title: Liability under post-tonsillectomy lethal bleeding of the tonsillar artery: a report of two cases.
abstract: Post-operative haemorrhage is a frequent complication of tonsillectomy: a primary haemorrhage occurring in the first hours is rapidly dealt with by the surgical team. A secondary haemorrhage, which commonly occurs once the child has returned home, can be fatal if it is not dealt with quickly. We present two cases of a lethal outcome in children following a secondary post-tonsillectomy haemorrhage, for which the parents filed legal proceedings. Medical liability can be exercised during all stages of health care. Performing an autopsy associated with histological analyses is found to be indispensable for the identification of the causes of bleeding, as well as its mechanism.
authors.affiliation: APHM, CHU Timone, Service de Médecine Légale et Droit de la Santé, 13385, Marseille, Cedex 5, France; Aix Marseille Université, CNRS, EFS, ADES UMR 7268, 13916, Marseille, France. Electronic address: lucile.tuchtan@ap-hm.fr.
authors.forename: L
authors.initials: L
authors.lastname: Tuchtan
authors.affiliation: APHM, CHU Timone, Service de Médecine Légale et Droit de la Santé, 13385, Marseille, Cedex 5, France; Aix Marseille Université, CNRS, EFS, ADES UMR 7268, 13916, Marseille, France; APHM, CHU Timone, Service d'anatomo-pathologie, 13385, Marseille, Cedex 5, France.
authors.forename: J
authors.initials: J
authors.lastname: Torrents
authors.affiliation: APHM, CHU Timone, Service de Médecine Légale et Droit de la Santé, 13385, Marseille, Cedex 5, France; Aix Marseille Université, CNRS, EFS, ADES UMR 7268, 13916, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Lebreton-Chakour
authors.affiliation: APHM, CHU Timone, Service de Médecine Légale et Droit de la Santé, 13385, Marseille, Cedex 5, France.
authors.forename: F
authors.initials: F
authors.lastname: Niort
authors.affiliation: APHM, CHU Timone, Service de Médecine Légale et Droit de la Santé, 13385, Marseille, Cedex 5, France.
authors.forename: M A
authors.initials: MA
authors.lastname: Christia-Lotter
authors.affiliation: APHM, CHU Timone, Service de Médecine Légale et Droit de la Santé, 13385, Marseille, Cedex 5, France.
authors.forename: E
authors.initials: E
authors.lastname: Delmarre
authors.affiliation: APHM, CHU Timone, Service d'ORL et de Chirurgie Cervico-Faciale Pédiatrique, 13385, Marseille, Cedex 5, France.
authors.forename: R
authors.initials: R
authors.lastname: Nicollas
authors.affiliation: APHM, CHU Timone, Service de Médecine Légale et Droit de la Santé, 13385, Marseille, Cedex 5, France; Aix Marseille Université, CNRS, EFS, ADES UMR 7268, 13916, Marseille, France.
authors.forename: M D
authors.initials: MD
authors.lastname: Piercecchi-Marti
mesh_terms: D001237:Asphyxia / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice; D014066:Palatine Tonsil / Q000098:blood supply; D019106:Postoperative Hemorrhage / Q000209:etiology*; D053120:Respiratory Aspiration; D014068:Tonsillectomy / Q000009:adverse effects*
keywords: Lethal outcome; Medical liability; Secondary haemorrhage; Tonsillectomy