Jaweher Kammoun

Atrav s de um estudo prospectivo descritivo dos atestados de bito m dico (CDMs) recebidos pelo departamento de medicina legal da Sfax-Tun sia, nossos objetivos foram estudar o conte do dos CDMs, avaliar a qualidade da escrita, analisar os erros de escrita e propor recomenda es pr ticas para a cria o dos CDMs. Classific mos os erros de escrita em seis erros maiores e cinco menores. Foram recolhidas 74 certid es de bito. A conclus o da sec o administrativa foi satisfat ria, com uma m dia de 13 dos 20 crit rios cumpridos. As quatro caixas de dados m dico-legais foram preenchidas em mais de tr s quartos dos certificados. O erro maior mais frequente foi a men o do mecanismo de morte sem causa de morte em 59,5% dos casos. Quanto aos erros menores, a presen a de abreviaturas foi de longe o erro mais frequente (em 87,8% dos casos). Nosso estudo mostrou que a qualidade das certid es de bito sofre de v rias defici ncias, o que nos leva a fazer mais esfor os na forma o de m dicos.

Through a prospective descriptive study of medical death certificates (MDCs) received by the forensic medicine department of Sfax-Tunisia, our objectives were to study the content of the MDCs, to evaluate the quality of writing, to analyze the writing errors and to propose practical recommendations for the establishment of MDCs. We classified the writing errors into six major and five minor errors. 74 death certificates were collected. The completion of the administrative section was satisfactory with an average of 13 out of 20 criteria met. The four boxes for medico-legal data were completed in more than three quarters of the certificates. The writing of the medical part was the source of almost all the writing errors. The most frequent major error was the mention of the mechanism of death alone without the cause of death in 59.5%. As for the minor errors, the presence of abbreviations was by far the most frequent error (in 87.8% of cases). Our study showed that the quality of death certificate writing suffered from several shortcomings, which encourages us to make more effort in training doctors.

Im Rahmen einer prospektiven deskriptiven Studie ber rztliche Todesbescheinigungen, die bei der gerichtsmedizinischen Abteilung von Sfax-Tunesien eingegangen sind, haben wir uns zum Ziel gesetzt, den Inhalt der Todesbescheinigungen zu untersuchen, die Qualit t des Schreibens zu bewerten, die Schreibfehler zu analysieren und praktische Empfehlungen f r die Erstellung von Todesbescheinigungen vorzuschlagen. Wir haben die Schreibfehler in sechs gr ere und f nf kleinere Fehler eingeteilt. 74 Sterbeurkunden wurden gesammelt. Der administrative Teil wurde mit durchschnittlich 13 von 20 erf llten Kriterien zufriedenstellend abgeschlossen. In mehr als drei Viertel der Bescheinigungen wurden die vier Felder f r die rechtsmedizinischen Angaben ausgef llt. Der h ufigste schwerwiegende Fehler war in 59,5 % der F lle die alleinige Nennung des Todesmechanismus ohne Angabe der Todesursache. Bei den geringf gigen Fehlern war das Vorhandensein von Abk rzungen der mit Abstand h ufigste Fehler (in 87,8 % der F lle). Unsere Studie hat gezeigt, dass die Qualit t der Totenscheine mehrere M ngel aufweist, was uns dazu veranlasst, mehr Anstrengungen bei der Ausbildung der rzte zu unternehmen.

Attraverso uno studio prospettico descrittivo dei certificati medici di morte (MDC) ricevuti dal dipartimento di medicina legale di Sfax-Tunisia, i nostri obiettivi erano di studiare il contenuto degli MDC, di valutare la qualit della scrittura, di analizzare gli errori di scrittura e di proporre raccomandazioni pratiche per l'elaborazione degli MDC. Abbiamo classificato gli errori di scrittura in sei errori maggiori e cinque minori. Sono stati raccolti 74 certificati di morte. Il completamento della sezione amministrativa stato soddisfacente con una media di 13 su 20 criteri soddisfatti. Le quattro caselle per i dati medico-legali sono state compilate in pi di tre quarti dei certificati. L'errore maggiore pi frequente stata la menzione del solo meccanismo di morte senza la causa della morte nel 59,5% dei casi. Per quanto riguarda gli errori minori, la presenza di abbreviazioni stata di gran lunga l'errore pi frequente (nell'87,8% dei casi). Il nostro studio ha dimostrato che la qualit dei certificati di morte soffre di diverse carenze, il che ci spinge a fare pi sforzi nella formazione dei medici.

Via une tude prospective descriptive des certificats m dicaux de d c s (CMD) parvenus au service de m decine l gale de Sfax-Tunisie, nos objectifs taient d' tudier le contenu des CMD, d' valuer la qualit de r daction, d'analyser les erreurs de r daction et de proposer des recommandations pratiques pour l' tablissement des CMD. Nous avons classe les erreurs de r daction en six erreurs majeures et cinq mineures. Nous avons collig 74 certificats de d c s. Le remplissage du volet administratif a t satisfaisant avec une moyenne de 13 crit res remplis sur 20. Les quatre cases des donn es m dico-l gales ont t remplies dans plus des trois quarts des certificats. La r daction de la partie m dicale a t l'origine de la quasi-totalit des erreurs de r daction. L'erreur majeure la plus fr quente tait la mention du m canisme du d c s seul sans la cause de d c s dans 59.5%. Quant aux erreurs mineures, la pr sence d'abr viations tait de loin l'erreur la plus fr quente (dans 87.8% des cas). Notre tude a montr que la qualit de r daction des certificats de d c s souffrait de plusieurs insuffisances ce qui nous incite fournir d'avantage d'effort dans la formation des m decins.

Through a retrospective study of 8 cases of medical liability in obstetrics and gynaecology, our objective was to study the circumstances of the practitioner's liability in case of post-partum haemorrhage, to study the jurisprudence in this field in Tunisian and comparative law and to identify the main measures for the prevention of medicolegal risk in obstetrics and gynaecology. The practitioner's fault could take place before the decision and the indication of the act, or during the intervention, or finally during the monitoring of the patient. The main situations that led to post partum haemorrhage were uterine rupture, uterine inertia, gravid hypertension and its complications and amniotic embolism. No fault was found by the experts. Five of the cases studied were dismissed. At the end of this study, we think that the prevention of medicolegal risk in obstetrics is based on the respect of recommended precautions and the information of the patient and her entourage, in particular in case of complications.