The retention of gauze within the mediastinum is considered an exceptional finding. We are presenting the case of a woman, affected by aorto-mitral valvulopathy, in whose mediastinum was found, during the autopsy, a gauzome without signs of active phlogosis, which had been "forgotten" in a previous surgery, acted 14 years before the death. A 39 y.o. woman had received surgical treatment of double aorto-mitral valve substitution and tricuspid plastic. At age 53, she successfully received surgery once again at a different hospital; she then started rehabilitation therapy, during which she deceased due to sudden hematemesis with infectious multi organ failure. During the autopsy, a 5 cm long surgical gauze was found in the mediastinum. A SEM/EDX (Scanning Electron Microscopy with Energy Dispersive X-ray spectroscopy) exam was ran on the foreign body and a sample of the same gauze used in the cardiac-surgical department of the hospital the victim had passed away in, to act a comparison between the two kinds of material. The exam showed a morphological difference between exogenous fibers incorporated within the gauzome and the control gauze. This case highlights the diagnostic and interpretative challenges in finding a foreign body within the mediastinum without signs of active phlogosis. SEM/EDX investigations executed on the gauzome and a "control gauze" allowed the attribution of malpractice to the first hospital the victim had been operated in 14 years before the exitus. The SEM/EDX exam confirms its importance in correctly identifying the case, which becomes an example for similar happenings.
Can SEM/EDX analysis be useful in prosecution of medical malpractice? / G. Gentile, S. Tambuzzi, R. Zoia. - (2020 Dec 02).
|Titolo:||Can SEM/EDX analysis be useful in prosecution of medical malpractice?|
GENTILE, GUENDALINA (Primo)
TAMBUZZI, STEFANO (Secondo)
ZOIA, RICCARDO (Ultimo) (Corresponding)
|Parole Chiave:||autopsy; forensic pathology; iatrogenic foreign body; malpractice; SEM/EDX analysis|
|Settore Scientifico Disciplinare:||Settore MED/43 - Medicina Legale|
|Data di pubblicazione:||2-dic-2020|
|Appare nelle tipologie:||23 - Pubblicazione su portale|