This Ruthless World

Adventures in absurdity

Do Medical Records Exonerate George Zimmerman? Not So Fast.

Over the past few months, I have refrained from writing about the shooting of Trayvon Martin (oblique references excepted), primarily because the controversy was fresh, and I wanted to allow for the possibility that the case is not as clear-cut as it seems at first blush. Still, I was leaning strongly towards the conclusion that George Zimmerman provoked an altercation with Trayvon Martin and murdered him. Moreover, based on my experience working at the intersection of law and medicine, I expected from the very beginning that sometime shortly before trial, the Zimmerman camp would produce a short, self-serving medical record, authored by some no-name internist practicing out of a dingy storefront called Something-Something Medical, P.C., and that “record” will indicate that Zimmerman came in right after the incident and was so horrendously injured, you’d think he had fallen off a skyscraper and been attacked by a pack of T-Rexes.

Well — surprise, surprise. The good folks who were lecturing us two months ago that Trayvon Martin deserved to die because he did not consistently exhibit saint-level perfection in appearance, academics, expressive language and personal behavior are now jumping up and down with glee over the supposed fact that medical records and Martin’s autopsy report supposedly “prove” that Zimmerman was fighting for his life.

Let’s take a closer look, shall we?

For starters, the “records” in question consist of a single three-page report by Zimmerman’s “personal physician”. Although the physician tentatively diagnosed Zimmerman with a nose fracture, apparently no x-rays were taken. Weirder still, although the report mentions two black eyes and extensive head wounds, Zimmerman did not undergo any diagnostic testing to assess internal damage and rule out the possibility of life-threatening intracranial bleeding. This omission is all the more remarkable in light of Zimmerman’s claim that Martin had been pounding his head against the pavement for about a minute. It is unthinkable for a doctor to evaluate a patient with injuries as severe as Zimmerman claims and not send that patient to the hospital for follow up or perform an appropriate diagnostic work-up.

Of course, the report in question mentions that Zimmerman declined to go to the hospital or have any follow-up, but … why? Why would Zimmerman, who supposedly sought medical attention in the first place, refuse to go to a hospital or to follow up with an ENT specialist? That makes no sense whatsoever. And there is no mention of any referrals for diagnostic work, truly stunning in a case supposedly involving traumatic head injury. Did Zimmerman show up at his personal physician’s office for the sole purpose of creating a record of his injuries? If so, why not go to the hospital, and have a CT scan and an x-ray taken — you know, create a record that’s much, much more reliable, detailed and probative? Could it be because he wasn’t injured at all and this report by a “family physician” is bullshit?

And then, the report contains this gem:

[Zimmerman] had a weapon as he is authorized to carry a firearm, and he fired at the attacker, killing him.

As part of taking down a patient’s history, a doctor or his or her staff would customarily include a blurb about the circumstances that led to the injury. However — and this is a big “however” — the circumstances are only documented to the extent that they impact on the care and treatment of the patient. Thus, for example, if a patient comes in with a neck injury from an automobile accident, it would be important for medical purposes to note whether the injury occurred as a result of traction or compression, but not whether the injured person has a valid driver’s license or an excellent driving record. Stating that Zimmerman was authorized to carry a firearm is completely irrelevant to his care and treatment (since the appropriate treatment would have been the same had he, in fact, been carrying the gun illegally). The whole statement is in the nature of legal argument, rather than medical history, and reflects a lay person’s misapprehension that a medically irrelevant statement in a doctor’s report is somehow binding on the trier of fact as evidence.

I know from my professional experience that it is remarkably easy to find a storefront “family doctor” who will falsify a report for you. There are some, in fact, who are known to do this routinely for accident litigation and don’t go to particular lengths to hide it. Hospital records, by contrast, are very difficult to falsify successfully — because hospitals, being under strict governmental oversight, have systems and bureaucracies in place to detect and severely punish falsification. Diagnostic films, similarly, may not be impossible to manipulate, but such a task would be technically daunting and necessitate the involvement of not only a doctor and a technician, but also of an engineer, possibly several.

In cases where someone’s medical condition is in controversy, medical records are typically taken at face value. However, there are certain tale-tale signs that lawyers and investigators look for that would indicate that a medical record is falsified. These signs are as follows:

  • (1) The report lists severe injuries, but the patient does not seek treatment from a critical care provider (such as a hospital), and this failure is not credibly explained.
  • (2) The appropriate diagnostic work-up is never done.
  • (3) The report contains self-serving language that is inappropriate in a medical record, such as comments on questions of law and other matters not relevant to the patient’s care and treatment.
  • (4) There is little or no follow-up treatment with the author of the report, such as to be inconsistent with the severity of the claimed injuries.
  • (5) There is no follow-up treatment with a specialist.
  • The report that supposedly exonerates Zimmerman shows all of the above indicia of fraud, and was almost certainly created for the trial and back-dated to February 27.

    There are a couple of other major inconsistencies in Zimmerman’s account. For one, the stationhouse video, taken on the night of the incident, shows two minor abrasions on the back of Zimmerman’s head, with no bleeding — an injury inconsistent with his claim that Trayvon Martin pounded his head on the pavement for a whole minute. Unless, of course, Zimmerman has a skull made of titanium, covered in dinosaur skin. Two, Zimmerman claimed that he shot Martin at close range while Martin was beating him — but the results of the autopsy indicate that the fatal shot was fired from intermediate range — which certainly contradicts Zimmerman’s account that his life was in imminent danger.

    “But wait,” Zimmerman’s supporters may interject at this point, “What about the bruising on Trayvon Martin’s knuckles from beating up on Georgy like a piñata?” Here too, I’m afraid, the supposedly exonerating evidence is underwhelming. The autopsy indicates that Martin had one small bruise on one of his knuckles, which he could have sustained in a variety of ways — but which would not be consistent with him repeatedly punching Zimmerman with his fists.

    In short, Zimmerman is still on the hook. And, if the prosecutor is even minimally competent, the good doctor will get fileted on the stand — which would be getting off lightly, in my opinion.

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    15 thoughts on “Do Medical Records Exonerate George Zimmerman? Not So Fast.

    1. Here’s what I love most about your blog: Come for the insightful, elegantly worded, professional posts on legally relevant matters; stay for the dinosaur references.

      Again, you knock this one out of the park. I’ve followed this case since the news outbreak initially hit in Florida, and not once have I seen even a glimmer of evidence that Zimmerman isn’t trying to ride “Stand your ground” all the way to full legal and social exoneration. To agree with you, I have also attempted to reserve judgement for that moment of grey that usually accompanies “black and white” cases, but every time someone attempts to point the finger at Martin, the more fervently the counter evidence stands to his defense.

      I can’t help but feel that perhaps it is a lack of empathy for victims of violence that may be what will hurt Zimmerman the most. No one who has actually had his or her head “smashed” into the ground even once or twice would purport to have suffered through it for a full minute. It is an excruciatingly painful attack to suffer through, and the dizziness that accompanies it would probably have made shooting Martin from the range stated in his autopsy report difficult if not impossible.

      My feeling is that had Zimmerman actually suffered this type of attack either at that moment or at some other time in his past, he would have concocted a better back story. Instead, his history of violent outbursts that has been sadly under-reported implies a severe disregard for others when causing pain.

    2. The way I see it is that Trayvon was going about his own business when he was aggressively confronted and threatened by Zimmerman, who was not a sworn police officer.

      Of course, Trayvon would defend himself. Anyone with any sense would. Does anyone really seriously expect that he should have stood there helplessly like a sheep and not try to defend himself? I know if it had been me, I’d have done my best to do so.

      The fact that Zimmerman had some injuries does not mitigate him being in the wrong to me one whit.

    3. George Weaver on said:

      I agree with Adelaide. Unfortunately, this case will be tried and re-tried in the media. Thank you for your careful analysis.

    4. Because it’s taking so long, I’m getting that sick feeling that the prosecutor, because of the way the law is written, can’t prove ‘beyond a reasonable doubt’ that Zimmerman could be charged with assult much less murder in any degree.
      I hope I’m wrong but……

      • The thing that goes most heavily against Zimmerman is that when he first called the police, he was told not to confront Martin, but to let them handle it. He ignored that advice and pursued Martin, which hardly meets the definition of “stand and defend”, as he was clearly on the offensive. IF anyone was defending, it was Martin.

        • And I agree. But can that be shown ‘beyond a reasonable doubt’ that Martin made no offensive move?
          Again I think Zimmerman should be tried and convicted of assult at the least, maybe Man 1 or 2.
          But in that it’s taking so long, I have that sick feeling that the prosecutor can’t prove ‘beyond that reasonable doubt’ because of the way the law was written.

        • Does the law really expect Martin to have stood there meekly as a sheep and to have made no efforts to defend himself? Do they twist this into an “offensive” action? I don’t think that Martin should have to have been a saintly sheep in order to convict Zimmerman.

    5. I have yet to see a qualified medical expert offer an opinion on the photos of the wounds on the rear of GZ’s head: both the cell phone photo from the scene and the several photos taken at the jail. He seems to have suffered a longish but fairly shallow horizontal cut on the left rear of his head, a shorter but deeper cut on the right side of his head, and a bit of a strawberry farther to the right of that cut. As a layman, these wounds don’t stike me as anywhere near severe enough to be consistent with the ‘repeated head bashing’ claim. But I’d really like an M.D. (E.R. doc?) to look at those pics and offer a ‘diagnosis,’ ideally someone from somewhere else who has never heard of GZ and TM, and could just read the wounds for what they are outside of the larger narratives. But, again, I haven’t ANY MD’s weighing in on this at all. Is there a doctor in the house??

    6. James F on said:

      The actual extent of George Zimmerman’s have no legal bearing under Florida self-defense law.

      Your implication of impropriety by the physician who treated Mr. Zimmerman borders dangerously on libel.

      • James F on said:

        In deciding whether defendant was justified in the use of deadly force, you must judge him by the circumstances by which he was surrounded at the time the force was used. The danger facing the defendant need not have been actual; however, to justify the use of deadly force, the appearance of danger must have been so real that a reasonably cautious and prudent person under the same circumstances would have believed that the danger could be avoided only through the use of that force. Based upon appearances, the defendant must have actually believed that the danger was real.

      • The actual extent of George Zimmerman’s injuries, and how he sustained them, certainly has legal bearing on whether the defense is telling the truth about the circumstances of Trayvon Martin’s killing. Merely claiming to have acted in self-defense does not automatically prove that that’s what actually happened. (Although the case I linked is from Texas, Florida law does not treat the claim of self-defense as self-proving, either — which the language you cited below clearly demonstrates.) And that’s the issue here: proof. When you say the extent of a defendant’s injuries has “no legal bearing”, what does it mean, exactly, in legal terms? That it’s irrelevant? Inadmissible? I strongly doubt that’s how the courts see it, even in Florida.

        As for the libel thing: thank you for your concern, James. However, expressions of opinion, even harsh and negative opinion, are not libel. Furthermore, inasmuch as this is a blog, and the post deals with a matter of intense public interest, what I have written is fair commentary on current events, likewise protected from retaliatory defamation lawsuits. Finally, I would note that in the current political climate, the standard for proving defamation has risen dramatically. After all, a myriad right-wing bloggers constantly insinuate that Trayvon Martin was a criminal, that the President is a non-citizen/Muslim terrorist/communist/foreign spy/traitor, that women who dare speak out on issues of women’s health from a liberal perspective are sluts/murderesses/illegal welfare recipients, and so forth. They do this with obvious malice and offer these statements as fact — and yet I don’t see any defamation judgments raining down on them. Do you? What I have stated is quite tame by today’s standards — and I’ve offered a basis for my opinion. So I really don’t see why I should treat the Zimmerman camp with kid gloves.

    7. Months after your wonderful insights, we have found out: Zimmerman only saw his local medical practitioner to sign him back to return to work, at his boss’s request, NOT for any horrendous injuries or even to log such as evidence.

      I’ve had a few head injuries, my last being the most deleterious, which hospitalised me overnight (they wanted to keep me longer, but I foolishly refused) and that was just ONE good blow to the left side of my head, playing softball. Zimmerman’s lack of knowledge re: concussions, supposes a full minute of ‘bangs’ to the head is necessary to intimate imminent danger. ONE good hit to the head can cause a Mild Traumatic Brain Injury (MTBI) AND can chronically affect one’s life via Post Concussion Syndrome; especially, it appears, if you’re female. So in conclusion, there’s no gauging how foolish Zimmerman really in, especially considering the amount of lies he’s told since your blog.

    8. it’s been reported that “nurse” shellie treated his head wounds at HOME. he didn’t seek treatment till the next day and if he was on the bottom sustaining a brutal beating why are the SLIGHT blood trails in a forward and down (like HE’s on top) motion? he hunted that boy and shot him. why didn’t he tell LE it was Frank Taffe’s townhouse he was parked in front of and is that who he can be heard telling “the keys are in the truck”? why were his keys found on the ground near an illuminated penlight? too many question, inconsistencies and outright LIES. his embellishments grow with every telling and it’s way too wordy and violent for all that to have occured in the 3-4 minutes it took him to stalk him down grab his sweatshirt so he COULDN’T get away and fire straight through him.
      He was not found in a Y position he was found with his arms under him ANOTHER lie out of GZ

    9. Police saw Zimmerman’s bleeding head and released him because it was quite obvious to them that he shot Martin in self-defense.
      It may very well be that Zimmerman broke the law by following Martin, but that does not mean that Martin did not attack him. It also does not mean that killing Martin was not self-defense.
      Both persons could potentially be victims of different crimes. Martin of being stocked, and Zimmerman of violent assault. From everything I read, I have no doubt that Martin assaulted Zimmerman. I also don’t agree that Zimmerman should have waited for serious injury before shooting Martin.
      When someone bangs my head to the ground, I don’t want to wait till I get unconscious, or dead. I support Zimmerman’s and everyone else’s right to defend themselves.
      Most importantly, I believe that the all discussion racism is wrong and irrelevant. This case would have been no different if Martin was White and Zimmerman was Black.

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