7.10.2012

Medical Experts and the Injuries Caused by Gripping Dogs

Dear Ms. James,

I wish to extend a thank you for your efforts and time spent on creating your blog, "The Truth About Pit Bulls". I found your blog after reading about this very endearing set of vintage photos about pit bulls being 'the Nanny dog' of the late 19th, early 20th century. Which completely surprised me and I wanted to know more. My search found your blog.

I am a pathologist. I have attended the autopsy of 3 different individuals within a 8 year period whose deaths are directly attributable to pit bulls. They were in two different states. To have encountered 3 deaths due to dog attacks is extremely rare considering that frankly in numbers of fatalities of deaths resulting in these accidents is statistically nil. This in no way minimizes the loss of the people and children that have died as a result of these vicious dog attacks.

I can share with you that the bites of these animals (based only on my observations of the 3 autopsies that I attended) are indeed vicious. The way that the tearing of skin, muscle, tendons and bones looked very similar to someone who had an injury from an auger from a farm accident. Complete devastation. All of the deaths are a result of blood loss due to the attack. All three of the victims were male. Two were boys- 4 and 8, the older male was in his late 40's.

I have eluded to the trauma that each body experienced with these dogs. Each incident was one pit bull. Verified by the bite marks that were attained from the wounds and from orthodontic cast moldings from the suspected animal. People read the word "mauled" by dogs. They do not understand the truly outlandish, macabre wounds inflicted by these dogs. I've been a pathologist for 9 years and in that time I have attended for those deceased on all manners of death imaginable. These 3 deaths are still the top 5 of the most horrifying because of the destruction. I'm trying to refrain in the details simply because for heaven's sake it's Saturday morning and you've probably not yet ate breakfast. But for any pathologist we have those deaths we've attended that are memorable. All of us have a story. All of us have our demons that haunt us at night, to say that THREE of my top 5 is from 1 breed- the pit bull-- attack says volumes. It's the severity of the wounds, from the head injuries and in one case all the way to the bottom of the feet. I recall the death investigator coming into my office and telling me that the neighbors in one of the child attacks said that they heard nothing. They did not hear the child screaming (death was quick with this attack as the pit bull went literally for the jugular first; all other wounds on this child was post-mortem). But the silence was also from the pit bull. The child was within only 14 feet of a neighbors home, they're windows were open, the reporter (neighbor) did not have his T.V. on. It was all stealth, quiet, secretive almost. If I could I would absolutely be able to put up for a case of at least manslaughter. But alas I can not, but thankfully each dog in this instance was sentenced appropriately to death shortly after our investigation(s) concluded.

There are way too many incidences of deaths and maiming that is directly as a result of pit bulls (and some other aggressive dogs) that the bite marks and the trauma inflicted shows the power, furiosity and cruelty to me shows that perhaps it would not be a bad idea for these dogs to become extinct. Either by hook or crook, I care not. I have no doubt that some of these pit bulls are nothing but lovebugs but to me and anyone else in attendance at these type of deaths would conclude they have no place in our society. None. Yes, very much a zero tolerance policy. After observing what I have, any other logical, sane human being would agree. This is not a complete 'owner is to blame' this is genetic, inbred instinct in these types of animals that can not be culled simply due to the fact it's been a part of their breeding/stock for multiple generations. Here I am pontificating outside of my competent 'domain', but it is what I believe wholeheartedly.

I wish to reiterate that your time, attention and dedication to exposing the candid, unvarnished truth of the issue with these types of dogs is appreciated.

Most Sincerely,
(name withheld)





JOHN BINI, MD, chief of surgery at Wilford Hall Medical Center



MORTALITY, MAULING, AND MAIMING BY VICIOUS DOGS, April 2011 Annals of Surgery



DAVID E. BLOCKER, BS, MD, Dog Bite Rates and Biting Dog Breeds in Texas, 1995-1997




PETER ANTEVY, pediatric E.R. physician, Joe DiMaggio Children's Hospital
Dr Antvey sees at least five dog-bite victims a month in his emergency room. Unfortunately, he said, "the biggest offender is the pit bull."



MELISSA ARCA, MD
The reality is that any dog can bite, and statistically speaking, a child is most likely to be bitten by the family dog or a dog that they know. When you're talking about bite severity resulting in life-threatening and even fatal injuries, pit bulls and Rottweilers are the main culprits.

Experience absolutely colors our perception, and in this case I can't help but be affected by what I've seen. I will never forget a young child I treated in the ER during my pediatric residency. She suffered severe facial lacerations and tears to her face after a pit bull attack in her local park.




HORSWELL BB, CHAHINE CJ, oral surgeons
Dog bites of the facial region are increasing in children according to the Center for Disease Control. To evaluate the epidemiology of such injuries in our medical provider region, we undertook a retrospective review of those children treated for facial, head and neck dog bite wounds at a level 1 trauma center. Most dog bites occurred in or near the home by an animal known to the child/family. Most injuries were soft tissue related, however more severe bites and injuries were observed in attacks from the pit-bull and Rottweiler breeds. Younger (under five years) children sustained more of the injuries requiring medical treatment. Injury Severity Scales were determined as well as victim and payer mix demographics, type and characteristics of injury, and complications from the attack.



DR RICHARD SATTIN, chief of unintentional-injuries section of the Centers of Disease Control
We're trying to focus public attention on this greatly underestimated public hazard.

In 1979, pit bulls accounted for 20 percent of fatal attacks by dogs. That figure had risen to 62 percent by 1988.


Nobody knows the dog population of the United States or the exact breakdown by breed.
We do not believe that pit bulls represent anywhere near 42% percent of dogs in the United States. Therefore, we believe that the pit bull excess in deaths is real and growing.



ROBERT D. NEWMAN, M.D.
As a pediatrician I was disturbed to read Vicki Hearne's assertion that there are no bad breeds, just bad dogs (Op-Ed, April 15). There is ample evidence to suggest that certain breeds of dogs are more dangerous to children than others.
From 1979 to 1994, there were 177 known dog-bite-related fatalities in the United States. Of these fatalities, 66 percent were caused by five breeds: pit bull, Rottweiler, shepherd, husky and malamute. If you include crosses among these five breeds, that number rises to 82 percent. Other breeds, like Labrador retrievers and golden retrievers were not implicated in a single fatality during this same period.
I laud the American Kennel Club's attempt to include information about dog breeds considered ''not good with children'' in the coming edition of ''The Complete Dog Book,'' and lament the fact that the book is being recalled at the request of some breeders.
Seattle, April 16, 1998



Dr. EDGAR JOGANIK (after trying to reattach scalp and ear to a pit bull victim)
Pit bull attacks are typically the most severe, and in about one-third of all attacks, the animals are family pets or belong to close friends.
That should be the message, that these dogs should not be around children, adults are just as likely to be victims.
Everyone should be extremely cautious.




DR. MICHAEL FEALY
When a Pit Bull is involved the bites are worse. When they bite, they bite and lock and they don't let go... they bite lock and they rip and they don't let go.



DR. CHRISTOPHER DEMAS
Bites from pit bulls inflict much more damage, multiple deep bites and ripping of flesh and are unlike any other domestic animal I've encountered. Their bites are devastating - close to what a wildcat or shark would do.



DR. AMY WANDEL, plastic surgeon
I see just as many dog bites from dogs that are not pit bulls as bites from pit bulls. The big difference is pit bulls are known to grab onto something and keep holding so their damage they create is worse than other breeds.



DR. PATRICK BYRNE, Johns Hopkins Hospital
I can't think of a single injury of this nature that was incurred by any other species other than a pit bull or a rottweiler.



ANDREW FENTON, M.D.
As a practicing emergency physician, I have witnessed countless dog bites. Invariably, the most vicious and brutal attacks I have seen have been from the pit bull breed. Many of the victims have been children. In a recent study from the Children's Hospital of Philadelphia, pit bull attacks accounted for more ER visits than all other breeds combined.

In young children, the most common part of the body injured was the face. Numerous studies have proven that the number-one cause of dog bite fatalities is the pit bull breed. I am certain that many attacks are due to owner negligence, but the fact remains that many were unpredictable and were perpetrated by formerly "loving and loyal" pets.

Dr. Chagnon has every right to leave our town as she claims she will if pit bulls are banned, just like every one of her patients has the right not to attend her clinic where she brings her pit bulls. I applaud Mayor Pro Tem Joanne Sanders for bringing this issue to the forefront. In the interest of public safety, I recommend we enforce a spay/neuter requirement on pit bulls while reviewing and revamping all of our policies relating to animal bites.




JUGPAL S. ARNEJA, MD, FRCSC, KARA PAPPAS, B.S., WILLIAM HUETTNER, M.D., ARLENE A. ROZZELLE, M.D., GURBALBIR SINGH, M.D., FRCSC
A ten-year, two-institution review of pediatric dog attacks: Advocating for a nationwide prohibition of dangerous dogs
PURPOSE:
Affectionately referred to as ‘man’s best friend’, dog attacks in the pediatric population often test this analogy. Pediatric dog attacks are a significant public health issue that negatively affects the psychological well-being of a child. We performed analysis of our cumulative two-institution pediatric dog attack data, present representative cases and offer evidence to support a nationwide prohibition of dangerous dogs.
METHODS:
A retrospective review was performed at two urban Children’s hospitals from 1996-2005 of all dog attacks presenting to the plastic surgery service. Charts were reviewed with analysis of patient demographics, injury site, operative intervention, and dog-specific data.
RESULTS:
109 patients were included for review, with 83% of attacks occurring in the facial region. Mean age was 3.9 years (range 2-18 years). 67% of attacks involved multiple anatomic sites, 95% required surgical intervention with 30% requiring a skin graft or flap reconstruction. 88% of dogs were known to the victim, 46% of attacks were provoked, 73% of dogs were euthanized and 57% of dogs were deemed to be of a dangerous breed (Pit Bill or Rottweiler). Mean hospital duration was 4.7 days and 27% required additional reconstructive plastic surgery. Figures below illustrate a representative case of a 4-year old female attacked by her aunt's dog, resulting in a complete nasal amputation, preoperatively (upper), at time of forehead flap reconstruction (middle), and five years post-operatively (lower), with an acceptable functional and aesthetic reconstruction.
CONCLUSION:
Dog attacks in the pediatric population produce significant costs including physical morbidity, psychological disability, and financial strains. A majority of attacks were by a known dog, in the facial region, by dogs which we define as of a dangerous breed. Much of the injury patterns are unique to children and these injuries and associated costs can be significantly diminished, as the problem is often preventable. Our cases present the ‘tip of the iceberg’ as our cases only represented consultations directed to Plastic Surgery. The Province of Ontario, Canada has banned Pit Bulls since 2004, as have several American cities. We describe the scope of the problem, preventative guidelines, and outline why organizational advocacy in plastic surgery should be directed towards a national prohibition of dangerous dogs.



M. A. DEWAN, EDWARD J. WLADIS, Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical College, Slingerlands, NY
Periorbital trauma from pit bull terrier attacks.
PURPOSE
To report the nature of periorbital trauma after pit bull attacks. While these attacks have been well-characterized in the popular media, no case series has documented the ophthalmic manifestations of this trauma.
METHODS
We retrospectively reviewed all cases of pit bull terrier attacks that presented to the oculoplastic and orbital surgery service at Albany Medical Center between 2008 and 2011. The age, gender, extent of the injuries, care provided, follow up interval, and complication rate were evaluated for each patient.
RESULTS
Seven patients were identified, with a mean age of 17.2 years. Six of the seven patients were in the pediatric age group. All patients suffered eyelid lacerations, and only one patient had additional injuries. Four patients (57.2%) suffered a canalicular laceration. Despite the lack of post-operative oral antibiotic use, no patient developed a wound infection.
CONCLUSIONS
In the ophthalmic setting, pit bull terrier attacks most frequently involve children and result in eyelid lacerations. Canalicular injuries are common after these attacks.



This list will be continually updated.

14 comments:

april 29 said...

It is appropriate for those in the medical community to voice concerns about public health hazards. The voices of doctors, vocal victims, and representatives of the insurance industry should be taken seriously by legislators considering laws to protect the public. It is unfortunate that so far, the voices of breed specific advocacy, and animal rights PACs seem to drown out common sense.

Jewel Jade said...

A strong dose of reality! Thank you for presenting the truth. Pit Bulls are a serious public safety hazard! These "dogs" need to be extinct!

Sputnik2009 said...

How sad that that MD Melissa Arca seems to feel a need to apologize for the fact that 'experience colors our perceptions'.

God help us all, this is the ONLY thing science is: experience colors our perceptions, worse yet, experience tells us about realities and determines our conclusions, never mind our fantasies and wishful hypotheses.

I'm thankful at any rate that the medical community is (as yet) willing to speak openly about realities.

snack sized dog said...

Powerful letter! Thank you to the person who submitted it.

vintage said...

April 1998 Dr writes letter: Some dogs are biters and owners should know

"From 1979 to 1994, there were 177 known dog-bite-related fatalities in the United States. Of these fatalities, 66 percent were caused by five breeds: pit bull, Rottweiler, shepherd, husky and malamute. If you include crosses among these five breeds, that number rises to 82 percent. Other breeds, like Labrador retrievers and golden retrievers were not implicated in a single fatality during this same period."

194 Americans have been killed by Pit Bulls since the letter was written....

dawn james said...

thank you vintage, i will add it to the others.

vintage said...

Dr. Patrick Byrne with Johns Hopkins Hospital -- where Allen is being treated -- speaks frankly about his injuries. "I can't think of a single injury of this nature that was incurred by any other species other than a pit bull or a rottweiler." Due to horrific nature of these bites, surgeons have had to develop new techniques to try to mend them. These procedures are highly expensive and still leave the victim with scars

dawn james said...

do you have the link?

vintage said...

109 patients were included for review, with 83% of attacks occurring in the facial region. Mean age was 3.9 years (range
2-18 years). 67% of attacks involved multiple anatomic sites, 95% required surgical intervention with 30% requiring a skin
graft or flap reconstruction. 88% of dogs were known to the victim, 46% of attacks were provoked, 73% of dogs were
euthanized and 57% of dogs were deemed to be of a dangerous breed (Pit Bill or Rottweiler).


CONCLUSION: Our cases present the ‘tip of the iceberg’ as our cases only represented consultations directed to Plastic Surgery. The Province of Ontario, Canada has banned Pit Bulls since 2004, as have several American cities. We describe the scope of the problem, preventative guidelines, and outline why
organizational advocacy in plastic surgery should be directed towards a national prohibition of dangerous dogs.

Meeting Abstract, 87th American Association of Plastic Surgeons, A Ten Year review of Pediatric Dog Attacks, Advocating for a nationwide prohibition of dangerous dogs

vintage said...

UK Plastic Surgeon gives his two pence after installing miles of suctures into Pit mauling victims:

http://www.youtube.com/watch?v=w2LI1oEQnQI

Peter P said...

Interesting notes. I became a pitbull owner after reading both pro- and con-pitbull blogs like (and including) your own. I do have problems with the pro-pitbull advocate's approach, as a lot of it seems to propagate unsubstantiated myth, and that doesn't help with understanding the breed. One needs to be well-informed and aware of the breed before taking on the responsibility of ownership.

What interests me is the one statistic reported upthread:

"In 1979, pit bulls accounted for 20 percent of fatal attacks by dogs. That figure had risen to 62 percent in 1988."

What happened there? Did the pitbull population explode in those 9 years? I'm curious. That's quite a jump.

Here's an interesting study, at least from my perspective.:

http://www.cdc.gov/homeandrecreationalsafety/images/dogbreeds-a.pdf

This covers dog fatalities from 1979-1998. There are some interesting numbers there, at least to me. Purebred pits rank highest in dog-related deaths overall, but rotties fared worse in the years from 1993-1998. Crossbred pits, average about 1 death a year. German Shepards (both purebred and mixes), purebred malamutes, purebred huskies, and purebred rotties fare as bad (in the case of German Shepherd mix) or worse.

Now, the pro-advocacy groups look at that study and say it's all BS, that the breeds were never identified by an expert, that the living conditions of the dog weren't taken into account, etc.

But I'm happy to stipulate those numbers as true. If a crossbred pit (which is what I have) is shows itself to be statistically as likely to cause a bite fatality as a crossbred shepherd, and less likely than a purebred shepherd/husky/malamute/rottie, is your position to eliminate those types of dogs as well, or just purebred pits and possibly rotties?

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