Falsch-positive Todesfeststellungen

Abstract

Apart from misdiagnosis, the Lazarus phenomenon, a spontaneous return of circulation after cardiac arrest, is a potential cause for false positive death certification. Because of medicolegal consequences and thus a negative publication bias, the incidence of false positive death certification is unknown. As a false positive death certification results in criminal prosecution and thus media interest, numerous media archives in Germany, Austria and Switzerland were searched for such reports. A total of nine cases of false positive death certification in these three countries were identified since the early 1990s of which eight occurred in an emergency medical service system setting. Apart from a lack of diligence of emergency physicians, a Lazarus phenomenon could be the reason for such incidents. As definite signs of death will not have developed only a few minutes after stopping CPR it might be difficult for an emergency physician to definitely certify a patient's death in an out-of-hospital setting with 100% safety. Thus, prehospital death certification poses a risk of error and subsequent legal prosecution of the emergency physician, as a Lazarus phenomenon may still occur in this phase. Delegation of death certification from emergency physicians to qualified physicians in a follow-up examination might increase both legal safety for emergency physicians in the field and patient safety.

Lazarus Phenomenon or the Return from the Afterlife—What We Know about Auto Resuscitation

“…Following him, in the same year, a group of German authors collected and expanded the set of described cases by another-a total of 42 [21]. In 2018, L. Hornby updated the list of global cases of autoresuscitation [22], and H. Herff described patients who developed Lazarus syndrome in German-speaking countries [23]. In 2020, L. Gordon et al, in a review article, presented a study of 65 cases of the Lazarus phenomenon from the years 1982 to 2018 based on medical databases: Google Scholar, Medline, and PubMed [24].…”