Lack of a standard places Charley's deaths in question

By LEONORA LaPETER, Times Staff Writer
Published August 24, 2004


Three days after Hurricane Charley blew through Florida, Hardee County Supervisor of Elections Dean Cullins died of a heart attack in his sleep. Cullins is counted as one of 25 deaths attributed to the storm.

Stephen J. Nelson, the medical examiner for Hardee, decided Cullins was a Charley victim because the 60-year-old's heart disease was exacerbated by working on a generator to power his home and clearing debris from his yard in Wauchula.

Hardee's public safety director, William Muhlfeld, disagreed, saying the county should continue to say it had no deaths.

In hurricane death reporting, Nelson has the upper hand. The state's medical examiners decide which deaths are related to a hurricane and which are not.

There are no state standards for classifying hurricane deaths; the decision is subjective.

Nelson, the medical examiner for Hardee, Highlands and Polk counties, is chairman of the state Medical Examiners Commission. He also counted in his Charley deaths an 86-year-old Fort Myers man who evacuated to Winter Haven. He hit his head and chest in a fall in his hotel room.

"We're being consistent with what happened with (Hurricane) Andrew," Nelson said. "Not everybody died of debris falling on them. The vast majority were after the fact from stress-related complications of the storm. Back in Andrew's time, the stroke of a pregnant woman was considered a hurricane death."

Nelson said classifying the indirect hurricane deaths helps the state get word out about, for example, the dangers of working with portable generators.

Just 10 of Florida's 25 Charley deaths were caused directly by the storm.

Among them, an elderly couple who refused to leave their Punta Gorda trailer were thrown 150 feet across the street. A Punta Gorda man bled to death after flying glass cut his leg. A banyan tree fell on a North Fort Myers man.

The other 15 died after the storm passed - from heart attacks, falls while cutting up yard debris and carbon monoxide poisoning from portable generators.

More deaths are pending.

Riazul Imami, medical examiner for Charlotte County, said he is waiting on a suicide note to determine if an 83-year-old man who hanged himself made mention of the hurricane. Imami also is looking into an accident that killed three at a Port Charlotte intersection. He said he'll classify a traffic accident as hurricane-related if power was out at the intersection or stop signs were blown down.

Ten years after Hurricane Andrew hit Florida, the number of deaths attributed to it varies.

The Centers for Disease Control reports 32 deaths, including 14 directly related to and 18 indirectly related to the storm; the National Hurricane Center reports 44 deaths, 15 direct and 29 indirect.

A 1992 CDC report following Hurricane Andrew noted the subjective nature of hurricane death reporting and recommended that a standard definition be adopted.

A CDC official said Monday no standard has been adopted.

Paul Filla, of Lee County Public Safety, said he was trying to figure out who classifies the deaths after people with his agency opened the newspaper to find three new deaths.

"We hadn't reported them (as hurricane deaths)," he said. One included a man who had reportedly been using candles before his home burned down; he died of carbon monoxide poisoning.

A spokesman for Muhlfeld said the Hardee County public safety director would not argue with the medical examiner, but he did not believe a person who died of a heart attack in his sleep is a hurricane death.

Nelson, the medical examiner, said he counted Cullins because he awoke in the middle of the night to refill a generator with gas, told his wife he felt better and went back to bed.

She found him dead when she awoke at 7 a.m.

"He was cleaning up trees and his house was on emergency portable power," Nelson said. "They may not consider it, but it was definitely an exacerbation of a pre-existing condition."

Times researcher Kitty Bennett contributed to this report.

[Last modified August 24, 2004, 00:08:14]