Ascertainment of the cause and tempo of death in forensic medical practice

In order to develop a method of ascertaining a cause of death and of evaluating its tempo the authors undertook a histological study and a study of a dehydration degree in 76 cases of death due to the below reasons: mechanical trauma, mechanical asphyxia, burn shock, and carbon monoxide intoxication. Acute emphysema of lungs, lack of edemas in lungs and brain, desquamation of pulmonary macrophages, hyperemia of renal capillaries, primary urine in some glomerules, prevalence of ischemic changes with karyopyknosis in medulla and hypohydration of brain were typical of fast death. Prevalence of dystelectasis in lungs, emptying of pulmonary capillaries, evident edema of lungs and brain, desquamation of pulmonary macrophages, lack of primary urine in glomerular capsules, acute circulatory disorders of renal hemodynamics with sweating of fibrin and erythrocyte glomerules into cavities, necrotic nephrosis, pigment cylinders in renal tubules, thrombi in vessels, prevalence of chromatolysis, karyolysis and cytolysis in medulla, pronounced glial reaction as well as pronounced edema of brain and its hyperhydration were typical of slow death.     

Combined trauma and sepsis in forensic medical practice

The relationship between combined injury and sepsis is an important problem of forensic medicine. A total of 227 cases with combined injuries have been investigated postmortem at Bureau of Forensic Medical Expert Evaluations of Moscow in 1997. Sepsis developed in 9.7% cases. The studies revealed a direct cause-and-effect relationship between mechanical injuries and development of sepsis in the overwhelming majority of cases. Sepsis may develop at any period of the traumatic disease, except the first one, and the infection is prone to generalization in the remote postoperative period.     

Posttraumatic neurosensory hypoacusis in forensic medical practice

Literature data and results of epidemiological examination show that traumas play a significant role in emergence of neurosensory hypoacusis (NSHA) in young healthy population. The diagnosis of NSHA is often missed in forensic-medical examination and this may cause a social problem. Audiometric signs of NSHA were studied in subjects with trauma of the labyrinth. Pure tone audiometry results can be used for differential diagnosis of mechanical and barotraumas and as additional criteria in determination of the harm to health.     

The forensic medical assessment of the micromorphology of brain stem hemorrhages in craniocerebral trauma

Microscopic features of primary and secondary hemorrhages in the stem portion of the brain in craniocerebral injuries are described. Criteria of differential diagnosis between primary and secondary hemorrhages in the stem in subjects dead during 24 h after isolated and combined craniocerebral injuries are defined. The forensic medical significance of differential diagnosis of hemorrhages in the stem for the solution of many expert problems is evaluated.     

司法医学鉴定中骨科伪病的防范与对策

提高司法医学鉴定人对司法医学鉴定工作的重视程度,增强其做好司法医学鉴定工作的责任感和使命感,对保证司法鉴定工作的质量、确保司法公正尤为重要.为充分发挥司法鉴定结论作为法定证据作用,司法鉴定人员除要具有职业道德和法律意识外,还要有鉴定人特有的责任意识,以提高医疗"诊断"的正确性,为司法鉴定提供科学依据.因此,对伪证的识别显得非常必要.     

司法医学鉴定中骨科伪病的防范与对策

提高司法医学鉴定人对司法医学鉴定工作的重视程度 ,增强其做好司法医学鉴定工作的责任感和使命感 ,对保证司法鉴定工作的质量、确保司法公正尤为重要。为充分发挥司法鉴定结论作为法定证据作用 ,司法鉴定人员除要具有职业道德和法律意识外 ,还要有鉴定人特有的责任意识 ,以提高医疗“诊断”的正确性 ,为司法鉴定提供科学依据。因此 ,对伪证的识别显得非常必要。一、对虚假病史和症状可信程度的分析⑴在一些损伤性疾病中 ,如骨折、扭挫伤、慢性劳损等 ,要通过生物力学的原理分析其致伤结果。一般当事人容易将其致伤经过夸大 ,并诉为直接的损…     

试论非法行医案的法医学鉴定

本文结合部分非法行医典型案例讨论该类案件的法医学鉴定问题 ,对于非法行医造成人身健康受到损害的程度如何界定 ,法律没有明确规定 ,作者认为应以刑法为基础 ,参照《人体轻微伤的鉴定》、《人体轻伤鉴定标准 (试行 )》和《人体重伤鉴定标准》作为主要依据 ,并考虑非法行医行为在这类案件中的参与程度 ,综合鉴定。     

试论非法行医案的法医学鉴定

本文结合部分非法行医典型案例讨论该类案件的法医学鉴定问题，对于非法行医行医造成人身健康受到损害的程度如何界定，法律没有明确规定，作者认为应以刑法为基础，参照《人体轻微伤的鉴定》、《人体轻伤鉴定标准（试行）》和《人体重伤鉴定标准》作为主要依据，并考虑非法行医行为在这类案件中的参与程度，综合鉴定。     

医疗纠纷司法鉴定的法律依据--兼谈正确处理司法鉴定与医疗事故鉴定的关系

司法鉴定是指人民法院、人民检察院、公安机关、国家安全机关、监狱、仲裁机关以及当事人对案件立案前取证、诉讼、执行、仲裁过程中所遇到的专门技术、专门知识问题,委托有鉴定权的机构或鉴定人依法检验或判断的活动。[1]当前,医疗纠纷诉讼到法院的案件日趋增多。在司法实践中,司法鉴定也作为判断医疗纠纷中医院是否具有过错及过错和损害后果之间的因果关系的一种常用方法。那么对医疗纠纷进行司法鉴定是否有法律依据呢?本文对于医疗纠纷进行司法鉴定的法律依据进行探讨。一、从医疗纠纷的定义上看:医疗事故只是医疗纠纷的一种广义上讲,凡…     

医疗纠纷司法鉴定的法律依据--兼谈正确处理司法鉴定与医疗事故鉴定的关系

司法鉴定是指人民法院、人民检察院、公安机关、国家安全机关、监狱、仲裁机关以及当事人对案件立案前取证、诉讼、执行、仲裁过程中所遇到的专门技术、专门知识问题，委托有鉴定权的机构或鉴定人依法检验或判断的活动。当前，医疗纠纷诉讼到法院的案件日趋增多。在司法实践中，司法鉴定也作为判断医疗纠纷中医院是否具有过错及过错和损害后果之间的因果关系的一种常用方法。那么对医疗纠纷进行司法鉴定是否有法律依据呢？本文对于医疗纠纷进行司法鉴定的法律依据进行探讨。     

鼻骨骨折的CT检查及法医学鉴定

鼻骨骨折在头面部损伤中多见 ,以往鼻骨骨折主要依赖于临床检查和Ｘ线拍片确诊。但由于鼻骨两侧对称 ,在侧位Ｘ线片上因影像重叠 ,往往容易漏诊 ,给法医学鉴定带来一定困难。自 1 998年以来 ,我们对于临床及Ｘ线检查疑有鼻骨骨折或骨折移位不明显的伤者 ,进行ＣＴ检查 ,其结果影像清晰 ,诊断明确 ,更容易显示骨折的部位和程度。现将我们检查鉴定的 1 6例报告如下 :方法与结果1 资料 :本组鼻骨骨折 1 6例 ,其中男 1 2例 ,女 4例 ;致伤物均系钝器 ;全部为直接外力作用于外鼻所致。2 ＣＴ检查的方法、体位及影像特点 :(1 )ＣＴ检查鼻骨采用冠…     

Algorhythm of making forensic medical expert examinations by medical documents in obstetric-gynecological practice

Most of the suits brought against medical professionals concern obstetricians-gynecologists. The experienced clinicians take part in commissions of experts to certify validity of diagnosis, treatment, operations, manipulations. Current state of obstetric-gynecological expertise is characterized. Algorithm of making obstetric-gynecological examinations is proposed. Criteria on forensic-medical assessment of medical care conducted in comparison with current standards of this care are formulated.     

鼻骨骨折的CT检查及法医学鉴定

鼻骨骨折在头面部损伤中多见,以往鼻骨骨折主要依赖于临床检查和X线拍片确诊.但由于鼻骨两侧对称,在侧位X线片上因影像重叠,往往容易漏诊,给法医学鉴定带来一定困难.自1998年以来,我们对于临床及X线检查疑有鼻骨骨折或骨折移位不明显的伤者,进行CT检查,其结果影像清晰,诊断明确,更容易显示骨折的部位和程度.现将我们检查鉴定的16例报告如下:     

Accuracy of cause of death determination without forensic autopsy examination

Medical examiners and coroners commonly determine cause and manner of death without an autopsy examination. Some death certificates generated in this way may not state the correct cause and manner of death. From the case files of the Department of Forensic Medicine in Sydney, Australia, the authors retrospectively reviewed investigative information of all cases in a 6-month period that were initially considered natural deaths (429). The authors, blinded to autopsy results, accepted 261 cases as appropriate for certification without autopsy and assigned a cause of death to each. Per standard local practice, all cases had been autopsied. The actual causes of death as determined by autopsy were then revealed and compared with the presumed causes of death. Most presumed and actual causes of death were cardiovascular (94% and 80%, respectively). The majority of presumed causes of death were listed as ASCVD as the cases lacked features of a more specific cardiovascular process. A large majority of cases had a presumed cause of death of ischemic heart disease based on individual case details. The actual causes of death demonstrated a large breadth of cardiovascular and noncardiovascular disease processes, even though ischemic heart disease accounted for 62% of deaths. The presumed cause of death was completely wrong in 28% of cases. A nonnatural manner of death was present in 3% of cases. This study demonstrates that experienced forensic pathologists may generate erroneous death certificates for cases that are not autopsied.     

The serological determination of myoglobin for forensic medical purposes

Possibility of using diagnosticum for myoglobin detection in passive hemagglutination reaction during evaluation of medicolegal objects is shown.