title: [Medical expert reports in chest disease; the question of imputability of death].
abstract: In the course of an investigation, judicial or not, the expert opinion encompasses several questions of a different nature, including the following one « did the patient die of a disease he/she was supposed to suffer from at time of death? » Based on a personal experience over one year in 2008, the goal of this paper is to tackle this question of imputability, which was asked in respect of 12 investigations, including ten of occupational diseases, one of nosocomial infection and one iatrogenic accident. Only two autopsies were carried out; one autopsy refusal was reported. In five out of 12 cases, the imputability of death related to an occupational disease or an iatrogenic accident was considered by the expert to be certain in one case, very probable in two cases, and possible in two cases; in seven out to 12 cases, imputability of death was unlikely, since the cause of death was unknown in two cases, or was not the suggested cause in five cases. The discussion considers several arguments that can help answer this question: evaluation of the vital prognosis of the disease, the importance of the quality of medical records, the contributions and limits of autopsy findings, deaths that result from multiple causes, and the concept of aggravating circumstances.
authors.affiliation: Service de Pneumologie, CHU de Nancy, Hôpital de Brabois, Rue du Morvan, 54511 Vandœuvre-les-Nancy, France. y.martinet@chu-nancy.fr
authors.forename: Y
authors.initials: Y
authors.lastname: Martinet
mesh_terms: D000059:Accidents; D001344:Autopsy; D015984:Causality; D003428:Cross Infection / Q000401:mortality; D004198:Disease Susceptibility; D005104:Expert Testimony; D005602:France; D006801:Humans; D007049:Iatrogenic Disease; D016365:Liability, Legal; D008175:Lung Neoplasms / Q000209:etiology; D008297:Male; D008318:Malpractice; D009784:Occupational Diseases / Q000401:mortality; D011552:Pseudomonas Infections / Q000209:etiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology; D012120:Respiration Disorders / Q000209:etiology / Q000401:mortality*; D018805:Sepsis / Q000209:etiology; D012806:Siderosis / Q000150:complications; D012829:Silicosis / Q000150:complications; D012943:Social Security / Q000331:legislation & jurisprudence; D014942:Workers' Compensation / Q000331:legislation & jurisprudence