Revista Espanola de Medicina Legal最新文献

Nowadays, diving is a safe practice and fatalities are uncommon. The main cause of death reported is drowning but others have been described, such as, those secondary to the biophysical foundations that govern the hyperbaric environment, like arterial gas embolism or decompression illness. Because of this, multidisciplinary investigation is essential for elucidating the cause of death.

A practical guideline is proposed to systematize and direct the collection of technical-police and medical-forensic data by the different professionals involved to correctly identify all events related to the accident.

It consists of two well-differentiated blocks which shows the sequence to choose the most appropriate autopsy techniques and complementary tests to carry out a complete analysis of each diving fatality, all aimed to avoid overdiagnosis of deaths by drowning.

This way, it will be possible to identify risk factors or unsafe behaviours about which to develop prevention measures.

This contribution will address the shown inconsistency with regard to the mental health field of the Spanish Ministry for Equality's Law 4/2023, which affects people with sexual diversity. In order to provide a context for it, an extensive, non-systematic search of related scientific articles was undertaken, mainly in the MEDLINE and InDICEs-CSIC bibliographic databases. It will consider, in particular: (a) gender discordance as a sexual health diagnosis; (b) sexology, minority, and Spanish law; and (c) counter-conditional health interventions. The aforementioned law modifies the registration of the sex of children between the ages of 12 and 14, contrary to the criteria of the General Council of the Judiciary Eliminate (CGPJ), and classifies as a very serious offence the application of conversion treatment to those concerned. This law contradicts current global nosologies, nosographies, and nosotaxies that certain mental disorders can seriously distort the will of some people.

Introduction

Obstetrics and gynecology is one of the specialties most involved in malpractice claims. However, there are few studies that provide scientific information on this topic. The aim was to analyze the characteristics of medical liability rulings in Spain in public health care in the speciality of obstetrics and gynecology.

Methods

Cross-sectional observational study that analyzed the rulings handed down in the contentious-administrative jurisdiction by the Superior Courts of Justice (2008–2020), in the speciality of obstetrics and gynecology. The variables were administrative, clinical, judicial and compensatory.

Results

We analyzed 1,015 rulings, of which 142 (13.99%) related to the speciality of obstetrics and gynecology. A total of 67.61% of the rulings were dismissed at first instance and 89.28% at second instance. The most frequent reasons for an upheld ruling were diagnostic and/or therapeutic malpractice (40.90%), lack of information (20.45%) and loss of opportunity (18.18%). The most frequently claimed damage was sequelae (66.14%). The median award was 53,758.50 euros (2,000-800,000).

Conclusions

The high frequency of claims in obstetrics and gynecology indicates that these are “high risk” specialties for litigation. The vast majority of judgments are dismissed, i.e. in favor of the administration. The analysis of these results helps to structure the role of lawsuits and to increase professionals' knowledge of the medico-legal aspect of health care.

Introduction

Calliphoridae flies allow estimating the post-mortem interval, as they are the first to arrive at a decomposing body. Its larvae feed on the carcass and then move away to pupate (post-feeding dispersal). Since the environment alters the physiology and behavior of insects, the dispersal of larvae and the final location of pupae could be related to the place where the carcass is deposited. The aim of this work was to study the dispersal of post-feeding larvae in relation to environmental variables in northern Patagonia.

Materials and methods

The distribution of pupae in response to different illumination, temperature and soil inclination conditions was evaluated. A circular box divided into quadrants was used for each treatment and a control. Post-feeding larvae were placed in the center of each box, allowing them to disperse until they pupate. Differences in the number of pupae collected in each quadrant were evaluated by X² tests.

Results

According to the control, the dispersion of post-feeding larvae occurs randomly (p = 0.098). Regarding temperature, the larvae eluded the heat source (p < 0.01). The inclination treatments showed that larvae avoided the raised surface (p < 0.01). Concerning illumination conditions, no trend was observed (p = 0.41).

Conclusions

Knowing the dispersal patterns of larvae, considering environmental variables, reduces search times and let infers the sectors with the highest probability of finding pupae. In this way, it is likely to estimate a more precise post-mortem interval in the framework of medico-legal investigations.

Introduction

Human bone remains from forensic contexts can present different degrees of complexity due to the action of postmortem processes that can alter the state of the corpse. In these cases, osteometric methods to determine sex are very useful. This work aims to adjust 8 discriminant functions previously developed by Mansegosa et al. 2018, to determine sex in long bones with applicability in modern populations of central-western Argentina.

Materials and methods

8 discriminant functions for long bones were adjusted by surveying 8 variables in the clavicle, humerus, ulna, radius, femur and tibia in 103 adult individuals (42 females and 61 males) belonging to the Osteoteca de Mendoza para la Investigación Científica y Forense (Mendoza, Argentina). A cross-validation test was carried out and then the formulas were applied to a sample of 12 individuals with known sex corresponding to real forensic cases worked on by the Anthropology Laboratory of the Cuerpo Médico y Criminalístico de Mendoza.

Results

Of the 8 discriminant functions, three reached acceptable values (> 80%) in both sexes, which correspond to the humerus, radius and clavicle. Cross-validation yielded overall percentages ranging from 72.3 to 87.5%. The sample from forensic contexts could be completely sexed with an efficiency of 91.7%. The generated model constitutes a first step in the generation of methodology to strengthen forensic anthropological research in Argentina.

Introduction

After the approval of Law 35/2015, the insurer is obliged to submit a motivated offer in cases of traffic accidents and the possibility of requesting an extrajudicial expert advice from the Institutes of Legal Medicine in case of disagreement with the previous one.

Objective

The objective of this paper is to describe the differences between the motivated offers of insurers and the forensic reports of the 409 extrajudicial expert advice requested to the Institute of Legal Medicine in Valladolid from 2021-2022 and to propose a methodology for comparing.

Material and methods

All extrajudicial expert advice data from 2021-2022 was obtained, analyzing the days of personal injury and sequelae and translating them into compensation variables.

Results

Forensic reports are more favorable for traffic injuries in about 81% of cases, granting on average an amount of almost € 1,400 more. This difference is mainly due to a greater consideration of sequelae, as well as a higher proportion of days of moderate particular damage in the forensic report. However, this difference is more or less accentuated, depending on the company that makes the motivated offer.

Conclusion

Translating the data from the forensic reports and motivated offers to compensation variables, allows us to make a comparison of the differences between both reports, observing that the forensic reports are more favorable than those issued by the insurers, at least in the province studied, and more studies are needed to have a more complete view.