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    Evaluation of the Obstetrical Brachial Plexus Injuries with Forensic Perspective
    (Galenos Publ House, 2021) Akçakaya, Nihan Hande; Colak, Muhammed Selman; Sevin, Abdulvahap; Gurpinar, Kagan; Asliyuksek, Hizir; Orhan, Elif Kocasoy
    Aim: Obstetrical brachial plexopathy (OBP) is the loss of function of the brachial plexus due to a traumatic, idiopathic, or iatrogenic reason since birth. OBP mostly occurs with a traumatic background that is secondary to a difficult birth. In this study, we aimed to investigate the medical characteristics of the OBP cases, which were evaluated for malpractice reasons by the Forensic Medicine and define the features that should be considered in the forensic evaluation of OBP. Methods: The medical files of all cases with OBP evaluated in the 2nd Specialization Board of the Council of Forensic Medicine between 2013 and 2017 due to malpractice were included in the study. The dates of birth, maternal ages, comorbid diseases of the mother, the number of pregnancies, birthplaces and birth weeks, birth weights, and additional comorbid pathologies were investigated retrospectively. Results: A total of 287 cases were evaluated in this study. The mean age of forensic evaluation was found to be 2.9 +/- 2.3 years. All patients were born with vaginal delivery except one caesarean case. In 55% of cases had shoulder dystocia, 16% clavicle fracture, 4% humerus fracture and humeral head dislocation were detected. 23.3% of the cases had a history of a difficult birth and 11.5 % had assisted delivery. In 45% of cases had developmental pathologies accompanied by hypotonia. None of the cases were evaluated as medical malpractice. Conclusion: Standard medical records of cases with OBPs contained sufficient information for neurological and forensic evaluation. Our study shows the OBP's does not only originate from the traumatic etiology; about half of the cases have different comorbid pathologies, especially neurodevelopment problems. In order to achieve standardization and understand the comorbidities of plexopathy better, it would be appropriate to expand the medical data in detail.
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    Neonatal Hemorrhagic Disease and Malpractice
    (Galenos Publ House, 2022) Silahlı, Nicel Yıldız; Gurpinar, Kagan; Asliyuksek, Hizir; Celkan, Tulin Tiraje
    Introduction: Early, classical and late type hemorrhagic disease may develop as a result of the decrease in the synthesis of Factors II, VII, IX, and X in the newborn due to the low rate of transfer of vitamin K from the placenta in the prenatal period. Neonatal hemorrhagic disease can be significantly prevented with postnatal vitamin K prophylaxis. Although the clinical presentation varies, intracranial hemorrhage and multiple system hemorrhages can be seen. In the study, it was aimed to discuss the sociodemographic, clinical, radiological and laboratory characteristics of the cases that did not receive vitamin K prophylaxis and were reflected in the medicolegal process. Materials and Methods: The study was planned as a descriptive retrospective study. Between January 2017 and June 2021, 7 cases who underwent medicolegal evaluation with the diagnosis of Neonatal Hemorrhagic Disease in the 7th Specialization Board of Forensic Medicine were included in the study. Sociodemographic, clinical, radiological and laboratory features of the cases were retrospectively analyzed and recorded. Results: The age range of 5 (71%) male and 2 (28.5%) female cases was 15-49 days (median: 29 days). Allegations of medical malpractice in all cases; It was related to the fact that vitamin K prophylaxis was not applied and the diagnosis was insufficient in the follow-up. It was recorded that all of the cases did not receive vitamin K prophylaxis in the neonatal period. All of our cases presented with intracranial hemorrhage and recovered with neurological sequelae. In the evaluation of the committee, malpractice was detected in two cases, and no medical malpractice was found in 5 cases. Conclusion: Since neonatal hemorrhagic disease is a preventable condition with high morbidity and mortality, the application of vitamin K prophylaxis should be standardized by expanding it.