Medical responsibility in the operating room: the example of an amniotic fluid embolism

J Forensic Sci. 2012 Jul;57(4):1120-3. doi: 10.1111/j.1556-4029.2012.02098.x. Epub 2012 Feb 28.

Abstract

Amniotic fluid embolism (AFE) continues to be one of the most feared complications of pregnancy. A healthy 32-year-old woman died during delivery after a normal 39-week third pregnancy. The family filed a complaint with a criminal court as the causes of death appeared unclear. No risk factor associated with AFE was identified. Clinical presentation was typical, including sudden onset of cardiovascular and respiratory symptoms. Autopsy confirmed the histological diagnosis of amniotic embolism and excluded an iatrogenic cause of death or anesthetic malpractice. This article highlights the value of both antemortem records and histological features in establishing the diagnosis of AFE and demonstrates the fundamental importance of autopsy in an unexpected death related directly or indirectly to a medical procedure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Embolism, Amniotic Fluid / pathology*
  • Female
  • Forensic Pathology*
  • Heart Arrest / etiology
  • Humans
  • Laminectomy
  • Lumbar Vertebrae
  • Malpractice*
  • Needles
  • Pregnancy
  • Pulmonary Edema / pathology