Anda di halaman 1dari 13

1

Final Examination In FORENSIC MEDICINE

Prepared By: Ahmad Deedatt L. Kalbit

ANSWERS:

I.

In the case of Reyes vs. Sisters of Mercy Hospital (20 pts.) Disc ss: a. !he si"ns and sy#pto#atolo"y of !yphoid fever infection. !he Si"ns and sy#pto#s of typhoid fever #ay incl de fever$ often to a prolon"ed ti#e chills$ severe headaches constipation or diarrhea$ a%do#inal pain$ fati" e or lethar"y$ loss of appetite rose&colored spots on the %ody$ di''iness$ # scle pains$ and s(ellin" of the nec) "lands$ liver$ or spleen. %. !he possi%le co#plications of !yphoid fever as an infectio s disease. !yphoid fever is a syste#ic infection involvin" virt ally all or"ans to varyin" de"rees. !he #ore co##on co#plications incl de intestinal perforation* intestinal %leedin"* cholecystitis (perforation$ e#pye#a)* osteo#yelitis* and a%scesses. Rare s r"ical co#plications incl de pancreatitis$ hepatic and splenic a%scesses$ ple ral eff sion$ and orchitis. c. +hat is #edical #alpractice, Medical #alpractice is a partic lar for# of ne"li"ence (hich consists in the fail re of a physician or s r"eons to apply to his practice of #edicine that de"ree of care and s)ill (hich is ordinarily e#ployed %y the profession "enerally$ nder si#ilar conditions$ and in li)e s rro ndin" circ #stances. In order to s ccessf lly p rs e s ch a clai#$ a patient # st prove that the physician or s r"eon either failed to do so#ethin" (hich a reasona%ly pr dent physician or s r"eon (o ld have done$ or that he or she did so#ethin" that a reasona%ly pr dent physician or s r"eon (o ld not have done$ and that the fail re or action ca sed in- ry to the patient. !here are th s fo r ele#ents involved in #edical ne"li"ence cases$ na#ely: d ty$ %reach$ in- ry$ and pro.i#ate ca sation. d. !he alle"ation that respondent doctors co##itted #edical ne"li"ence. !he petitioner/s principal contention (as that 0or"e did not die of typhoid fever. Instead$ his death (as d e to the (ron"f l ad#inistration of chloro#ycetin. !hey contended that had respondent doctors e.ercised d e care and dili"ence$ they (o ld not have reco##ended and r shed the perfor#ance of the +idal !est$ hastily concl ded that 0or"e (as s fferin" fro# typhoid fever$ and ad#inistered chloro#ycetin (itho t first cond ctin" s fficient tests on the

patient/s co#pati%ility (ith said dr ". !hey char"ed respondent clinic and its directress$ Sister Rose Palacio$ (ith ne"li"ence in failin" to provide ade1 ate facilities and in hirin" ne"li"ent doctors and n rses. e. +hy the testi#ony of Dr. 2acallares (as ref ted %y another physician, !he testi#ony of Dr. 2acallares (as contested %y t(o other physicians Dr. 3otion" and Dr. Panopio$ 4ccordin" to Dr. 3otion"$ the patient/s history and positive +idal !est res lts ratio of 5:620 (o ld #a)e hi# s spect that the patient had typhoid fever. 4s to Dr. 2acalares/ o%servation re"ardin" the a%sence of lceration in 0or"e/s "astro&intestinal tract$ Dr. 3otion" said that s ch hyperplasia in the intestines of a typhoid victi# #ay %e #icroscopic. He noted that since the to.ic effect of typhoid fever #ay lead to #enin"itis$ Dr. 2acalares/ a topsy sho ld have incl ded an e.a#ination of the %rain. 7i)e Dr. 3otion"$ Dr. Panopio a"reed that the 5:620 ratio in 0or"e/s case (as already the #a.i# # %y (hich a concl sion of typhoid fever #ay %e #ade. 8o additional infor#ation #ay %e ded ced fro# a hi"her dil tion. He said that Dr. 2acalares/ a topsy on 0or"e (as inco#plete and th s inconcl sive. 9inally$ accordin" to the co rt (hen petitioners presented Dr. 2acalares as an e.pert (itness$ (e do not find hi# to %e so as he is not a specialist on infectio s diseases li)e typhoid fever. 9 rther#ore$ altho "h he #ay have had e.tensive e.perience in perfor#in" a topsies$ he ad#itted that he had yet to do one on the %ody of a typhoid victi# at the ti#e he cond cted the post#orte# on 0or"e Reyes. It is also plain fro# his testi#ony that he has treated only a%o t three cases of typhoid fever. f. :Res ipsa lo1 itor; < the doctrine/s application to this case.

:Res ipsa lo1 itor; (hich #eans :the thin" spea)s for itself$= a doctrine of la( that one is pres #ed to %e ne"li"ent if he>she>it had e.cl sive control of (hatever ca sed the in- ry even tho "h there is no specific evidence of an act of ne"li"ence$ and (itho t ne"li"ence the accident (o ld not have happened. !his doctrine finds no application to the instant case$ the co rt conc rred (ith the r lin" of the ?o rt of 4ppeals. In the Ramos case$ the 1 estion (as (hether a s r"eon$ an anesthesiolo"ist$ and a hospital sho ld %e #ade lia%le for the co#atose condition of a patient sched led for cholecystecto#y. In that case$ the patient (as "iven anesthesia prior to her operation. 8otin" that the patient (as ne rolo"ically so nd at the ti#e of her operation$ the ?o rt applied the doctrine

of res ipsa loquitur as #ental %rain da#a"e does not nor#ally occ r in a "all%lader operation in the a%sence of ne"li"ence of the anesthesiolo"ist. !a)in" - dicial notice that anesthesia proced res had %eco#e so co##on that even an ordinary person co ld tell if it (as ad#inistered properly$ (e allo(ed the testi#ony of a (itness (ho (as not an e.pert. In this case$ (hile it is tr e that the patient died - st a fe( ho rs after professional #edical assistance (as rendered$ there is really nothin" n s al or e.traordinary a%o t his death. Prior to his ad#ission$ the patient already had rec rrin" fevers and chills for five days nrelieved %y the anal"esic$ antipyretic$ and anti%iotics "iven hi# %y his (ife. !his sho(s that he had %een s fferin" fro# a serio s illness and professional #edical help ca#e too late for hi#. Respondents alle"ed fail re to o%serve d e care (as not i##ediately apparent to a lay#an so as to - stify application of res ipsa loquitur. !he 1 estion re1 ired e.pert opinion on the alle"ed %reach %y respondents of the standard of care re1 ired %y the circ #stances. 9 rther#ore$ on the iss e of the correctness of her dia"nosis$ no pres #ption of ne"li"ence can %e applied to Dr. Marlyn Rico.

II.

In cases of rape$ the #edico&le"al certificate is one critical doc #ent presented as evidence < descri%e co#prehensively content details$ incl din" physical e.a#ination done. (50 pts.)

III.

In the case of Pp. vs. 0oseph 7eones: (50 pts.) Disc ss:

a. Possi%le reasons for Irene D lay/s alle"ed feelin" of headache and di''iness after inta)e of three ta%lets of aspirin$ a pain relievin" dr ". !he alle"ed feelin" of headache and di''iness s ffered %y the victi# Irene D lay #ay %e ca sed %y 4spirin @verdose for ta)in" three (6) ta%lets at one ti#e. 4lso$ Irene D lay (as on her first #enstr al period that #ay ca se her of feelin" headache. %. Differentiate #enstr al %lood fro# %lood d e to lacerated hy#en. Bleedin" fro# a %ro)en hy#en is "enerally li"hter than a period and t rns %ro(nish and tapers (ithin a day or t(o. !he flo( of periods is "enerally dar) and stic)y (hile fresh hy#ennal %leed is thin red %lood. Periods flo( is associated (ith a%do#inal cra#ps and pain (hile hy#enal tear (ill have pain %elo(.

IV.

In Pp. vs. 3errico 2ale-o: (20 pts.)

a. ?ite the pertinent "enital e.a#ination findin"s on the victi# Daisy Diolala. !he 3enital A.a#ination findin"s are the follo(in"* & P %ic hair$ no "ro(th. 7a%ia #a-ora and #inora$ "apin" and con"ested. Hy#en$ #oderately tall$ thic) (ith fresh lacerations$ co#plete at 6:00$ B:00 and C:00 o/cloc) positions$ ed"es (ith %lood clots. (4 topsy Report 8o. B!8@&CC&5D2) %. Disc ss the forensic si"nificance of appearance of hy#enal lacerations and sta"e of healin". S perficial laceration of the hy#en #ay heal in two or three days. More e.tensive tear #ay re1 ire lon"er ti#e$ s ally seven to ten days. ?o#plicated types and those (ith intervenin" infection #ay ca se delay in the healin" dependin" pon the e.tent of the involve#ent of the s rro ndin" tiss e and the de"ree of infection. ?o#plicated laceration #ay even re1 ire s r"ical intervention. c. Pro%ative val e of D84 evidence in reference to the S?& approved 200E R les. D84 is an or"anic s %stance fo nd in a person/s cells (hich contains his or her "enetic code. A.cept for identical t(ins$ each person/s D84 profile is distinct and ni1 e. +hen a cri#e is co##itted$ #aterial is collected fro# the scene of the cri#e or fro# the victi#/s %ody for the s spect/s D84. !his is the evidence sa#ple. !he evidence sa#ple is then #atched (ith the reference sa#ple ta)en fro# the s spect and the victi#. !he p rpose of D84 testin" is to ascertain (hether an association e.ists %et(een the evidence sa#ple and the reference sa#ple. !he sa#ples collected are s %-ected to vario s che#ical processes to esta%lish their profile. !he test #ay yield three possi%le res lts:

5) !he sa#ples are different and therefore # st have ori"inated fro# different so rces (e.cl sion). !his concl sion is a%sol te and re1 ires no f rther analysis or disc ssion* 2) It is not possi%le to %e s re$ %ased on the res lts of the test$ (hether the sa#ples have si#ilar D84 types (inconcl sive). !his #i"ht occ r for a variety of reasons incl din" de"radation$ conta#ination$ or fail re of so#e aspect of the protocol. 2ario s parts of the analysis #i"ht then %e repeated (ith the sa#e or a different sa#ple$ to o%tain a #ore concl sive res lt* orF 6) !he sa#ples are si#ilar$ and co ld have ori"inated fro# the sa#e so rce (incl sion). In s ch a case$ the sa#ples are fo nd to %e si#ilar$ the analyst proceeds to deter#ine the statistical si"nificance of the Si#ilarity. In assessin" the pro%ative val e of D84 evidence$ therefore$ co rts sho ld consider$ a#on" others thin"s$ the follo(in" data: ho( the sa#ples (ere collected$ ho( they (ere handled$ the possi%ility of conta#ination of the sa#ples$ the proced re follo(ed in analy'in" the sa#ples$ (hether the proper standards and proced res (ere follo(ed in cond ctin" the tests$ and the 1 alification of the analyst (ho cond cted the tests.

V.

In the case of Pp. vs. Marivic 3enosa: Disc ss. (20 pts.)

a. :Battered (o#an syndro#e; theory. !he concept has %een reco"ni'ed in forei"n - risdictions as a for# of selfdefense or$ at the least$ inco#plete self&defense. By appreciatin" evidence that a victi# or defendant is afflicted (ith the syndro#e$ forei"n co rts convey their : nderstandin" of the - stifia%ly fearf l state of #ind of a person (ho has %een cyclically a% sed and controlled over a period of ti#e.; 4 %attered (o#an has %een defined as a (o#an :(ho is repeatedly s %-ected to any forcef l physical or psycholo"ical %ehavior %y a #an in order to coerce her to do so#ethin" he (ants her to do (itho t concern for her ri"hts. Battered (o#en incl de (ives or (o#en in any for# of inti#ate relationship (ith #en. 9 rther#ore$ in order to %e classified as a %attered (o#an$ the co ple # st "o thro "h the %atterin" cycle at least t(ice. 4ny (o#an #ay find herself in an a% sive relationship (ith a #an once. If it occ rs a second ti#e$ and she re#ains in the sit ation$ she is defined as a %attered (o#an. Battered (o#en e.hi%it co##on personality traits$ s ch as lo( self& estee#$ traditional %eliefs a%o t the ho#e$ the fa#ily and the fe#ale se. role* e#otional dependence pon the do#inant #ale* the tendency to accept responsi%ility for the %atterer/s actions* and false hopes that the relationship (ill i#prove. More "raphically$ the %attered (o#an syndro#e is characteri'ed %y the so&called :cycle of violence$ (hich has three phases: (5) the tension&% ildin" phase* (2) the ac te %atterin" incident* and (6) the tran1 il$ lovin" (or$ at least$ nonviolent) phase. D rin" the tension&% ildin" phase$ #inor %atterin" occ rs && it co ld %e ver%al or sli"ht physical a% se or another for# of hostile %ehavior. !he (o#an

10

s ally tries to pacify the %atterer thro "h a sho( of )ind$ n rt rin" %ehavior* or %y si#ply stayin" o t of his (ay. +hat act ally happens is that she allo(s herself to %e a% sed in (ays that$ to her$ are co#paratively #inor. 4ll she (ants is to prevent the escalation of the violence e.hi%ited %y the %atterer. !his (ish$ ho(ever$ proves to %e do %le&ed"ed$ %eca se her :placatory; and passive %ehavior le"iti#i'es his %elief that he has the ri"ht to a% se her in the first place. Ho(ever$ the techni1 es adopted %y the (o#an in her effort to placate hi# are not s ally s ccessf l$ and the ver%al and>or physical a% se (orsens. Aach partner senses the i##inent loss of control and the "ro(in" tension and despair. A.ha sted fro# the persistent stress$ the %attered (o#an soon (ithdra(s e#otionally. B t the #ore she %eco#es e#otionally navaila%le$ the #ore the %atterer %eco#es an"ry$ oppressive and a% sive. @ften$ at so#e npredicta%le point$ the violence :spirals o t of control; and leads to an ac te %atterin" incident. !he ac te %atterin" incident is said to %e characteri'ed %y %r tality$ destr ctiveness and$ so#eti#es$ death. !he %attered (o#an dee#s this incident as npredicta%le$ yet also inevita%le. D rin" this phase$ she has no control* only the %atterer #ay p t an end to the violence. Its nat re can %e as npredicta%le as the ti#e of its e.plosion$ and so are his reasons for endin" it. !he %attered (o#an s ally reali'es that she cannot reason (ith hi#$ and that resistance (o ld only e.acer%ate her condition. 4t this sta"e$ she has a sense of detach#ent fro# the attac) and the terri%le pain$ altho "h she #ay later clearly re#e#%er every detail. Her apparent passivity in the face of ac te violence #ay %e rationali'ed th s: the %atterer is al#ost al(ays # ch stron"er physically$ and she )no(s fro# her past painf l e.perience that it is f tile to fi"ht %ac). 4c te %atterin" incidents are often very sava"e and o t of control$ s ch that innocent %ystanders or intervenors are li)ely to "et h rt. !he final phase of the cycle of violence %e"ins (hen the ac te %atterin" incident ends. D rin" this tran1 il period$ the co ple e.perience profo nd relief. @n the one hand$ the %atterer #ay sho( a tender and n rt rin" %ehavior to(ards his partner. He )no(s that he has %een vicio sly cr el and tries to #a)e p for it$ %e""in" for her for"iveness and pro#isin" never to %eat her a"ain. @n the other hand$ the %attered (o#an also tries to convince herself that the %attery (ill never happen a"ain* that her partner (ill chan"e for the %etter* and that this :"ood$ "entle and carin" #an; is the real person (ho# she loves.

11

4 %attered (o#an s ally %elieves that she is the sole anchor of the e#otional sta%ility of the %atterer. Sensin" his isolation and despair$ she feels responsi%le for his (ell&%ein". !he tr th$ tho "h$ is that the chances of his refor#in"$ or see)in" or receivin" professional help$ are very sli#$ especially if she re#ains (ith hi#. 3enerally$ only after she leaves hi# does he see) professional help as a (ay of "ettin" her %ac). Get$ it is in this phase of re#orsef l reconciliation that she is #ost thoro "hly tor#ented psycholo"ically. !he ill sion of a%sol te interdependency is (ell&entrenched in a %attered (o#an/s psyche. In this phase$ she and her %atterer are indeed e#otionally dependent on each other && she for his n rt rant %ehavior$ he for her for"iveness. Hnderneath this #isera%le cycle of :tension$ violence and for"iveness$; each partner #ay %elieve that it is %etter to die than to %e separated. 8either one #ay really feel independent$ capa%le of f nctionin" (itho t the other.

12

%. !he post&#orte# e.a#ination findin"s of Dr. Refelina ?erillo$ cond cted on Ben 3enosa/s %ody. 4ccordin" to Dra. ?erillo there is only one in- ry and that is the in- ry involvin" the s)eletal area of the head (hich she descri%ed as a Ifract re/ that ca se the death of Ben. 4nd that %ased on her e.a#ination$ Ben had %een dead 2 or 6 days and his %ody (as already deco#posin". She concl ded that the ca se of Ben/s death (as Icardiop l#onary arrest secondary to severe intracranial he#orrha"e d e to a depressed fract re of the occipital %one. c. !he ca se of death as opined %y Dr. Ra1 el 9ort n$ a forensic patholo"ist. 4ccordin" to Dr. Ra1 el 9ort n$ then the only 1 alified forensic patholo"ist in the co ntry$ (ho opined that the description of the death (o nd (as c lled fro# the post&#orte# findin"s$ A.hi%it I4/) is #ore a)in to a " nshot (o nd than a %eatin" (ith a lead pipe. d. :Post&tra #atic stress disorder; as cited %y Dr. Pa-arillo. 4ccordin" to Dr. Pa-arill$ the affliction of Post&!ra #atic Stress Disorder depends on the v lnera%ility of the victi#. He said that if the victi# is not very healthy$ perhaps one episode of violence #ay ind ce the disorder* if the psycholo"ical sta#ina and physiolo"ic constit tional sta#ina of the victi# is stron"er$ it (ill ta)e #ore repetitive tra #a to precipitate the post&tra #atic stress disorder and this is very dan"ero s. In psychiatry$ the post&tra #atic stress disorder is incorporated nder the Ian.iety ne rosis or ne rolo"ic an.ietis#. It is prod ced %y over(hel#in" %r tality$ tra #a. Dr. Pa-arillo e.plained that (ith ne rotic an.iety$ the victi# relives the %eatin" or tra #a as if it (ere real$ altho "h she is not act ally %ein" %eaten at that ti#e. She thin)s of nothin" % t the s fferin". 4 (o#an (ho s ffers %attery has a tendency to %eco#e ne rotic$ her e#otional tone is nsta%le$ and she is irrita%le and restless. She tends to %eco#e hard&headed and persistent. She has hi"her sensitivity and her Iself& (orld/ is da#a"ed. Dr. Pa-arillo said that an a%nor#al fa#ily %ac)"ro nd relates

13

to an individ al/s illness$ s ch as the deprivation of the contin o s care and love of the parents. Dr. Pa-arillo said that a (o#an s fferin" post tra #atic stress disorder try to defend the#selves$ and Ipri#arily (ith )nives. Hs ally pointed (eapons or any (eapon that is availa%le in the i##ediate s rro ndin" or in a hospital %eca se that a%o nd in the ho sehold. He said a victi# resorts to (eapons (hen she has Ireached the lo(est roc) %otto# of her life and there is no other reco rse left on her % t to act decisively./