Cause of Death and Time of Death *MERGED* (Warning: Contains Graphic Content!)

wenwe4 said:

I have a few theories in mind about what might have led to Zahra's death. Of course there are theories of abuse, both physical and sexual. I am more curious about the effects of Neglect on Zahra. Essentially, withholding from the child the very things they need to thrive and grow. For Zahra, we know she needed a prosthetic leg, crutches, and continual medical monitoring for her amputation - as well as ensuring her cancer didn't return.

We have a WS member here who has invaluable first hand information about amputees and prosthesis. I am hoping Allusonz will again post about how often a child needs to have checkups and adjustments, etc on their prosthetic leg.

What would be the consequences of an ill fitting prosthesis? I am wondering if wounds - left untreated could result in infection and a systemic response.

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First i must say how close to home this particular case has hit me and i am soooooooooo upset but i have to believe that zahra is dancing and well above her freckled star

Fittings of the prothesis is critical. The sores occur rapidly, are extremely painful and yes infection can set in, to the point i have seen where the doctors have had to go in and do a revision (further amputation) higher above the dead tissue. Until later in age she was seen at least every 2 months by a group of professionals. Surgeries, growth spurts necessitated additional followups and this was always done with the entire team of 20. The best comparison i can come up with at the moment would be a diabetic whose sores will not heal, in this case if forced to wear the prothesis over these sores, up hills etc would create an environment of deep gravity for her health especially a weakened immune system from cancer etc. As well for EB to make her run like a normal child that is simply impossible. It is more like a hop/skip for any of you that have watched Terry Fox run that is the extent of their run for an above knee amputation. The moisture, bacteria from forcing her to wear it would again complicate the issue. Often a debriment is needed before an additional amputation to get rid of the rotten tissue and infection. She never wears her prothesis to bed.

Sorry all this would be no different from any other person that had an infected sore that the doctors cannot control. I anticipate MOO that she indeed had an infection and dont want to think what they did from there

RIP Zahra may your sweet smile shine always

ty allusonz! I was so hoping you would weigh in on this thread. You're RL experience will be invaluable in the days to come.

I would suspect stress alone could have contributed lack of health and decrease the body's immune system's protection.

I can only imagine the pain in the hip of her good leg when walking due to the imbalance of the prosthesis.

I can also imagine an infection from the ill fitting prosthesis becoming sepsis then gangrene setting in. In the last picture with the black eye her skin pallor was not right and reminded me of someone very ill.

I suspect one of the biggest issues will be determining time of death! If the new mattress does not have any evidence of Zahra that will definitely narrow the timeline down.

If she had a serious oozing sepsis infection anywhere on her body I'd suspect there will be evidence on the old mattress.

Either way there is definitely a case against AB for medical neglect.
(My opinon only)

To clarify further after a surgery a nurse accidently put the wrong size of tensor bandage on her stump do to a surgery on her hip. Within 5 hours the infection had spread throughout her system, she was immediately taken to surgery for an additional amputation unrelated to the hip surgery simply from the tightness of the tensor bandage. It then required a further debriment and a week of specialized bath treatments. This can happen slowly or very quickly but it will happen when the prothesis is not fitting correctly and made to wear it......:banghead:

Allusonz said:

To clarify further after a surgery a nurse accidently put the wrong size of tensor bandage on her stump do to a surgery on her hip. Within 5 hours the infection had spread throughout her system, she was immediately taken to surgery for an additional amputation unrelated to the hip surgery simply from the tightness of the tensor bandage. It then required a further debriment and a week of specialized bath treatments. This can happen slowly or very quickly but it will happen when the prothesis is not fitting correctly and made to wear it......:banghead:

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Allusonz they tried to fit my mom with a prosthesis after her leg was amputated. She had already gotten sepsis then it turned to gangrene within just a few days. They had to amputate again but she passed away 2 hours after that. The infection and gangrene had a horrible smell and moved with rapid speed! I'll never forget it.

Don't you think there would be evidence of that on the old mattress?
There would also have been a horrible stench in her room just from that.

COD: felonious child abuse by EB

MOD: Murder 1

That's all I got I'm sorry. JMHO

I too have lots of thoughts and concerns. I am not a verified RN certified in pediatrics on WS (yet- email has been sent) but I can say from my perspective medically there are sooo many things that could have happened. Several key points I wanted to make:
1)Cancer in children can sometimes seem to happen very quickly. Ive heard the saying a thousand times...children bounce back better than adults but they go down they crash hard. Children have this natural resealunce (sp>) they can compensate things for a very long time, their bodies can I mean. But once their body says hey I can't take this anymore it can change very very quickly. That is why children are dealt with very aggressively when it comes to cancer and not waiting until they are sicker. They can usually tolerate the high Chemo etc better than adults in the begining.
2)MOO Zahra had a double whammy in regards to her cancer. Not only did she have cancer of the bone but the treatment for cancer can also make the bones extremely weak. If anyone was physically abusing her they could have very easily broken a bone with little effort on their part. When a child even a 10y old child is denied sun (*Remember neighbors at the HKY residence never seen zahra so she was not outside alot) a key ingredient the body needs to help absorb vitamin d Lack of vitamin D causes lack of calcium thus fragile bones. Think of the osteoporis commercials and the frail older ladies whose bones break very easily. One thought I just had particularly about this is maybe that is why she may have been dismembered. Did someone break a bone and they wanted to hide this particular part from the rest of the body?? quick note that i just read on wikipedia.com Ricketts- symptom of lack of vitamin d and weakening of bones can cause blood clots just like broken bones can....
3) I AM NOT TAKING UP FOR EB!! but...thinking medically I wonder if some (and I mean SOME) of the bruises could have been related to some form of her Cancer returning. A reasonable parent noticing lots of bruising in a 10 yr should have seen this as a red flag..(aka AB) Just a thought I had when thinking about cancer in children
4)Sepsis can set in from any wound not treated. Sepsis can also set in from any illness that sets up. It can be viral(rare) or bacterial. If you take someone who has a weak immune system already from cancer it may be alot worse/alot quicker. If a person is denied nutrition, water etc...it can be quicker. Sepsis (an infection of the bloodstream) left untreated=death. Sepsis rates are higher in immunocompromised individuals such as Zahra.
5) The fact her prosthetic was most likely ill fitting and EB forced her to runa dn walk frequently for punishment she probably had wounds on her stump. mho
6) Drugs...hum. This could be an interesting fact in this case too. With Zahra's cancer and all her treatments I wonder if her liver function was good. Sometimes people can not tolerate the same doses of ANYTHING when their liver is damaged. I will have to research some more but it makes me wonder could a few doses of OTC cold/cough medicine killed her...not to mention illegal drugs. Shoot EB could have been slowly poisoning her and blaming it on the cancer returning...'oh adam i think she is getting sick again....'

Ultimately we dont know what her health status was since she was never treated here or the living conditions so it is scary the possibilities of COD when you look at just her medical history and childhood cancer.
* I just wanted to throw my info out there to help others understand how much her medical hx may indeed affect this case. I pray she didnt suffer and that it may be just natural causes from her cancer but I still fear that she her environment affected it in a big way.**

tiredblondy said:

Allusonz they tried to fit my mom with a prosthesis after her leg was amputated. She had already gotten sepsis then it turned to gangrene within just a few days. They had to amputate again but she passed away 2 hours after that. The infection and gangrene had a horrible smell and moved with rapid speed! I'll never forget it.

Don't you think there would be evidence of that on the old mattress?
There would also have been a horrible stench in her room just from that.

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Yes there is a distinct smell, they must acutally leave the wound open to ensure that the infection is cleaned out. There would definately be evidence of that whether in the bathroom for obvious reasons the bed again for obvious reasons. She would be very weak and would require IMMEDIATE medical assistance. Yes she was put into isolation not just for the smell but to ensure strict medical procedures where in place to prevent further complications. Hope this helps and my thoughts and prayers are with you, your family, and know your mom is no longer suffering i simply have to believe that!!! This is a life and death situation

Allusonz said:

Yes there is a distinct smell, they must acutally leave the wound open to ensure that the infection is cleaned out. There would definately be evidence of that whether in the bathroom for obvious reasons the bed again for obvious reasons. She would be very weak and would require IMMEDIATE medical assistance. Yes she was put into isolation not just for the smell but to ensure strict medical procedures where in place to prevent further complications. Hope this helps and my thoughts and prayers are with you, your family, and know your mom is no longer suffering i simply have to believe that!!! This is a life and death situation

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Thank you so much. After years of watching her suffer with a terminal illness there was relief that she was not suffering any more, although she is missed terribly.

We did have to wear gowns to enter her room and the medical staff had to wear masks, gloves and gowns.

You know after what we know of Zahra's suffering it is a relief to know she suffers no more!

I'd heard of sepsis but had never seen the ravages of it or how quickly gangrene can begin. Once it's in the bloodstream like you said it is unstoppable. (I think it's a shame IF that was what happened EB and AB didn't catch it...oh but I forgot...they'd take themselves to the hospital.)

I know this sounds harsh but even a pulmonary embolism from a clot would have been a blessing instead of being beaten to death.

Does anyone know if sepsis is like mrsa in that once it leaves the body as in a blood droplet that dries the mrsa dies. Sepsis is so easily spread I'd like to think there would be some on that mattress if that is what happened.

Allusonz said:

Yes there is a distinct smell, they must acutally leave the wound open to ensure that the infection is cleaned out. There would definately be evidence of that whether in the bathroom for obvious reasons the bed again for obvious reasons. She would be very weak and would require IMMEDIATE medical assistance. Yes she was put into isolation not just for the smell but to ensure strict medical procedures where in place to prevent further complications. Hope this helps and my thoughts and prayers are with you, your family, and know your mom is no longer suffering i simply have to believe that!!! This is a life and death situation

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Maybe if the smell from the possible sepsis was getting so bad, maybe that's why there was a comforter and pillow in the car? Did EB maybe put her in there because of the smell from the leg infection? And she died in the car?

DLT88 said:

Maybe if the smell from the possible sepsis was getting so bad, maybe that's why there was a comforter and pillow in the car? Did EB maybe put her in there because of the smell from the leg infection? And she died in the car?

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Very good question..

Sure it could have been a return of the cancer – when cancer does come back it usually does come back with a vengeance; fast and hard. But her risk of relapse was very, very low. But isn’t this why children have loving parents who bring them to follow-up appointments? I’m sure the stress of being abused wouldn’t help much.

Sure it could have been sepsis from an out-dated prosthesis and from being forced to run on it even when she was in pain. But isn’t this why children have loving parents who bring them to follow-up appointments? Oh wait, I already said that.

Sure it could have been from her head being slammed into the wall or being beaten.

Doesn’t matter; all of the above are the direct responsibility of her step-mother and her “father”.

And I guess they were more concerned about covering their tail feathers then on giving her a proper burial. Why yes, parents of the year.

I am mad:furious:, mad:furious:, mad :furious: right now. Someone else wrote something like, “how dare they abuse a child who can’t hear them coming and can’t even run from them?” That sort of sums it up.

I know I’m preaching to the choir here, but I just had to vent.

God help me, i so don't want to type this. *WARNING GRAPHIC*

what if she did have an infection and AB/EB realized they would be investigated for neglect if they took her to the hospital because they let it go too long so in some sort of drug fueled lunacy or something they decided to "fix it themselves" hence, the bone located in a different area. i've seen other cases where "parents" stitch up abused children or try to set broken bones etc. just a thought MOO

ETA still means murder IMO

A friend of mine is a grandmother to twins. The mother of the boys is into these online fantasy games. Due to friction in the family, both grandmothers were shut out of the kids' lives for a time. When they finally bullied their way into the house they discovered: Mom of the twins kept the boys locked in their bedroom in diapers all day. The boys were near age of qualifying for school, but were not toilet trained. They also had not been taught to talk. The twins had developed their own language for communicating with each other and did not want contact with anyone else. By mutual consent, the 2grandmothers turned the case over to CPS and the boys were taken away from Mom. The boys were separated from each other because as long as they could access each other, they would not interact with anyone else who was trying to help them. My friend told me that these poor little guys were like wild animals. Foster parents, special ed teachers, and social workers were involved helping the boys. Speech therapists said the kids may never speak normally, because if kids don't learn to speak by a certain age, they lose for life their ability to make some sounds. While the grandparents were still trying to decide whether to help the parents of the twins get the kids back or what else could be done, the mother of the kids went to CPS without consulting anyone, said she didn't want the kids in the first place, and signed them away to custody of the state. How sad for those kids that she didn't do that in the first place!

Based on what I saw in that case, Here is what I think happened to Zahra:

After the punishment and conflict and abuse, Zahra got terribly sick from sepsis and/or a broken bone. She was confined to the one room and soon became too weak to leave the bed on her own steam. While EB tried to figure out what to do (foremost consideration being to cover her own *advertiser censored**), she shut the door on Zahra and zoned herself out by getting online with fantasy games ... kind of like someone escaping their woes through drink or drugs. This might have gone on for days, and Zahra slipped away from poor health.

The only question in my mind is why AB was willing to collude in trying to cover up what happened and get rid of the body. EB probably convinced him that he'd be equally liable for the condition of Zahra's body, the bad smell in the room, and whatever evidence was clearly on or in the mattress. IMO, it will probably become pretty obvious what happened to this little trouper--because instead of "getting rid of evidence," they seem to have spread and tracked it all over the place.

sayd said:

Sure it could have been a return of the cancer – when cancer does come back it usually does come back with a vengeance; fast and hard. But her risk of relapse was very, very low. But isn’t this why children have loving parents who bring them to follow-up appointments? I’m sure the stress of being abused wouldn’t help much.

Sure it could have been sepsis from an out-dated prosthesis and from being forced to run on it even when she was in pain. But isn’t this why children have loving parents who bring them to follow-up appointments? Oh wait, I already said that.

Sure it could have been from her head being slammed into the wall or being beaten.

Doesn’t matter; all of the above are the direct responsibility of her step-mother and her “father”.

And I guess they were more concerned about covering their tail feathers then on giving her a proper burial. Why yes, parents of the year.

I am mad:furious:, mad:furious:, mad :furious: right now. Someone else wrote something like, “how dare they abuse a child who can’t hear them coming and can’t even run from them?” That sort of sums it up.

I know I’m preaching to the choir here, but I just had to vent.

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Thank you! Just want to say, it's okay to feel angry. These were the very people who were expected to protect her and meet all of her "special" needs.

I also wanted to say Thank You to all of you who bring special expertise to this forum, as well as the experience of real life struggles. Your perspective helps us all to understand how this child was failed, in an effort to make sure other children will never have to suffer. The power of WS is enormous and our collective help is so valuable.

What worries me is that if it were somehow determined that she died of natural causes bought on by neglect, what charges would they face? The thought of these two breathing the same air as me makes me furious, the thought they could get away with it makes me rage.
I hope they can find enough forensic evidence to keep them behind bars for the rest of their natural lives...or worse.
I think Zahra's end was hastened by abuse as well as neglect which is murder by any standard.

perhaps negligent homicide? I am not sure what the technical charge would be but it is considered murder if you neglect someone to the point where a reasonable person would foresee death as the end result.

I was going to write a long winded answer, but I instead will keep this short.

I don't think she was taken care of. I think she was neglected. I think she got sick, she was ignored (possibly mentally, verbally and physically abused because she was "faking it") and in the end her body gave.

Both of the people responsible for Zahra (I won't DARE call them parents of any sort) need to be held responsible.

My heart wont rest till both are held responsible for this.

Scamperoo said:

What worries me is that if it were somehow determined that she died of natural causes bought on by neglect, what charges would they face? The thought of these two breathing the same air as me makes me furious, the thought they could get away with it makes me rage.
I hope they can find enough forensic evidence to keep them behind bars for the rest of their natural lives...or worse.
I think Zahra's end was hastened by abuse as well as neglect which is murder by any standard.

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Sometimes I've heard of cases that did not end the way I thought they should,as far as the sentence received but once in jail prisoners administered their own justice. I would suspect this case would get to the hardest of criminal hearts, especially with a child.

They may not be able to determine COD, but possibly manner of death.
I did some googling and that term can be a little different medically as opposed to legally, but the gist of it is, dying of natural causes can mean by illness, disease, heart attack, stroke, anything that happens internally, and not by something done externally that caused death.
I have to say that if she had some illness or signs of the cancer returned and they did not seek medical help..... they will most certainly be charged with negligent homicide. And considering they they probably dismembered her body and tried to conceal her death, and then attempted to file a fraudulent report of a missing child.... they are not going to get off light with this, I guarantee it!! I hope they throw the book at them and the prosecutor goes for a life sentence!
What they allegedly did to her AFTER her death is going to carry as much weight with a jury as if they had murdered her.... and they may have, we don't know yet.