Max's Search Warrants Released!!!! Discuss Max's Death here #2

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Good points. But if the hospital made a report of possible abuse in this case, they certainly would have taken in account any injuries that were the result of emergency care. Hospitals are very lawsuit-saavy and self protective. I believe they are careful in covering for own financial interest.

In almost all cases involving children where there are severe injuries, CPS is asked to investigate.

When my youngest was in his earliest athletic endeavors, I realized at one point at SD Children's Hospital, when the nurses were questioning my son about how he received his injury, that she was inquiring about possible abuse. Thank goodness the staff is so vigilant. (Son had given a karate kick demonstration and managed to kick a stone wall and "lift the knee cap"...all boy...This is the same lad that was going to "fly" into the canyon from the roof of a garden building.)

I am considering the scrapes, etc might be a result of the EMT/Medics hurried procedures and need to improvise for intubation, etc. I'm sure those were frantic moments.
 
Below was taken from the County of San Diego Guidelines shown under 'Reportable Deaths'

"Coma:
All deaths in which the patient is comatose on arrival to the hospital and remains so throughout the hospital course should be investigated unless the cause of the coma has been definitely established as being due to a natural disease."

http://www.co.san-diego.ca.us/me/hospitals/reporting.html#top

Also California has, 'The California Child Abuse & Neglect Reporting Law'. Dr. Peterson would have been a mandated reporter. When he suspected Max was suffocated he would have been required to report that immediately.

Dina and Jonah would also be mandated reporters I would think. In any case Jonah is a lawyer so he would have known about it, no? Didn't Jonah also have medical input from Howard Luber?

http://www.dss.cahwnet.gov/Forms/English/PUB132.pdf
 
IMO, the genesis that Max's fall was not an accident began when a doctor gave that opinion to the parents. Has anyone ever revealed what JS reaction was to such an accusation? Because, unlike DS, he supposedly loved BOTH of the deceased.

I am puzzled by the way JS has placidly accepted both rulings...of accident and suicide...while both families and their supporters are so ardent in trying to get questions answered. He seems...uninvolved. In actuality, he is the person who lost the most...who lost two loved ones. But he is also the person who seems most content with the status quo.

If he despises this crazy ex-wife of his...and even has the slightest inkling she may have hurt the woman he loved, why isn't he using his influence and money to run her to the ground? It's not like they were best friends.

And if he thinks RZ murdered his child, why isn't he standing with Dina?

And finally, if he thinks the investigations were shoddy, he is in a position few people are...to use his resources and contacts to bring pressure.

But nothing.
 
IMO, the genesis that Max's fall was not an accident began when a doctor gave that opinion to the parents. Has anyone ever revealed what JS reaction was to such an accusation? Because, unlike DS, he supposedly loved BOTH of the deceased.

I am puzzled by the way JS has placidly accepted both rulings...of accident and suicide...while both families and their supporters are so ardent in trying to get questions answered. He seems...uninvolved. In actuality, he is the person who lost the most...who lost two loved ones. But he is also the person who seems most content with the status quo.

If he despises this crazy ex-wife of his...and even has the slightest inkling she may have hurt the woman he loved, why isn't he using his influence and money to run her to the ground? It's not like they were best friends.

And if he thinks RZ murdered his child, why isn't he standing with Dina?

And finally, if he thinks the investigations were shoddy, he is in a position few people are...to use his resources and contacts to bring pressure.

But nothing.
 
IMO, the genesis that Max's fall was not an accident began when a doctor gave that opinion to the parents. Has anyone ever revealed what JS reaction was to such an accusation? Because, unlike DS, he supposedly loved BOTH of the deceased.

I am puzzled by the way JS has placidly accepted both rulings...of accident and suicide...while both families and their supporters are so ardent in trying to get questions answered. He seems...uninvolved. In actuality, he is the person who lost the most...who lost two loved ones. But he is also the person who seems most content with the status quo.

If he despises this crazy ex-wife of his...and even has the slightest inkling she may have hurt the woman he loved, why isn't he using his influence and money to run her to the ground? It's not like they were best friends.

And if he thinks RZ murdered his child, why isn't he standing with Dina?

And finally, if he thinks the investigations were shoddy, he is in a position few people are...to use his resources and contacts to bring pressure.

But nothing.

Agree, but Jonah is also a very smart business man who cares deeply about his professional reputation and the financial aspects of his business. I believe his PR team instructed him, rightly, to stay away from the negative limelight regarding the horrific deaths. That is likely why he only put out one letter last year to the AG giving the sympathetic appearance of requesting a re-opening of Rebecca's case but directly voicing approval and accepting the case ruling of suicide. It was good PR.
 
Just commenting as I read, trying to catch up.

CDS22 asked me:

I believe that Maxie's death was an accident.
I believe there may have been some horseplay going on on the stairway banister earlier that morning, before the teenaged shacknai's left. I don't doubt that all the minors were horsing around on that railing.

I have no real speculation regarding the specifics.

I would believe many possibilities, none of them malicious. I'd even believe XZ could have been involved or a witness

but I'd also buy a scenario in which Maxie, having been warned of the dangers, waited until XZ & RZ were both in the bathroom to try his stunt.
This is my working theory
Thanks for your response.

Do you have any specific theories on how he went over the railing and got fatal whiplash? That's what gets me -

how he got his spinal cord unplugged from his brain in a way that typically only happens in a car accident with no seat belt. I can't see him getting enough velocity even if he fell from the railing or jumped. Plus it wouldn't explain his back injuries and the fact that he was found with a scooter on his leg.
This is in my working theory too... I am having a problem with the velocity.
Just bringing forward relevant posts that are Important in the discussion.. Demo below:
72d0b279.jpg
Yes you're right she did. It has bothered me too. Also she said (paraphrazing)
the last time she had seen the scooter had been a couple days ago (at time of accident) and was upstairs

It is in her statement to police. I can no longer open the docs as I get file damaged. Wish I had of saved them.


ETA:
she said that Max was warned not to play with the scooter upstairs.

IMO The scooter HAD to be involved in the accident~ And IMO Ocean was too!(so to speak) Would a 6 yr old boy chase a dog indoors when riding a scooter?...
Blame the victim?... blame the "scooter"? ... blame the dog...

OK IMO Ocean did not go over the banister with Max, but the scooter DID!

Those scooters don't weigh much. Just my thoughts here!

♦ What if RZ angrily... picked the scooter up and flung it over the balcony toward the 1st floor (the scooter is not supposed to be upstairs!)
♦ Scooter gets "hung" in chandelier instead of landing on 1st floor.
♦ Max wants his scooter and asks XZ for help.

What if XZ were to be added into this scenario? Max was never running but he was trying to get something from the chandelier... could XZ have been sitting/leaning over banister holding Max by the legs to assist him in retrieving the object?
Like this?
Idea.jpg

Could explain how the scooter ended up on his legs because all three fell together?
Still reading just don't want to forget my thoughts!:moo:
 
IMO The scooter HAD to be involved in the accident~ And IMO Ocean was too!(so to speak) Would a 6 yr old boy chase a dog indoors when riding a scooter?...
Blame the victim?... blame the "scooter"? ... blame the dog...

OK IMO Ocean did not go over the banister with Max, but the scooter DID!

Those scooters don't weigh much. Just my thoughts here!

♦ What if RZ angrily... picked the scooter up and flung it over the balcony toward the 1st floor (the scooter is not supposed to be upstairs!)
♦ Scooter gets "hung" in chandelier instead of landing on 1st floor.
♦ Max wants his scooter and asks XZ for help.

What if XZ were to be added into this scenario? Max was never running but he was trying to get something from the chandelier... could XZ have been sitting/leaning over banister holding Max by the legs to assist him in retrieving the object?
Like this?
View attachment 26881

Could explain how the scooter ended up on his legs because all three fell together?
Still reading just don't want to forget my thoughts!


I think other scenarios such as yours are plausible enough to investigate. Or such variables as Max was pushed by Ocean, lifted, IDK. We just got back from visiting the grandkids. Even the 2 year old is climbing on everything now and I mean EVERYTHING! I watched as his older sister gave him a hard push on his plastic ride thingy in the garage (he ended up going over my toe - ouch and he went backwards on the concrete). It happened in a split second, unexpectedly, and thankfully he was ok. Luckily they have a door at the bottom of their stairs as he also climbs right over the gate at the top of the stairs.

My point being that something can happen in a split second with even one object and you might not know what occurred if you weren't watching. With Max we have multiple possible objects and structures that COULD be involved. I think it is impossible to pick out the exact scenario, but what I liked about your scenario is that it points out the scooter could have damaged the Newel post at some point but not at the same time as the accident. The scooter could have been in the chandelier or Max could have used the handle to lean over (at the 26" mark) and try and get the ball out of the chandelier when Ocean ran up and jumped on him. That would propel him somewhat, especially if Max was trying to stand on or was already on top of the banister.

My grandkids also have a big dog... wow, he is so gentile and let's them get away with so much (Golden Retriever) but he loves to play and can get really worked up if kids start running around (or I do), especially with one of his favorite sticks. He doesn't give up on a tug of war easily but had he let go, I'm sure I would go flying in the opposite direction, let alone a smaller kid. Maybe Max had the scooter all ready to go on top of the with him and Ocean grabbed it to play. Maybe Max was running down the hallway toward the stairs, thinking he'd get a jump up on the banister, but Ocean ran after and into him, flinging him off the balcony.... his scooter could have been up there on the Newel post waiting and he grabbed it as he went off, creating the gouges and landing near him/on him.

Some of my scenarios may be obviously discounted, but there are a lot of variables one has to consider in this situation given certain parameters and evidence and they may never know the exact chain of events.

The 26 inch height is still of concern for me, but may or may not have anything to do with the accident.

Stair handrails and guardrails safety #4.
The required stair handrails height is between the 34” and 38”

Stair handrails and guardrails safety #9.
Stair guardrails in single family properties must be a minimum of 36” high from the walking surface (balconies, decks, galleries) and no climbable / horizontal bars – kids love climbing.

http://www.checkthishouse.com/1961/stair-handrails-and-guardrails-safety-issues.html

It was Dinah and Jonah's responsibility to see that this structure, the banister over the stairs, was safe for a child.
 
Another reference, because I don't know why no one it seems almost no one is questioning that this staircase was a safety hazard to begin with.

Minimum Guard Height Requirements : 36 inches residential, 42 inches commercial. Just like the opening requirements, older codes allowed for railings as low as 30”, and in some cases even lower. For adults and children alike, a low railing is a hazard for falling over. Therefore, it is highly recommended that the height of any non-compliant railings be modified to at least meet the minimum requirement.
http://www.nomma.org/displaycommon.cfm?an=1&subarticlenbr=52
 
I've posted what was said by the doctor in the SW.

Now let's see what was said in the AR:

https://docs.google.com/viewer?a=v&...DctZGRjMy00ODVkLTk1YWItODAxZjAxMzE5OTVl&hl=en

And the accompanying diagram of MS's injuries:

http://www.autopsyfiles.org/reports/Other/shacknai, max_report.pdf

Cause of death:

Anoxic/ischemic encephalopathy
Due to resucitated cardiopulmonary arrest
Due to cervical spinal cord contusion
Due to blunt force trauma of head and neck

Look at this and reverse it. This describes his accident and what followed.
♦ Max fell landing on his face/head
blunt force trauma of head and neck
♦ Upon landing he recieved
cervical spinal cord contusion
♦ This caused his heart to stop and require epinephrine to restart it
resucitated cardiopulmonary arrest
♦ The lack of oxygen to his brain BEFORE resuscitation caused irreversible brain damage/death
Anoxic/ischemic encephalopathy

IMO he fell straight down like he was "diving into a shallow lake"

IMO it does not sound like he ever "hit" the other railing
* (It would require propulsion to go from one banister to the next & by hit it as well prior to landing. Wouldn't that have broken/slowed the speed of his fall?)


Something else to think about: MS's spinal cord contusion was very severe.
Most falls down the stairs or from the railing don't result in fatal injuries
. (Link is on original thread). So what could have stopped him from having control of his head and neck muscles so that when he landed on a carpeted surface, he sustained whiplash severe enough to die from (link on thread one about why whiplash is almost never fatal)? Could it be that he was unconscious (from smothering) and that is why
he couldn't break his fall with his hands or control his neck muscles to keep from hitting the floor that hard and snapping back?

JMO

All I can come up with is that he was holding onto the chandelier or was "caught" in it and unable to... (upside down using his hands to free himself)
when it fell from where it was hung! ~jmo

The problem is explaning how the scooter made it over the railing.

JMO

I so agree!

I don't think anyone here is disputing the AR findings that MS ultimately died from lack of oxygen, or that he had a spinal cord contusion. I think what some of us are debating (and are in agreement with Dr. Brad Peterson about) is that MS might have been unconscious prior to his fall.

The fall alone wouldn't have rendered him unconscious til he hit the ground, since hitting the ground is what apparently caused the contusion. (AR for reference)

The only way I can see MS having the velocity to hit the ground with the force that he did, and the only way I can see him not having the ability to break his fall with his hands, is if he was unconscious prior to hitting the ground.

JMO


CDS It's not a matter of velocity, it's how the person lands.
I had a 17 yo in the ICU with SIGNIFICANT brain injuries and he was simply sitting in the back of a truck on top of tailgate. When the red light turned green and began to move forward, he fell out backwards landing on his head. Some velocity there I guess but NOT MUCH, he just "toppled over"
His skull just popped like an egg.

According to the AR, RZ was not doing CPR when the officer arrived on scene.
Also, according to the AR, CPR was started after EMT's arrived. The EMT's manually pumped the heart and gave oxygen until the heart resumed beating.

According to both the ICU Chief and the ME, the initial lack of oxygenated blood to the BRAIN resulted in brain death. We can argue forever about whether or not his heart stopped because of the fall or suffocation but the result to Max was the same. Those first minutes of unpumped blood killed him. RZ was a certified medical technician who worked for surgeons. So, yes, I do question why she was not performing CPR on Max when the officer arrived. If she had done so, the outcome may be different.
CPR wasn't started in the first several minutes
A very odd pattern of abrasions down the boy's back
An unexplained scooter on top of him
Unexplained balls
Unexplained cut shirt
A claim he said "ocean"
Deep cuts to a girl's leg who was said to be in the shower at the time

All, add up to a very suspicious death of a small child.

JMO
I don't think any medical professional could have done anything to help without the "epi" and/or a defibrillator...
I still don't understand why she was not performing CPR though ~ unless she thought his neck was broken and it was a moot point but still!...

The abrasions down the back of an active 6 yo old boy don't bother me so much. I assume there was a good bit of glass in the area from the chandelier

(unless he didn't fall alone and that was not reported. There might have been glass between him and XZ...)

It was never mentioned that he had any glass in these cuts or that any had to be removed from his wounds did it?

The balls, cut shirt and the Ocean comment do!

The cuts on XZ IMO almost support that she was in the shower and got them upon entering the area or kneeling at Max's side to try and render aid...

AGAIN if she and Max fell together along with the chandelier and she landed on top of him... (which would add velocity as well as force) then XZ got the cuts as she got up and tried to help him???
All moo and again trying to digest this new info!

still sounding accidental...
The 15-20 min of RZ not hearing ANYTHING from an active 6 yo boy and then a "crash" sounds like he might have been doing/into something
he should not have been...
As any parent knows when kids are too quiet that can be a RED FLAG!
 
cardiac arrest is first. Breathing is useless if the heart is not circulating oxygenated blood to the brain.

That's why traditional CPR training included rescue breathing plus chest compressions.

JMO

I need to find a link nursing school was a LONG time ago! IIRC a spinal cord "injury" (however it occurs with or without a fracture) Will not cause immediate cardiac arrest. It causes RESPIRATORY ARREST. ~due to the height of the injury the victim can no longer take a breath on their own.
CARDIAC ARREST occurs a few min after there is no respiratory effort due to lack of oxygen and brain death ensues...
Rescue breathing would be required in order to prevent the heart from stopping. IMO

Think about it... People who sustain certain spinal cord injuries are quadriplegics and on ventilators. Their hearts still beat on their own because the brain stem is functioning.

A BRAIN STEM injury is the only thing that will cause cardiac arrest immediately in this type of situation.

An example would be a gun shot to the head...

Max's brainstem showed no hemorrhage or necrosis... pg 14
http://www.autopsyfiles.org/reports/Other/shacknai, max_report.pdf

He "suffocated" because he could not breathe, then his heart stopped.

pg 5 2nd paragraph
http://www.autopsyfiles.org/reports/Other/shacknai, max_report.pdf

It was the brain swelling that progressed to the point of requiring a shunt to be placed into his brain to drain the fluid causing pressure in his brain that ended up causing his death...
pg 16 http://www.autopsyfiles.org/reports/Other/shacknai, max_report.pdf

Climbing trees and falling off them is a more common accident for children, even falling down stairs, I don't think falling off of banisters is all that common.

Kids also like to climb on the outside of the railing . To see that at the top is terrifying .

After looking at that picture of the stairs again I was thinking Max might have been doing that as well!

http://www.apparelyzed.com/respiratory.html
With a spinal cord injury of C4 and higher, all the muscles which control breathing will be paralysed. these are the intracostal muscles, the diaphragm and the abdominal muscles. In order to breath, the person will need a machine called a ventilator to breath for them, this machine forces air in and out of the lungs to re-oxygenate the blood. In order to cough, the person will need help by way of a carer performing an assisted cough procedure.
[ame="http://en.wikipedia.org/wiki/Spinal_cord_injury"]Spinal cord injury - Wikipedia, the free encyclopedia[/ame]
Injuries at the C-1/C-2 levels will often result in loss of breathing

http://www.helium.com/items/1769175-how-the-body-can-be-impacted-by-a-brain-stem-injury
*Brain stem injuries can go into sudden cardiac arrect or respirator disorder:

A person suffering from a severe brain stem injury can go into sudden cardiac arrest or into a respiratory disorder.
All moo but I can not find anything that says a spinal cord injury causes the heart to stop immediately... BUT I have been wrong before.
 
So in fact we have no evidence Rady Children's Hospital ever discovered Max had spinal cord damage, which would explain why the doctor felt visible injuries didn't fit with brain swelling and cardiac arrest-which they didn't. Just the injuries to Max's face would not explain cardiac arrest or brain swelling. But autopsy clearly showed Max had severe spinal cord damage explaining both cardiac arrest and brain swelling (due to lack of oxygen).

I have no idea-I am not a physician. I am not sure he actually had a C5 abnormality-he had no broken bones in his neck and no fractures, as far as I can tell from the autopsy. All his damage was to the spinal cord as I understand it. Maybe the Rady's was actually correct in that he didn't have a C5 abnormality-I believe C5 refers to the spine itself, not the cord.
~ I am a little confused here myself...
They were treating a traumatic brain injury here???
It says "cerebral edema (brain swelling) rotational artifact (a "blip" on the CT) and possible C-5 abnormality...

http://radiographics.rsna.org/content/24/6/1679.full
Artifacts can seriously degrade the quality of computed tomographic (CT) images, sometimes to the point of making them diagnostically unusable.

C-5 refers to both the spine and cord...giving the suspected location of the injury it's at the 5th cervical vertibra...

http://www.apparelyzed.com/support/functionality/c5.html
"Able to breathe without a ventilator using diaphragm"

pg 2 2nd paragraph
"He was found to have head trauma and transferred to Rady's..."
pg 4
He had a frontal and vertex skull fracture..."

"He had non reactive pupils and decordicated posturing..." - that IMO is more from a brain injury not a spinal one... a C-5 injury could be in addition to a traumatic brain injury but in and of itself would not cause non reactive pupils and posturing....

Frontal skull fracture... he HAD to land on his forehead!

sad skills with trying to show what I mean but...
Say the black area is the floor....
and his forehead hit first his body would have bent to cause the
trauma...
floor.jpg



moo
 
http://lib.bioinfo.pl/pmid:20173663

Prognosis for Children in Cardiac Arrest Shortly After Blunt Cranial Trauma

The goal of this investigation is to determine the success rate of aggressive cardiorespiratory resuscitation in children who experience blunt cranial trauma of sufficient magnitude to quickly cause cardiac arrest.

The average cardiopulmonary resuscitation time was 36 (2-107) minutes. A sinus rhythm was established in 50% but was not sustained in most. The sole survivor was an 8-year-old boy who was ejected and had asystole at the scene. At discharge, he was walking well but had cranial nerve deficits and learning disability. CONCLUSION:: Survival in 40 consecutive children with documented cardiac arrest caused by blunt cranial trauma was 2.5%. This series, when combined with other published reports, is supportive of the position that aggressive resuscitation is rarely successful after 10 minutes and futile after 20 minutes.
 
~ I am a little confused here myself...
They were treating a traumatic brain injury here???
It says "cerebral edema (brain swelling) rotational artifact (a "blip" on the CT) and possible C-5 abnormality...

C-5 refers to both the spine and cord...giving the suspected location of the injury it's at the 5th cervical vertibra...

pg 2 2nd paragraph
"He was found to have head trauma and transferred to Rady's..."
pg 4
He had a frontal and vertex skull fracture..."

"He had non reactive pupils and decordicated posturing..." - that IMO is more from a brain injury not a spinal one... a C-5 injury could be in addition to a traumatic brain injury but in and of itself would not cause non reactive pupils and posturing....

Frontal skull fracture... he HAD to land on his forehead!

sad skills with trying to show what I mean but...
Say the black area is the floor....
and his forehead hit first his body would have bent to cause the
trauma...
View attachment 26890



moo

Wouldn't that conflict with what Dr. Melinek claimed? Sorry, I'm really confused and so appreciate those of you who know what you are talking about.
 
Wouldn't that conflict with what Dr. Melinek claimed? Sorry, I'm really confused and so appreciate those of you who know what you are talking about.
The skull fracture?
I don't know what Dr. Melinek claimed... (going to go find out though)
What did DR M say?
What else could have caused Max to have a frontal skull fracture?...

eta: at first glance
"The nature and location of Max's skull fracture and subgaleal contusion are indicative of a head-first contact with the first floor surface and thus are consistent with Max moving or being moved over the railing following the assault causing him to fall to the first floor,"

Read more: http://www.foxnews.com/us/2012/08/0...icide-independent-report-finds/#ixzz27SxDiLvi

I am REALLY undecided if Max was unconscious prior to the fall ~she seems to think he was...

still researching....
 
Running full out..... boys love to run full out.... especially when playing with a dog.... the scooter is at the top of the stairs... the boy trips over the dog .... grabs at anything close to break his fall... finds the handle of the scooter.... leaning up against the newel post.... boy and scooter go over the low point of the bannister and get caught in the chandelier....

the boys head snaps against the middle bannister causing the spinal injury... the fall to the carpet covered cement....causes the front head injury.... explains why his hands were not broken etc... if you were conscious you would naturally try to break your fall with your hands in front of your head....

need to know the length of the chandelier... height of bannisters... length of scooter... lenght of MS arms outstretched....
 
Weird accidents happen. Someone I know was trying to cut a tree limb and was standing only a few feet up a ladder. The cut tree limb landed on the ground, bounced oddly and swept the ladder out from under him. He only fell a few feet, but is on life support....

My biggest question is why isn't there an accident specialist called in? I know that it has been "officially" recreated. Did they use actual accident re-creation specialists? My dad is a safety engineer and he has been called on to analyze accident scenes (usually with plane crashes). It is all physics. Anyways, it seems like a team of professional safety engineers along with a medical professional or two could release a few good scenarios as to what happened. JS could totaly afford that if he was interested. JMO

I am a newbie to this case so I apologize if this was addressed in another thread of the case.
 
Does anyone here have thoughts on why there was plant material found in Max's lungs on autopsy?
 
Does anyone here have thoughts on why there was plant material found in Max's lungs on autopsy?


I thought KZ explained that a while back - was it possibly food because of regurgitation?
 
I thought KZ explained that a while back - was it possibly food because of regurgitation?


No, I never saw that. The first time I saw it was on Dr Melenick's report.
I don't think it could be food because of regurgitation though.
 
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