Retrospective analysis of anaesthesia-related deaths during a 12-year period: looking at the data from a forensic point of view

Abstract

Anaesthesia-related death is one of the most complex events to be studied in forensic pathology because of its rarity and its doubtful presentation. Particularly, the difficulties in assessing the cause of deaths in such circumstances are underlined. A scale must be considered in order to determine the causal role of anaesthesia in the process leading to death. Indeed, beyond deaths exclusively explained by anaesthetic care, there are deaths that are not anaesthesia-related and deaths explained by surgery and co-morbidities in which the role of anaesthetic care has to be carefully investigated. A retrospective analysis of 3138 autopsies is presented with the aim of better understanding the patho-physiological process of anaesthesia-related mortality and to determine the causal role of anaesthesiological care in the process leading to death, thus assessing the real incidence of deaths due to anaesthesia (0.16%). In the present study, the number of deaths generically anaesthesia-related (33 cases) accounts for 2.06% of autopsies due to medical malpractice claims and 1.05% of all autopsies. The number of deaths totally related to anaesthesic care is rather low with 0.32% of autopsies due to medical malpractice claims and 0.16% of all autopsies. Anaesthesia-related deaths were due to lack of or delay in intubation (2 cases), acute cardio-respiratory failure (2 cases) and anaesthetic-induced hepatotoxicity (1 case). The importance of a careful forensic investigation (clinical and familial history, medical records, complete autopsy and toxicology), which can lead to a clear understanding of anaesthesia-related deaths, is also stressed.

Auditory performance in a group of elderly patients after cochlear implantation

“…In this aspect, the influence of anaesthesia on mortality and postoperative morbidity is still controversially discussed in the medical literature [35][36][37]. The incidence of true anaesthesia-related mortality is low (0.014-0.16%) [38][39][40]. The rate of early and late complications depends on the study and varies between 6.9 and 25% [41][42][43][44].…”

The Emergence and Effects of the First Anatomy Theatres in Western Europe

“…It seems that Italy paved the way for human dissection in Europe first. Especially in the sixteenth century, Italy was a pioneer in the advancement of both technical and diagnostic anatomical research and training future doctors (Turillazzi et al, 2012;Sblano et al, 2014). Since cadaver supply was more accessible in Italian cities such as Padua and Bologna, medical students from many parts of Europe preferred these cities for their education (Vázquez et al, 2015).…”

Medical Therapy-Related Deaths and the Medical Examiner

“…Several authors have conducted retrospective reviews of autopsy reports to examine the number of suspected deaths due to medical therapy. These studies have focused on medical malpractice (13–17), therapeutic complications (18, 19), anesthesia-related deaths (20), medication-related deaths (21), and overall iatrogenic deaths (22, 23). Of note, only three of these studies were conducted in the United States (18, 19, 23).…”