Preservation of evidence during pediatric organ donation: a modified thoracotomy procedure designed to increase consent in medical examiner cases.
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Deceased potential organ donors are often under the jurisdiction of medical examiners/ coroners. In these deaths, the medical examiner/coroner has the statutory responsibility of determining cause and manner of death but is also responsible for presenting findings from the complete autopsy in court. The ability to analyze findings such as location, nature, and age of rib fractures and patterned skin injuries may be crucially important to legal disposition, even though those findings may not be critical to determination of cause and/or manner of death. Potential alteration or destruction of those findings is one reason why a medical examiner/coroner may deny organ donation. We present here a modified surgical approach to accessing thoracic organs in children so that posterior rib fractures, which have particular significance in child abuse cases, can be preserved unaltered for subsequent autopsy. This simple modification of surgical technique has greatly facilitated the mutual goals of the medical examiner and the designated organ procurement organization in our jurisdiction, and it has thus decreased the frequency of denials of organ donation. (+info)
Axonal injury in young pediatric head trauma: a comparison study of beta-amyloid precursor protein (beta-APP) immunohistochemical staining in traumatic and nontraumatic deaths.
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Can we use medical examiners' records for suicide surveillance and prevention research in Nova Scotia?
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INTRODUCTION: Medical examiners' records can contribute to our understanding of the extent of suicide in a population, as well as associated sociodemographic and other factors. METHODS: Using a mixed methods approach, the key objective of this pilot study was to determine the sources and types of information found in the Nova Scotia Medical Examiner Service (NSMES) records that might inform suicide surveillance and targeted prevention efforts. A secondary objective was to describe the one-year cohort of 108 individuals who died by suicide in 2006 in terms of available sociodemographic information and health care use in the year prior to death. RESULTS: Data extraction revealed inconsistencies both across and within files in terms of the types and amounts of sociodemographic and other data collected, preventing correlational analyses. However, linkage of the records to administrative databases revealed frequent health care use in the month prior to death. CONCLUSION: The introduction of systematic data collection to NSMES investigations may yield a comprehensive dataset useful for policy development and population level research. (+info)
Impact of the growing use of narrative verdicts by coroners on geographic variations in suicide: analysis of coroners' inquest data.
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