When is a periprocedural death iatrogenic in natu

Authors: Marian Wang Gilbert Lau

Publish Date: 2011/06/11

Volume: 8, Issue: 1, Pages: 23-33

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Abstract

In almost any instance of suspected iatrogenic fatality the attending forensic pathologist faces the challenging and often daunting task in ascertaining the cause of death determining if an iatrogenic injury had indeed occurred and if so its contribution to the causation of death The Forensic Medicine Division of the Health Sciences Authority in Singapore embarked on a 6 year study of such deaths to identify pertinent factors that may facilitate the assessment of iatrogenic injuries and their contribution to mortality A total of 106 iatrogenic deaths arising from 613 coroner’s periprocedural autopsies conducted during the period of 2005–2010 were reviewed with particular reference to the following parameters 1 clinicopathological correlation 2 the length of survival 3 the number of interventional procedures A comprehensive analysis of these cases indicated that they could be classified into the following 3 categories in relation to the role of clinicopathological correlation in the ascertainment of the causes of death A advantageous but not essential B essential C critical A large proportion of the cases 765 were assigned categories B and C Only the minority of cases 236 were assigned category A Also as the number of days of survival between injury and death and the number of interventional procedures after injury increases the greater the need for detailed clinical documentation to ascertain the cause of death

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