of course, document the total situation, but will not be released to the public (as they should NOT be, unless the family desires this). However, his neurological condition and prognosis would have been an ongoing discussion with family-- not just "one" conversation at as specific moment in time. Families are understandably in shock when a loved one is injured so severely, and often don't hear or interpret, or understand the explanations, especially in the first hours and days. I cannot fault Dina for hoping his condition was recoverable, nor can I fault her for not accepting or comprehending the gravity of the situation. From all that I have read, I cannot believe any physician held out any real hope that he could recover. The global cerebral edema was too massive at that point, and herniation was a matter of time, even with aggressive treatment to reduce intracranial pressure.

-A number of things have to be coordinated once a patient is declared brain dead, and the donation teams notified. These teams of surgeons and support personnel come from outside of the hospital, and are not in any way involved with the care of the patient while alive, nor participate in the decision to declare brain death. As Max's case was still under investigation at the time of his brain death, permission from the ME/ LE had to be also be given to allow donation. All of that takes time, as well as identifying and mobilizing the recipient patients and their caregivers.

During that period of time, no one is waiting for "toxins" to be eliminated from the donor. All meds that affect brain function and consciousness, such as pain meds, sedatives, and anesthetics, are withdrawn during the period of time BEFORE brain death is declared, so that the true picture of brain function can be assessed over time-- without those meds clouding the clinical picture. The patient continues to remain on the ventilator and receive bodily care, and certain meds (such as some blood pressure meds, electrolytes, etc) can still be given to ensure that target organs, remain in optimum condition for donation. This is an exquisitely difficult time for family members, as they observe many preparations for donation occurring, and care still being delivered aggressively to the patient's body in the ICU setting.

- It is true that many cases where children sustain serious or suspicious injuries are reported to social services, and then on to the police for investigation. That doesn't mean that there WAS anything that occurred that was non-accidental, nor does it ESTABLISH that there was any assault or child abuse before the fall. It's just part of the documentation and reporting process because Max sustained an unwitnessed accident.

Thank you so much K_Z for taking the time to explain all this and share your expertise with us!

 

[Salem]

I have moved a few posts discussing Rebecca's death here: [ame="http://www.websleuths.com/forums/showthread.php?p=8246438#post8246438"]Rebecca's Death - Websleuths Crime Sleuthing Community[/ame]


Let's try to keep our threads on topic. I know sometimes there is a cross over and that's okay, but remember the focus here is Max's death and reopening the investigation.

Thanks,

Salem

PS - if someone alerts other posts as they are reading through the thread, I can move them also.

 

[Quester]

No, you are wrong and here is the information:

"A Facebook posting Friday by the daughter of millionaire Jonah Shacknai indicated her brother Max was dead, but officials with the San Diego County Medical Examiner's office said they have not been notified of the 6-year-old's passing.

"RIP Maxie. We'll miss your sweet smile and kind heart more than you'll ever know. I'll love you forever," was the posting on the Facebook page of Gabby Shacknai, the teenage daughter of Jonah Shacknai.

http://www.760kfmb.com/story/15075598/coronado-mansion-death?redirected=true

HOWEVER it was later discovered that the post was actually by the daughter of Dina's boyfriend, Mark Salazar, CS. AND it was NOT on FB, but on http://www.formspring.me, and the post was up as recently as April. There was a screenshot of the page on the Hinky Meter. If that is ever restored, I will prove that to you as well.

Of course, 760kfmb.com never corrected the story.

You are referring to GS' post on Friday.

I was referring to DS' boyfriend's daughter's post on Monday evening, day of MS' fall - she stated something like: "[MS]", “fell”, "from balcony", “coma”, “no brain activity”, etc. Much was discussed on this in earlier threads here at WS.

 

[MyBelle]

I have been reluctant over the past year to discuss Brad Peterson's comments, but I will briefly, because they are directly related to what is currently transpiring with DS's investigation. He is a very experienced, well respected pedes anesthesiologist/ pediatric intensivist. I don't have any idea to what extent he was personally involved with Max's care. BP is the chief of the Rady PICU, according to their website, so it could be that he was clinically caring for Max, or it could be that as chief, he spoke with DS and JS as the administrative chief of the unit. He is without question not the ONLY doc that cared for Max once he was admitted to ICU. I'm sure many docs were involved with his care, and several docs had to be involved in the process AND decision to declare brain death. One doc is not permitted to establish brain death-- has to be at least 2, and sometimes more by policy in some institutions. There are very well established criteria for how the process is conducted.

JS is a very prominent person, so it's possible that Max's parents received an increased level of personal attention from many different administrative personnel, in addition to the clinical docs. BP has stayed completely out of the public media coverage of this case, as he should, and I'm sure, as the hospital attorneys have advised. No comments, no interviews. And this is because there is the still -open possibility that what he told the family was interpreted in such a way, and was possibly retold to others, that this then became motive for Rebecca's potential revenge murder. That is a heckuva sticky position for him, as well as the hospital to be in.

There is no record of what exactly he said to the family. Families ask many questions, and docs will do their best to explain what is going on using language that is appropriate for the understanding level of the family members, and taking their shock into consideration. I suspect (and hope) Dina and Jonah asked MANY questions, and had very LONG conversations with BP and other docs, several times a day.

At some point in the conversation, BP presumably used language that included the word "smother", or a description of anoxia/ hypoxia, and examples of causes. He is a respected professional, and accustomed to choosing his words carefully. As I have pondered this over the past year, I cannot believe any professional in his position would have volunteered a theory of nefarious smothering with the presentation that this child had, in the first day or so. What I keep returning to is the almost certain MULTIPLE conversations that occurred between docs and DS and JS explaining Max's condition. Global hypoxia would have been part of that conversation. I think it is highly likely that this was explained using comparables-- as in "we see this kind of injury in situations where the brain has been starved of oxygen, such as prolonged cardiac arrest and smothering situations".

Now, I don't claim for a single moment to know that this is how BP used the word smother, but it could have been an unfortunate choice of word on his part, IMO. Or, he may not have ever used the word smother, and his explanation was interpreted this way by DS.

I am not surprised that BP has not given any interviews or made any further statements about his use of the word "smother", if indeed he used that word in conversation with JS and DS. I certainly can believe that he was surprised at the grave situation Max was in from a fall from the staircase-- that is entirely believable. Remember that the investigation had barely begun at that point-- there were no CPD schematics of the fall, no police reports for him to look at. The first MRI that identified the high spinal cord contusion may not have been completed when he had the "hypoxia" conversation with DS/ JS. We simply don't know, and probaby won't ever know what he said, and how that was interpreted and received by JS/ DS.

Right now, we only have the mention in the LE reports that the docs were concerned about the mechanism of accident, and DS's comments about "smothering". The LE reports make sense to me-- as a consequence of the social worker report, and I attribute DS's comments about smothering as her interpretation of what he said-- heresay. Until or unless BP is willing to go on the record outside of a LE investigation (which he would be crazy to do), we will never know. He has done a very good job staying quiet and out of the media. For all we know, he may be very upset that his words were interpreted in such a way as to implicate another person. He may be upset that his words could have possibly lead to another person being killed for revenge-- particularly if the cord damage was unknown/ undocumented when he spoke them.

I think it is VERY telling that neither he, nor Rady hospital spokespeople, have had ANY public statements in support of the child abuse/ assault theory put forth by DS and her investigative team, or at any point in the last year. He clearly said SOMETHING that was interpreted as "smothering"-- at this point, it is ONLY Dina's word what he did say. Even Jonah has not said anything about this.

I'm surprised you find it very telling that no public comment has been made by the hospital or doctor. I'm not a health professional but I do know all are required by law to abide by federal privacy laws explained here:

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/privacysummary.pdf


I'm also not sure why you are trying to spin the private conversations that took place between Dina and her son's medical professionals. Her son was gravely injured while in the care of a babysitter. The doctor had every right to express his honest opinion and a duty to report his concerns to LE, which was done. Who exactly is going to sue him? I expect he will testify honestly if there is a wrongful death action filed.

JMO

 

[time]

You are referring to GS' post on Friday.

I was referring to DS' boyfriend's post on Monday evening, day of MS' fall - she stated something like: "[MS]", “fell”, "from balcony", “coma”, “no brain activity”, etc. Much was discussed on this in earlier threads here at WS.

You can find a copy of her post here:

http://coronado.patch.com/articles/today-show-features-zahau-case

She refers to Max as having his accident "this morning", he is in a coma, that he doesn't have any brain activity, and that he is too young to die.

 

[MyBelle]

Good post! I would imagine that the AG could be concerned by the lack of rigor taken and/or some of what LE hasn't revealed conflicts with their conclusions and presentation. That's what it appears to me or else they have lots that they haven't revealed. We have no evidence of related to some gaping alibi holes. As you said above concerning Rebecca's death, "Forensics are needed on this one since there are so many variables." That's one reason I don't speculate as much on her death, there seems to be too much missing. I'm really dismayed also that they did not take her liver temp or get a coroner there faster. That could probably have pinned down TOD better.

I'm not aware of any request made by DS to the AG but in cases ruled a suicide and an accident, what would be the reason for LE to publicly reveal anybody's alibi?

 

[CuriousGeorgia]

You can find a copy of her post here:

http://coronado.patch.com/articles/today-show-features-zahau-case

She refers to Max as having his accident "this morning", he is in a coma, that he doesn't have any brain activity, and that he is too young to die.

This is the continuation of the post I am talking about. It was by CS on Friday. GS NEVER posted.

 

[CuriousGeorgia]

MyBelle and Ocean Blue Eyes - Do you think that some of RZ's injuries could have been caused IF and WHEN she pulled down the chandelier to "stage" the scene? I am thinking that is a big possibility.

 

[Quester]

This is the continuation of the post I am talking about. It was by CS on Friday. GS NEVER posted.

Incorrect info!

ETA: <modsnip>confuse DS' boyfriend's daughter's post on Monday evening with GS' post on Friday?

 

[FightTheOstrich]

I have been reluctant over the past year to discuss Brad Peterson's comments, but I will briefly, because they are directly related to what is currently transpiring with DS's investigation. He is a very experienced, well respected pedes anesthesiologist/ pediatric intensivist. I don't have any idea to what extent he was personally involved with Max's care. BP is the chief of the Rady PICU, according to their website, so it could be that he was clinically caring for Max, or it could be that as chief, he spoke with DS and JS as the administrative chief of the unit. He is without question not the ONLY doc that cared for Max once he was admitted to ICU. I'm sure many docs were involved with his care, and several docs had to be involved in the process AND decision to declare brain death. One doc is not permitted to establish brain death-- has to be at least 2, and sometimes more by policy in some institutions. There are very well established criteria for how the process is conducted.

JS is a very prominent person, so it's possible that Max's parents received an increased level of personal attention from many different administrative personnel, in addition to the clinical docs. BP has stayed completely out of the public media coverage of this case, as he should, and I'm sure, as the hospital attorneys have advised. No comments, no interviews. And this is because there is the still -open possibility that what he told the family was interpreted in such a way, and was possibly retold to others, that this then became motive for Rebecca's potential revenge murder. That is a heckuva sticky position for him, as well as the hospital to be in.

There is no record of what exactly he said to the family. Families ask many questions, and docs will do their best to explain what is going on using language that is appropriate for the understanding level of the family members, and taking their shock into consideration. I suspect (and hope) Dina and Jonah asked MANY questions, and had very LONG conversations with BP and other docs, several times a day.

At some point in the conversation, BP presumably used language that included the word "smother", or a description of anoxia/ hypoxia, and examples of causes. He is a respected professional, and accustomed to choosing his words carefully. As I have pondered this over the past year, I cannot believe any professional in his position would have volunteered a theory of nefarious smothering with the presentation that this child had, in the first day or so. What I keep returning to is the almost certain MULTIPLE conversations that occurred between docs and DS and JS explaining Max's condition. Global hypoxia would have been part of that conversation. I think it is highly likely that this was explained using comparables-- as in "we see this kind of injury in situations where the brain has been starved of oxygen, such as prolonged cardiac arrest and smothering situations".

Now, I don't claim for a single moment to know that this is how BP used the word smother, but it could have been an unfortunate choice of word on his part, IMO. Or, he may not have ever used the word smother, and his explanation was interpreted this way by DS.

I am not surprised that BP has not given any interviews or made any further statements about his use of the word "smother", if indeed he used that word in conversation with JS and DS. I certainly can believe that he was surprised at the grave situation Max was in from a fall from the staircase-- that is entirely believable. Remember that the investigation had barely begun at that point-- there were no CPD schematics of the fall, no police reports for him to look at. The first MRI that identified the high spinal cord contusion may not have been completed when he had the "hypoxia" conversation with DS/ JS. We simply don't know, and probaby won't ever know what he said, and how that was interpreted and received by JS/ DS.

Right now, we only have the mention in the LE reports that the docs were concerned about the mechanism of accident, and DS's comments about "smothering". The LE reports make sense to me-- as a consequence of the social worker report, and I attribute DS's comments about smothering as her interpretation of what he said-- heresay. Until or unless BP is willing to go on the record outside of a LE investigation (which he would be crazy to do), we will never know. He has done a very good job staying quiet and out of the media. For all we know, he may be very upset that his words were interpreted in such a way as to implicate another person. He may be upset that his words could have possibly lead to another person being killed for revenge-- particularly if the cord damage was unknown/ undocumented when he spoke them.

I think it is VERY telling that neither he, nor Rady hospital spokespeople, have had ANY public statements in support of the child abuse/ assault theory put forth by DS and her investigative team, or at any point in the last year. He clearly said SOMETHING that was interpreted as "smothering"-- at this point, it is ONLY Dina's word what he did say. Even Jonah has not said anything about this.

You raised a very good point regarding "Dina's interpretation of what he said". Anyone who has ever been in a stressful situation realizes that at times their brains don't process like they typically do and that their memories from this period are often blank. IMO, it's really difficult to put much stock in her memory of conversations during that period.

 

[CuriousGeorgia]

BBM


So now you are accusing those that don't share YOUR opinions to be hired help? Sorry, I speak for myself and it is not "spin". It is my opinion. And my opinion is based on FACTS, not rumors.

Originally Posted by Just Checking
"A significant issue in the closed investigation that both parties want to understand, as well as those interested on this blog, is what level of investigation rigor occurred. Where alibi's accepted without "sufficient" due diligence? Was first level evidence accepted without "sufficient" due diligence? Of course, all of you are commenting on these very issues. Since this is such a concern by literally everyone there will be a significant amount of speculation and comments that are simply "IMO." What does LE have that we dont? What does AB have that we dont that was considered significant enough that the Attorney General at least has considered sufficient to consider in deciding to open the case or not? Same goes for DS and her attorney, if they have made as much progress wiith AG as AB has...

Spin control is occurring literally by everyone - even by individuals on this blog. It wouldnt be a stretch for JS's PR hired team to join blog's to manage and influence communication. This happens in numerous companies and product related blogs."


Not sure how I arrived at that conclusion? See you comment above in BOLD.

 

[i.b.nora]

However, a blog is just that a blog! Not a repository of undeniable facts. It is a social commentary open community with guidelines, which this site and administrator has explained thoroughly. ... You dont control this blog nor does anyone else other than site owners.

I snipped.

FYI: Websleuths dot com is NOT a blog and just because you say it is does not make it so. In the 'olden' days of the world wide web, a site similar to this might have been called a 'bulletin board'. The Well was one of the early communities.
It makes your opinions less credible to me when you call Websleuths a blog. Just thought you might like to know.

 

[Just Checking]

I snipped.

FYI: Websleuths dot com is NOT a blog and just because you say it is does not make it so. In the 'olden' days of the world wide web, a site similar to this might have been called a 'bulletin board'. The Well was one of the early communities.
It makes your opinions less credible to me when you call Websleuths a blog. Just thought you might like to know.

[/QUOTE]

OK - I'm not looking for validation... [ame="http://en.wikipedia.org/wiki/Blog"]Blog - Wikipedia, the free encyclopedia[/ame] call it whatever, as if every visitor on this site knows or cares what you want to call it! The activity is what is relevant. I could care less if you think my opinions are credible - jeeze-o-pete!

 

[screecher]

MyBelle and Ocean Blue Eyes - Do you think that some of RZ's injuries could have been caused IF and WHEN she pulled down the chandelier to "stage" the scene? I am thinking that is a big possibility.

I'm not MyBelle or Ocean Blue Eyes - but seeing as this is a PUBLIC thread I have input.

Mother Mary...how would RZ incur her injuries? Sprinting over the railing, missing the chandelier, bouncing off the staircase back into chandelier, getting wrapped up in the chain that chandelier was hanging from? Oh perhaps that would explain the OTHER mark around her neck?

Bwaahahaha

 

[screecher]

Couple points of clarification as I read thru the comments here. (I am a WS-verified health care professional):

- It's unlikely Max had a cardiac consult to determine if he could be a transplant candidate. Max had sustained a 30+ min cardiac arrest, and had (at a minimum) 2 rounds of epi in addition to whatever supportive meds (cardiac, pressors, etc) that he was receiving in ICU. Typically, a patient with that history would not be considered a candidate for heart donation.

-There is no evidence he was defibrillated at the scene by paramedics. The reports state he had ROSC after 2 rounds of epi and CPR. ROSC is "return of spontaneous circulation." If he was in aystole, or had an agonal rhythm, or electromechanical dissociation (any or all of which are the most likely scenario), electricity is not indicated. Paramedics would have treated him differently if he was in a shockable rhythm.

-The process of determining brain death is complex, multifactorial, and involves numerous tests and measures over time. Typically, if a patient has fairly stable cardiac and physiological function, the process will occur over 24-72 hours or so-- every situation is different. But it is seldom a situation when the patient is alive with some hopeful prognosis one minute, and brain dead the next. The prognosis was not hopeful for Max from admission to the first hospital, when his decorticate posturing demonstrated a very grave situation-- BEFORE he was even transferred to Rady. Medical records, of course, document the total situation, but will not be released to the public (as they should NOT be, unless the family desires this). However, his neurological condition and prognosis would have been an ongoing discussion with family-- not just "one" conversation at as specific moment in time. Families are understandably in shock when a loved one is injured so severely, and often don't hear or interpret, or understand the explanations, especially in the first hours and days. I cannot fault Dina for hoping his condition was recoverable, nor can I fault her for not accepting or comprehending the gravity of the situation. From all that I have read, I cannot believe any physician held out any real hope that he could recover. The global cerebral edema was too massive at that point, and herniation was a matter of time, even with aggressive treatment to reduce intracranial pressure.

-A number of things have to be coordinated once a patient is declared brain dead, and the donation teams notified. These teams of surgeons and support personnel come from outside of the hospital, and are not in any way involved with the care of the patient while alive, nor participate in the decision to declare brain death. As Max's case was still under investigation at the time of his brain death, permission from the ME/ LE had to be also be given to allow donation. All of that takes time, as well as identifying and mobilizing the recipient patients and their caregivers.

During that period of time, no one is waiting for "toxins" to be eliminated from the donor. All meds that affect brain function and consciousness, such as pain meds, sedatives, and anesthetics, are withdrawn during the period of time BEFORE brain death is declared, so that the true picture of brain function can be assessed over time-- without those meds clouding the clinical picture. The patient continues to remain on the ventilator and receive bodily care, and certain meds (such as some blood pressure meds, electrolytes, etc) can still be given to ensure that target organs, remain in optimum condition for donation. This is an exquisitely difficult time for family members, as they observe many preparations for donation occurring, and care still being delivered aggressively to the patient's body in the ICU setting.

- It is true that many cases where children sustain serious or suspicious injuries are reported to social services, and then on to the police for investigation. That doesn't mean that there WAS anything that occurred that was non-accidental, nor does it ESTABLISH that there was any assault or child abuse before the fall. It's just part of the documentation and reporting process because Max sustained an unwitnessed accident.

Many thanks K Z.

 

[time]

This is the continuation of the post I am talking about. It was by CS on Friday. GS NEVER posted.

If it is a continuation of a post that C made on a Friday then the Friday you are talking about would have to be before Max had his accident. :banghead:

It has nothing to do with whether GS posted or not.

C is posting on the day of Max's accident, that's very clear.

 

[katydid23]

I'm not MyBelle or Ocean Blue Eyes - but seeing as this is a PUBLIC thread I have input.

Mother Mary...how would RZ incur her injuries? Sprinting over the railing, missing the chandelier, bouncing off the staircase back into chandelier, getting wrapped up in the chain that chandelier was hanging from? Oh perhaps that would explain the OTHER mark around her neck?

Bwaahahaha

If I remember correctly, RZ said that her younger relative injured herself on shards of glass from the chandelier when she was 'cleaning it up.' So why the ' bwahahahaha?

 

[x_files]

Thank you Jjenny for stopping the never ending morphing story. We really have to work hard here to keep on keeping on keeping this story straight. It's like doing battle with an out of control alien monster.

This is just my lame attempt at humor so please don't take offence. However, your point is well taken and this is a serious matter.

I totally agree that the reason for Rebecca's alleged suicide seems to change with each version of events. However, I do not believe any version of this story logically proves she committed suicide. The circumstances of her death point to murder in my opinion.

What are the chances RZ knew how to tie these knots? Is it something she knew about fro boating? Girl Scouts? Hobby? Did she look up online how to hang yourself first?
Who was in the house that did know how to tie knots?
I think she'd have to research suicide ropes, hanging first IMHO.

 

[CuriousGeorgia]

If it is a continuation of a post that C made on a Friday then the Friday you are talking about would have to be before Max had his accident. :banghead:

It has nothing to do with whether GS posted or not.

C is posting on the day of Max's accident, that's very clear.

The article I posted clearly states it was Friday, April 15, 2011. The Friday after Maxie's accident that Monday the 11th.

 

[CuriousGeorgia]

I was saying that some of the injuries found on Rebecca (the few, small bumps on her head for instance) could have been caused by the chandelier hitting Rebecca - IF Rebecca removed the chandelier, and placed in near Max, along with the razor scooter to stage the scene.