Medico- Legal Aspects of Shoulder Dystocia

Posted by Dr Mike O'Connor on 27 February 2014
An increasing number of recent requests for expert evidence seem to involve claims for brachial plexus palsy in babies as a result of shoulder dystocia. The definitions are as follows:

1. Shoulder Dystocia: (incidence 0.5-1.5% of deliveries a.Prolonged Head to Body Delivery Time >60 seconds
b. Resnik (1980) : Condition requiring special manoeuvres after failure to deliver the shoulders with downward traction
c. Arrest of spontaneous delivery due to impaction of the anterior...
Posted in: Shoulder Dystocia  

Iron Deficiency Anaemia in Women

Posted by Dr Mike O'Connor on 11 February 2014
One in 3 Australian women have been diagnosed with iron deficiency by age 50.This is largely caused by disorders of menstruation and pregnancy. In one study 11% of women (mostly premenopausal) without anaemia were nevertheless iron deficient. Menstrual loss of iron is approximately 1mg per day and a pregnancy, delivery and puerperium accounts for a loss of about 1000 mg.

The impact of anaemia in pregnancy includes higher rates of preterm delivery (Chinese study) spontaneous abortion, low b...
Posted in: Iron  

Congenital unilateral absence of an ovary medicolegal case

Posted by Dr Mike O'Connor on 28 January 2014
Recently I was asked to provide an expert opinion on the causation of a missing ovary discovered at  a third laparoscopy. It was alleged by another expert witness that this must have been surgically removed at one of the 2 previous laparoscopies, both of which were brief procedures. The witness stated that in his experience congenital absence of one ovary had never occurred. In fact there have been a number of case reports of just such congenital absence of only one ovary: in 1978...
Posted in: Ovaries  

Digital Rape - is it associated with evidence of trauma?

Posted by Dr Mike O'Connor on 28 January 2014
Recently I was asked to provide medico-legal expert evidence in a case of digital sexual assault. It was pointed out to me by the Defence that one publication cited a detected genital injury rate after digital sexual assault of in excess of 80%.
However the American publication involved:

1. Colposcopic examination with tissue dyes such as toluidine blue (both of these techniques substantially increase the detection rate)
2. Short time periods before forensic examination (<72 hours aft...
 

Cerebral Palsy and the National Disability Insurance Scheme

Posted by Dr Mike O'Connor on 11 November 2013
Cerebral palsy affects two to 2.5 infants per thousand live births in Australia.  It had been estimated that the prevalence of patients with cerebral palsy in Australia in 2007 was nearly 34,000 persons.  According to an Access Economics Report in 2007 the cost of caring for each affected individual was $43,431 annually, amounting to a national cost of $1.47billion.  This is 0.14 per cent of Gross Domestic Product.

The new Australian National Disability Insurance Scheme is s...
Posted in: Cerebral Palsy  

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