News From Terre Haute, Indiana

Letters

June 15, 2014

Readers’ Forum: June 16, 2014

Criticism of coroner ruling based on false assumptions

After having read the letter criticizing Vigo County Coroner Dr. Amos in the June 8 Tribune-Star, I felt compelled to respond to this unwarranted attack. In the letter, the author stated “Amos cannot see any connection between brain trauma resulting from being punched and kicked in the head and a subsequent ischemic stroke. Really?”

As someone with considerably more knowledge of this case than that of the letter’s author, let me point out a few relevant issues. For one, being severely beaten is not necessarily synonymous with brain trauma. In fact, the medical records provided by Union Hospital did not document any history of traumatic brain injury, but did in fact mention several other co-morbidities which are associated with stroke in young individuals.

The author also suggests that having a stroke under the age of 50 virtually never happens in the absence of trauma, although his own reference states that it increases the risk by 60 percent. From my calculations, a 60 percent increase over zero would still be zero. Obviously, there are strokes in individuals under 50. If not, there would not have been enough of a study population to compare those with and without prior trauma, and arrive at the 60 percent figure. Whereas “Dr. James Burke and colleagues have a slightly different point of view,” neither he nor his colleagues examined this particular patient or his medical records. As a Forensic pathologist, I have found that it is generally considered a fairly important consideration to do so before rendering scientific based conclusions.

Another major problem I have with this letter is that the author has based his conclusions about Dr. Amos on three assumptions, which are all seriously in error. First of all, he has assumed that the newspaper article regarding Dr. Amos’s decision was a comprehensive and thorough discussion of all facts in the case. As someone who has dealt with local media coverage of death investigations for nearly 30 years, I can assure you that this is a very dangerous assumption.

Local media gives a brief summary at best, keeps it simple for the average reader, and almost never provides all relevant information. Long detailed stories with all pertinent facts do not get published because of time and space considerations,

Secondly, the author in his attack assumes that Dr. Amos acted alone in making this determination. In reality, the determination was made after review of detailed medical records by myself and Union Hospital’s chief quality officer Dr. Bolinger, consultation with the Board Certified Neurosurgeon who treated the patient, and a complete autopsy. Only after all these medical investigators deliberated and discussed the various medical facts and findings, was the cause of death determined.

Finally, although the author cites a reference to a respected medical journal, he assumed that the best way to communicate this to Dr. Amos was in the form of a letter, submitted to the editorial page of the Tribune-Star, instead of a phone call or letter to her directly. Really?

— Roland M. Kohr, M.D., Forensic Pathologist, Terre Haute

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