مجله پزشکی قانونی
سال دهم شماره 2 (پیاپی 34، تابستان 1383)

In spite of efforts of medical staff and also the progress made in treatment technology, today the patient dissatisfaction and complaints are increasing. On the one hand, this could be a result of medical mistakes, on the other hand, the root of the problem is doctors` failure in establishing a close relationship with their patients which has recently been the main reason for bringing an action against them. This study which was a cross sectional descriptive one was carried out in 2001 -2002 on 768 cases of complaint about medical negligence in the medical commission of Legal Medicine Organization of Iran.Using SPSS helped in analysis of the data. Ninety seven cases (%12.63) were about medical negligence in obstetric and gynecology. After a thorough study, among 97 cases,there had been some medical negligence in 41 cases. It had been recognized that obstetric and gynecology specialists in 36 cases (%37.11), obstetric staff in 9 cases (%9.28) and anaesthesiology staff in 4 cases (%4.12) were negligent of their duties. Most complaints were about death of the patient (43 cases, %44.33) including 23 neonates, 17 pregnant women and 3 women who were not pregnant. Legally speaking, the most common sorts of negligence had been lack of expertise and carelessness, respectively. Among these cases, most complaints in 38 cases(%39.8) had been reported from private centers and among all cases of negligence which were confirmed, the number of ones related to university centers were less than those of other treatment centers. Obstetricians and gynecologists are recommended not only to behave well towards patients andtheir relatives but also inform them about unpredictable and possible complications of any medical treatmentas well. They should hold meetings to advise patients and pay much attention and care to them before and aftersurgery.Also doctors should be instructed on their legal issues of their preofession.

The study is aimed at comparing family functioning of divorcingand non-divorced couples. This is a descriptive and cross – sectional (ex post factor) study. Subjects were 26 divorcing couples referred to the psychiatric ward of forensic medicine organization and 40 non divorced couples. They were selected by convenient sampling methods on the basis of predetermined criteria. Reseach tools were psychiatric interview, General Health Questionnaire (GHQ) and Family Assessment Device (FAD). Data were analyzed using t – student test for unequally sized, logestic linear regression, variance analysis, Tukey’s HSD test and also descriptive statistics. Results show that the probability of occuring divorce has been estimated at 0.34 by family functioning, also two subscales "family problem solving " and "general family functioning " are the best precipitating factors for divorcing. Also, education plays an effective role in maintaining the family system and disorders in the four dimensions of FFD will demonstrably increase divorce.

Suicide with firearms is common in European and North American countries, but because of limited access to firearms in Iran, it is seen in Iran much less than suicide by hanging, self-burning or self-poisonning. However, due to an increase in firearms imported by way of smuggling through eastern and western boundaries and also access of military personnel and police agents and in particular conscripts, to firearms, it seems necessary to pay more attention to this matter. The data regarding firearms mortality were gathered on the basis of forms about cases of suspected suicide, made available by the statistics department of Iranian LMO. For data about world statistics valid saurces were used. In 2001, nearly 8 percent of suidcides resulting in death were performed using firearms. The rate of this kind of suidice was 0.42 in 100000 of general population and some provinces (Kermanshah, Ilam and Lorestan) had higher than average rates. Nearly four fifth of subjects were unmarried 55.7 percent of them were between 16 to 20 and 22.7 percent of them were in the age group of 21-25. Most cases of suicide have happened in military facilities or guard houses. The rate was highest at summers and lowest at winters. Smuggling of firearms into western and eastern regions of the country and easier access to firearms in these regions has resulted in higher rates of suicide using firearms. Also a large part of cases are performed by conscripts, that considering social and mental problems of this particular group has special importance.

Commenting on injuries in cases referred to LMO requires specific knowledge in this field.Therefore a research project was carried out for the first time in 2001 at Legal Medicine Organization in orderto develop new methods through reviewing earlier methods of evaluation of ear trauma. In this study, 532 cases who were Referred to Legal Medicine Organization in 1380 becauseof ear trauma were evaluated. Data was collected through history, physical examination, paraclinic tests asrecorded in information forms, then Analyzed by SPSS. 71.8 Percent of cases were male (382 cases) and 28.19 percent of them were female (150 cases). Inphysical examination, 288 cases had perforated tympanic membrane and 10 cases (3.47 percent) had accidentinduced injury. 90.63 percent of cases healed up spontaneously and 9.37 needed surgery.In 48.14 percent healing occurred after 3 weeks but in 51.85 percent took more than 3 weeks. Because of insufficient duration of treatment (3week) in 51.85 percent of perforated tympanicmembrane cases, it’s better to spend much time to make forensic physician’s work easier, saving much timeand money and prevent prolongation of legal procedure.

Suicide is threatening self injury with informed aim, accounting for 0.4-0.9% of all cases of death. Among adolescents, suicide is the third leading cause and in young people, suicide is the seventh cause of death. Regarding to young population and increasing suicideal rate in recent years and time and cost required for recovery of patients, survey of suicidal causes is essential. In this cross-sectional study, we designed a questionnaire containing demographic and social objects and underlying causes of suicide. After daily going to hospital and interview with patients, results were collected. Data were analyzed by SPSS ver 9 software and X2 test with confidence interval 95%. from 240 suicidal attempt, 98 cases (40.8%) were male and 142 cases (59.2%) were female. Most cases were 15-19 years (33.3%) and were educated in guidance school (30.4%). In 22.9% cases, there was history of suicidal attempt. Familial discord (54.6%), love related emotional disorder 18.8%), economic problems (8.3%), physical or psychological disorders (7.9%) and other predisposing causes (7.9%) were the major causes of suicide and in 2.5%, predisposing factor was not detected. There was significant difference between married and non-married and below 25 and more than 25 years old (Pvalue 0.05). Familial discord is the major risk factor of suicide that would necessitate the founding of consultation centers for adolescents and youths in order to meet their needs, answer their questions and give them guidance and support. Love-related emotional problems constitute the second most important factor that threatens young people. Thus, they should be persuaded to seek professional help and encouraged to frankly express their feelings to specialist in order that appropriate guidance be provided.

Interpersonal violence is a significant public health problem throughout the world. This study aims to clarify the pattern of interpersonal violence in six trauma centers in Tehran. In this cross-sectional study, Victims of as assault-related injuries in a data registry established by Sina Trauma Research Center were studied. Most of our 479 studied cases were young males. Men and women were more commonly injured in streets and at home, respectively (P<0.001). Men and women more frequently suffered from penetrating and blunt injuries, respectively. Assault by sharp objects was the predominant mechanism of trauma followed by unarmed bodily force. Upper extremities were the most common sites of injuries followed by crainium and face, chest, abdomen and lower extremities. Mean length of stay in hospital was 4.1 days and 76.4% of cases had no source of reimbursement. The frequencies with which knives are used are worrisome (42.6% of all assaults). This is probabley due to lack of any practical laws against wearing sharp weapons in public and the unavailability of firearms due to strict legislations one ownership of warm weapons. Although control of ownership and wearing of knives and other sharp objects are practically more difficult than firearms, it seems to be worth trying especially in the developing countries.

Low-velocity wounding agents characteristically penetrate the thinnest parts of the cranial bone. One of these areas is the orbital roof and there are rare case reports of such foreign bodies with transorbital penetration into the cranial space. In near by all of such cases mortality is inevitable and in the rest injury to the globe and permanent neurologic complications will occur. In this article, we report the case, a young man with a radio antenna of a car that pierced his left orbital cavity and reached the temporal lobe without any eye damage or significant complications.

Negligence, as a tort, is the breach of a duty caused by omission to do something which a reasonable person would do, or doing something which a prudent and reasonable person would not do. It has many manifestations, it may be active or passive negligence, collateral negligence, comparative negligence, concurrent negligence and willful or reckless negligence. It is not unusual to find allegations of negligence being reported against doctors by the print and the electronic media nowadays. This article reviews the various features of negligence, the legal aspects thereof and the defenses of a doctor in a suit of neglig