MEDICAL MALPRACTICE VERDICTS OF HIGH COURT IN TURKEY

Amaç: İnsan sağlığının korunmasında ve geliştirilmesinde çok önemli rolü olan tıp biliminin uygulayıcıları zaman zaman bu görevlerini tam olarak yerine getirmedikleri iddiasıyla karşılaşmaktadır. Yüksek Yargıya taşınan bu olumsuz durumların incelenmesiyle hem tıp mensuplarının karşılaştıkları iddialara açıklık kazandırmak hem de uygulamada bu aksaklıkların giderilmesine katkı sağlamak amaçlanmıştır. Yöntemler: Bu çalışmada Türkiye'de 1978-2006 yılları arasında Yargıtay'a intikal etmiş 30 olgunun dosyaları retrospektif olarak incelenerek elde edilen veriler ilgili literatür ışığında tartışılmıştır. Bulgular: Yüksek yargıya yansıyan olguların %93'ünün (28 olgu) tazminat davası konusu olduğu belirlendi. Olayın gerçekleştiği zaman ile yargıtay kararları arasında 10 olguda 5-10 yıl arası iken 4 olguda sürenin 10 yılı geçtiği gözlendi. Yargılamaya konu olan tıbbi girişimlerin ölümle veya sekelle sonuçlanıp sonuçlanmamasının, yüksek yargı kararı çıkana kadar geçen süre ile anlamlı ilişkisinin olmadığı belirlendi (χ²=1,272; p=0,529). Sağlık çalışanlarının yüksek yargı organının kararlarına göre belirlenen kusur nedenleri arasında ilk sırada 14 hastada yanlış tedavinin geldiği (%47) bunu sırasıyla 10 hastada özen ve dikkat göstermeme (%33), 4 hastada (%13) ihmal, 2 hastada (%7) ise tanı hatasının takip ettiği gözlendi. Uzmanlık alanlarına göre kusur dağılımı incelendiğinde istatistiksel olarak anlamlı fark bulunmamıştır (χ²=15,152; p=0,651). Sonuç: Sağlık çalışanlarının önde gelen kusurlu bulunma nedenlerine dikkat çekilmeye çalışıldı. Tıbbi uygulama hatalarına yönelik yasal mevzuatın içeriğinin düzenlenmesi gerekliliği konusu tartışıldı. Objectıve: Medical malpractice claims increases against health professional and this issue gain importance in the world. Judgment involving inquiry and prosecution procedures are still dilemma for health professional in the world. The judgment on the verdict also takes interest of lawyers, patients. In this study, we aimed to discuss the verdicts of the High Court on malpractice cases. Methods: We presented thirty cases which have sentenced by the High Court of Turkey on medical malpractice claims and judgment between the years of 1978-2006. The files of these cases were examined retrospectively.Results: Of the cases, 93% (n=28) of verdicts were related to compensation. The period between the time that incident (event resulted to malpractice claim) occurred and the time of High Court sentence were longer than 10 years in 4 cases, between 5-10 years in 10 cases. Significant difference was not found in the outcomes of medical interventions resulted to death or functional losses between the period of time spent in justice (χ²=1.272; p=0.529). Causes of liabilities according to judgment; incorrect treatment was found in 14 cases (47%), lack of care and attention, careless in 10 cases (33%), negligence in 4 cases (13%) and misdiagnosis in 2 cases (7%) were observed. Significant difference was not found in the cases found liable between the specialties (χ²=15.152; p=0.651). Conclusıon: Major causes of liabilities were reviewed. The necessity of a malpractice legislation was discussed by the help of the literature

Sex Estimation From Sternal Measurements Using Multidetector Computed Tomography

We aimed to show the utility and reliability of sternal morphometric analysis for sex estimation. Sex estimation is a very important step in forensic identification. Skeletal surveys are main methods for sex estimation studies. Morphometric analysis of sternum may provide high accuracy rated data in sex discrimination. In this study, morphometric analysis of sternum was evaluated in 1mm chest computed tomography scans for sex estimation. Four hundred forty 3 subjects (202 female, 241 male, mean age: 44 +/- 8.1 [ distribution: 30-60 year old]) were included the study. Manubrium length (ML), mesosternum length (2L), Sternebra 1 (S1W), and Sternebra 3 (S3W) width were measured and also sternal index (SI) was calculated. Differences between genders were evaluated by student t-test. Predictive factors of sex were determined by discrimination analysis and receiver operating characteristic (ROC) analysis. Male sternalmeasurement values are significantly higher than females (P< 0.001) while SI is significantly low in males (P< 0.001). In discrimination analysis, MSL has high accuracy rate with 80.2% in females and 80.9% in males. MSL also has the best sensitivity (75.9%) and specificity (87.6%) values. Accuracy rates were above 80% in 3 stepwise discrimination analysis for both sexes. Stepwise 1(ML, MSL, S1W, S3W) has the highest accuracy rate in stepwise discrimination analysis with 86.1% in females and 83.8% in males. Our study showed that morphometric computed tomography analysis of sternum might provide important information for sex estimation

Evaluation of the Cases Admitted to the Disability Board After A Traffic Accidental Head Trauma, in Terms of Neuropsychiatric Sequelae

Objective:Trauma is the most important cause of death in underdeveloped and developing countries. Although the brain has protective layers such as the cranium and scalp, it can be damaged as a result of various traumas, causing permanent neurological and psychiatric sequelae. In our study, we aimed to evaluate the demographic data of patients who applied to our department to be evaluated in terms of disability after head trauma due to a traffic accident, and to emphasize that objective data criteria are required in the evaluation of neuropsychiatric sequelae.Methods:Sociodemographic characteristics, neuropsychiatric complaints, neuropsychological testing results and disability rate/duration of patients evaluated in the disability board of our department between 01.01.2019-31.12.2020.Results:It was observed that 579 of the patients investigated during the study period had head trauma. It was observed that 173 of 579 patients had intracranial injury and neuropsychiatric sequelae and a related disability rate was determined. 79.2% of the cases were male, 20.8% were female, the mean age was 29.6±15.6. Most common symptoms were dementia in 113 cases (65.3%), headache in 60 cases (34.6%) and psychiatric complaints in 48 cases (27.7%).Conclusion:As a result of the study, it was seen that neuropsychiatric sequelae due to head trauma are quite common and varied. The severity of the trauma and clinical situation should be determined by objective criteria. Detailed examination, neuropsychological testing and radiological examinations will prevent such cases from being overlooked

Bose-Einstein correlations of charged hadrons in proton-proton collisions at s\sqrt s = 13 TeV

Bose-Einstein correlations of charged hadrons are measured over a broad multiplicity range, from a few particles up to about 250 reconstructed charged hadrons in proton-proton collisions at $\sqrt{s}$ = 13 TeV. The results are based on data collected using the CMS detector at the LHC during runs with a special low-pileup configuration. Three analysis techniques with different degrees of dependence on simulations are used to remove the non-Bose-Einstein background from the correlation functions. All three methods give consistent results. The measured lengths of homogeneity are studied as functions of particle multiplicity as well as average pair transverse momentum and mass. The results are compared with data from both CMS and ATLAS at $\sqrt{s}$ = 7 TeV, as well as with theoretical predictions.[graphic not available: see fulltext]Bose-Einstein correlations of charged hadrons are measured over a broad multiplicity range, from a few particles up to about 250 reconstructed charged hadrons in proton-proton collisions at $\sqrt{s} =$ 13 TeV. The results are based on data collected using the CMS detector at the LHC during runs with a special low-pileup configuration. Three analysis techniques with different degrees of dependence on simulations are used to remove the non-Bose-Einstein background from the correlation functions. All three methods give consistent results. The measured lengths of homogeneity are studied as functions of particle multiplicity as well as average pair transverse momentum and mass. The results are compared with data from both CMS and ATLAS at $\sqrt{s} =$ 7 TeV, as well as with theoretical predictions

Search for dark matter in events with a leptoquark and missing transverse momentum in proton-proton collisions at 13 TeV

A search is presented for dark matter in proton-proton collisions at a center-of-mass energy of root s= 13 TeV using events with at least one high transverse momentum (p(T)) muon, at least one high-p(T) jet, and large missing transverse momentum. The data were collected with the CMS detector at the CERN LHC in 2016 and 2017, and correspond to an integrated luminosity of 77.4 fb(-1). In the examined scenario, a pair of scalar leptoquarks is assumed to be produced. One leptoquark decays to a muon and a jet while the other decays to dark matter and low-p(T) standard model particles. The signature for signal events would be significant missing transverse momentum from the dark matter in conjunction with a peak at the leptoquark mass in the invariant mass distribution of the highest p(T) muon and jet. The data are observed to be consistent with the background predicted by the standard model. For the first benchmark scenario considered, dark matter masses up to 500 GeV are excluded for leptoquark masses m(LQ) approximate to 1400 GeV, and up to 300 GeV for m(LQ) approximate to 1500 GeV. For the second benchmark scenario, dark matter masses up to 600 GeV are excluded for m(LQ) approximate to 1400 GeV. (C) 2019 The Author(s). Published by Elsevier B.V.Peer reviewe

Measurement of electroweak WZ boson production and search for new physics in WZ + two jets events in pp collisions at √s=13TeV

A measurement of WZ electroweak (EW) vector boson scattering is presented. The measurement is performed in the leptonic decay modes WZ→ℓνℓ′ℓ′, where ℓ,ℓ′=e,μ. The analysis is based on a data sample of proton-proton collisions at √s=13 TeV at the LHC collected with the CMS detector and corresponding to an integrated luminosity of 35.9 fb−1. The WZ plus two jet production cross section is measured in fiducial regions with enhanced contributions from EW production and found to be consistent with standard model predictions. The EW WZ production in association with two jets is measured with an observed (expected) significance of 2.2 (2.5) standard deviations. Constraints on charged Higgs boson production and on anomalous quartic gauge couplings in terms of dimension-eight effective field theory operators are also presented

Azimuthal separation in nearly back-to-back jet topologies in inclusive 2-and 3-jet events in pp collisions at root s=13TeV

A measurement for inclusive 2- and 3-jet events of the azimuthal correlation between the two jets with the largest transverse momenta, Delta phi(12), is presented. The measurement considers events where the two leading jets are nearly collinear ("back-to-back") in the transverse plane and is performed for several ranges of the leading jet transverse momentum. Proton-proton collision data collected with the CMS experiment at a center-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 35.9 fb(-1) are used. Predictions based on calculations using matrix elements at leading-order and next-to-leading-order accuracy in perturbative quantum chromodynamics supplemented with leading-log parton showers and hadronization are generally in agreement with themeasurements. Discrepancies between the measurement and theoretical predictions are as large as 15%, mainly in the region 177 degrees <Delta phi(12) <180 degrees. The 2- and 3-jet measurements are not simultaneously described by any of models.Peer reviewe

Search for an L-mu - L-tau gauge boson using Z -> 4 mu events in proton-proton collisions at root s=13 TeV

A search for a narrow Z' gauge boson with a mass between 5 and 70 GeV resulting from an L-mu - L-tau U (1) local gauge symmetry is reported. Theories that predict such a particle have been proposed as an explanation of various experimental discrepancies, including the lack of a dark matter signal in direct-detection experiments, tension in the measurement of the anomalous magnetic moment of the muon, and reports of possible lepton flavor universality violation in B meson decays. A data sample of proton-proton collisions at a center-of-mass energy of 13 TeV is used, corresponding to an integrated luminosity of 77.3 fb(-1) recorded in 2016 and 2017 by the CMS detector at the LHC. Events containing four muons with an invariant mass near the standard model Z boson mass are analyzed, and the selection is further optimized to be sensitive to the events that may contain Z -> Z'mu mu -> 4 mu decays. The event yields are consistent with the standard model predictions. Upper limits of 10(-8)-10(-7) at 95% confidence level are set on the product of branching fractions B(Z -> Z'mu mu)B(Z' -> mu mu), depending on the Z' mass, which excludes a Z' boson coupling strength to muons above 0.004-0.3. These are the first dedicated limits on L-mu - L-tau models at the LHC and result in a significant increase in the excluded model parameter space. The results of this search may also be used to constrain the coupling strength of any light Z' gauge boson to muons. (C) 2019 The Author(s). Published by Elsevier B.V.Peer reviewe

Studies of Beauty Suppression via Nonprompt D-0 Mesons in Pb-Pb Collisions at root s(NN)=5.02 TeV

The transverse momentum spectra of D-0 mesons from b hadron decays are measured at midrapidity (vertical bar y vertical bar D-0 yield is found to be suppressed in the measured p(T) range from 2 to 100 GeV/c as compared to pp collisions. The suppression is weaker than that of prompt D-0 mesons and charged hadrons for p(T) around 10 GeV/c. While theoretical calculations incorporating partonic energy loss in the quark-gluon plasma can successfully describe the measured B -> D-0 suppression at higher p(T), the data show an indication of larger suppression than the model predictions in the range of 2 <p(T) <5 GeV/c.Peer reviewe

Observation of the χb1(3P)\chi_{b1}(3P) and χb2(3P)\chi_{b2}(3P) and measurement of their masses

The $\chi_{b1}(3P)$ and $\chi_{b2}(3P)$ states are observed through their $\gamma(3S)_\gamma$ decays, using an event sample of proton-proton collisions collected by the CMS experiment at the CERN LHC. The data were collected at a center-of-mass energy of 13 TeV and correspond to an integrated luminosity of $80.0  fb^{−1}$. The$\gamma(3S)$ mesons are identified through their dimuon decay channel, while the low-energy photons are detected after converting to $e^+e ^−$ pairs in the silicon tracker, leading to a $\chi_{b1}(3P)$ mass resolution of 2.2 MeV. This is the first time that the J=1 and 2 states are well resolved and their masses individually measured: $10513.42±0.41(stat)±0.18(syst)  MeV$ and $10524.02±0.57(stat)±0.18(syst)  MeV$; they are determined with respect to the world-average value of the $\gamma(3S)$ mass, which has an uncertainty of 0.5 MeV. The mass splitting is measured to be $10.60±0.64(stat)±0.17(syst)  MeV$