MartinLeeAnderson.com

Justice for Martin Lee Anderson, who died of suffocation at the hands of Charles Helms Jr, Henry Dickens, Charles Enfinger, Patrick Garrett, Raymond Hauck, Henry Mcfadden, Joseph Walsh II, Kristen Schmidt. Martin died after enrollment at Bay County Boot Camp in January of 2006. Dr Charles Siebert ruled Martin Lee Anderson died of complication of sickle cell trait, manner of death was natural causes. Forced ammonia inhalation and occlusion of the mouth suffocated Martin Lee Anderson. The ammonia caused a spasm of the vocal cords, the hand of the mouth blocked Martin Anderson’s airway.
Justice for Martin Lee Anderson, who died of suffocation at the hands of Charles Helms Jr, Henry Dickens, Charles Enfinger, Patrick Garrett, Raymond Hauck, Henry Mcfadden, Joseph Walsh II, Kristen Schmidt. Martin died after enrollment at Bay County Boot Camp in January of 2006. Dr Charles Siebert ruled Martin Lee Anderson died of complication of sickle cell trait, manner of death was natural causes. Forced ammonia inhalation and occlusion of the mouth suffocated Martin Lee Anderson. The ammonia caused a spasm of the vocal cords, the hand of the mouth blocked Martin Anderson’s airway.
Justice for Martin Lee Anderson, who died of suffocation at the hands of Charles Helms Jr, Henry Dickens, Charles Enfinger, Patrick Garrett, Raymond Hauck, Henry Mcfadden, Joseph Walsh II, Kristen Schmidt. Martin died after enrollment at Bay County Boot Camp in January of 2006. Dr Charles Siebert ruled Martin Lee Anderson died of complication of sickle cell trait, manner of death was natural causes. Forced ammonia inhalation and occlusion of the mouth suffocated Martin Lee Anderson. The ammonia caused a spasm of the vocal cords, the hand of the mouth blocked Martin Anderson’s airway.
Justice for Martin Lee Anderson, who died of suffocation at the hands of Charles Helms Jr, Henry Dickens, Charles Enfinger, Patrick Garrett, Raymond Hauck, Henry Mcfadden, Joseph Walsh II, Kristen Schmidt. Martin died after enrollment at Bay County Boot Camp in January of 2006. Dr Charles Siebert ruled Martin Lee Anderson died of complication of sickle cell trait, manner of death was natural causes. Forced ammonia inhalation and occlusion of the mouth suffocated Martin Lee Anderson. The ammonia caused a spasm of the vocal cords, the hand of the mouth blocked Martin Anderson’s airway.
Justice for Martin Lee Anderson, who died of suffocation at the hands of Charles Helms Jr, Henry Dickens, Charles Enfinger, Patrick Garrett, Raymond Hauck, Henry Mcfadden, Joseph Walsh II, Kristen Schmidt. Martin died after enrollment at Bay County Boot Camp in January of 2006. Dr Charles Siebert ruled Martin Lee Anderson died of complication of sickle cell trait, manner of death was natural causes. Forced ammonia inhalation and occlusion of the mouth suffocated Martin Lee Anderson. The ammonia caused a spasm of the vocal cords, the hand of the mouth blocked Martin Anderson’s airway.
Justice for Martin Lee Anderson, who died of suffocation at the hands of Charles Helms Jr, Henry Dickens, Charles Enfinger, Patrick Garrett, Raymond Hauck, Henry Mcfadden, Joseph Walsh II, Kristen Schmidt. Martin died after enrollment at Bay County Boot Camp in January of 2006. Dr Charles Siebert ruled Martin Lee Anderson died of complication of sickle cell trait, manner of death was natural causes. Forced ammonia inhalation and occlusion of the mouth suffocated Martin Lee Anderson. The ammonia caused a spasm of the vocal cords, the hand of the mouth blocked Martin Anderson’s airway.
Justice for Martin Lee Anderson, who died of suffocation at the hands of Charles Helms Jr, Henry Dickens, Charles Enfinger, Patrick Garrett, Raymond Hauck, Henry Mcfadden, Joseph Walsh II, Kristen Schmidt. Martin died after enrollment at Bay County Boot Camp in January of 2006. Dr Charles Siebert ruled Martin Lee Anderson died of complication of sickle cell trait, manner of death was natural causes. Forced ammonia inhalation and occlusion of the mouth suffocated Martin Lee Anderson. The ammonia caused a spasm of the vocal cords, the hand of the mouth blocked Martin Anderson’s airway.
Justice for Martin Lee Anderson, who died of suffocation at the hands of Charles Helms Jr, Henry Dickens, Charles Enfinger, Patrick Garrett, Raymond Hauck, Henry Mcfadden, Joseph Walsh II, Kristen Schmidt. Martin died after enrollment at Bay County Boot Camp in January of 2006. Dr Charles Siebert ruled Martin Lee Anderson died of complication of sickle cell trait, manner of death was natural causes. Forced ammonia inhalation and occlusion of the mouth suffocated Martin Lee Anderson. The ammonia caused a spasm of the vocal cords, the hand of the mouth blocked Martin Anderson’s airway.
Charles Helms Jr
Henry Dickens
Charles Enfinger
Patrick Garrett
Raymond Hauck
Henry Mcfadden
Joseph Walsh II
Kristin Schmidt

 

Dr. Thomas Andrews

Below is the report of Dr. Andrews as sent to Assistant State Attorney Michael Sinacore. Dr. Andrews is a forensic pathologist from Massachusetts.

Report of Dr. Andrews as sent to :

December 5, 2006

RE: MARTIN LEE ANDERSON
State of Florida Executive Order 06-36
Amended Executive Order 06-37

Dear Attorney Sinacore:

At your request I have reviewed the following material regarding the above-named individual: 1) Florida Department of Law Enforcement Investigative Summary FDLE Case #PC-01-0043, Volumes 1,2 and 3,2) Medical records from Bay Medical Center, Bay County Boot Camp, the Department of Juvenile Justice and the office of Dr. Samir H Ebeid, 3) Medical records from Airheart Ambulance service and Sacred Heart Hospital, 4) transcripts of sworn statement of Dr. Charles F. Siebert, Jr., 5) Autopsy Report generated by Dr. Siebert, 6) Second Autopsy Report by Dr. Vernard Adams, 7) National Climatic Data Center weather information for Panama City, Florida January 5, 2006, 8) Hillsborough County Sheriff Draft report 06-220911, 9) correspondence from Dr. Vernard Adams to Dr. John Kark and from Dr. Kark to Dr. Charles Siebert, 9) transcripts of sworn statements of Dennis Arnold (2), and Delores Nelson, 10) literature from various sources on the uses and potential toxicity of ammonia, with emphasis on ammonia as “smelling salts,” 11) additional past medical records from Bay Medical Center, 1991 and 1998, 12) transcripts of sworn statement of Melinda Keiffer, 13) report of Dr. John Downs, 14) copies of 24 digital images from the first autopsy, 15) copies of approximately 516 digital images from the second autopsy, 16) 88 historical slides and 17) DVD’s(3) of events at the Bay County Boot Camp involving Martin Anderson and Camp staff. Opinions offered herein are based on my review of this material as well as my training and experience in pediatrics and forensic pathology. My curriculum vita has been previously submitted.

To briefly summarize Martin Lee Anderson, age 14, was ordered to the Bay County Boot Camp and was undergoing the standard physical assessment on intake day, January 5, 2006. Ambient temperature and humidity were moderate. After a sequence of sit-ups and push-ups wherein each youth was to da as many as possible of each in a two minute time frame, with rest in between, Anderson began a run variably estimated to be between 1 and 1 1/2 miles - 16 laps around a dirt track in the exercise yard of the Boot Camp. Roughly 2/3 through the run Anderson uttered an expletive that prompted what has been termed “counseling” by Boot Camp staff. This appears to consist of at least two staff members restraining the offender against a fence or pole and speaking loudly and directly into the offender’s ears. Anderson resumed his run after this initial encounter, but then appeared to tire and fall forward a short time later. This began a sequence of events in which he was repeatedly “counseled,” with physical contact escalating to include forcing Anderson to the ground in a prone position, “knee strikes” and “hammer (fist) blows” to the upper and lower extremities and repeated. Prolonged application of ammonia capsules. This sequence of events continued until Anderson’s terminal collapse.

Ultimately. Sluggish pupillary reflexes trigger a call to 9-1-1 and an ambulance is on scene in very short order. All are in agreement that Anderson is spontaneously breathing and has a pulse on initial evaluation by the ambulance crew. He was transported to Bay Medical Center in Panama City where he was intubated, stabilized and prepared for air transport to Sacred Heart Hospital in Pensacola. At Sacred Heart Anderson’s course was marked by relentless clinical deterioration with development of disseminated intravascular coagulopathy and multisystem organ failure. Life support was withdrawn and Anderson was pronounced dead some minutes later at 1:52 AM on January 6, 2006.

Autopsy performed by Dr. Charles Siebert at 2:00 PM on January 6,2006 revealed the presence of retroperitoneal hemorrhage, pulmonary edema and soft tissue contusions. Toxicology was negative for drugs of abuse and therapeutic agents and the hemoglobin electrophoresis revealed 41% hemoglobin S consistent with sickle cell trait. Death was certified as due to complications of sickle cell trait. A second autopsy examination on Martin Anderson’s exhumed remains was conducted on March 13, 2006 at the Hillsborough County Medical Examiner’s Office headed by Dr. Vernard Adams with consultative assistance from Dr. Sam Gulino (cardiac pathology) and Dr. Laura Hair (neuropathology). Dissections carried out during this examination were more extensive than those of the first, yielding more anatomically specific evidence of the various soft tissue contusions sustained by Anderson consistent with what is observable on the videos and attested to by Boot Camp staff. Dr. Adams also documented specific conversations he had with various witnesses, health care providers and consultants. His conclusions are summarized in his reports.

Based on my review of the case file as listed above, the death of Martin Anderson was multifactorial in nature and is best described as being the result of multisystem organ failure and disseminated intravascular coagulopathy due to intravascular sickling due to decompensated sickle cell trait due to exertion, dehydration, multiple soft tissue contusions of extremities and intermittent hypoxia induced by repeated, prolonged application of ammonia capsules by nasal inhalation with occlusion of the mouth. The convergence of this combination of circumstances was critical in the fatal outcome of this case, therefore all must be considered as a whole rather than attributing the death to either solely natural causes or to bypoxia alone. Cause of death is defined as the disease or injury, or combination of the two that initiates an ultimately lethal train of events and without which, death would not have occurred. Analysis of all the factors in the Anderson case lead logically to the conclusion that both a natural condition (decompensated sickle cell trait) and injury (repetitive blows to the extremities and improper use of ammonia capsules resulting in hypoxia) with the added aggravating factors of exertion, relative dehydration and the stress induced by the entire ordeal were all required to bring about the death of Martin Anderson.

Events on the morning of January 5, 2006 were captured in large part, on video, as is standard procedure at the Boot Camp. While Anderson is not in direct view at all times -- even after the more significat events begin -- it appears evident he was having difficulty before the application of physical force and ammonia. I am of the opinion this represented, not malingering or mere fatigue, but the beginnings of decompensation of Anderson’s, as then, undiagnosed sickle cell trait. It was not particularly hot or humid that morning. Had he been permitted rest and/or fluids it is more likely than not Anderson would have spontaneously recovered.

I remain puzzled by the nurse’s representation of Anderson’s pulse and respirations being “normal” on her first assessment. If indeed he had a pulse of around seventy and was breathing at a normal rate after push-ups, sit-ups, and two thirds of his run, this in itself may have suggested something may have been amiss. Her next assessment while Anderson was being restrained against a pole is especially disturbing in that this is the time when Anderson appears to demonstrate visibly evident loss of muscle tone, yet during this period the nurse is seen to speak in an agitated manner (statement transcript suggests Anderson made some movement interpreted as “aggressive” in nature) and was “escorted” to a prone position, sustaining more blunt impacts and ammonia administration. In fact, what may have been involuntary or semi-voluntary muscular movement such as forming a fist was repeatedly interpreted as aggressiveness and/or non-compliance and was met with physical blows. It was during this period that the ultimately lethal train of events gained substantial momentum.

Of particular concern is the non-standard use of ammonia capsules. Ammonia capsules are typically broken to release their fumes and held or waved 2-3 inches from the subject’s nose for one to several seconds, usually in an effort to treat fainting or light-headedness. Occasionally it is used in the same manner to determine if someone who has apparently fainted is malingering and rarely has been used as a negative reinforcement tool in psychiatric settings. In the Anderson case, ammonia was applied directly under the nose for prolonged periods and his mouth was manually occluded by the Boot Camp staff member using the ammonia capsule, ostensibly to force compliance with their directions. Even at time of terminal collapse Boot Camp staff, including the nurse on scene seem only vaguely aware of the gravity of the situation.

The terminal collapse presents as more neurological than anything cardiac or respiratory. Anderson was spontaneously breathing and was tachycardic on arrival of emergency medical personnel. The issue of subglottic spasm induced by ammonia and resultant suffocation has been raised. Suffocation as a mechanism of death was challenged given the relatively low levels of carbon dioxide measured in blood at the first blood gas drawn very shortly after intubation. I defer to the expertise of Dr. Downs regarding the amount of time it would take for carbon dioxide levels in the blood to decline with the resumption of spontaneous respirations and the assistance of a non-rebreather mask. Given all the other features of the case, however, I cannot attribute death to suffocation alone. Nevertheless, intermittent hypoxia as described above looms as the most critical feature in the entire sequences of events. The hospital course adds little more to the case than a more complete understanding ot the catasrtophic nature of the final collapse as the Boot Camp.

The lack of peripheral sickling in the blood smears does not negate the possibility of widespread intravascular sickling. In the very acute phase the sickled cells are sequestered within the small vessels of individual organs and it is not necessarily surprising that they do not appear in a peripheral smear. Calculations proffered regarding percentages of sickled cells at various times during the hospital couse may be of academic interest, however, cannot accurately predict what was occurring during the dynamic, fluid situation in the exercise yard. Likewise, sickling observed at autopsy versus what was present during the hoospital course and even more importantly during the critical period of time in the exercise yard are not likely to correlate given the continued deterioration with acidosis during hospitalization and profound hypoxia after termination of ventilatory support.

To summarize and briefly offer a final clinicopathological correlation I would opine that Martin Anderson, with undiagnosed sickle cell trait, began to develop symptoms of intravascular sickling on the exercise yard of the Boot Camp in response to exertion, perhaps with an added element of dehydration. When Anderson collapsed multiple physical blows and the inappropriate application of ammonia capsules, significantly compounded the unfolding medical catastrophe. Intermittent hypoxia brought about by the use of the ammonia capsules in the manner in which they were used represents a tipping point in the terminal collapse of Martin Anderson on the exercise field at which time no amount of medical intervention could have reversed the ultimate outcome. But for the combination of all these factors rather than any single one alone. Martin Lee Anderson died.

Quick Links

What Happened - 10/17/07
Autopsies - 11/01/07
Court of Public Opinion - not available
Matter of Law - 10/03/07
Ammonia Facts - 10/03/07
Sickle Cell Trait and EHI - 10/10/07
Dr. Siebert 10/13/07
Dr. Adams
Dr. Andrews 11/26/07
Dr. Gravenstein 11/29/07
Dr. Downs 10/29/07
Dr. Steinberg 11/27/07
Dr. Eichner
Science for Suffocation - Must read 10/10/07

This site is dedicated to the memory of Martin Lee Anderson. For information, send mail to justice@martinleeanderson.com