Forensic data analysis on 34 death cases of medical disputes due to aortic dissecting aneurysm rupture / 复旦学报（医学版）

ABSTRACT

Objective To investigate the reasons for the death of patients,the relationship of medical disputes with their death by aortic dissecting (AD) aneurysm (known as AD) ruptures during diagnostic and therapeutic procedures and the judgement for contribute ratios.Methods A total of 34 sudden death cases due to AD were collected from 2001 to 2016 due to medical tangle and underwent forensic pathological analysis.Clinical data were checked according to the results of forensic pathology.The reasons for the death of patients and the relationship of medical disputes with their death and contribute ratios of medical disputes were analyzed according to literature reports.Results In the 34 cases,23 cases were from medical institutions at the country level,and 11 cases were from municipal medical institutions.All patients had other diseases,in whome 27 cases had definite hypertension,31 cases died of cardiac tamponade,and 3 cases of hemorrhagic shock.The pathological analysis showed that aorta cystic in the middle necrosis,coronary atherosclerosis and coronary artery stenosis (grade Ⅰ-Ⅳ).Fifteen cases had coronary and aortic atherosclerosis,and 1 case had pulmonary artery dissection.All cases were not given definite clinical diagnosis and effective treatment for AD.Therefore,there was cause-and-effect relationship between clinical procedures of misdiagnosis and mistreatment and the death of patients.Conclusions The pathogenesis of AD is complicated,and a lack of awareness in grass-roots doctors leads to the misdiagnosis and mistreatment easily primary care doctor.In medical disputes of sudden death induced by AD,clinical procedures of misdiagnosis and mistreatment lead to indirect causal relationship with the death of patients.