Deontological examination: Clinical and forensic medical diagnoses discrepancies

• Main Authors: Sandra Mazeikiene, Sigitas Laima, Sigitas Chmieliauskas, Dmitrij Fomin, Gerda Andriuskeviciute, Mante Markeviciute, Audrone Matuseviciute, Algimantas Jasulaitis, Jurgita Stasiuniene
• Format: Article
• Language: English
• Published: SpringerOpen 2016-12-01
• Series: Egyptian Journal of Forensic Sciences
• Subjects: Forensic medical deontological examination; Final diagnosis; Main disease; Physicians
• Online Access: http://www.sciencedirect.com/science/article/pii/S2090536X16000198

Background: Globally, the frequency of discrepancies between clinical and forensic medical diagnoses is about 30%. The most common errors made during determination are the main disease pathogenesis and tanatogenesis. Aims: To identify the causes of incorrect diagnosis determination and suggest the rules for the precise diagnosis formulation. Materials and methods: A retrospective analysis of the forensic medical deontological examinations from the case histories data of the State Forensic Medicine Service has been done from 1984 to 2014. There were 1192 forensic medical deontological examinations. A descriptive method was used. The foreign literature data was analysed in order to compare the results for a comprehensive study. Results: 1192 deontological expertises were analysed during 1984–2014. This study revealed that 37% of clinical and forensic medical diagnosis did not match completely, 24% – matched partially, 37% – matched. Majority of the discrepancies between diagnoses were identified of surgeons – 13.42%, obstetricians-gynecologists – 8.10%, neurosurgeons – 7.34%, and 23% of all cases when a person was treated at the intensive care unit. Conclusions: More common discrepancies between diagnoses were identified of surgeons, obstetricians-gynecologists, neurosurgeons and when a person was treated at the intensive care unit. Frequency of discrepancies between clinical and forensic medical diagnoses is growing. The correct formulation of the clinical diagnosis is the first step towards a proper treatment. The final diagnosis should consist of three sections: main disease/injury, pathology followed by the complications and the accompanying conditions of the patient.