Iranian Journal of Forensic Medicine
Year:2002 | Volume:8 | Issue:27|Papers Count:11

Background: Medical negligence is one of the most important legal problems in medicine and most of the physicians know little about the problem. We determined the prevalence of medical negligence leading to death. Methods: This study was performed in legal medicine organization between 1995 and 1999. Variables included: age, gender, hospitals, high risk procedures, type of negligence and specialty of the physicians. Results: a total of 2307 files were reviewed. There were 884 complaints against medical groups and in 326 of them the patients were died. Of 326 files, in 173 cases, some negligence had been shown. The most frequent complaints were against physicians and then against hospital administrators. The complaints were more common in six courses included: Anesthesiology, general surgery, gynecology, internal medicine, general practitioner and neurosurgery respectively. Conclusion: Carelessness was the most common type of negligence and the physicians did not follow the governmental rules in the second rank. The most common type of carelessness included: carelessness in getting history and physical examination by the physicians and not to follow the governmental rules by hospital administrators.However, the most complaints were against medical groups, the most neglect happened by hospital administrators.

Background: The Knowledge of physicians about the rules is very important. In this study we evaluated the Knowledge of physicians about issuance of testimonies.Methods: A questionnaire included 23 questions about circumstances of testimony was planned and filled by general practitioners in a congress in Tehran in 2001.Results: Five hundred general practitioners (31.6% female and 68.4% male) participated in the study. The scores were between and 16 (mean 8.8 ± 0.23). The mean score between two groups (male & female) was not statistically different (p=0.12). There was association between mean of age of study group and mean of obtained scores (p=0.02). Conclusion: The Knowledge of general practitioners on this subject is lower than standard and education should be noticed.

Background: In this study we evaluated the level of effectiveness of expert viewpoints in judiciary system.Methods: A total of 650 files were reviewed in 4 courts in Tehran.Results: Of all of the files, expert viewpoints did not accepted completely in 62 cases (9.8%) and completely accepted in 386 cases (60.9%). In 58 cases (9.1%) the viewpoints accepted partially and in 102 cases (16.1%), there was not any request from legal medicine organization. In sexual crimes this was more usual. The judges determined the fine personally in 36 cases (5.7%) and had some fault in determination of the fines in 47 cases (7.4%).Conclusion: This study shows that different judges don't use legal Medicine expert viewpoints in a similar way. It seems that usage of expert viewpoints in special tasks is mandatory and the judges should request expert viewpoints.

Background: Today, suicide is one of the major social and mental health problems in many countries especially European countries. The mortality rate following suicide is higher than accidents in many countries. In this paper, we reviewed the last statistics for suicide in Iran, compared with the statistics for the world.Methods: The rates of suicide were based mainly on statistics of legal medicine organization during the year 2002.Results: During the year 2002, 5.7 out of 100,000 men and 3.1 out of 100,000 women committed suicide causing death in the country. There was statistically significant differences in methods, used in suicidal attempts between males and females (p<0.001). For males, the most frequent method was hanging (56%) and for females was self burning (63.4%). The rate of suicide was at the highest level for men in Hamedan, Lorestan and Ilam provinces and for women in Kermanshah and Lorestan.Conclusion: The rate of suicide in Iran is lower than western countries but is in a higher level in Middle East countries. Thus the etiologies leading to suicidal behavior should be more evaluated.

Background: With the respect of high mortality rate due to addiction, study in this field in different directions is needed. We evaluated the prevalence of mortality in addict persons due to narcotics during the first six months of the year 2000. In addition we assessed the other basic reasons.Methods: In This descriptive- analytic study, all of the mortalities due to drugs to legal medicine organization were evaluated.Results: Of 404 mortalities due to chemical substances, 286 cases were due to narcotic substances, nine of them were female. The most common age range was between 21 and 30 years. Intravenous injection was the most common route in these drug abusers. Incidental death was the most common type of mortalities. They were often in low educational and economical levels.Pathologic reports revealed significant changes in heart, lungs and liver in 90% of the dead persons.Conclusion: Mortality due to narcotic drugs has many different aspects, that is related to geographic and economic status.Removal of the basic predisposing factors is very important in prevention of addiction.

Background: Renal damage after renal Ischemia and reperfusion has been studied frequently and it is known that the ACE inhibitors have a pronounced effect on its prevention. Also there are many reports about the effect of KATP channels on heart ischemia and reperfusion to the heart. In regard to above research, in this study the effect of blockers on potassium channels related to ATP was compared to the effect of captopril in kidneys which were ischemic and then reperfused were studied.Methods: In this study, Glibenclaimide (1,5,25 mg/kg) and Captopril (5mg/kg) were administred to rats. Then they anesthesized with ketamin (50 mg/kg) and xylocaine (10 mg/kg), their flanks were opened. The left renal vein was obstructed for 30 minutes, then opened for 2 hours, afterward, the rats were killed and their left and right kidney were studied microscopically.Results: The results showed that captopril can decrease ischemia damage, but Glibenclamide had not such effect.Conclusion: The effect of captopril is not related to KATP channels and is probably due to oxygen free radicals and protein kinase C.

Background: We evaluated the conception and function of professor and assistant about saying the diagnosis to nontreatable patients leading to death.Methods: A total of 100 physicians (50 professors and 50 assistants) selected randomly. The participants answered to 6 questions in an interview. Questions were about saying or not saying the diagnosis, results of revealing the diagnosis and information about legal aspects.Results: Seventy four percent of respondents did not say the diagnosis to the patients, therefore the patients did not have enough information about the prognosis and the treatment decisions. Fear of unpleasant results of revealing the diagnosis is the most important reason that the physicians were avoiding revealing diagnosis.Conclusion: With the changes in this conception in other countries, detailed evaluation of the ethic and legal aspects of revealing the diagnosis with considering the social and cultural factors, is needed.

Background: Today poisoning is a serious problem in the world and it is the second cause of death following infections. In this study we evaluated epidemiologic status of pediatric poisoning in Ahvaz.Methods: In this retrospective study we reviewed all of the files of the children referred to Amirkabir and Abozar hospitals. Results: 58.2% of poisoned children were male and 41.5% were female. The most common age range of the patients was between 1 and 3 years. The causes of poisoning were petroleum (kerosene) in 43.6%, drugs in 31.8%, narcotic substances in 13.6%, insecticides in 5.5% and toxic plants in 5.5%. Three of the cases died. Conclusion: The most common cause of poisoning was petroleum but in east European and North American countries are household materials like vitex. Often family members prescribe opium and other products to relieve some complaints of the children. Opium in infancy is very hazardous, and sometime leads to death. Often poisoning happens incidentally and parents should be careful in preserving the drugs and chemical substances.

Penetrating trauma of the skull is rare and includes 0.4 percent of brain injuries. In this report a young woman underwent craniectomy and a foreign body removed. There were on signs of infection and vascular complication in 2 years follow up.

The second generation anticoagulant rodenticide agents (superwarfarin agents) are threatening for health in the world and Iran. Increasing consumption of these agents is due to lack of resistance of rodents, high potency and longstanding effects against first generation. This is the reason that we have to understand the management of poisoning of these agents. These agents like other warfarin agents inhibit the synthesis of vit K dependent coagulant factors and causes coagulation disorders and bleeding. Ingestion of little amount of these agents produces few symptoms of poisoning but in higher amount it may be life threatening.Management includes stabilizing the patient, increase the excretion of poisonous substances, prescribe the antipoisn drugs and other supportive and symptomatic managements. We can use biological specimens like serum, plasma, urine and tissues (lung, liver and spleen) to determine the type and amount of the poisonous substances in the body. The most important laboratory analytic methods of these agents are KPTLC, HPLC and GC/MS.