Thursday, March 05, 2009

Medical Homicide

I was reading an article on “Medical Homicide and Extreme Negligence” in my recent edition of The American Journal of Forensic Medicine and Pathology (no link). Having had a case of medical neglect found to be homicide by an inquest jury it was nice to review some of the pertinent definitions. We will continue to watch for other medical cases along with our “more usual” investigations:

Reckless endangerment…the conscious disregard of a known substantial likelihood of injury to the patient

Criminal neglect typically is defined as the failure to provide timely, safe, adequate, and appropriate services, treatment, and/or care to a patient.

In instances of extreme medical negligence, a homicide manner of death is appropriate because the fatality is due to criminal acts (or inactions) of another.

I stand by the jury verdict in our case and will not hesitate to rule similarly in the future if I feel that the case meets these definitions.

Natural deaths…natural disease... Therapeutic complications…predictable complications…appropriate medical therapy…Accidents…unanticipated complications and/or inappropriate therapies…Homicides…death at the hand of another person or death due to the hostile or illegal act or inaction of another person.

Our ruling of a homicide does not mean criminal prosecution should or will occur, but, importantly such a ruling:

…also furthers one of the major goals of the medicolegal death investigation system, which is to safeguard the public health.

(American Journal of Forensic Medicine and Pathology, March 2009; 30: 18-22)


Shawna said...

I was just catching up on my news for the day and found an NPR piece on the recently enacted Death with Dignity law in Washington. I found the bill very interesting and somewhat related to your post, in a reversed sort of way.

Curious52 said... (Joshua Robinson) Attached documents, including a crime scene photo.
Autopsy Report:
"Tardieu spots on the anterior surfaces of the thighs, as well as on the posterior surface of the body"
"Red-purple parenchyma with pulmonary edema"
I can't understand how the Medical
Examiner came to the conclusion of Suicide with these findings.
McGregor PD did not investigate, thus, no investigative findings.
I believe my son, Josh, was murdered by police and hung in teh chain for a 'staged suicide.'

Dr. Richard Keller said...

Tardieu spots are lung "spots" so I am not sure what the ME is referring to here.

Suicide ia an investigative finding (based on scene examination, evidence collection, interviews, etc) not an autopsy finding.

Curious52 said...

"Tardieu spots on the anterior surfaces of the thighs, as well as on the posterior surface of the body" is clearly listed in my son's autopsy.
McGregor PD did NOT investigate the death, let alone talk to me, the mother, about possible suicidal gestures, depression, whether Josh may have been on antidepressants.......
I've been fighting for the truth for about 3 years. I even sent the documents~crime scene photos, dispatch logs, and statements of the four officers, on scene, to the Medical Examiners~Drs. Reade Quinton and Jeffrey Barnard/SWTMC/Dallas, and they would not consider these factors!
Midwest Autopsy now has a copy of Josh's report and has since early December. I am still waiting to hear from them.

Anonymous said...

What do you mean, suicide is an investigative finding?
Then, how does an ME rule Suicide, with no investigative findings?
Are you willing to view the autopsy report?
I need an email address to send the report.

Dr. Richard Keller said...

The finding of suicide is decided after case investigation—the scene, interviews with family, friends, professionals involved in their care before death, etc. Not all the evidence that needs to be considered is at the scene. This is the case in either a Coroner system or an ME system. An ME can usually “rule” quicker because they do not do inquests (or case conferences as we do).

I don’t give opinions on autopsies and do not do work as an expert witness. I may be able to help with factual interpretation of other findings, but that would be the extent of my involvement in any review (