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, 8 (3), 259-62

Fatal Exsanguination From Hemodialysis Vascular Access Sites


Fatal Exsanguination From Hemodialysis Vascular Access Sites

James R Gill et al. Forensic Sci Med Pathol.


Exsanguination from hemodialysis vascular sites may cause a rapid death. Due to extensive blood loss at the scene, investigators may initially suspect a homicide or suicide. We reviewed 100 deaths due to hemorrhage from hemodialysis shunt sites. The majority (81%) of these hemorrhages occurred at home and 44% subsequently died at home. Recognition of this medical complication at the scene is important to prevent the dispatch of the crime scene or homicide unit. In these instances, the common causes of kidney failure included hypertensive cardiovascular disease and diabetes mellitus. The manners of death were certified as therapeutic complication (93%), accident (5%), and suicide (2%). These fatal shunt hemorrhages are rapid and large due to their superficial subcutaneous locations and elevated shunt pressures from the arterial-venous anastamosis. The cause of death statement must include the proximate cause of death, which is usually the disease that resulted in kidney failure, if it is known.

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    1. Forensic Sci Med Pathol. 2007 Jun;3(2):128-32 - PubMed
    1. Kidney Int. 2005 Nov;68(5):2323-30 - PubMed
    1. Kidney Int Suppl. 1991 Dec;35:S19-23 - PubMed
    1. Kidney Int. 2001 Jul;60(1):1-13 - PubMed
    1. J Forensic Sci. 1985 Jan;30(1):158-66 - PubMed

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