Tag: medical negligence

Medico-Legal Journal, Ahead of Print.
An Air India Express Flight AI1344 travelling from Dubai to Calicut (Kozhikode), when attempting to land, unfortunately, overshot the runway and crashed causing many casualties as the impact caused the aircraft to break up into multiple pieces. The response to a disaster, specifically an aviation disaster, is highly complex. It involves multiple government agencies and calls for a truly inter/multidisciplinary response from diverse domains including forensic experts, fire experts, aeronautical engineers, humanitarian experts who must together form an ideal post-rescue recovery team. The author was intricately involved in the recovery mission launched after the above air disaster. This case study considers the process of collecting and managing the personal effects of those affected along with the various challenges involved.

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Medico-Legal Journal, Ahead of Print.
A suicide where the deceased has employed more than one means of ending his or her life is defined as a complex suicide (CS). Forensic practitioners may face difficulties caused by the articulated mechanisms underlying this event. Among CS, the combination of hanging and gunshots is unusual. In this study, we present three unique cases of such planned complex suicides (PCS) that we have encountered in our 28 years of activity at the Bureau of Legal Medicine of Milan. Careful inspection of the death scene, precise analysis of the anamnestic-circumstantial data, and accurate medico-legal autopsy examination were the starting points for a better understanding of the causes and manner of death. In particular, the presence of vital reactions of tissues involved in the two different means used, the coherence of the areas involved with a self-inflicted wound, and the absence of signs of third party intervention allowed us to classify these events as suicides. As for the chronology of events, the lethality of the cerebral lesions caused by the gunshots in all cases, in accordance with the cervical lesions caused by hanging, led us to conclude that we were dealing with PCS and catalogue these three cases as unusually planned complex suicides avoiding incorrect and superficial classification.

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Medico-Legal Journal, Ahead of Print.
Binge eating is characterised by the ingestion of large quantities of food in a short time. Cases in the literature deal exclusively with gastric perforation in people with a history of anorexia nervosa, binge eating disorder or bulimia nervosa.We report the case of a young woman with no previous diagnosis of mental illness and a history of only two binge-eating episodes that occurred a few years earlier. She died suddenly during a binge-eating episode from stomach rupture resulting from a single perforation of the stomach with leakage of food material within the abdominal cavity. There was no sign of gastric necrosis or peritonitis. The deceased died quickly.Our case, which appears unique in the literature, shows that there is a risk of death even in people with no diagnosis of eating disorders and a history of only few and isolated binge-eating episodes. Physicians should carefully investigate a patient’s history to assess any risks.

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Medico-Legal Journal, Ahead of Print.
Vaccine hesitancy and anti-vax movements are increasing globally. Covid-19 pandemic has caused and causes emergency situations where available resources do not always meet the need for community care.In this article, the authors analyse the bioethical and medico-legal implications of the possibility – in conditions of scarcity of resources – of selecting patients who must have access to medical care based on vaccination against Sars-CoV-2.

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Medico-Legal Journal, Ahead of Print.
Female homicide or femicide is an increasingly worrying and complex problem for many western European countries and continues to be a major issue globally. The Republic of Ireland has seen a substantial increase in cases of female homicide in recent years prompting an outcry from both women’s groups and the wider public, which has led to discussions within government as to the best way forward in dealing with the ever-increasing situation of unlawful killing of women in the country. Despite the outrage little research exists on the subject beyond the newspaper headlines and media reporting. In a review of 240 cases of female homicide over a 30-year period from 1991–2021 using newspapers and court reports, many patterns emerge regarding the causes of death and motives behind the killings.

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Medico-Legal Journal, Ahead of Print.
In December 2021 the Court of Appeal (Civil Division) published its ruling in Worcestershire County Council, R (On the Application Of) v Secretary of State for Health and Social Care [2021] EWCA Civ 1957, a case about a dispute between two local authorities regarding which of them should bear the duty to provide after-care for a patient (service user) following her discharge from her second detention under section 3 of the Mental Health Act 1983. The primary issue in the case was where she was ordinarily resident at the time of her second detention under s 3 of the Mental Health Act 1983. This paper reviews the case, surveys the evolution of the duty to provide after-care and comments on specific aspects of the Court of Appeal’s decision.

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Medico-Legal Journal, Ahead of Print.
Covid-19 requires practitioners to reflect on how they deliver health services. Using technology, in particular video technology, has increased, especially in primary care. This article considers the implications of technology for assessments under the Mental Health Act 1983. NHS Covid-19 guidance anticipated its use in assessments, but this was held to be unlawful. Is this the right decision or is it too restrictive an interpretation of the 1983 Act? The article argues that consideration should be given to the potential role, if any, of video technology in assessments and identifies some issues that need to be addressed. Use of these technologies should be part of the current review of the 1983 legislation.

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Medico-Legal Journal, Ahead of Print.
Few studies consider the effects of impaction, resulting in inaccurate estimation of age using third molar. We aimed to assess the significance of impaction in estimating age using Modified Demirjian’s method. 200 orthopantomograms of patients between 16–25 years were collected comprising 171 tests and 212 controls. Chronologic age (CA) and estimated age (EA) were calculated. Independent sample t-test, chi-square test, paired t-test and Kolmogrov-Smirnov test of normality were used. The mean difference between the CA and EA in both the tests and control samples were significant (mean difference test group = 2.6 ± 2.07, control group = 2.0 ± 1.8; p = 0.01). It provided a difference of 0.6 which is equal to 7.2 months. The results of our study indicate that impacted mandibular third molars are susceptible to undergo slower mineralization, leading to erroneous lower age estimation. These results in an Indian population are noteworthy. However further studies are needed.

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