Forensic-medical evaluation of medical care errors in obstetric-gynecological practice

The authors show the necessity of elaboration and practical application of normative documents (standards) and forensic-medical criterions of assessment of defects in obstetric-gynecological medical aid. The examples of the above assessment are given in the article.     

Forensic medical expert evaluation of lethal poisoning with narcotics

Morphological manifestations of lethal narcotic poisoning are analyzed on the basis of results presented in "Acts of Medical Examination of Corpse" and "Expert Conclusions" on 352 cases with lethal narcotic poisoning, suspected (with good grounds) poisoning, and combined poisoning with narcotics and other agents. Causes of failure to detect narcotics in forensic chemical analysis of biological material from the corpse are enumerated.     

Forensic medical expert evaluation of gunshot injuries of brain skull

Forensic medical experts are offered a set of morphological signs which help identify the gunshot origin of a skull injury, identify which of the injuries is the inlet and which is the outlet, specify the direction of the shot and succession of formation of injuries in cases with several shots. The author suggests evaluating a gunshot wound in the head with due consideration for the mechanisms of its formation. From a complex of signs of a gunshot injury to the brain skull he singles out the tissue defect with a conical channel and the edge of bone defect, additional injury to the external compact plate near the inlet, and type, number, and location of the radial and concentric cracks. Analysis of the morphology of the above listed signs of gunshot injuries to the skull notable extends the potentialities of forensic medical expert evaluation in cases with gunshot injuries.     

Urgent problems of forensic medical expert evaluation of disability in civil suits

The author discusses urgent medicolegal problems related to evaluation of the degree of occupational disability, necessity of additional diet for victims, which arise in connection with civil actions of persons who underwent non-occupational trauma.     

Expert evaluation of medical documentation data in estimating the severity of injuries

Analysis of false expert conclusions related to unjustified clinical diagnosis is given. Failure of critical attitude of medicolegal experts to X-ray and neurologic symptomatology data in posttraumatic period is stressed.     

New prospects in forensic medical expert evaluation of perforating wounds of the eye

The criterion "percentage of stable loss of total working capacity" is usually used in expert evaluation of perforated wounds of the eyes. However it does not always allow an objective evaluation of the ocular status. Visual acuity can vary greatly during the posttraumatic period for a rather long time, becoming worse or better during up to 1 year. Treatment and observations of 160 victims (165 eyes) helped determine the major clinical symptoms of perforated wounds and distinguish 8 symptoms characteristic of severe injuries. Use of these symptoms as criteria for evaluating the severity of injury inflicted to health helps make an objective conclusion without waiting for recovery.     

The notion and classification of expert errors

The author presents the analysis of the legal and forensic medical literature concerning currently accepted concepts and classification of expert malpractice. He proposes a new easy-to-remember definition of the expert error and considers the classification of such mistakes. The analysis of the cases of erroneous application of the medical criteria for estimation of the harm to health made it possible to reveal and systematize the causes accounting for the cases of expert malpractice committed by forensic medical experts and health providers when determining the degree of harm to human health.     

Criteria of expert assessment of professional errors in dentistry

The most frequent errors in dental practice are analysed. Questionnaires, schemes and formula for objective assessment of medical documentation quality in dentistry are proposed.     

Organization and procedure of forensic medical expert evaluation of professional working capacity loss

Sixty-one forensic medical expert conclusions on the loss of professional working capacity are analyzed and typical errors are characterized. The procedure of forensic medical expert evaluation of the degree of loss of professional working capacity in accordance with the Civil Code and Civil Judicial Procedure Code of the Russian Federation and the actual norm-setting documents is described.     

Antigenic differentiation of blood stains by the Lewis system in practical forensic medical expert evaluation

A modification of quantitative absorption and absorption elution tests with blood stain washing before the absorption phase is presented. Due to washing, the effect of carrier object on anti-Le(a) and anti-Le(b) sera is decreased and the sensitivity of the method is increased. Additional adsorption of the sera and elution into test erythrocytes treated with protease C is suggested for increasing the number of standard sera fit for the absorption-elution test. A new technology for preparing anti-Le(a) and anti-Le(b) immunoreagents is described.     

Abortion laws and medical developments: a medico-legal anomaly in Queensland

In October 2010 the District Court sitting in Cairns, Queensland, found Tegan Leach not guilty of attempting to procure her own abortion and Sergie Brennan not guilty of supplying Leach with the drugs Mifepristone and Misoprostol to procure an abortion. Brennan obtained the drugs from his sister in the Ukraine through the regular postal system. R v Brennan and Leach was the first case in Queensland's history where a woman was charged with procuring her own abortion. The drugs are accepted by the medical profession worldwide for medical abortions. A prosecution witness gave evidence that Mifepristone is not harmful or injurious to the health of a woman and it is listed as an essential medicine by the World Health Organisation and approved for use by the Australian Therapeutic Goods Administration. The jury found the defendants not guilty because they were not satisfied beyond reasonable doubt that the combination of the drugs Mifepristone and Misoprostol was a "noxious" substance under the Criminal Code (Old). This article concludes that there is no regulatory miracle which will stop the traffic of Mifepristone and Misoprostol into Australia and therefore an intelligent regulatory response is required which would make it unnecessary for women to seek Mifepristone and Misoprostol from overseas networks and the internet. Among other things, this would include the repeal of confusing, inappropriate and ineffective abortion laws.     

Forensic medical expert evaluation in connection with civil actions of patients complaining of improper dental care

The authors discuss questions facing forensic medical experts in connection with civil "medical" actions. The questions are classified as common and private. Expert evaluations of correspondence of the scope and quality of dental care are offered as the base for analysis of these problems within the framework of civil legislation. The data evidence efficiency of forensic medical expert evaluations in civil legal procedure and the significance of forensic medical service in the solution of problems of quality and efficiency of medical (including dental) care of the population.     

Principles of medical and trace examinations in expert evaluation of transport accident traumas based on roentgenological methods

Airtraffic and car traumas illustrate possibilities of x-ray methods in expert examination of transport trauma. X-ray data is most important in clarification of traumatic mechanisms and defects on the clothes of the victims which point to the accident details. Further accumulation of the material will allow introduction of more precise assays of the signs assessment.     

Basic approaches to medical,forensic, and biomechanical studies in expert evaluation of a car injury

Modern approaches to forensic medical expert evaluation of car injuries are discussed. Many problems remain unsolved after examination of injuries in victims inside the car, which negatively tells on the versions suggested during criminal investigation of car accidents. The experts often neglect the most sensitive methods for evaluation of these injuries and many fundamental approaches to the problem: differential diagnosis of primary and secondary injuries; basic medical and biomechanical methods and studies of the clues; fundamentals of total systems evaluation of the results of forensic medical expert evaluation.