title: [Delayed aortic rupture following a fall from an examination couch. Clinical and forensic aspects].
abstract: BACKGROUND
  Physicians frequently have to face an investigation of their work from a judicial point of view. Due to these proceedings the number of cases when they are reproached with malpractice is increasing.
  
  
  METHODS
  We report the rare case of a 76-year-old female patient who fell from a 68 cm high couch after a sedative was applied during gastroscopical examination. She died 24 hours after the incident. Forensic necropsy revealed a delayed aortic rupture as the cause of death. The preliminary proceedings against the physician involved for culpable homicide by criminal negligence were suspended after he paid a fine. The possible legal consequences under German law for physicians involved in such cases are discussed as well as strategies to avoid them.
  
  
  CONCLUSIONS
  Physicians who are under investigation for malpractice should act carefully. They are advised to seek professional help at an early stage of preliminary proceedings. A public trial should be avoided if possible.
authors.affiliation: Institut für Rechtsmedizin, Johannes-Gutenberg-Universität Mainz. Thomas.Riepert@medizin.uni-koeln.de
authors.forename: T
authors.initials: T
authors.lastname: Riepert
authors.forename: F
authors.initials: F
authors.lastname: Glenewinkel
authors.forename: R
authors.initials: R
authors.lastname: Urschbach
mesh_terms: D000058:Accidental Falls; D000368:Aged; D001011:Aorta / Q000293:injuries*; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D005554:Forensic Medicine / Q000331:legislation & jurisprudence*; D005773:Gastroscopy; D005858:Germany; D006801:Humans; D016365:Liability, Legal; D011182:Postoperative Care