Archiwum medycyny sa̧dowej i kryminologii
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Arch Med Sadowej Kryminol · Apr 2009
[Medico-legal opinionating in cases of insobriety in medical personnel].
The authors analyzed the medico-legal opinions in cases of insobriety in medical personnel. The studies were based on the results of 157 medico-legal evaluations in criminal cases performed in the years 2005-2007. ⋯ The necessary analysis should include activities that have been or should have been performed by a physician with respect to his patients, their health status (degree of danged to life or health) and the effect of the physician's alcohol intoxication on his abilities to perceive and assess the reality, make decisions and perform his duties. The Polish law in force lacking the equivalent of Article 147 found in the Polish penal code of 1969 causes problems in penalization of insobriety in medical personnel.
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The authors draw attention to the importance of X-ray examinations in craniocerebral gunshot injuries. A life-saving neurosurgical operation of a victim resulted in changes occurring not only in the soft tissue, but also in the bony structures of the cranium, which practically rendered impossible any assessment of and differentiation between the location of entrance and exit wounds during autopsy. The assessment of preoperative head X-ray demonstrated the presence of characteristic crater-like bone defects, what allowed for determining the location of the entrance and exit wounds. The medico-legal examination of bone defects indicated that the entrance wound was situated on the left side, contrary to information provided by hospital medical records.
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Bullet embolism is an uncommon consequence of penetrating firearm injuries, rarely observed in everyday forensic practice. The present report presents two cases of gunshot bullet embolism. ⋯ The second case pertains to a gunshot in the head, with the bullet shot from a point blank range. The wound channel had a downward course and terminated in the superior vena cava at the level of the pericardium, where from the bullet was transported down the inferior vena cava to the right femoral vein.
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Arch Med Sadowej Kryminol · Apr 2008
[Medico-legal assessment of medical management in "chest pain" cases based on the review of cases analyzed in the Chair and Department of Forensic Medicine, Medical University of Silesia, Katowice, in the years 2000-2006].
Among all investigations aiming at assessing medical management carried out in our department between 2000 and 2006, the cases of "chest pain" constituted the largest percentage. In 70% of such cases, the employed medical procedures were found to be incorrect; what might be qualified as medical decisive errors, committed in rescue ambulances, outpatient clinics or in admission rooms. The authors present some examples of causes of such incorrect management strategies, such as neglecting proper and profound clinical examination (with medical history taking); lack or incomplete differential diagnosis; failure to observe appropriate critical attitude and prudence; focusing only on one, most common disease.