Oğuz Polat

Comparison of the clinical diagnosis and subsequent autopsy findings in medical malpractice.

The rate of diagnostic error has not declined over the last 30 years despite the improvement in diagnosis methods. Today, the probability to encounter a major diagnostic change in autopsy is still high. The special autopsy that provides clinicians the necessary feedback is performed seldom in our country. This study has been started upon the claim that the malpractice cases in scope of forensic cases could be a very useful database. About 525 cases with faulty medical application that resulted in death have been encountered according to the cases that have been sent to the Forensic Medical Institution, which has been the consultative authority of the Ministry of Justice between the years 2001 and 2005. Among these, 375 cases on which autopsies have been conducted are included in the scope of the study. The cases with and without major diagnostic changes have been compared in aspects of gender, age groups, and period spent in health units. When the concordance between autopsy and clinical diagnosis for the 375 cases that were included in the study is examined, it can be seen that clinical diagnosis is verified with autopsy in 49.1% of the cases whereas neither autopsy nor clinical diagnosis was encountered in 14.7% of them. The diseases where diagnostic faults are mostly encountered are ruptured aortic aneurysm, myocardial infarction and pneumonia. The majority of the cases without a clinical diagnosis comprises of complications that occur after operations. In the study, considerable major diagnostic changes were realized after autopsy, which shows that autopsy has an important place in Turkey in spite of the improved methods of diagnosis. Also, in the cases with major diagnostic changes, the medical malpractice rate was high. This shows that autopsy is influential in revealing medical malpractice failures. In the study, we found out that the number of autopsies was high in the cases with a malpractice claim. We aim to increase this number. We are sure that such increment would increase decision accuracy.

Childhood deaths due to suicide

Suicide has been reported as the second or third most common cause of death in children and adolescents all over the world. The aim of the study was to investigate the general properties of suicide in childhood and adolescents, and to evaluate the results in the light of literature. Reports of autopsies performed between 2001 and 2005 in the Morgue Department of the Council of Forensic Medicine in Istanbul (n = 16853) were examined retrospectively. Deaths between 0–18 years of age doubtlessly considered as suicide were included in the study. Childhood and adolescent (0–18 years) deaths comprised 10.4% (n = 1761) of all medico-legal autopsy cases. 136 cases of suicidal origin were evaluated in terms of age, gender, and method of suicide. The ages ranged between 7 and 18, with a mean of 15.54 ± 2.691(SD). The most common method of suicide was hanging (59.2%) in both genders. Older adolescents (16–18 age group) constituted the overwhelming number (63.2%, n = 86) of all cases. Seven cases of 10 years of age and below were determined, and hanging was the method of suicide in five of these cases. In order to prevent childhood suicides, families and society should be aware of their responsibilities.

Autopsy profiles of malpractice cases.

Claims for medical malpractice and the number of lawsuits filed thereafter are increasing in Turkey as is the case throughout the world. In the present study all files issued by the associated boards of the Council of Forensic Medicine between 2001 and 2005 were studied and of those, 525 death cases in which there was a medical malpractice claim were included. 303 of the cases (57.7%) were male, 215 (41%) were female, while no gender was mentioned in seven cases (1.3%). The age of the subjects ranged between 0 and 90, with an average of 26.8. 147 cases (28%) were related to Emergency Units. 92% of the cases (482 cases) were resolved in the Council of Forensic Medicine, Ministry of Justice. 167 of the resolved cases were concluded as medical malpractice.