Delayed aortic rupture following a fall from an examination couch. Clinical and forensic aspects

Background: Physicians frequently have to face an investigation of their wo rk from a judicial point of view. Due to these proceedings the number of ca ses when they are reproached with malpractice is increasing. Case Report: We report the rare case of a 76-year-old female patient who fe ll from a 68 cm high couch after a sedative was applied during gastroscopic al examination. She died 24 hours after the incident. Forensic necropsy rev ealed a delayed aortic rupture as the cause of death. The preliminary proce edings against the physician involved for culpable homicide by criminal neg ligence were suspended after he paid a fine. The possible legal consequence s under German law for physicians involved in such cases are discussed as w ell as strategies to avoid them. Conclusion: Physicians who are under investigation for malpractice should a ct carefully. They are advised to seek professional heir at an early stage of preliminary proceedings. A Public trial should he avoided if possible.