Detainee lost brain tissue, but no signs of trauma

CINCINNATI — Otto Warmbier, who was medically evacuated from a 17-month detainment in North Korea this week, has extensive loss of brain tissue and is in a state of unresponsive wakefulness, UC Health doctors said Thursday afternoon.

Doctors said they don’t know what caused the brain damage. When asked whether it could be the result of beating or other violence while in prison, they said Warmbier did not show any obvious indications of trauma, nor evidence of either acute or healing fractures.

Rather, Daniel Kanter, medical director of the neuroscience intensive care unit at UC Medical Center said, it appeared consistent with cardiopulmonary arrest, with damage caused by lack of blood flow to the brain. Respiratory arrest could have several causes including intoxication or a traumatic injury, said Jordan Bonomo, neurointensivist at UC Gardner Neuroscience Institute.

It is possible to have respiratory arrest caused by an overdose of medication, intentional or otherwise, he said.

Warmbier’s condition, its possible causes and his treatment while detained in North Korea are of intense interest in a case that threatens to worsen already fraught relations between the United States and North Korea. President Donald Trump called Warmbier’s parents Wednesday night to tell them that his administration had worked hard to secure their son’s release, and to ask how he was doing.

Warmbier has undergone a battery of tests since his arrival at the University of Cincinnati Medical Center Tuesday night. Throughout that time, his family has been at his bedside, doctors said.

They declined to discuss his prognosis or speculate about the future, at the family’s request.

They said he has spontaneous eye- opening and blinking but shows no signs of understanding language or awareness of his surroundings. He has not spoken, nor has he engaged in any purposeful movement, Kanter said.

It has been almost a year and a half since Warmbier was detained in North Korea, which he had visited on a fiveday tourist trip on his way to a study-abroad trip to Hong Kong with the University of Virginia. On his last night there, he apparently tried to remove a large propaganda sign. He was charged with “hostile acts against the state” and, after a trial, sentenced to 15 years of hard labor.

It has been about 15 months since all contact was severed. He was allowed no consular visits.

About a week ago, his parents suddenly got news: Their 22-year-old son was in a coma, and had been for more than a year.

They were told — but did not believe — that shortly after the trial that Warmbier contracted botulism and was given a sleeping pill and that he had never recovered.

Joseph Yun, the State Department’s special representative for North Korea, rushed to help secure Warmbier’s medical evacuation. Late Tuesday, the Gulfstream jet touched down in Cincinnati, and his family finally got to see him, before medical personnel carried him off the plane into an ambulance.

At a news conference earlier Thursday, Fred Warmbier said the family is left with many questions, and no answers.

“There is no excuse for any civilized nation to have kept his condition secret and denied him top-notch medical care for so long,” Fred Warmbier said.

On Thursday, North Korea’s state- run news agency said a court had allowed Warmbier to return home “on humanitarian grounds.”

When asked about that, Fred Warmbier said he thinks the State Department was pretty tough with them. “They did not do this out of the kindness of their hearts.”