Death Related to a Congenital Vascular Anomaly of Pulmonary Hamartoma Type: Malpractice or Tragic Fatality?

Abstract

In forensic pathology, apparently straightforward cases can often hide rarities that, if not correctly interpreted, can alter the results of the entire investigation, leading to misinterpretations. This occurs when the investigation is conducted to assess medical malpractice. An unexpected death, with no known apparent cause, is often linked to an underlying disease process of unclear etiological origin whose nature can, unfortunately, be properly investigated only post-mortem. This presentation shows a case study, in which it was possible to reconduct the death of a patient to a natural pathology and not to medical treatment. Here, the authors illustrate a case with a hamartoma developed in chronic inflammatory conditions (bronchiectasis) that was difficult to differentiate from lung cancer due to the inability to perform specific instrumental examinations. The hamartoma, usually benign and identifiable by standard instrumental investigations, in this case, led to the patient’s death precisely during the execution of a bronchoscopy. However, in the absence of a certain cause of death, public opinion unanimously attributes a patient’s disease to medical error. Indeed, a routine practice such as bronchoscopy should not cause death and consequently, the doctor must have made a mistake. Fortunately, the autopsy not only demonstrated the origin of the bleeding but also unveiled the reason for this, as rare congenital lung disease. Fate, one might say.

Bladder exstrophy-epispadias complex related litigation: A legal database review

“…Research exists regarding litigation in treatment and diagnosis of paediatric congenital anomalies including cardiac, vascular, respiratory, pharyngeal, and cleft lip cleft palate malformations. 8,13 –18 Within the field of paediatric urology, legal database reviews are limited. 9,12,19 Similar to our findings, litigation in these reviews most commonly relate to negligent surgical performance and post-operative surveillance and were decided in favour of the surgeon.…”

Photography as the Sole Means of Proof: Medical Liability in Dermatology

“…Is it right to put judicial protection first rather than patient care? In this scenario of “malpractice hunting,” the physician must be better protected and must, therefore, have the tools to defend himself, considering that the diagnosis of melanoma, as we have seen in our case, must be timely and the survival rate depends precisely on the celerity of the diagnosis [ 19 , 20 , 21 , 22 ]. Actually, it would suffice to comply with a protocol to be followed in the case of skin lesions that need removal.…”