The Role of a Good Quality Autopsy in Pediatric Malpractice Claim: A Case Report of an Unexpected Death in an Undiagnosed Thymoma

Nunno, Nunzio Di; Patanè, Federico Giuseppe; Amico, Francesco; Asmundo, Alessio; Pomara, Cristoforo

doi:10.3389/fped.2020.00031

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Even if rare, endocrine diseases should be closely related to nc-SD. Notably, when other causes are excluded, this tragic event may be related to different pathological statuses such as adrenal insufficiency (although infrequent, it may occur in individuals treated for other critical conditions where impairment of corticoadrenal function often happen) [ 98 , 99 ], diabetic coma [ 100 ], severe hypothyroidism (myxedema) [ 101 ], parathyroid crisis [ 102 , 103 ], thymoma [ 104 ], etc.…”

Section: Causes Of Sudden Deathmentioning

confidence: 99%

Sudden Death in Adults: A Practical Flow Chart for Pathologist Guidance

et al. 2021

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The medico-legal term “sudden death (SD)” refers to those deaths that are not preceded by significant symptoms. SD in apparently healthy individuals (newborn through to adults) represents a challenge for medical examiners, law enforcement officers, and society as a whole. This review aims to introduce a useful flowchart that should be applied in all cases of SD. Particularly, this flowchart mixes the data obtained through an up-to-date literature review and a revision of the latest version of guidelines for autopsy investigation of sudden cardiac death (SCD) in order to support medico-legal investigation. In light of this review, following the suggested flowchart step-by-step, the forensic pathologist will be able to apply all the indications of the scientific community to real cases. Moreover, it will be possible to answer all questions relative to SD, such as: death may be attributable to cardiac disease or to other causes, the nature of the cardiac disease (defining whether the mechanism was arrhythmic or mechanical), whether the condition causing SD may be inherited (with subsequent genetic counseling), the assumption of toxic or illicit drugs, traumas, and other unnatural causes.

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Section: Causes Of Sudden Deathmentioning

confidence: 99%

Sudden Death in Adults: A Practical Flow Chart for Pathologist Guidance

et al. 2021

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“…Autopsy remains the gold standard method to establish the cause of death: knowledge of the cause of death may be critically important, both in health policies and in penal diatribes [ 31 , 32 ]. In the case of a post-mortem investigation, the histologic findings may be considered mandatory to define the exact cause of death, particularly in the case of sudden infant death [ 33 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Congenital Cystic Adenomatoid Malformation (CCAM) Type II: A Rare Case of Sudden Infant Death

et al. 2022

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Congenital cystic adenomatoid malformation (CCAM) is a developmental lesion of the lungs and terminal respiratory structures, which is characterized by pseudocysts, lesions, and cystically dilated airways. CCAM is also known as congenital pulmonary airway malformation (CPAM). Various classification systems for CCAM have been described, and based on a recent classification, CCAMs are classified morphologically into five different types (Type 0, I, II, III, and IV) based on lesion sizes. The most common manifestation of CCAM in neonates and children is respiratory distress (RD). Spontaneous pneumothorax is a rare manifestation of CCAM. In this case report, we discuss a CCAM type-II case of a 38-day-old female infant with a radiological post-mortem diagnosis of a large left-side spontaneous pneumothorax. The gross examination of the lungs revealed multiple emphysematous air bubbles up to 0.5 cm in diameter, and the histological examination revealed focal pleural fibrosis, accompanied by thickened septa and atelectasis. In this scenario, the routine use of prenatal ultrasonography would be important to obtain a timely prenatal diagnosis. At the same time, improvements in surgical techniques, as well as greatly improved imaging techniques, have improved the outcome of these patients. Finally, it is important to remark on the importance of autopsy in the case of sudden infant death with a suspected CCAM.

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“…It was a useful tool, which should be applied to the routine autopsy protocol [ 32 , 33 , 34 ]. Autopsy plays a crucial role in identifying the cause of death beyond any doubt [ 35 , 36 , 37 , 38 , 39 ]. Many unexpected deaths are currently associated with cardiovascular diseases and in many cases without any type of confirmation.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report

et al. 2021

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Arteriovenous malformations (AVMs) are rare congenital conditions with a prevalence of less than 1% and are mostly asymptomatic. However, these malformations can suddenly cause intense pain or bleeding, leading to life-threatening medical problems. This report presents a case of an unexpected death in a 37-year-old previously healthy woman due to an intra-cerebellum arteriovenous malformation rupture identified during autopsy. While infective processes where preliminarily excluded, a Post Mortem Computed Tomography (PMCT) identified a tetra ventricular hemorrhage and intra-cerebellum hemorrhage. Toxicological examination was negative for most substances of abuse. During autopsy an intense hemorrhagic infiltrate in the subarachnoid space was observed. After formalin fixation of the brain the cerebellum showed hemorrhagic infarction on fourth ventricle sides, as well as several small reddish infarctions across the entire cerebellum parenchyma. Histological examination of the brain and cerebellum showed a suffusion of erythrocytes in the sub-arachnoid region. Evidence of an arterio-venous malformation, with several intertwine vessels of variable diameter, surrounded by hemorrhagic evidence. The autopsy played a crucial role in identifying the location and the possibly affected vessel, as well as defining the cause of death. It is necessary to have a greater number of autopsies to make an epidemiological contribution. Furthermore, it is crucial to create a multicenter data network with other authors from other departments to improve information about epidemiological, clinical, diagnostic and therapeutic data. Most brain AVMs as cause of death are often undiscovered.

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The Role of a Good Quality Autopsy in Pediatric Malpractice Claim: A Case Report of an Unexpected Death in an Undiagnosed Thymoma

Cited by 3 publications

References 17 publications

Sudden Death in Adults: A Practical Flow Chart for Pathologist Guidance

Sudden Death in Adults: A Practical Flow Chart for Pathologist Guidance

Congenital Cystic Adenomatoid Malformation (CCAM) Type II: A Rare Case of Sudden Infant Death

Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report

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