[Profiles of medical malpractice in the prophylaxis of pulmonary thromboembolism].
Deaths caused by pulmonary thromboembolism (PTE) are often of forensic interest, due to the frequent preexistence of a traumatic event the suddeness of death, and possible professional responsibility. Early diagnosis of vein thromboembolism is often difficult. Fatal PTE usually presents itself on an unexpected and large scale, chronologically occurring shortly before death and thus irreconcilable with any consequent efficacious therapy. Pharmacological prophylaxis, aiming at reducing the state of blood hypercoagulability, is the elective therapeutic strategy for vein thromboembolism. These are the premises for this work which, after a brief pharmacological and clinical description of heparin prophylaxis and a review of data emerging from a sample of 24 deaths due to PTE, makes some considerations regarding professional responsibility.
Montisci
Massimo
M
Dipartimento di Medicina Ambientale e Sanità Pubblica Sede di Medicina Legale e delle Assicurazioni Università degli Studi Via Falloppio, 50 35121 Padova. massimo.montisci@unipd.it
Snenghi
Rossella
R
Pasquali
Alessandro
A
Prandoni
Paolo
P
Ferrara
Santo Davide
SD
D000925:Anticoagulants / Q000008:administration & dosage*; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007558:Italy; D008318:Malpractice; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011292:Premedication / Q000592:standards; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D011787:Quality of Health Care; D020246:Venous Thrombosis / Q000150:complications* / Q000209:etiology
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin