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确定药物性精神病患者的死亡方式:一例非典型头部刺伤病例

Determining the manner of death in victims in drug-induced psychosis: a case of an atypical head stab wound.

作者信息

Handlos Petr, Klabal Ondřej, Vojtek Vladimír, Handlosová Klára, Krejčí Tomáš, Uvíra Matěj

机构信息

Department of Forensic Medicine, University Hospital Ostrava, 70852, Ostrava, Czech Republic.

Department of Forensic Medicine, Faculty of Medicine, University of Ostrava, 701 03, Ostrava, Czech Republic.

出版信息

Forensic Sci Med Pathol. 2024 Dec;20(4):1458-1463. doi: 10.1007/s12024-024-00784-w. Epub 2024 Mar 27.

Abstract

This case report presents a rare case of an atypical head stab wound suffered by a drug addict and inflicted with a screwdriver during drug-induced psychosis. It describes the diagnostic and treatment procedures in the hospital and the findings of the subsequent autopsy. It also analyzes the review of the interpretation of the CT scans made upon admission and the subsequent treatment by an independent medical review panel, which revealed signs of medical mismanagement. Therefore, it also discusses the legal consequences that the case may have involved for the attending physicians in addition to the consequences for the suspected perpetrator. The report raises many issues encountered in the case in terms of the clinical treatment and forensic determination of the manner of death in cases of injuries caused by sharp instruments and highlights the importance of comprehensive evaluation of the circumstantial evidence together with the clinical or autopsy findings, since such evidence may sometimes be overlooked in clinical practice.

摘要

本病例报告呈现了一例罕见的非典型头部刺伤案例,受害者为一名吸毒成瘾者,在药物所致精神错乱期间被螺丝刀刺伤。报告描述了在医院的诊断和治疗过程以及后续尸检的结果。它还分析了由独立医学审查小组对入院时所做的CT扫描解读及后续治疗情况的审查,结果显示存在医疗管理不当的迹象。因此,报告除了讨论该案件对疑似行凶者的影响外,还探讨了其可能给主治医生带来的法律后果。该报告提出了在锐器致伤案件中临床治疗和法医判定死亡方式方面遇到的诸多问题,并强调了将间接证据与临床或尸检结果进行综合评估的重要性,因为这类证据在临床实践中有时可能被忽视。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1adf/11790715/b3aa5cd8c3da/12024_2024_784_Fig1_HTML.jpg

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