Medical neglect death due to acute lymphoblastic leukaemia: an autopsy case report.

Yosuke Usumoto, Naomi Sameshima, Akiko Tsuji, Keiko Kudo, Naoki Nishida, Noriaki Ikeda
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Abstract

We report the case of 2-year-old girl who died of precursor B-cell acute lymphoblastic leukaemia (ALL), the most common cancer in children. She had no remarkable medical history. She was transferred to a hospital because of respiratory distress and died 4 hours after arrival. Two weeks before death, she had a fever of 39 degrees C, which subsided after the administration of a naturopathic herbal remedy. She developed jaundice 1 week before death, and her condition worsened on the day of death. Laboratory test results on admission showed a markedly elevated white blood cell count. Accordingly, the cause of death was suspected to be acute leukaemia. Forensic autopsy revealed the cause of death to be precursor B-cell ALL. With advancements in medical technology, the 5-year survival rate of children with ALL is nearly 90%. However, in this case, the deceased's parents preferred complementary and alternative medicine (i.e., naturopathy) to evidence-based medicine and had not taken her to a hospital for a medical check-up or immunisation since she was an infant. Thus, if she had received routine medical care, she would have a more than 60% chance of being alive 5 years after diagnosis. Therefore, we conclude that the parents should be accused of medical neglect regardless of their motives.

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医疗疏忽导致急性淋巴细胞白血病死亡:尸检病例报告。
我们报告一个2岁的女孩死于前体b细胞急性淋巴细胞白血病(ALL),这是儿童最常见的癌症。她没有特别的病史。她因呼吸窘迫被转送医院,在抵达医院4小时后死亡。死前两周,她曾发烧39摄氏度,在服用一种自然疗法草药后消退。她在死亡前一周出现黄疸,死亡当天病情恶化。入院时的实验室检查结果显示白细胞计数明显升高。因此,死亡原因被怀疑是急性白血病。法医尸检显示死因是前体b细胞ALL。随着医疗技术的进步,ALL患儿的5年生存率接近90%。然而,在这个案例中,死者的父母更喜欢补充和替代医学(即自然疗法)而不是循证医学,并且从她还是婴儿以来就没有带她去医院进行体检或免疫接种。因此,如果她接受了常规的医疗护理,她将有超过60%的机会在诊断后5年存活。因此,我们的结论是,无论父母的动机如何,都应该被指控为医疗疏忽。
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