Profili di Responsabilita’ del Medico Competente

Gli autori analizzano la sentenza di cassazione n. 1856/2013 che chiarisce, ampliandolo, il concetto di collaborazione (con il datore di lavoro) del medico Competente previsto dall'art. 25 del D.Lgs 81/2008 sottolineando altresì i profili di responsabilità.

Fatal anaphylactic shock and Taenia solium infestation: a possible link?

Unexpected death for Takayasu aortitis associated with coronary ostial stenosis: case report.

The differential diagnosis of vasculitis is often a difficult task due to the frequent morphological similarities that various vasculitic syndromes express when the heart is the target organ. The more the lesions are limited to the arterial tree with absent or almost silent coronary events, the less specific the anatomical and clinical frameworks. To create a series of clinical records and on the basis of these assumptions, the authors report a case concerning the sudden death of a 43-year-old woman which occurred while an ergonometric test was being carried out 28 days after the onset of the symptoms. A subsequent postmortem investigation/autopsy enabled us to detect a granulomatous aortit…

Ustioni da elettrobisturi: contributo casistico e considerazioni medico-legali

[Electrosurgery burns: case series and medico-legal issues] In general and specialist surgical practice the use of the electrosurgical unit is consolidated for minimally invasive interventions, due to the ability to control the bleeding of the operative field and the interaction between the cutting and coagulative mechanisms. The authors take inspiration from four cases of personal observation, related to thermal injury produced by electrosurgery, to conduct a brief review of the literature on this issue and present some medical and legal aspects derived from their expert’s observation, in terms of healthcare liability. The authors underline the importance of an accurate knowledge of the pr…

La sicurezza del paziente in ambiente ospedaliero e la responsabilità professionale dei vertici strategici

[Patient safety in the hospital setting and the professional responsibilities of top managers] The authors underline the evolution of legislation concerning the creation of Hospital Companies and the reasons for the implementation of clinical risk management activities, then analyse the responsibilities involving the top figures of the top hospital management. In particular, the authors highlight the obligation and responsibilities of the strategic apex of a Hospital Company and show that, sometimes, the technical consultants – who express a medical-legal advice – underestimate the responsibility of these figures. It is a management responsibility that determines the obvious and inevitable …

Death by Facial and Skull Injuries of a Motorcyclist Wearing a Full-Face Helmet: Case Report and Literature Review

We describe a case of death by facial and skull fractures with brain injuries of a motorcyclist wearing a full-face helmet. A 40-year-old man driving a high-powered motorcycle crashed violently into the rear of a stopped car. The main results from the autopsy revealed the deformation of the left orbito-zygomatic and fronto-temporoparietal regions corresponding to bone fractures with laceration at the left temporal lobe. The CT scan of the helmet revealed the detachment of the energy-absorbing liner. Moreover an impact speed of 93 Km/h resulted from the analysis of accident dynamics. We analysed the literature regarding the effectiveness of full-face helmets in reducing the risk of fatality …

La responsabilità dei preposti per la sicurezza dei lavoratori nel SSN: indagine conoscitiva in alcune aziende sanitarie siciliane.

Gli autori analizzano la figura professionale del preposto nell'ambito delle Strutture Sanitarie sottolineando le responsabilità ricadenti su detto operatore, anche alla luce di alcune sentenze della Cassazione (civile e penale), IV sezione. Vengono inoltre presentati i risultati di una indagine conoscitiva condotta mediante distribuzione di un questionario anonimo ai preposti di alcune Aziende Sanitarie Siciliane

An unusual fatal case of overdose of Vinblastine and review of literature

The pharmacological treatment of neoplasia is based on the use of chemotherapeutic substances. Chemotherapeutic agents can cause acute and chronic toxicity even at therapeutic doses. For this reason their overdose puts a patient’s life at severe risk. This work presents an unusual fatal case of overdose subsequent to an accidental massive administration of Vinblastine (90 mg instead of 9 mg), slow bolus (five minutes), to a 33-year-old woman who suffered from Hodgkin’s Lymphoma. The administration of the massive dose was due to a transcription error of the therapeutic treatment plan and miscommunication between the health professionals which caused the use of the wrong dose. The foren…

Peculiar and Unusual Drowning in Waste Oil from Motor Vehicles: Case Report

Drowning is one of the most frequent causes of accidental or suicidal death, and more rarely it is associated with a homicide. Cases of drowning in water or in the sea are common. The authors report an unusual and peculiar case of drowning, that of a woman who accidentally fell inside a collection tank of waste oil of motor vehicles.

ustione corneale durante intervento di facoemulsificazione: contributo casistico e considerazioni medico-legali

[Corneal burn during phacoemulsification surgery: case report and medico-legal considerations] The authors report a case of severe corneal burn, occured a few seconds later the beginning of the surgical procedure of phacoemulsification on a 63 years old woman affected by cataract. The authors analyzed the case as a result of claims for damage to the surgeons and the hospital by the patient. In terms of assessment of responsibility, medico-legal investigation is aimed at identifying whether the responsibility of the event of damage to the patient is to be attributed to the negligent conduct of the surgeon or to defects or damage to the equipment used by the same. The authors underline the im…

Unexpected death for takayasu aortitis associated with coronary ostial stenosis

The differential diagnosis of vasculitis is often a difficult task due to the frequent morphological similarities that various vasculitic syndromes express when the heart is the target organ. The more the lesions are limited to the arterial tree with absent or almost silent coronary events, the less specific the anatomical and clinical frameworks. To create a series of clinical records and on the basis of these assumptions, the authors report a case concerning the sudden death of a 43-year-old woman which occurred while an ergonometric test was being carried out 28 days after the onset of the symptoms. A subsequent postmortem investigation/autopsy enabled us to detect a granulomatous aortit…

Sudden death in water: Diagnostic challenges

Abstract The authors report a case of sudden death in a breath-holding diver and highlight the forensic diagnostic difficulties in opining the cause of sudden death in water. The autopsy showed increased thickness of the left ventricular wall with a distinct pattern of concentric hypertrophy, evident particularly in the subaortic interventricular septum. Histological examination revealed diffuse interstitial fibrosis and associated findings of multifocal myocyte disarray especially evident in the subaortic interventricular septum. The analysis and discussion of this case made it possible to attribute sudden death to a lethal arrhythmia following myocyte disarray and hypoxia caused by breath…

Skull and Encephalic Injuries Caused by Beach Umbrellas: Case Reports and Review of Literature

This study reports two unusual cases of skull-encephalic injuries in bathers that were caused by violent impacts with beach umbrellas. The first case concerned a 36-year-old man who, while lying on a sun bed, was struck on his left temple by a beach umbrella, which had been blown away by a gust of wind. The second case concerned a six-year-old child who was struck on the right temporal region while he was playing on the sand. Both subjects died. A review of the literature was carried out. Various skull and brain injuries caused by several objects were found, but no injuries caused by beach umbrellas were detected. There were only cases of injuries caused by normal umbrellas. These cases sho…