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ONE PUNCH. Three skull fractures. Two brain operations. Two heart surgeries. Twelve days fighting for his life after he was hit by Mayor Daleys nephew. Newly released hospital records shed light on . . .
Pilgrims gather by the thousands to hold all-night prayers on the eve of beatification
ManhitbyDaleynephewdiedaftercardiacarrest,4surgeriesin12days
is skull fractured in three places, his brain dangerously swollen, David Koschman was loaded onto a backboard by Chicago Fire Department paramedics and rushed to the emergency room at Northwestern Memorial Hospital. It was 10 minutes to four in the morning on April 25, 2004 about half an hour after Koschman had been punched in the face by Richard J. R.J. Vanecko, a nephew of Mayor Daley and William Daley, President Obamas chief of staff, in a drunken confrontation on Division Street at Dearborn. Koschman, whod been out drinking with friends, fell backward and hit his head on the street. The 21-year-old from Mount Prospect was moaning and thrashing when he got to the emergency room, newly obtained records show. He would never regain consciousness and never leave Northwestern. In his 12 days there, doctors would perform two brain operations and two heart surgeries including a coronary bypass. He died at 11:26 a.m. on May 6, 2004, six minutes after doctors, acting with the permission of his mother, Nanci Koschman, took him off life support. His final days and the details of his medical treatment are described in 1,338 pages of records his mother obtained from Northwestern Memorial. The records show Koschman was in grave condition from the moment his head struck the pavement. Less than three hours later, surgeons were drilling a hole in his skull and inserting a device to monitor the pressure on his brain. Despite the severity of Kos-
Staff Reporters
David Koschman was punched on Division Street between State and Dearborn on April 25, 2004. | KEITH HALE~SUN-TIMES
1 without seeking criminal charges. Going over the medical records was painful for Nanci Koschman. I really would like R.J. to read them, to realize what that one simple punch did to my son, she says. Nanci Koschman has recently been contacted by city of Chicago Inspector General Joseph Ferguson, who is investigating the police departments handling of the case. Ferguson declined to comment. Vaneckos father Dr. Robert M. Vanecko, a brother-in-law of the mayor is a cardiothoracic surgeon and former chief of staff at Northwestern. He didnt treat Koschman, according to the hospital records. Among those who did was Dr. Patrick M. McCarthy, who succeeded Vanecko as head of cardiothoracic surgery. Vanecko didnt respond to an interview request. McCarthy and other hospital officials declined to discuss Koschmans case.
prepping him for neurosurgery. Within the hour, they drilled into his skull and screwed in a bolt to help monitor pressure on his brain. By 7:15 a.m., Koschman was sent to the hospitals Neurological Surgical Intensive Care Unit. Patient is sedated, Rosenow wrote. He is in a cervical collar. He does not open his eyes. He does not follow commands. He will localize painful stimuli with his left upper extremity. He will withdraw his right upper extremity. He will move both his legs symmetrically to stimulation. Koschman also was occasionally moving spontaneously, so doctors restrained him to keep him from dislodging the lines and tubes helping keep him alive, hooking him to the ventilator, brain monitor and IV.
chmans injuries, the Chicago Police Department which initially classified the case as a battery halted its investigation that same day, and detectives didnt try to talk with most of the witnesses until after Koschman died. The Cook County Medical Examiners Office called Koschmans death a homicide. The case remained dormant for seven years, until Jan. 4, when the Chicago Sun-Times requested records of the investigation. Top Chicago Police Department brass then ordered a new investigation, and detectives determined that the 6-foot-3, 230-pound Vanecko punched the 5-foot-5, 140-pound Koschman but did so in self-defense. They closed the case March
and who, in addition to his neurological problems, began developing numerous other complications. More than 30 family members and friends showed up at the hospital before Koschman went to the operating room. They had us all say goodbye to him because they didnt think hed come out of it, Nanci Koschman says, but, He came through heart surgery. Two days later, I got a call. They said they were removing parts of his brain. Koschmans brain had continued to swell, measured in part by the increasing size of his pupils, which were unequal in diameter and did not respond to light. By the morning of May 3, 2004, his ninth day in the hospital, the pressure on his brain had tripled. A doctors note said he was very grave. That morning, surgeons performed a lobectomy: They removed a flap of bone from Koschmans skull so they could remove part of his brain and also drained a blood clot.
After surgery, Koschman who had gained about 40 pounds from fluid build-up during his hospital stay remained in a coma. At one point, he had eight IVs and was on more than a dozen medications. A day after the lobectomy, his temperature spiked from 101.8 degrees to 111.8 degrees in less than an hour. Nurses gave him an ice bath and cooling blanket. His temperature dropped to about 100. On May 6, 2004, Koschmans 12th day in the hospital, doctors noted he was developing renal failure. After talking with Nanci Koschman, Rosenow signed a do not resuscitate order, and David Koschman was taken off all of the life-support devices. Six minutes later, he died. Making the decision to turn off life support was the toughest decision any mother should have to make, Nanci Koschman says. I would like R.J. to understand that the punch killed my son, maybe not right away, but gradually, which I had to watch.