The concept of forensic emergency medicine as illustrated by an unusual complication of pulmonary artery catheterization

The American Journal of Forensic Medicine and Pathology
Marc De Leeuw, Werner Jacobs

Abstract

Forensic pathologists are regularly confronted with emergency and invasive medical procedures performed on critically ill or traumatized patients. Basic knowledge of such procedures and their possible complications is therefore mandatory in medico-legal practice. In this article, we describe a very unusual complication of pulmonary artery catheterization: through-and-through perforation of the carotid artery, initially without hemodynamic consequence. Death resulted from an aggravation of the preexisting cerebral edema (secondary to a craniocerebral trauma). The misplacement of the pulmonary artery catheter was clinically missed because the guidewire was initially deflected on the cervical spine towards the subclavian vein where the catheter--by chance--entered the circulatory system and followed its normal route further. The forensic importance of leaving all invasive medical devices in situ on a deceased person when a medico-legal autopsy is to be expected and the mutual interaction between emergency and forensic medicine (forensic emergency medicine) are discussed.

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Citations

Oct 27, 2009·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Marc De Leeuw, Werner Jacobs
Dec 18, 2013·Legal Medicine·Raquel Vilariño VillaverdeCristian Palmiere
Jul 29, 2010·The Clinical Journal of Pain·Ida MariniGiulio Alessandri Bonetti
Mar 31, 2019·European Journal of Public Health·Max HerkeMatthias Richter
May 2, 2013·Canadian Journal on Aging = La Revue Canadienne Du Vieillissement·Katie Mairs, Sandra L Bullock
Jun 22, 2013·The British Journal of Psychiatry : the Journal of Mental Science·Matthias C AngermeyerGeorg Schomerus

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