摘要:

During routine spinal anesthesia, an ampule of potassium chloride, instead of bupivacaine, was mistakenly opened and inadvertently administered intrathecally to a patient, resulting in pain, cramps, and death within 2.5 hours of injection. We discuss the medicolegal implications of such an error and possible preventive measures pertaining to this case.

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A 35-year-old postpartum woman who was receiving bromocriptine (Parlodel) for only several days to suppress lactation experienced an episode of a seizure, complained of chest pains, and died in the emergency department. At autopsy, acute coronary thrombosis of the left main, left anterior descending, and circumflex arteries was found. Cases of reported cardiac-related complications associated with bromocriptine use in the puerperium are extremely rare. The mechanism of bromocriptine-related acute coronary thrombosis is poorly understood and warrants further scrutiny, because the synthetic brominated ergopeptide is generally regarded as safe. The updated review of reports available in literature mandates the acknowledgment of possible serious and even lethal cardiac events as a result of untoward effects of bromocriptine.

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Objective:To analyze features of a series of fatalities caused by amphetamine-derivative designer drugs marketed as "Ecstasy" in South Australia, and to identify reasons for the recent marked increase in number of these deaths.Materials and Methods:Following the death of a 26-year-old woman after alleged ingestion of Ecstasy tablets, a retrospective search of files at State Forensic Science, Adelaide and the South Australian State Coroner's Department was undertaken from February 1992 to January 1997 to identify similar cases.Results:Six fatalities were found, all of which have occurred since September 1995 (M:F ratio, 1:1; age range, 22 to 36 years; average age, 27.7 years). All individuals had histories of recent ingestion of illegal drugs thought to be Ecstasy (methylenedioxymethamphetamine, MDMA) at the time of purchase. Delay occurred in seeking medical attention, despite severe symptoms. Causes of death involved documented hyperthermia in 3 cases (temperatures of 41.5-46.1°C), with features of hyperthermia in one other case, and intracranial hemorrhage in another. Drugs in toxic/lethal amounts identified at postmortem included paramethoxyamphetamine(PMA) in all cases, amphetamine/methamphetamine in 4 cases, and methylenedioxymethamphetamine(MDMA or Ecstasy) in only 2 cases. Interaction with a prescription medication (fluoxetine) may have occurred in 1 case.Conclusions:The number of deaths due to amphetamine derivatives apparently due to substitution of PMA for MDMA(Ecstasy) have recently increased markedly in Adelaide. Potential users should be warned that PMA has been associated with a much higher rate of lethal complications than other designer drugs, and that no guarantee can be made that tablets sold as Ecstasy are not PMA.

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Thanatochemistry is an increasingly important ancillary procedure in forensic practice. Alterations are known to take place in biochemical components during the postmortem period, particularly in the blood, and both research results and their interpretation have been the object of some controversy. For that reason, emphasis has been placed on the examination of fluids that are neither altered nor contaminated as rapidly as blood after death. This study tested the hypothesis that pericardial fluid (PF) may be a suitable medium for biochemical analysis in corpses. The study sought to determine concentrations of urea, creatinine, glucose, creatinine kinase 2, proteins, calcium, sodium, and potassium, in the pericardial fluid of corpses. The study sample was divided into two groups, natural deaths and violent deaths. Intergroup results were compared, using Mann-Whitney's U test for paired data. No significant differences were obtained between the natural death and violent death groups for the parameters studied, with the exception of urea (p< .05). Further studies are required to compare these results and create the possibility for new conclusions.

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Medical examiners have a unique database about trauma victims, many, if not most, of whom died at the scene or in transit to a hospital and who, thus, never had their injuries documented by trauma surgeons and so never entered into a local or regional trauma registry. These trauma registries have assisted in assessing the magnitude of traumatic injuries in the community and in evaluating the community's emergency medical systems. Without information about those who are dead at the scene or who die in transit, these trauma registries are incomplete and the evaluations based on them inaccurate. The data about the 50% of trauma victims who never enter the medical system are lacking in these registries. Such information is present in the death investigation and autopsy reports in the various medical examiner/coroner offices in the country. To access this important information more easily in trauma registries, an expert computer system was developed. This pilot study presents the results of using that system to gather medical examiner data. Injury descriptions were abstracted from autopsy reports of 50 consecutive nonhospitalized persons fatally injured in Mobile County, Alabama and its environs. Injury descriptions for all cases were successfully coded in International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) and the Abbreviated Injury Scale (AIS-90) by an expert system. For some cases the expert system "requested" and received clarifying information, all of which was present in the medical records. This research demonstrates the feasibility of gathering accurate and consistent information on the estimated 50% of trauma deaths who do not reach a hospital and who are not included in acute care registries. Without data on such patients, our evaluation of trauma systems is incomplete and resources directed at prevention and treatment may be misapplied.

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

An empiric validation of a proposed typology of murder-suicide events was carried out in the Central District of the Office of the Chief Medical Examiner of Virginia for two cohorts, 1980 to 1984 and 1990 to 1994; use of a single typology allows description of trends in these events over time, a unique aspect of this study. For both cohorts, a total of 53 successful events with 63 victims (116 total deaths) was evaluated. A significant shift in the characteristics of location, perpetrators, and victimology of such events between the two cohorts is demonstrated: events changed from urban, multiple victim events with a majority of white perpetrators to rural, dyadic events in which victims did not live with perpetrators, the majority of whom were black. The results are compared with published data, and the implications for use of this typology as a clinical evaluation tool for prevention are addressed in light of current domestic violence emphases in public health. Additionally, the need for prospective tracking of these events is reiterated and use of the Hanzlick-Koponen typology as the tool for such tracking is suggested.

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

There are no reports on rates of amino acid racemization in bones. To investigate the possibility of estimating age by evaluating amino acid residue racemization in human bones, a heating experiment was performed and the rate of aspartic acid racemization was determined using the Arrhenius equation. Assuming an annual mean temperature of 15°C, the rate constant (k) for aspartic acid racemization in bone was calculated, and the racemization rate at 15°C k (y) was 4.1036 × 10−9-much lower than that of dentin. These results suggest that it is more difficult to accurately determine age by analyzing aspartic acid residues in bone than in dentin.

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Theprimum movensof a forensic autopsy is to track down the crime. The perfect crime can be defined as one which will never be suspected and/or one for which the criminal will never be arrested. We have reported several cases that have been adjudicated or are being adjudicated, and we show how actual homicides could have been taken for accidental deaths, suicides, or even natural deaths.

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0195-7910    

出版商:OVID    

年代:1998

数据来源: OVID