Pratica Medica & Aspetti Legali
Not a member yet
203 research outputs found
Sort by
Le criticità etico-deontologiche e giuridiche della contraccezione d’emergenza
Get PDFThe Author examines the problems concerning emergency contraception and analyzes them in relation with levonorgestrel (LNG) mechanism of action and with different ethical implications surrounding the starting of life
Tromboembolismo venoso in chirurgia ortopedica. Aspetti clinici e medico-legali
Get PDFThe incidence of venous thromboembolism in orthopaedic patients is high and can lead to pulmonary thrombo-embolism (PTE). Deaths caused by PTE are often of forensic interest, due to the suddeness of death, and possible professional responsibility. Early diagnosis of vein thromboembolism is often difficult, therefore prevention and clinical management deserves special attention: a lack of prophylaxis, inadequate prophylaxis, lack of monitoring of coagulative parameters, insufficient duration of prophylaxis, lack of diagnostic testing can frequently lead to legal suits. In order to avoid blame on the profession to choose suitable and correct treatment is essential. The availability and the adoption of pharmacological methods has revealed a costant and continuous reduction of events during which orthopaedic and trauma patients were affected by TEP. Guidelines recommend pharmacological prophylaxis with low molecular heparin or fondaparinux in patients with total hip and knee arthroplasty and with proximal femur fractures. We report two cases: the first one illustrates an example of lack of adequate prophylactic measures, the second one describes the clinical risk correlated to underdosage. These cases are the premise for a brief pharmacological and clinical description of deep venous thrombosis prophylaxis and for some considerations regarding professional responsibility
Danni cerebrali neonatali: la fallacia del post hoc ergo propter hoc
Get PDFPerinatal cerebral injury is an important subject in medical malpractice litigation. In most cases of claims for neonatal injuries the Italian Courts sentence the medical or hospital liability. The authors present a case of obstetrical negligence claim, in which parents alleged the severe mental retardation of their term born infant to negligence during labour. Although the most part of severe mental retardation is not the result of intrapartum injuries, the official expert call upon to judge established causation and identified the breach of duty in negligence in intermittent auscultation of foetal heart rate during labour. The authors underline that the research on the causation of neonatal cerebral injuries needs to focus more on antenatal events and reckon the causation not determinable in this case, lacking markers of the time of onset of brain injury, exclusion of other causes of mental retardation, and enough evidence to evaluate the use of foetal heart rate monitoring for assessment of its well being. The official expert’s conclusions are an example of post hoc fallacy
Il consenso informato
Get PDFFor many doctors the process of obtaining informed consent for a treatment from a patient begins and ends with the signature of the patient on the consent form. Indeed this is not so as this process is deeper than that and all specialists need to understand the true meaning of this form to ensure that implementation of the process of informed consent is mutually beneficent to both patient and doctor. Ethicists and the medicolegal system agree that patients have rights to information prior to an elective medical procedure. In Italy there are many court cases emphasize the importance of informed consent. This paper presents a brief legal history of the doctrine along with a discussion of contemporary standards of disclosure and the emerging right of the patient to understand informed consent disclosures. The aim is to analyse the criteria used to define adequate informed consent and the contribution to define “reasonable” medical informed consent, including elements as disclosure of information, competency, understanding, voluntariness, and decision-making
La valutazione medico-legale dei disturbi cognitivi nel settore assistenziale
Get PDFThe authors examine cognitive disorders (dementia in particular) and the Italian norms concern it. They discuss the interpretative problems regarding the definition of daily living activity and analyze different multidimensional evaluation scales internationally proposed. Finally, they purpose an interpretative framework of dementia multi-axis evaluation and individualize an operative proposal to evaluate the absence of self-sufficiency
Lesioni iatrogene del nervo accessorio spinale: responsabilità professionale,rischio del medico e aspetti giuridici
Get PDFThe majority of lesions of the spinal accessory nerve occur as an iatrogenic injury after lymph node biopsy in the posterior cervical triangle. In most cases the accessory nerve palsy is not recognised immediately after the injury. Therefore surgical repair is often performed too late to regain sufficient function of the paralytic trapezium muscle. We report a case of a 23 year old patient who was taken in Hospital for a non Hodgkin’s lymphoma. After biopsy a strong pain to right shoulder emerged. Despite the man’s complaints of left arm weakness the doctor waited several weeks to look into the matter. Only one year later he was properly diagnosed with a iatrogenic accessory nerve injury. The iatrogenic injuries of the accessory nerve may lead to significant lifelong disability. The diagnosis is not always made in time with consequent delay in repair may be regarded as an unfavourable issue during medical-legal discussions. The Author recommends in interest to prevent nerve injury in the posterior triangle of the neck to perform operation in special department
Complicanze in endoscopia digestiva.Aspetti clinici e medico-legali
Get PDFThe optimal outcome of endoscopy is conditioned by numerous factors: the most important are represented by trained endoscopists with standard techniques, by a systematized approach to event management, by a good documented patient informed consent and communication before and after the procedure. Complications are quite rare, but when they occur they can cause adverse events and patient injury, increasing the probability of malpractice actions. This article will focus on potential lawsuits that are likely to be pursued when there is the lack of one of these procedures
