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Medicolegal Evaluation of Fatal Pulmonary Thromboembolism (From Forensic Pathology Reviews, Volume 3, P 285-302, 2005, Michael Tsokos, ed, -- See NCJ-209976)

NCJ Number
209985
Author(s)
James R. Gill M.D.
Date Published
2005
Length
18 pages
Annotation
This chapter describes the medicolegal evaluation of fatal pulmonary thromboembolism.
Abstract
Venous thromboembolism (VTE) encompasses pulmonary thromboemboli (PE) and deep venous thrombosis (DVT) and is a commonly diagnosed immediate cause of death by forensic and hospital pathologists. Deaths caused by pulmonary emboli may involve medicolegal issues and as such, a dependable protocol is necessary for their investigation. The medicolegal investigation of fatal PE commonly includes photographic, written, and microscopical documentation of the embolism and DVT. The timing of a pulmonary embolism should be considered as it may have important medicolegal consequences. A broad histological range of thrombosis and organization may be noted due to the pathophysiology and propagation of a thrombus. It thus becomes important to conduct a histological examination of residual deep vein thrombus to determine the age of the thrombus. New DNA techniques allow for postmortem testing of hereditary thrombophilias in decedents who are younger than 45 years of age, those whose deaths were related to pregnancy, those with a history of unexplained stillbirths, or those with weak risk factors. These DNA tests are beneficial to both the investigator examining the proximate cause of death and to surviving family members who may be alerted to the hereditary nature of the disease. Figures, references