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https://www.readbyqxmd.com/read/28343286/a-mimic-of-sexually-motivated-homicide-insect-stings-and-heat-exhaustion-in-a-forest
#1
Nancy X Liu, Michael S Pollanen
We report the case a woman who was found dead in a forest. The body was nude and the position of the body suggested a sexually motivated homicide. We concluded that death was not related to homicide, but was related to the conjunction of environmental factors, including insect stings, and acute psychosis. A medicolegal death investigation with postmortem examination was undertaken to determine cause of death. At the scene, the body was supine with legs spread apart and the knees flexed, exposing the external genitalia...
March 25, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28340081/retroocular-and-subdural-hemorrhage-or-hemosiderin-deposits-in-pediatric-autopsies
#2
Marc R Del Bigio, Susan M Phillips
The presence of hemosiderin in the optic nerve sheath and/or retina is sometimes used to estimate the timing of injury in infants or children with suspected non-accidental head trauma. To determine the prevalence of hemosiderin in deaths not associated with trauma, we performed a prospective study of retroocular orbital tissue, cranial convexity, and cervical spinal cord dura mater in infants and children <2.5 years age. In 53 cases of non-traumatic death, approximately 70% had blood or hemosiderin within the orbital fat, ocular muscles, and parasagittal cranial and/or cervical spinal subdural compartment...
March 14, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28338605/comparing-species-composition-of-passive-trapping-of-adult-flies-with-larval-collections-from-the-body-during-scene-based-medicolegal-death-investigations
#3
Michelle R Sanford
Collection of insects at the scene is one of the most important aspects of forensic entomology and proper collection is one of the biggest challenges for any investigator. Adult flies are highly mobile and ubiquitous at scenes, yet their link to the body and the time of colonization (TOC) and post-mortem interval (PMI) estimates is not well established. Collection of adults is widely recommended for casework but has yet to be rigorously evaluated during medicolegal death investigations for its value to the investigation...
March 24, 2017: Insects
https://www.readbyqxmd.com/read/28323801/predicting-acute-compartment-syndrome-pacs-the-role-of-continuous-monitoring
#4
Andrew H Schmidt, Michael J Bosse, Katherine P Frey, Robert V OʼToole, Daniel J Stinner, Daniel O Scharfstein, Vadim Zipunnikov, Ellen J MacKenzie
The diagnosis of acute compartment syndrome (ACS) is a common clinical challenge among patients who sustain high-energy orthopaedic trauma, largely because no validated criteria exist to reliably define the presence of the condition. In the absence of validated diagnostic standards, concern for the potential clinical and medicolegal impact of a missed compartment syndrome may result in the potential overuse of fasciotomy in "at-risk" patients. The goal of the Predicting Acute Compartment Syndrome Study was to develop a decision rule for predicting the likelihood of ACS that would reduce unnecessary fasciotomies while guarding against potentially missed ACS...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28321374/ectopic-pituitary-adenomas-presenting-as-sphenoid-or-clival-lesions-case-series-and-management-recommendations
#5
Bobby A Tajudeen, Edward C Kuan, Nithin D Adappa, Joseph K Han, Rakesh K Chandra, James N Palmer, David W Kennedy, Marilene B Wang, Jeffrey D Suh
Background An ectopic pituitary adenoma presenting as a clival or sphenoid mass is a rare clinical occurrence that may mislead the clinician and result in unnecessary interventions or potential medicolegal consequences. Here, we present one of the largest multi-institutional case series and review the literature with an emphasis on radiological findings and critical preoperative workup. Methods Retrospective chart review. Results Nine patients were identified with ectopic pituitary adenomas of the sphenoid or clivus...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28320795/cross-sectional-survey-on-defensive-practices-and-defensive-behaviours-among-israeli-psychiatrists
#6
I Reuveni, I Pelov, H Reuveni, O Bonne, L Canetti
OBJECTIVE: Psychiatry is a low-risk specialisation; however, there is a steady increase in malpractice claims against psychiatrists. Defensive psychiatry (DP) refers to any action undertaken by a psychiatrist to avoid malpractice liability that is not for the sole benefit of the patient's mental health and well-being. The objectives of this study were to assess the scope of DP practised by psychiatrists and to understand whether awareness of DP correlated with defensive behaviours. METHODS: A questionnaire was administered to 213 Israeli psychiatry residents and certified psychiatrists during May and June 2015 regarding demographic data and experience with malpractice claims, medicolegal literature and litigation...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#7
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28286926/informal-hallway-medical-consultation-in-orthopedics-is-it-as-common-as-it-seems
#8
Leonid Kandel, Yair Barzilay, Adi Friedman, Idan Ilsar, Ori Safran, Yoav Mattan
INTRODUCTION: Informal (hallway) medical consultation is an integral part of the physician's work. As musculoskeletal complaints are very common, orthopedic surgeons stand in the frontline of this practice. Many of these consultations are poorly, if at all, documented, thus imposing a potential medical danger to the patient and a medicolegal danger to the surgeon. We conducted this first study to examine whether this practice is common among the orthopedic surgeons in university hospital...
March 12, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28286377/ischemia-reperfusion-injury-following-acute-myocardial-infarction-a-critical-issue-for-clinicians-and-forensic-pathologists
#9
REVIEW
Margherita Neri, Irene Riezzo, Natascha Pascale, Cristoforo Pomara, Emanuela Turillazzi
Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality. Reperfusion strategies are the current standard therapy for AMI. However, they may result in paradoxical cardiomyocyte dysfunction, known as ischemic reperfusion injury (IRI). Different forms of IRI are recognized, of which only the first two are reversible: reperfusion-induced arrhythmias, myocardial stunning, microvascular obstruction, and lethal myocardial reperfusion injury. Sudden death is the most common pattern for ischemia-induced lethal ventricular arrhythmias during AMI...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28284948/compulsive-methamphetamine-taking-under-punishment-is-associated-with-greater-cue-induced-drug-seeking-in-rats
#10
Oscar V Torres, Subramanian Jayanthi, Bruce Ladenheim, Michael T McCoy, Irina N Krasnova, Jean Lud Cadet
Methamphetamine (METH) addicts lose control over drug consumption despite suffering multiple adverse medicolegal consequences. To mimic the negative events associated with drug addiction in humans, we recently introduced a rat model of self-administration (SA) with response-contingent punishment on METH intake. These procedures allowed us to distinguish between two addiction-like phenotypes in rats, those that sustained METH taking despite negative consequences (shock-resistant, SR) and rats that significantly reduced their METH intake (shock-sensitive, SS)...
March 9, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28273502/ruptured-berry-aneurysm-with-minimal-subarachnoid-hemorrhage
#11
Tyler J Gardner, Joseph A Prahlow
Cerebral artery aneurysm rupture is usually associated with significant subarachnoid hemorrhage; however, there are rare cases where there is a lack of hemorrhage into the subarachnoid space. While subdural hemorrhage can occur with ruptured aneurysms, isolated subdural hemorrhage is more often associated with trauma. In this case, a 51-year-old obese woman, who recently visited an Urgent Care Center for elevated blood pressure, was found dead roughly a month later. She had been complaining of headaches, and received medication for her blood pressure at the visit...
February 28, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28272089/mediators-of-inflammation-in-asthma-a-forensic-perspective
#12
Maria Laura Schirripa, Maria Pia Scarpelli, Cristian Palmiere
In the clinical setting, the role of systemic inflammation in patients with asthma has attracted increased attention, and some authors showed that increased IL-6 and high-sensitivity C-reactive protein characterized a group of asthmatic patients. In the realm of forensic pathology, a postmortem diagnosis of asthmatic death can be extremely challenging. The aim of this study was to determine the postmortem serum levels of C-reactive protein, IL-6, and tumor necrosis factor α in a series of severe acute bronchial asthma deaths that underwent medicolegal investigations...
March 8, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28267353/medicolegal-malpractice-and-ethical-issues-in-radiologyi-m-being-pressured-to-testify-in-a-malpractice-lawsuit-can-i-refuse
#13
Leonard Berlin
No abstract text is available yet for this article.
March 7, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28255948/what-adverse-events-and-injuries-are-cited-in-anesthesia-malpractice-claims-for-nonspine-orthopaedic-surgery
#14
Christopher D Kent, Linda S Stephens, Karen L Posner, Karen B Domino
BACKGROUND: Malpractice claims that arise during the perioperative care of patients receiving orthopaedic procedures will frequently involve both orthopaedic surgeons and anesthesiologists. The Anesthesia Closed Claims database contains anesthesia malpractice claim data that can be used to investigate patient safety events arising during the care of orthopaedic patients and can provide insight into the medicolegal liability shared by the two specialties. QUESTIONS/PURPOSES: (1) How do orthopaedic anesthetic malpractice claims differ from other anesthesia claims with regard to patient and case characteristics, common events and injuries, and liability profile? (2) What are the characteristics of patients who had neuraxial hematomas after spinal and epidural anesthesia for orthopaedic procedures? (3) What are the characteristics of patients who had orthopaedic anesthesia malpractice claims for central ischemic neurologic injury occurring during shoulder surgery in the beach chair position? (4) What are the characteristics of patients who had malpractice claims for respiratory depression and respiratory arrests in the postoperative period? METHODS: The Anesthesia Closed Claims Project database was the source of data for this study...
March 2, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28255789/-incidental-findings-evaluation-management-recommendations-and-legal-considerations
#15
P Mildenberger
Incidental findings are part of the routine radiological reporting workflow and describe findings which are not primarily the focus of the clinical context or the request of the referring physician. The clinical implications of such incidental findings can be very different, for example simple renal cysts or space-occupying lesions suspected of being tumors. A categorization of clinical findings according to the clinical relevance is therefore recommended. Documentation and communication of clinically relevant incidental findings are a part of the radiological reporting process and essential for reduction of the medicolegal risk...
March 2, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28254503/medicolegal-review-essure-lawsuits-and-legal-strategies-adverse-to-gynecologists
#16
REVIEW
Amber M Klimczak, Russell R Snyder, Mostafa A Borahay, John Y Phelps
The minimally invasive Essure procedure for hysteroscopic sterilization is an ongoing target for litigation. While efficacious, this device's safety has been scrutinized by the FDA due to alleged complications. Patients affected by these potential complications are filing lawsuits against Bayer, the manufacturer of Essure. Many of these lawsuits have been barred by preemption, a legal doctrine that limits what can be required of a product by state lawsuits once the FDA approves it. However, of the lawsuits allowed to proceed, the manufacturer has used a legal strategy termed the learned intermediary doctrine in an effort to shift blame to the gynecologist to absolve itself of liability...
February 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28246569/acute-thrombotic-occlusion-of-the-popliteal-artery-following-knee-dislocation-a-case-report-of-management-local-unit-practice-and-a-review-of-the-literature
#17
Anthony Dean Godfrey, Fadi Hindi, Callum Ettles, Mark Pemberton, Perbinder Grewal
Arterial complications following traumatic knee injury are relatively rare but mandate timely recognition and treatment to avoid significant comorbidity and medicolegal ramifications. In this report we describe a case of acute thrombotic occlusion of the popliteal artery occurring after knee dislocation, successfully repaired by intimal fixation and a limited venous patch reconstruction. We present a review of local practice in screening vascular injuries following knee dislocation, aligned with a review of the literature and considerations for practice...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28240354/the-effect-of-decomposition-on-the-efficacy-of-biometrics-for-positive-identification
#18
Kelly Sauerwein, Tiffany B Saul, Dawnie Wolfe Steadman, Chris B Boehnen
Biometrics, unique measurable physiological and behavioral characteristics, are used to identify individuals in a variety of scenarios, including forensic investigations. However, data on the longevity of these indicators are incomplete. This study demonstrated that iris and fingerprint biometric data can be obtained up to four days postmortem in warmer seasons and 50 + days in the winter. It has been generally believed, but never studied, that iris recognition is only obtainable within the first 24 hours after death...
February 27, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28233422/forensic-radiology-and-imaging-for-veterinary-radiologists
#19
Elizabeth Watson, Hock Gan Heng
Imaging studies are often of evidentiary value in medicolegal investigations involving animals and the role of the veterinary radiologist is to interpret those images for courts as an expert or opinion witness. With progressing interest in prosecuting animal crimes and strengthening of penalties for crimes against animals, the participation of veterinary radiologists in medicolegal investigations is expected to increase. Veterinary radiologists who are aware of radiographic and imaging signs that result in animal suffering, abuse, or neglect; knowledgeable in ways radiology and imaging may support cause of death determinations; conversant in postmortem imaging; comfortable discussing mechanisms and timing of blunt or sharp force and projectile trauma in imaging; and prepared to identify mimics of abuse can assist court participants in understanding imaging evidence...
February 24, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28230898/manifestations-and-medicolegal-significance-of-loeys-dietz-syndrome
#20
Roger W Byard
Loeys-Dietz syndrome is a recently described autosomal dominant disorder with underlying vasculopathy characterized by aortic and other vascular aneurysmal dissection/rupture. A 61-year-old man is reported who died suddenly and unexpectedly and at autopsy was found to have a ruptured abdominal aortic aneurysm. Additional findings included dolichostenomelia, high-arched palate, and pectus excavatum. There was a strong family history of Loeys-Dietz syndrome, although the decedent had never been tested. Death was, therefore, due to a ruptured abdominal aortic aneurysm in a case of probable Loeys-Dietz syndrome...
February 23, 2017: Journal of Forensic Sciences
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