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Öğe Evaluation of intentional and unintentional injuries in children and adolescents with trauma scoring systems(2022) Hosukler, Erdem; Erkol, ZerrinAim: To evaluate the general characteristics of cases under the age of 18 years who presented at our forensic medicine clinic due to intentional or unintentional trauma and to evaluate the severity of injury using trauma scoring systems. Methods: This study included all cases under the age of 18 years with a forensic report prepared due to trauma in the forensic medicine clinic between 2017-2021. The cases included in the study were evaluated in terms of the following parameters: “gender, age, forensic event, cause of accidental injury, intentional or unintentional injury, injury site, location of traffic accident victims, safety belt using, degree of forensic injury, trauma scores [Injury Severity Score (ISS) and New Injury Severity Score (NISS)]. The ISS and NISS were calculated using the Abbreviated Injury Scale (AIS) 2008 update. The results were statistically compared and evaluated. Results: The majority of the cases were male (n=281, 75.13%), and the mean age was 12.03±4.83 years. More than half of the cases (n: 190, 50.80%) were unintentional injuries. The victims were injured most frequently due to battery (n=180, 48.10%). The most common injury sites were the head and neck (n=136, 36.40%). The majority of child and adolescent victims of traffic accidents under the age of 18 did not use helmets, seat belts, and protective equipment. The mean injury severity score (ISS) of the cases was 3.66±5.79, and the mean new injury severity score (NISS) was 5.03±7.58. The ISS and NISS values were significantly higher in unintentional injuries than in intentional injuries. Conclusion: More severe injuries were caused unintentionally in children and adolescents. Pedestrians, cyclists, and motorcyclists were at the greatest risk for serious injury. It is necessary to provide necessary training on the importance of protective equipment for this age group and to increase the controls.Öğe Evaluation of Juveniles Pushed to Crime: A Retrospective Study(2022) Hosukler, Erdem; Yilmaz, Aziz; Erkol, ZerrinObjective: Evaluation of children and adolescents pushed to crime should be different from adult offenders. In this study, it is aimed to analyze the qualities of children and adolescents pushed to crime and to discuss them in the light of the literature. Methods: Children who were evaluated in terms of criminal liability at Bolu Abant İzzet Baysal University Faculty of Medicine Department of Forensic Medicine and Bolu Forensic Medicine Branch Office between January 1, 2016 and December 31, 2018 were included in the study. Results: A total of 237 children and adolescents were included in the study. Of the cases, 76.8% (n=182) were male and 23.2% (n=55) were female. The mean age was 13.38±0.83. Of the cases, 80.6% were living in the nuclear family. Twenty-two cases (9.3%) were working in any job and sixty-four (27%) of the cases had one or more substance use history. Of the cases, 47.7% committed deliberate wounding crimes whereas 20.3% of cases committed burglary crimes. One hundred and fifty two cases (64.1%) committed a crime for the first time. One hundred and ten (46.4%) cases committed the crime together with a group of friends. Forty-seven cases (19.8%) had a psychiatric disorder. In 60.8% of the cases (n=144), it was reported that they had criminal responsibility. Conclusion: It is necessary to increase the number of child support centers and to develop effective intervention methods for juveniles pushed to crime in these centers, and more studies should be conducted on these issues.Öğe Forensic Geriatric Trauma Cases(Galenos Publ House, 2024) Hosukler, Erdem; Erkol, Zehra ZerrinObjective: This study aimed to evaluate the general characteristics of geriatric cases aged >= 65 years, who presented at the Forensic Medicine Clinic due to trauma, and the severity of injury using trauma scoring systems. Methods: The study included all trauma cases over 65 years with a forensic report prepared in the Forensic Medicine Clinic between 2015 and 2021. Evaluations were made using the chi-square, Mann-Whitney U, and Kruskal-Wallis (post -hoc: Dunn-Bonferroni) tests. A value of p<0.05 was considered statistically significant. Results: Two-thirds of the cases were male (67.6%) and mean age was 73.23 +/- 6.25 years. More than half of the cases were exposed to battery -related trauma (54%). There was an injury in more than one region in 37.4% (n=52) of the cases. The median injury severity score (ISS) of the cases was 2 (1.5) and the median new-injury severity score (NISS) was 3 (1.8). The scores of ISS and NISS in cases aged >75 years were higher than in those aged <= 75 years (p<0.05). The score severity of ISS and NISS of the cases injured in traffic accidents and other accidents was higher than in those injured due to battery (p<0.001). Almost half (48.1%) of the traffic accident -related cases were pedestrians, and it was seen that pedestrians suffered more severe trauma. Conclusion: Increasing the necessary safety measures in traffic, especially pedestrian safety, and taking measures to make daily life easier for the elderly may help protect this vulnerable population from the effects of severe trauma.Öğe Forensic medical evaluation of nasal trauma cases(2022) Hosukler, Erdem; Erkol, Zerrin; Dincer, GamzeAim: The purpose of this study was to evaluate the cases for which a final report was made due to nasal trauma and to reveal the errors made in the diagnosis. Materials and Methods: Among the forensic reports prepared in the Forensic Medicine Clinic of Bolu Abant İzzet Baysal University Training and Research Hospital between 2015-2019, cases with \"a history of nasal trauma\" were included in the study. Results: In this study, 315 cases with a history of nasal trauma were included. Two hundred sixty-four (83.8%) of the cases were male and 51 (16.2%) are female. Two hundred thirty-one of the cases (73.3%) were injured as a result of the intentional blunt injuries. Before applying to the Forensic Medicine Clinic, 28 (8.9%) of the cases were evaluated only by physical examination, 46 (14.6%) by physical examination + direct radiography, 241 (76.5%) by physical examination + direct radiography + CT. It was evaluated that the report prepared by emergency department physicians on 203 cases (64.4%) was correct, whereas the report prepared on 112 (35.6%) cases was erroneous. It was evaluated that the reports prepared by Otorhinolaryngologists on 117 cases (80.1%) were correct, whereas the reports prepared on 29 (19.9%) cases were erroneous. Conclusion: We believe that it is more appropriate to give the final forensic report of cases with nasal trauma by a Forensic Medicine Specialist rather than Emergency Department physicians or an Otorhinolaryngologist.Öğe Göz Travması Olgularının Adli Tıp Yönünden Analizi(2022) Hosukler, Erdem; Erkol, Zerrin; Yazgi, Buğra KaanAmaç: Adli Tıp Kliniğine göz travması ile başvuran adli olguların değerlendirilmesi. Gereç ve Yöntem: Bir Üniversite Hastanesi Adli Tıp Kliniğinde 2015-2019 yılları arasında kati rapor düzenlenen olgulara ait dosyalar retrospektif olarak taranmış ve göz bölgesine travma hikayesi olan tüm olgular çalışmaya dahil edilmiştir. Bulgular: Göze yönelik travma hikayesi olan toplam 411 olgu çalışmaya dahil edilmiştir. Olguların 305’i (%74,2) erkek, 106’sı (%25,8) kadın cinsiyetti. Yaş ortalaması 35±16,1 (min:1, max:86) olduğu tespit edilmiştir. Göz ve çevre yumuşak doku travması en sık kasım (n :45, %10,9) ve ekim (n:44, %10,7) aylarında meydana gelmiştir. Olguların 408’i (%99) travma sonrası aynı gün hastaneye başvurmuştur. Bununla birlikte olguların 365’inde aynı gün göz muayenesi yapılmıştır. Göz travmasına maruz kalan olguların 326’sı (%79,3) kasten yaralama sonucu yaralanmıştır. 94 olguda (%22,8) göz küresinde yaralanma olduğu tespit edilmiştir. Göz küresinde yaralanma tespit edilen 94 olgunun; 89’unda (%94,6) kapalı yaralanma, beşinde (%5,4) ise açık yaralanma olduğu belirlenmiştir. Sonuç: Göz travması iddiası olan adli olgularda multidisipliner yaklaşım büyük önem arz etmektedir. Mağdurların göz muayenesinin en kısa sürede yapılması ve olay öncesinde yapılmış göz muayenelerinin sorgulanması gerekir.Öğe Medical malpractice allegations related otolaryngologists(2022) Hosukler, Erdem; Yazgi, Buğra Kaan; Hösükler, Bilgin; Üzün, IbrahimThis study aims to raise the awareness of otolaryngologists regarding medical malpractice allegations. Among the files adjudicated between 01/01/2012 and 31/12/2015 by the First Specialization Board of The Council of Forensic Medicine, cases with malpractice allegations accused of otolaryngologists were analyzed retrospectively. Fifty-seven cases were included in the study. Thirty-six cases (63.2%) were male, 21 cases (36.8%) were female. The mean age was 32.87±20.3 years (1-84). The cases were mostly in the 18-39 age group (n=22, 38.6%). The event subject to the claim occurred most frequently in the state hospital (n=24, 42.1%). In 57 cases, a total of 68 otolaryngologists were accused of malpractice. The most common diagnoses made in the health institution were trauma (n=13, 22.8%) and respiratory tract infection (n=10, 17.5%). Otolaryngologists were most frequently blamed for inadequate treatment (n=25, 26.3%) and lack of indifference (n=15, 26.3%). Surgical treatment was performed on 26 patients (45.7%). The most common operations were septorhinoplasty and tonsillectomy. Complications occurred in 73.7% of the cases. The board's opinion was that only 10.5% of the cases had malpractice. A comprehensive review of the medical malpractice allegations will contribute to a better understanding of these cases and necessary strategies to reduce possible claims and improve health services.Öğe Medical Malpractice Claims Against Physical Therapy and Rehabilitation Physicians(2022) Hosukler, Erdem; Hösükler, Bilgin; Üzün, IbrahimObjective: Physicians have been strongly affected by the stress caused by malpractice lawsuits. This study aims to increase the aware ness of physical therapy and rehabilitation physicians about cases with al leged medical malpractice. Material and Methods: Allegations of medical malpractice against physical therapy and rehabilitation physicians were ex amined retrospectively from the report archives of the First Specialization Board of Council of Forensic Medicine between 01.01.2010 and 31.12.2015. Results: This study included 22 cases: 11 cases (50%) were male, 11 were (50%) female. The mean age was 48.86±22.9 (minimum: 16, maximum: 85), and 40.9% of the cases were 60 years or older. The event that was the subject of the complaint occurred most frequently in the state hospital (n=7, 31.8%) and the private hospital (n=6, 27.3%). One-fourth of the physical therapy and rehabilitation physicians (27.3%) intervened as consultant physicians. Twenty-five physicians (5 residents, 18 specialists, 1 assistant professor, and 1 professor) were charged with malpractice allegations. The most frequent diagnosis was “lumbar disc herniation” (n=5, 22.7%), fol lowed by paraplegia (n=3, 13.6%). While medical malpractice was not found in 21 cases, it was confirmed in only 1 case by the Board. Conclu sion: In this study, 95.5% of the physical therapy and rehabilitation physi cians were accused of unfair reasons. The new malpractice law needs to be regulated as soon as possible. Until the new law is passed, physicians should analyze the cases with claims of medical malpractice and develop strategies and approaches to prevent these claims.Öğe Old female case who died as a result of bear attack(2021) Yilmaz, Aziz; Hosukler, Erdem; Erkol, Zerrin; Samurcu, Hakan; Gundogdu, Veyis; Celme, Hamit Aykut; Turan, TolgaHuman encounters with wild animals are of great concern to humans. In nature, humans are usually defenseless against wild animals, however humans do not always take precautions from possible encounters. Wild animals tend to attack mostly sensitive areas of the body, and elderly individuals often fail to defend themselves compared to young people. All of these factors contribute to the increase in the mortality rate associated with these encounters. In forensic practice, deaths due to bear attacks are very rarely seen. In these cases, well-known bear attack pattern and bear-specific tooth and paw marks are observed, facilitating the work of physician who performed the autopsy. In this study, we aimed to discuss a case of a 77-year-old woman who died as a result of bear attack in the light of the existing literature.Öğe TRACTOR RELATED DEATHS (ROLLOVER, FALL, ACCIDENT, LIGHTNING STRIKE)(2022) Hosukler, Erdem; Hösükler, Bilgin; Koç, SermetObjective: Tractor-related accidents are more common than other agricultural vehicles. Tractor overturning is one of the major risk factors for farmers. In this study, it was aimed to discuss the sociodemographic characteristics, autopsy findings, the cause of death and measures to be taken of the tractor-related deaths with literatüre.Material and Methods: In this study, reports of tractor-related deaths were investigated retrospectively in cases where an autopsy was performed in the Morgue Department of Istanbul Council of Forensic Medicine between 2008 and 2012.Results: It was determined that 42 (0.2%) of 20,559 cases who were autopsied in Istanbul between 2008-2012 were tractor-related deaths. Thirty-eight (90.5%) of the cases were male and four cases (9.5%) were female. The average age was 44.54 ± 20.66 (min: 2, max: 80) with the most common death occurring at 60 years and above. Twenty-six (61.9%) of the cases were drivers. The most common death occurred in July and November (n: 7, 16.6%). The death occurred due to tractor overturns in 50% of the cases (n: 21), whereas the reason for death was falling from the tractor in 31% (n=13), traffic accident in 7.1% (n=3), run-over in 7.1% (n=3) and lightning strikes in 4.8% (n=2).Conclusion: In the prevention of tractor-related deaths, is necessary to prohibit the use of tractors as a means of transport and increase the use of seat belts and roll-over protective structures (ROPS) in all tractors.
