Fatal hemmorhage following extraction of first molar.

A case involving extraction of right upper 1st molar leading to massive hemorrhage and death in an undiagnosed case of Arteriovenous Venous Malformation of maxilla is presented along with the relevant investigations, standard treatment to be given and the related medicolegal issues. A 16 year old male presented to a dentist with history of Grade III mobility of right upper 1st molar without any known etiology. The dentist extracted the tooth without properly assessing the patient clinically and advising any relevant investigations thereby leading to massive hemorrhage and death of the patient. Proper clinical assessment, relevant investigations adequate treatment is to be given or the surgeon faces the risk of legal action for medical negligence under the provisions of Sec.304A of IPC. History taking, proper clinical examination, relevant investigations and adequate treatment are imperative in treating any case and in case of complications, the patient must be shifted to the ED of the nearest hospital without any delay.

Positional asphyxia: An opinion of exclusion.

The process of normal respiration depends upon three vital components i.e. a patent airway, an intact surface for gas exchange and a normally working ventilatory apparatus. The positional asphyxia has been defined as asphyxia caused due to unusual position of the body which interferes with the breathing and thus pulmonary ventilation. We are reporting a case of an adult female, who under the influence of alcohol positioned herself in such a way which led her to death due to positional asphyxia. The internal and external findings were non-specific. Therefore the exclusion criteria were used to conclude that the death was due to positional asphyxia. The cases of positional asphyxia are difficult to diagnose because of the absence of any specific external findings. The internal findings found in such cases are also non-specific and can be found in any case of an asphyxial death.