Ehrlich Edwin, Riesselmann Benno, Tsokos Michael
State Institute of Legal and Social Medicine, Turmstrasse 21, Haus L, 10559 Berlin, Germany.
Leg Med (Tokyo). 2009 Apr;11 Suppl 1:S100-2. doi: 10.1016/j.legalmed.2009.01.016. Epub 2009 Feb 28.
Patient deaths in hospitals due to medical staff are very rare. In the autumn of 2006, preliminary proceedings were initiated against a nurse on account of an overdose of medication leading to death, administered during her care of the patient. In the course of these proceedings, exhibits relating to the deaths of a total of 13 patients who had died due to chemical-toxicological causes were reviewed. Nine of them were exhumed. On average, death had occurred 22 months prior to exhumation (range of 1-34 months). The average age of the deceased was 76 years (range of 65-92 years). In five of the cases, analysis results and an evaluation of the medical records confirmed that a final, undocumented dose of sodium nitroprusside or midazolam was administered. After administration of sodium nitroprusside, the active agent rapidly releases nitrogen monoxide, itself undetectable. Another indicator that can be detected, however, is the cyanide that is also released. In one of the exhumed patients, cyanide could still be detected 18 months after death. The nurse stated that her motive was sympathy towards seriously ill patients. She was sentenced res judicata to life imprisonment on five counts of causing the death of a patient.
医院中因医护人员导致的患者死亡极为罕见。2006年秋,针对一名护士展开了初步调查程序,该护士在护理患者期间因用药过量导致患者死亡。在这些程序过程中,对总共13名因化学 - 毒理学原因死亡患者的死亡相关证据进行了审查。其中9名患者被挖掘尸体。平均而言,死亡发生在挖掘尸体前22个月(范围为1 - 34个月)。死者的平均年龄为76岁(范围为65 - 92岁)。在5例案件中,分析结果和病历评估证实,最后使用了未记录的硝普钠或咪达唑仑剂量。使用硝普钠后,活性剂会迅速释放一氧化氮,一氧化氮本身无法检测到。然而,另一种可检测到的指标是同时释放的氰化物。在一名挖掘尸体的患者中,死后18个月仍能检测到氰化物。该护士称其动机是同情重症患者。她因五项导致患者死亡罪名被终审判决终身监禁。