Abstract and keywords
Abstract (English):
The article considers the clinical and forensic aspects of the possibility of establishing a causal relationship between the use of the drug “Naropin” and the death of a patient during local anesthesia. In this case, the patient sought outpatient medical care for paraproctitis. The decision made by the doctor the decision for local anesthesia is the use of the drug “Naropin”. At 20 minutes of administration of the drug in the required dosage, the patient suddenly developed convulsions and clinical death occurred, and later the patient died. When conducting a forensic examination of the corpse, the most significant was the following: a small pinpoint wound in the upper quadrant of the right buttock, pulmonary edema, liquid blood and small loose blood clots in the heart cavities, brain edema. During a post-mortem Toxicological examination of the blood, the presence of ropivacaine (a component of naropine) was found to exceed the threshold toxic concentration. Repeated expert research has found that led to the onset of death-the erroneous introduction of the anesthetic “Naropin” directly into the blood vessel, which is prohibited by the instructions for its use due to a very narrow zone of toxic action.

Keywords:
naropin, forensic medical examination, toxicology, medical error, cause and effect, iatrogeny
References

1. Belyh A.N., Bozhchenko A.P., Tolmachev I.A. Osobennosti semiotiki i metodologii medicinskoy diagnostiki i svyazannye s nimi prichiny gnoseologicheskih oshibok // Medicinskaya ekspertiza i pravo. 2016. № 6. S. 14-19.

2. Ovechkin A.M., Gnezdilov A.V. Naropin (ropivakain) v lechenii boli: ideal'nyy vybor? // Vestnik intensivnoy terapii. 2000. № 3. S. 13-17.

3. Sudebnaya medicina kak kolybel' otechestvennoy toksikologii / V.L. Popov, A.N. Grebenyuk, Yu.I. Pigolkin i dr. // Sudebno-medicinskaya ekspertiza. 2013. № 5. S. 57-61.

4. Hrustaleva Yu.A. Prichinno-sledstvennye svyazi v sudebnoy medicine: soderzhanie, sposoby vyyavleniya i znachenie pri mehanicheskoy travme: dis. … d-ra med. nauk -14.03.05. SPb., 2018. 392 s.

5. Leone S., Di Cianni S., Casati A., Fanelli G. Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine // Acta biomed. 2008, vol. 79. P. 92.

Login or Create
* Forgot password?