Cause of girl’s death leaves family asking more questions

Friday, Nov. 28, 2003 | 11:08 a.m.

The wording of the official cause of death for 13-year-old Tabatha Speas has left her family and attorney with more questions than answers.

Clark County Coroner Michael Murphy said Wednesday that the immediate cause of death was "an upper airway obstruction due to hypoglottic injury due to traumatic intubation."

The autopsy results indicate injuries from a medical tube shoved down the girl's throat caused swelling that killed her on Nov. 6.

"It (the finding) means Tabatha should still be alive today," Tabatha's grandfather Bob Speas said.

The Speas' attorney, John Wawerna, said it was his understanding that the tube knocked a piece of Tabatha's cartilage loose and the cartilage nicked her larynx -- the voice box. That apparently caused the swelling.

He said his next step will be to gather all of the medical information, including the coroner's report and "sit down with my forensic pathologist" and look at the information.

Tabatha died in Bob Speas' arms, four days after her release from the University Medical Center, where she had been in a coma for two weeks.

"She survived the accident -- she should not have died," Speas said Wednesday. "I believe there are more questions than answers. But it is better to finally know the cause. This is a long way from being over."

The family is still questioning why she died and why she was released from the hospital two days after coming out of a coma. The family may pursue a lawsuit. Tabatha Speas was hit by a car Oct. 15.

The manner of death was "accidental," Murphy said, stemming from "multiple blunt force injuries in an auto-pedestrian accident."

Tabatha's mother Melody Frenzel was "shook up" and not immediately available for comment, Bob Speas said. His son Michael Speas was with family in Texas for the Thanksgiving Day holiday and also was not immediately available for comment.

Bob Speas said tubes were initially stuck down his granddaughter's windpipe at the scene of the accident in Southern Highlands and at the hospital on a number of occasions.

Shortly after her Nov. 2 discharge, Tabatha told family and other friends that she had been released too soon and that something was wrong. Her family brought her back to the hospital late on Nov. 3 because she had difficulty breathing and other symptoms. She was released early on Nov. 4.

"After she was discharged no one listened to her or to us," Speas said. "If everybody listened to her she would still be alive."

Murphy said, in determining the manner of death, his office is charged with tracing events to the source that sets in motion the course that follows.

"We look for the temporal relationship between what caused the medical reason for one to cease life," Murphy said. "This young lady was involved in an accident that required her to be intubated."

While Murphy could not give a detailed medical explanation of how Speas died, he said that her hyoid bone was damaged.

The hyoid is a horseshoe-shaped bone suspended above the larynx at the front of the throat. It is the only bone in the human body that does not touch any other bone. It helps support the tongue and serves as an attachment point for several muscles that help elevate the larynx during swallowing and speech.

Murphy said the reason it took two weeks to reach the findings was because officials were waiting for toxicology tests and other tissue studies. Those tests "were not contradictory to the cause and manner of death," he said.

Tabatha Speas and her friend, Adriana Lauzon, also 13, were struck by a car on Oct. 15 as they crossed Shinnecock Hills Avenue near Tucci Street in in southwest Las Vegas. Both girls were brought by helicopter in critical condition to UMC.

Lauzon died at UMC on Oct. 21. Tabatha was in a coma until Oct. 31, and was discharged two days later. Both girls were eighth grade students at Canarelli Middle School.

In the Nov. 21 edition of the Sun Frenzel said that, based on a prior conversation with the Clark County Medical Examiner shortly after the autopsy was performed, it was her understanding that Tabatha's throat had swollen shut.

She said it was the result of injuries caused by a tube that had been shoved down the teen's windpipe, whether at the scene of the accident or at the hospital.

Attorney Wawerna and Michael Speas have said the care instructions the hospital provided when Tabatha was discharged were in adequate. They simply told the family to bring the girl to an orthopedic surgeon, pulmonary specialist and pediatrician within two weeks of leaving the hospital.

When Tabatha was brought back to UMC on Nov. 3 complaining of difficulty breathing, dizziness, blurry vision and nausea, the family was sent home with instructions on how to deal with Tabatha's croup and told to buy a vaporizer, the family said.

The instructions noted that "croup is a swelling of a portion of the voice box and is usually caused by a virus."

Such incidents have caused the family to question whether its lack of health insurance contributed to Tabatha's quick discharge after coming out of her coma.

The Clark County-run UMC has denied that people without insurance are not given the same quality care as those who have insurance.

Hospital spokesman Dale Pugh on Wednesday said he could not discuss the coroner's report because of new federal patient privacy laws that he said extend confidentiality beyond the patient's life. Pugh noted, however, that before such laws were enacted, UMC did not comment on medical treatments of patients who died.

Pugh reiterated the hospital's position that it is charged with caring for all people regardless of whether they have insurance and that everyone gets quality care.

Pugh pointed to statistics that show UMC treats more than half of the cases of indigent, uninsured and underinsured patients in Southern Nevada. In the fiscal year that ended June 30, the hospital forgave more than $176 million in charity care charges.

"We take pride in the care we have provided thousands of patients since 1931," Pugh said.

He also noted it is not uncommon for trauma patients to be intubated and that such intubation often begins in the field.