Pediatric Cases That Composed Temporary Legal Report; Whom? When?

Abstract

Objective: Reports to legal authorities must be made for a variety of patients who present to emergency departments (EDs). This study summarises paediatric cases reported with a temporary legal form from our ED and reviews the literature on this topic with reasons and possibilities. Material and Methods: Charts were reviewed of all patients presenting to the university ED up to 18 years of age who were declared to hospital police as a legal case between January 1, 2008 and December 31, 2009. Demographic and clinical details were recorded. SPSS version 12 was used for statistical analysis. Results: During the study period, 889 paediatric cases (mean age 8±5 years, 58% male) were referred to the hospital police as cases requiring legal action. The categories of injuries/events to patients due to the chief complaint were as follows: poisonings in 28% (n=255), falls in 23% (n=208), and traffic accidents in 16% (n=144). Over half (55%) of patients were discharged home while 45% were admitted: 13% to paediatric surgery, 8% to neurosurgery, and 7% to paediatrics. Conclusion: Patients who were admitted to the emergency service due to falls could be reported to the legal authorities by doctors as a result of a suspicion of child abuse, neglect or any kind of physical violence instead of simple reasons due to the findings of the patients. It was observed that patients who had no significant physical findings or a history could not be reported.

Evaluation of Pediatric Forensic Cases in Emergency Department: A Retrospective Study

“…Pediatrik yaş grubu adli olgularda erkek cinsiyet genellikle daha fazla görülmektedir (9,(11)(12)(13). CDC verilerine göre ölümcül olmayan yaralanmalar 1-19 yaş aralığında erkek çocuklarda kız çocuklarına göre daha fazla görülmektedir (1).…”

“…Öz kıyım girişimi, iş kazası, düşme gibi adli olayların birçoğunun arkasında çocuk istismarı ve ihmali olabileceği şüphesi göz önünde bulundurulmalı ve buna yönelik bulgular aranmalıdır. Çünkü acil servis başvurularında belirgin fizik bulgu ya da öyküsü olmayan çocuk olguların adli olgu olarak değerlendirilmediği ve ihbar edilmediği izlenmiştir (12). Yapılan çalışmalarda 2-17 yaş aralığıdaki olguların %80'nin hayatında en az bir kez %13 olgunun da hayatı boyunca iki veya daha fazla kez şiddete maruz kaldığı belirtmektedir (30,31).…”

Trauma and Intentional Injury Characteristics of Pediatric Forensic Cases Applying to Emergency Room

“…However Çetinel et al [18] reported a rate Sexual abuse 1 100,0 0 0,0 *Includes cases of falls from the same level and from a height, ** Includes impact cases, hitting an object or hit with an object, ***Injury with sharp object, ****Firearm injury of 23.38%, higher than that generally stated in the literature. In our study poisoning cases (11.4%) were fourth in emergency services applications.…”

“…The majority of these cases (64.7%) were male patients. In international studies the poisoning rate is approximately 12%, while national studies generally show wide variations in poisoning rates, ranging from 5% to 30% [9,10,13,18]. Many studies state that head-neck and upper extremity regions are the most frequently injured body areas.…”

“…Nearly 2/3 of patients had mild injuries requiring basic medical intervention and they were discharged after outpatient treatment. Çetinel et al [18] reported that half of pediatric forensic applications required hospitalization. The death rate of these cases was 9.0%.…”