MIAMI (CBSMiami/AP) — A Miami homeless man, hospitalized after a brutal and vicious attack in which 75-percent of his face was chewed off by another man, faces a bigger threat from infection than from the injuries themselves, according to experts on facial reconstruction.
He will require months of treatment to rebuild his features and be permanently disfigured.
Though gruesome, such severe facial injuries are generally not life threatening. The most serious risk to 65-year-old Ronald Poppo are germs that may have been introduced by the bites of the naked man who attacked him. One of Poppo's eyes was also gouged out.
"The human mouth is basically filthy," said Dr. Seth Thaller, the chief of plastic and reconstructive surgery at the University of Miami's Miller School of Medicine.
It's not clear why Poppo was attacked Saturday afternoon by 31-year-old Rudy Eugene alongside the MacArthur Causeway.
Police have released few details, but surveillance video from the Miami Herald building shows Eugene pulling Poppo from the shade, stripping and pummeling him before appearing to hunch over and then lie on top of him.
A witness described Eugene ripping at Poppo's face with his mouth and growling at a Miami police officer who ordered him to get off the homeless man. The officer shot and killed Eugene.
Eugene's younger brother said he was a sweet person who didn't drink much or use hard drugs.
"I wish they didn't kill him so he could tell us exactly what happened. This is very uncharacteristic of him," said the brother, who asked for anonymity to protect his family from harassment.
His mother also spoke out Wednesday and said she wanted to remember her son's kindness. She told CBS4's Peter D'Oench that her son was "no zombie."
"I feel devastated," said the mother, who did not want her name or face revealed. "That was not him who was seen on TV doing that. He was a nice kid. He was a good kid. He gave me a nice card on Mother's Day. Everyone says he was a Zombie. He was no Zombie. That was my son."
"I never had any problems with him," she said. "The police don't have to shoot him. They could have tased him. I saw what happened on TV and I started crying. He had two baby brothers," she said, "and they used to go to church all the time together."
Rudy Eugene's girlfriend said the attacker on the causeway was nothing like the man she knew and loved.
"Rudy Eugene was not no zombie or 'Miami Zombie' like they're saying. He was a human being and that wasn't him," said the woman, who requested CBS4 News not use her name or show her face.
She described him as a "sweet loving gentleman" and a "hard working man" who worked at a car wash and dreamed of owning his own business.
She said she has no idea what caused the vicious attack but she didn't see any signs of violence in the nearly five years they lived together.
"That wasn't him, that was his body but it wasn't his spirit. Somebody did this to him," she said. She described Eugene as religious.
"He loved God he always read the Bible he would give you knowledge on the Bible. Everywhere he went his Bible went. When he left he had his Bible in his hand." She said Eugene left her home about 5:30 Saturday morning.
She said his last words to her were, "I love you and I'll be back."
According to Miami-Dade court records, Eugene did have a troubled past and had been arrested for multiple misdemeanors, mostly marijuana-related charges. However, in 2004, there was an incident in which North Miami Beach Police had to use a Taser to subdue him during a domestic dispute involving his mother.
Click here to read the full police report from 2004.
None of his past incidents involved any level of the violence that occurred on the causeway on Saturday.
Miami Police union officials representing the officer said the scene on the MacArthur Causeway was one of the goriest they had ever seen.
"He had his face eaten down to his goatee. The forehead was just bone. No nose, no mouth," said Sgt. Armando Aguilar, president of the Miami Fraternal Order of Police.
Poppo has been in critical condition in recent days, but police didn't give an update on his condition Wednesday.
Thaller, who is not treating Poppo, and other plastic surgeons said the rebuilding of Poppo's face would happen in stages after doctors try to keep his wounds clean, salvage viable tissue and determine a plan for skin grafts. Protecting his remaining eye and maintaining an airway are priorities.
To keep the wounds clean, doctors use grafts of the patient's skin, cadaver skin or synthetic skin to cover the exposed bone or cartilage, said Dr. Blane Shatkin, a plastic surgeon and director of the wound healing center at Memorial Hospital Pembroke in South Florida. The coverage would act like a dressing, protecting the wound as it heals.
Poppo's lifestyle and health before the attack could determine how doctors proceed and whether they eventually consider a facial transplant, plastic surgeons said. Poppo had been homeless for more than 30 years, previously survived a gunshot wound and faced multiple charges of public intoxication, among other arrests.
"You would not just take this guy to the OR for a face transplant — you really have to go in a staged fashion. You save what you can and use what you have available first, don't burn any bridges and move forward slowly," Shatkin said. "And you have to see what he wants."
Psychological care is important to the recovery, and patients need to participate in the decision-making process, said Dr. Bohdan Pomahac, a surgeon at Brigham and Women's Hospital in Boston. He performed a facial transplant on a Connecticut woman who was mauled by a friend's pet chimpanzee in 2009.
"I think the patient has to be able to cope with the injury and the trauma and needs to figure out what has happened. It often takes them weeks to understand what has happened," Pomahac said.
The chairman of the Miami-Dade County Homeless Trust, Ron Book, said the last time Poppo sought help from the agency finding someplace to sleep was in 2004. However, the Thursday before he was attacked, Jungle Island on Watson Island called for an outreach team to deal with Poppo, who had been living on the roof of the attraction's parking garage.
Poppo was belligerent and aggressive, but he was not arrested, Book said.
A report from the group says that Poppo had been homeless before arriving in Florida. He first came to one of the group's shelters in Miami on Dec. 27, 1999, and he stayed for 141 days. Since then he stayed at another shelter in 2003 for 10 days and several other shelters for one night each.
The attack was captured by security cameras at The Miami Herald's headquarters. It shows a naked Eugene walking west on the sidewalk alongside an off-ramp of the causeway. A bicyclist speeds past Eugene just as he turns to something in the shade, in an area obscured by palm trees.
After a couple minutes, Eugene rolls Poppo's body into the sun and begins stripping off his pants and pummeling him. Later, the footage shows Eugene pull Poppo farther up the sidewalk. Though the view is partially obstructed, Eugene appears to hunch over and lie on top of Poppo.
The footage shows a bicyclist slowly pedaling past the men about halfway through the attack, followed by a car slowly driving on the shoulder of the ramp. Cars regularly pass by the scene from the beginning of the attack, but their view was likely obstructed by a waist-high concrete barrier.
Two more bicyclists cross the scene before a police car arrives nearly 18 minutes into the attack.
An officer gets out of the car and appears to do a double-take at the scene before pulling out his gun. He fatally shot Eugene, apparently within a minute of arriving, but the shooting is obscured from view by the MetroRail tracks.
Miami police have not released 911 calls. The medical examiner declined to discuss Eugene's autopsy, and results of toxicology tests could take weeks.
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