Five doctors agree with examiner in Scientology death
By THOMAS C. TOBIN
ęSt. Petersburg Times, published March 9, 1997
CLEARWATER - Five pathologists say it is clear from key lab results that Lisa McPherson was severely dehydrated when she died after a 17-day stay at a Church of Scientology retreat.
The Times interviewed the doctors after the much-publicized disagreement between the church and Pinellas-Pasco Medical Examiner Joan Wood over how McPherson died. None of the doctors were previously familiar with the case.
While many of their conclusions echo what Wood has said about McPherson's death, most of the doctors said they needed more information before they could say, as Wood did, that McPherson was unconscious for up to 48 hours before her death and did not have liquids for five to 10 days.
Two of the doctors questioned the Church of Scientology's statement that McPherson "suddenly took ill" and its suggestion that a staph infection was a major factor in her death.
Scientology's Los Angeles-based lawyer Elliot Abelson responded Friday by placing calls to several of the doctors to question them about their interviews with the Times.
Earlier, in an interview before he made the calls, Abelson said the doctors based their comments on partial information about the case, including facts from Wood's autopsy report, which the church alleges is seriously flawed.
In recent weeks, Abelson has accused Wood of being biased against the church, drawing conclusions "off the top of her head" and making irresponsible comments to reporters. Abelson also has called Wood "a hateful liar." And a Scientology lawsuit against Wood alleges that Wood's statements "are not supported by the autopsy report."
At the center of the issue are results from lab tests done on McPherson's eye fluids, which shaped Wood's central conclusion - that McPherson was severely dehydrated.
Five pathologists, including a worldwide expert on post-mortem chemistry from Minnesota, were given those lab results to see what their conclusions were.
"In my opinion, it is highly probable that this death is, indeed, due to dehydration," said Dr. Ed Friedlander, chairman of the pathology department at the University of Health Sciences in Kansas City, Mo.
"If my scenario is correct, then anyone, even a lay person who was caring for her, has a lot of explaining to do," Friedlander said after reviewing McPherson's full autopsy report.
In addition, Friedlander and another doctor expressed serious doubts about the church's version of McPherson's death.
Scientology officials have said it did not appear she needed medical care until the 17th day of her stay at the church's Fort Harrison Hotel in downtown Clearwater, when she suddenly fell ill and died. They point to a blood sample from the hospital where she was taken, which tested positive for a staph infection.
"That's really hard to buy," Dr. Edward Wilson said of the sudden illness and staph infection scenario. Wilson is deputy medical examiner for the state of Oregon and sits on the board of directors for the National Association of Medical Examiners. He said he has been a medical examiner for nearly 30 years and has previously worked as a medical examiner for Maryland and Utah.
Friday, Abelson questioned the conclusions because not all of the doctors had the entire case file. Scientology recently went to court seeking access to all of Wood's records in the case, but a Pinellas judge released only some of them.
"This sounds pretty outrageous because these people don't have all the facts," Abelson said.
Wood's autopsy report on McPherson is available to the public, as are some lab reports and a handful of color pictures of her hand. Scientology wants its own experts to independently test her body fluids and tissue, but the courts have not yet granted that access.
Abelson said all five doctors should have been given the entire autopsy report, not the eye fluid tests alone. He added, however, that church representatives do not trust the autopsy anyway.
In fact, he said, the church is suspicious of every single finding Wood's office has reached in the McPherson case, including whether the lab results are valid.
To challenge Wood's findings, "we have hired the finest experts in the country," Abelson said. "And when the time comes, their opinions are going to be made available."
Abelson declined to identify the experts.
Wood, the medical examiner under fire from Scientology, has declined to comment further in the case.
The Church of Scientology came to Clearwater in 1975 and made the city its spiritual headquarters. Parishioners from around the world come to the Fort Harrison and other buildings to receive Scientology counseling, which is based on the writings of L. Ron Hubbard.
Critics say the church is a money-making scheme that charges exorbitant fees for its services. Church officials say the fees are affordable and that Scientology improves people's lives.
McPherson had been a Scientologist since she was 18. Paramedics took her to Morton Plant Hospital on Nov. 18, 1995, after she took off her clothes at the scene of a minor traffic accident in Clearwater.
That day, according to records, a Morton Plant doctor released her to fellow Scientologists, one of whom objected to her receiving psychiatric treatment. They promised to care for her and watch her 24 hours a day. Physically, McPherson was fine when she left Morton Plant, the records state.
Church officials say she checked into the Fort Harrison and was well cared for while isolated in one of the guest rooms. She stayed until Dec. 5, 1995. That evening, she was driven in the back seat of a church van 24 miles to a New Port Richey Hospital, where she was to be evaluated by a doctor who is a Scientologist. But McPherson was dead before the van arrived.
State and local authorities are investigating the death, and McPherson's estate has filed a wrongful death lawsuit against the church, seeking damages.
Meanwhile, Scientology's lawyers have roundly criticized Wood since she told reporters last month that McPherson had gone without liquids for five to 10 days before her death and was unconscious for 24 to 48 hours.
Wood said she based those conclusions in large part on lab tests performed on McPherson's eye fluid. Each adult human eye contains about one-fifth of a teaspoon of the jelly-like fluid, which is called vitreous humor.
Medical examiners use it for two reasons: It is an accurate indicator of the blood's contents at the time of death and it remains in good condition much longer than blood, which quickly deteriorates after death.
The fluid is tested for the presence of several substances, each of which says something about the body's condition at death.
McPherson's eye fluid contained several unusually high readings, the five pathologists said.
The sodium content, an indicator of the body's moisture level, was 180 milliosmoles per liter. A normal reading would be 135 to 145, according to the 1994 edition of the text Current Medical Diagnosis & Treatment.
The urea nitrogen content, which can be used to gauge dehydration, was 300 milligrams per deciliter. A normal reading would be 8 to 20, according to the text.
The creatinine content, which reflects the kidney's condition, was 2.6 milligrams per deciliter. A normal reading would be 0.6 to 1.2, according to the text.
The chloride content was 161 milliosmoles per liter. A normal reading would be 98 to 107, according to the text.
The doctors cited these readings in endorsing the medical examiner's conclusion that McPherson was severely dehydrated.
McPherson's sodium reading was so unusually high that it warrants double-checking, said John Coe, who was the medical examiner in Minneapolis for 20 years before retiring in 1984. Coe is a past president of the National Association of Medical Examiners and is considered one of the world's top experts in post-mortem chemistry.
According to autopsy records and a sworn statement by Wood, the readings for McPherson's eye fluid were double-checked by the lab that conducted the tests. Wood said in the sworn statement she is satisfied they are accurate. The statement was given to a Scientology attorney as part of the church's lawsuit against Wood.
Assuming the results are correct, Coe said, the readings indicate McPherson did not get enough water and suffered severe dehydration. He said the high nitrogen and chloride readings also point to dehydration.
The eye fluid alone is not enough to tell exactly how many days a person went without liquids or whether that person was unconscious, Coe said. Without more information, it's an "educated guess," he said.
But he added: "She was not getting fluids and adequate medical help."
Dr. Michael Graham, chief medical examiner in St. Louis since 1989, also was given the eye fluid readings. He is secretary/treasurer of the National Association of Medical Examiners.
"She's dehydrated," Graham concluded.
He said sodium readings as high as McPherson's are not seen often, and added: "I've seen fatalities in that range."
He also said McPherson's high urea nitrogen level, another indicator of dehydration, was "way out of whack."
Dr. Don Reay, who has been the chief medical examiner in Seattle since 1975, said he was struck by the creatinine reading. He said the high level indicated kidney failure. In other words, he said, the numbers indicate McPherson was so dehydrated, her kidneys could have shut down.
The autopsy report from Wood's office makes no reference to kidney damage.
Referring to all the readings, Reay said: "This is pretty good evidence of severe dehydration."
He also was asked whether he concurred with Wood's statements about McPherson not receiving water for 5 to 10 days and being unconscious for up to 48 hours.
"That sounds reasonable," he said.
Abelson said Reay's statement was "a whole lot different" from Wood's comments about McPherson being unconscious and without fluids.
When a person is dehydrated, the salts in the body become concentrated, which results in the high sodium reading, Coe said.
According to Reay, the absence of fluids can thicken the blood, which promotes clotting. Wood has concluded that McPherson died of a blood clot brought on by "bed rest and severe dehydration."
Officials for the Church of Scientology have not disputed there was a blood clot. However, they are promoting a separate theory for what caused it.
According to records at the New Port Richey hospital, McPherson's blood tested positive for a staph infection. The blood was drawn nearly an hour after she died. The doctor who pronounced her dead concluded on a report that she died of "sepsis," which is the presence of bacteria or other disease-causing organisms in the blood.
Scientology points to these findings, suggesting the blood clot that killed McPherson could have been the result of a sudden illness caused by a severe staph infection.
Wood has called that scenario "impossible," saying the lab results point to a slow deterioration in McPherson's health over several days, not a sudden turn for the worse, as the Scientologists have described.
In her sworn statement from the lawsuit, Wood also indicated that a staph infection would have shown up in McPherson's heart. But the heart, she said, showed no sign of infection.
Friedlander, the Kansas City pathologist, agreed and called the staph infection scenario "nonsense." Staph infections are commonplace in the blood after a person dies, he said.
He also pointed to the sodium level in her eye fluid, which was unusually high at 180 milliosmoles per liter.
"You can't dry out that fast," he said. "180 doesn't happen overnight."
Wilson, the deputy medical examiner in Oregon, used terms similar to Wood's when asked if McPherson could have appeared fine one day and fatally ill of a staph infection the next.
"That's impossible," he said, noting the autopsy found no sign of infection in McPherson's lungs.
Abelson responded: "He wasn't there."
In the past, Abelson has stated that McPherson became ill on the final day of her stay at the Fort Harrison.
On Friday he indicated she may have been sick before that, and said: "We've never said she appeared fine" in the days before her death.
He declined to elaborate.
Wilson also said he had trouble believing that a fatal amount of bacteria could have gotten into McPherson's blood in a day's time. Even a staph infection would have been more gradual, he said.
The victim would be sweating, feverish, bed-ridden and getting worse by the day, Wilson said. "There should have been enough warnings that she should have been taken for medical care." The five pathologists
After the dispute between the Church of Scientology and Pinellas-Pasco Medical Examiner Joan Wood over the cause of Lisa McPherson's death, the Times sought a second opinion. We actually received five opinions.
Drawing from references and a list of board members and officers of the National Association of Medical Examiners, we solicited and found five pathologists with strong credentials who reviewed lab results from McPherson's autopsy. The five are:
Dr. John Coe, who was the medical examiner in Minneapolis for 20 years before retiring in 1984. Coe is a past president of the National Association of Medical Examiners and is considered one of the world's top experts in post-mortem chemistry.
Dr. Ed Friedlander, chairman of the pathology department at the University of Health Sciences in Kansas City, Mo.
Dr. Michael Graham, chief medical examiner in St. Louis since 1989. He is secretary/treasurer of the National Association of Medical Examiners.
Dr. Don Reay, who has been the chief medical examiner in Seattle since 1975.
Dr. Edward Wilson, deputy medical examiner for the state of Oregon, and on the board of directors for the National Association of Medical Examiners. He said he has been a medical examiner for nearly 30 years.
These and several other doctors were contacted by phone. Some agreed to participate; some referred a Times reporter to other doctors. The goal was to find independent sources who could not be accused of bias. None of the doctors were paid to participate.
Before they gave their conclusions, none of the five doctors consulted for this story were told the case involved Scientology. Two of them asked about McPherson's caretakers and were told about the Scientology connection, but only after they supplied their opinions.
All of the doctors were given the lab results that Wood used as the cornerstone for her conclusions in the case.
Some asked for and received selected additional information from Wood's autopsy report. One doctor, Friedlander, asked for the full report and was sent a copy. He later provided a two-page report.
All five doctors were asked to advance their own conclusions before being told what Wood had told reporters about the case. None of them previously had heard about the case.
ęCopyright 1997 St. Petersburg Times. All rights reserved.
Troubles dogged "medical liaison'
By THOMAS C. TOBIN
ęSt. Petersburg Times, published March 22, 1997
CLEARWATER - A Church of Scientology staff member who helped care for Lisa
McPherson shortly before her death is a medical doctor whose practice in Arizona was restricted after two hospitals raised questions about her use of prescription drugs.
The doctor, Janis K. Johnson-Fitzgerald, agreed to an order in October 1993 in which she surrendered her right to write prescriptions; promised not to see patients; agreed to random drug tests; and was to have her progress monitored by another doctor.
At the time, according to records from the Arizona Board of Medical
Examiners, Johnson-Fitzgerald was not planning to continue practicing medicine anyway. She cited chronic problems with her back and feet that limited her ability to move from patient to patient. She said she once had taken pain medications to deal with the back and feet problems, but had stopped.
"I don't even take Advil," she told board members. Still, the board's chairman expressed concern and said Johnson-Fitzgerald risked more severe action if she didn't agree to the terms of the order. Six months after agreeing to have her practice restricted, Johnson-Fitzgerald allowed her Arizona medical license to expire.
Lisa McPherson died in December 1995 after a 17-day stay at the Fort Harrison Hotel, a Scientology retreat in downtown Clearwater.
Church lawyers have said that Johnson-Fitzgerald worked in the church's medical liaison office, which, they said, refers Scientology staffers in need of medical care to local doctors.
They have said Johnson-Fitzgerald was called in to see McPherson after McPherson fell ill, and that she was in the church van that took McPherson to a hospital 24 miles away in New Port Richey.
McPherson, who had been a Scientologist for 18 years, was dead on arrival. She had entered the Fort Harrison to recuperate from an emotional upheaval but had no physical problems. Her death at age 36 is still under investigation by state and local authorities.
Johnson-Fitzgerald, 40, is not a licensed physician in Florida. Church of Scientology officials say she was never hired as a physician and was not acting as one while in the medical liaison office.
"She was helping in the care, just like other people were caring for (McPherson) and wanting the best for her," said Leisa Goodman, the church's international spokeswoman. Goodman declined to elaborate.
Brian Anderson, the church's Clearwater spokesman, said Johnson-Fitzgerald joined the church staff in July 1994, well after her experience in Arizona.
He added: "She got her life straightened out and got off drugs because of Scientology."
Anderson said Johnson-Fitzgerald no longer works for the medical liaisonoffice and has since been assigned to other responsibilities. Anderson didnot say what her new duties were, but said the change was not related to the McPherson case.
Johnson-Fitzgerald could not be reached for comment.
The Arizona Board of Medical Examiners never determined whether the complaints against Johnson-Fitzgerald were true.
In fact, some board members emphasized that the action was not disciplinary. But board chairman Dr. Nicholas Soldo also said "this board still has some concerns," about allowing Johnson-Fitzgerald to retain her license without the restrictions and drug monitoring.
Later, Johnson-Fitzgerald signed a board order agreeing to the restrictions and monitoring.
According to records, two Tucson, Ariz., hospitals submitted allegations about Johnson-Fitzgerald to the Board of Medical Examiners. The doctor had worked as an anesthesiologist at both hospitals.
One hospital said it modified Johnson-Fitzgerald's privileges based on a suspicion she had been using a prescription pain medication. According to a transcript of a hearing in the case, Johnson-Fitzgerald violated hospital policy in removing a medication from the operating suite. In addition, nurses reported she made frequent trips to the bathroom and kept syringes in her pockets.
The second hospital gave the board similar information about Johnson-Fitzgerald.
According to records, staffers for the medical board said they were "fairly well satisfied" that allegations of substance abuse were without merit, "with the exception that (Johnson-Fitzgerald's) dependence on the pain medication to control her medical problems might have led the hospital to believe that she had a drug problem when that was not the case."
Johnson-Fitzgerald appeared before the board saying she did not plan to practice medicine anymore, but wanted the option to keep her license "on hold" should she need it for future employment. At the time, she said she was exploring the possibility of working for a law firm or an insurance company.
She said she kept syringes in her pockets to save time in situations in which she had to treat large numbers of patients in a short time.Johnson-Fitzgerald and her attorney asked whether the allegations could be dismissed. But board members said they were concerned.
"We just can't do that," said Soldo, the board chairman.
At a later hearing, board members were informed by staff members that Johnson-Fitzgerald had defied the board order by refusing to undergo a drug test. They also were told she made false statements to the board, saying she had not seen a psychiatrist when a medical record indicated she had.
Because some of the board's records are not available to the public, it was unclear how the case was resolved. The last public record of board action is July 1994, when the board decided to continue its investigation of Johnson-Fitzgerald.
By then, she was a Scientologist living in Clearwater.