从法医角度看医疗纠纷及其产生的原因与防范

从医疗纠纷鉴定人角度研究医疗纠纷,为相关机构防范医疗纠纷提供思路。医疗纠纷是多种原因引起的,一般采用诉讼方式解决。法医在医疗纠纷的解决中扮演重要角色。在医疗纠纷鉴定中要判定诊疗行为对患者造成的损害后果,判定诊疗行为是否存在医疗过失,判定医疗过失与损害后果之间的因果关系．正确地进行死因分析和证据的取舍认定。在引起医疗纠纷的原因中,以技术性、责任心、医患交流不足等方面的原因居多。医护人员应提高自身的业务水平、责任心及服务质量;加强医患交流,建立畅通的医患沟通渠道;增强自我法律防护意识,建立健全的医疗规章管理制度。     

法系不同 本质相同——对司法会计与法务会计的认识

我们不能简单总结司法会计与法务会计的区别,应将其放在特定的法律环境中进行分析。司法会计与法务会计最根本的区别在于法律渊源即法系基础不同,但其本质相同,都是同一种技术学科在不同法律体系下的不同实现与发展;目标相同,都是为法庭提供财务会计方面的证据;理论依据相同,采用的也都是基本相同的技术方法。     

UNIX系统取证的内容搜索方法研究

大量重要的应用服务器或网络服务器使用可靠性强的UNIX操作系统。研究UNIX系统下常用的内容搜索技术及其原理,可以减少取证分析过程中需要检查的数据量,快速挖掘有效证据。UNIX环境下的搜索工具在静态取证分析中的应用研究,可以帮助调查人员在证据收集和分析过程中缩小检查的数据范围,提高取证分析效率。     

Intraobserver Error in Macromorphoscopic Trait Data, ,

As part of a much larger investigation into the use of macromorphoscopic trait data by forensic anthropologists to estimate ancestry from unidentified skeletal remains, we conducted a fourteen‐year (2002–2016) intraobserver error study. Motivated by the development of a large macromorphoscopic database―which will potentially utilize data collected in 2002―quantification of observer error, the impact of technological improvements in macromorphoscopic trait data collection and observer experience is necessary. To maximize comparisons between the two samples, ten macromorphoscopic traits were assessed. Results revealed three patterns of error relating to observer experience, the introduction of new technologies, and error inherent in the method. Overall, this study found the effect of error on macromorphoscopic trait analysis could be predicted and did not significantly impact their utility.     

Cascading Bias of Initial Exposure to Information at the Crime Scene to the Subsequent Evaluation of Skeletal Remains,

Thirty‐eight participants took part in a study that investigated the potential cascading effects of initial exposure to extraneous context upon subsequent decision‐making. Participants investigated a mock crime scene, which included the excavation of clandestine burials that had a male skeletal cast dressed either in female or gender neutral clothing. This was followed by a forensic anthropological assessment of the skeletal remains, with a control group assessing the same male skeletal cast without any clothing context. The results indicated that the sex assessment was highly dependent upon the context in which participants were exposed to prior to the analysis. This was especially noticeable in the female clothing context where only one participant determined the male skeletal cast to be male. The results demonstrate the importance of understanding the role of context in forensic anthropology at an early stage of an investigation and its potential cascading effect on subsequent assessments.     

A Statistical Method for Reassociating Human Tali and Calcanei from a Commingled Context

In a commingled context, assessing that a talus and a calcaneus correspond to the same individual could become a primary step for accurately sorting human remains. For this purpose, the lengths and widths of the trochlea, posterior calcaneal articular surface, and posterior talar articular surface were measured in 197 individuals (105 males, 92 females) from the Athens Collection. A total of 12 highly accurate equations for reassociating tali and calcanei were developed, using simple and multiple linear regression analysis and they were found to be suitable for sorting commingled human remains. Bilateral asymmetry and sex did not have an effect on the accuracy of the method.     

Preliminary Study on Determining the Sequence of Intersecting Lines by Fluorescence Technique

The determination of the sequence of intersecting lines is an important part of questioned document examinations. A fluorescence technique was used to determine the sequence of heterogeneous intersecting lines produced using inkpad ink, stamp‐pad ink, ballpoint pens, gel pens, fountain pens, colorants of carbon paper, photocopiers, laser printers, and inkjet printers. A SteREO Discovery.V20 equipped with the ZEN Blue Lite software was chosen to perform the tests.As the results obtained from the study were positive under most conditions, the fluorescence technique was found to be very successful in determining the sequence of intersecting lines from ballpoint pen, gel pen, fountain pen, photocopier, laser and inkjet printers, and inkpad inks. The method was also successful in determining the sequence of intersecting lines from ballpoint pen, photocopier, laser printer, and stamp‐pad inks under most conditions. The technique was not successful in determining the order of crossing lines blending together.     

Clinical Characteristics of Fatal Methamphetamine‐related Stroke: A National Study

The study aimed to determine the clinical characteristics of fatal methamphetamine‐related stroke in Australia, 2009–2015. There were 38 cases, 60.5% male, with a mean age of 40.3 years. In no case was there evidence that this was the first time methamphetamine had been used by the decedent, and 52.6% had known histories of injecting drug use. The stroke was hemorrhagic in 37 of 38 cases. In 21.1% of cases, the stroke was purely parenchymal and, in 18.4%, involved purely the subarachnoid space. A ruptured berry aneurysm was present in 31.6% and in 68.8% of initial subarachnoid hemorrhages. There was evidence of systemic hypertension in 8 of 25 cases in which full autopsy findings were available. With increased use of methamphetamine, there is a high probability of increased hemorrhagic stroke incidence among young people. In cases of fatal hemorrhagic stroke among young cases presenting to autopsy, the possibility of methamphetamine use should be borne in mind.     

Trace DNA Sampling Success from Evidence Items Commonly Encountered in Forensic Casework

Trace DNA analysis is a significant part of a forensic laboratory's workload. Knowing optimal sampling strategies and item success rates for particular item types can assist in evidence selection and examination processes and shorten turnaround times. In this study, forensic short tandem repeat (STR) casework results were reviewed to determine how often STR profiles suitable for comparison were obtained from “handler” and “wearer” areas of 764 items commonly submitted for examination. One hundred and fifty‐five (155) items obtained from volunteers were also sampled. Items were analyzed for best sampling location and strategy. For casework items, headwear and gloves provided the highest success rates. Experimentally, eyeglasses and earphones, T‐shirts, fabric gloves and watches provided the highest success rates. Eyeglasses and latex gloves provided optimal results if the entire surfaces were swabbed. In general, at least 10%, and up to 88% of all trace DNA analyses resulted in suitable STR profiles for comparison.     

A Two‐Year Study of Δ 9 Tetrahydrocannabinol Concentrations in Drivers; Part 2: Physiological Signs on Drug Recognition Expert (DRE) and non‐DRE Examinations,,

Whole blood samples were examined for ?⁹‐Tetrahydrocannabinol (THC) over 2 years in drivers suspected of driving under the influence. Part one of the study examined the link between [THC] and performance on field sobriety tests. This portion examined objective signs, eye examinations and physiological indicators; and their relationship to the presence of THC. Several objective signs were excellent indicators of the presence of THC: red eyes (94%), droopy eyelids (85.6%), affected speech (87.6%), tongue coating (96.2%), and odor of marijuana (82.4%). About 63.6% of THC positive subjects had dialted pupils (room light). THC positive subjects had either rebound dilation or hippus in 88.8% of cases. Pulse and blood pressure (BP) were evaluated to determine any correlation with [THC]. An increased pulse rate correlated well to the presence of THC (88.5%), but not [THC]. BP did not correlate to [THC] and was also a poor indicator of THC in the blood (50% high).