Browsing by Author "Wijerathne, N.A.S.P."

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Case of Sudden Death due to Septic Pulmonary Embolism
(College of Forensic Pathologists of Sri Lanka, 2013) Kitulwatte, I.D.G.; Wijerathne, N.A.S.P.
INTRODUCTION: Sudden deaths in hospital following a short duration of seemingly improving illness arouse suspicion of medical maltreatment. It is mandatory to have a medico-legal investigation in to such deaths. Facts, explanations, and opinions made by the forensic pathologists at the end of an autopsy examination are of crucial importance to eliminate or confirm such doubts. We report how a thorough autopsy examination including ancillary testing can lead to effective administration of justice in such cases. CASE HISTORY: A 42 year woman with diabetes mellitus was admitted to hospital with fever and right knee joint swelling and tenderness of one week’s duration. There was cellulitis over the right knee joint and underlying septic arthritis. Surgical drainage of the joint was done and intra venous antibiotics were given and the condition seemed to be improving. On the 4th day of admission, she developed sudden onset of shortness of breath and central chest pain resulting in death 12 hours later. At autopsy she was pale and icteric. There was evidence of septic arthritis with surrounding necrotizing fasciitis and deep venous thrombosis of the right calf. There was consolidation of the right lung with patchy focal pale yellow areas with surrounding erythema, and evidence of multi-organ sepsis. Microscopy confirmed multi organ involvement and revealed pneumonia of the right lung with early abscess formation and multiple bilateral peripheral septic thrombo emboli. There was septic thrombosis of the calf veins with associated thrombo phlebitis. CONCLUSION: Facts revealed at autopsy explained the sudden death and the possibility of such death was scientifically clarified. The cause of death was concluded as septic pulmonary thrombo embolism due to deep venous septic thrombosis and thrombophlebitis due to septic arthritis and necrotizing fasciitis.
Remarks documented on medico-legal examination forms on sexual abuse cases; are they properly comprehended by the police?
(College of Forensic Pathologists of Sri Lanka, 2013) Kitulwatte, I.D.G.; Rajapaksha, W.R.A.S.; Edirisinghe, P.A.S.; Perera, W.N.S.; Wijerathne, N.A.S.P.; Sihanada, A.A.S.; Bulathsinhala, B.A.A.R.; Gunathilake, R.
INTRODUCTION: Expert medical evidence is widely used in sexual abuse cases, but its contribution to the progress of legal cases is unclear. Poor understanding of the remarks given by the medical officers in a Medico Legal Examination Form (MLEF) in alleged sexual abuse cases by the police officers may affect effective administration of justice. OBJECTIVE: This study is mainly aimed at assessing the degree of understanding by the police officers’ when reading three commonly expressed medico-legal remarks in cases of alleged sexual abuse. Secondly, to identify the areas of poor understanding, for which interventions need to be carried out. STUDY DESIGN: Cross sectional descriptive study was conducted among 64 police officers, in the rank of police constables and sergeants from western province, who are attending to routine work of a police station (criminal investigations, children and women’s desk and traffic unit). Data collection was done by self administered questionnaire after a briefing regarding the study and instructions on how to fill the questionnaire. RESULTS: 72% of the officers believed that they understood the statements written on Medico-Legal Examination Form (MLEF) when it is in native language while only 32% believed so for statements in English. However the analysis of the correct responses revealed that only 28.9% of officers understood the exact meaning in native language while it was 10.4% for English. The understanding about the statement on absence of medical evidence to confirm or exclude the allegation when given in Sinhala was 26.6% while it was 10.9% in English. The statement on evidence of vaginal penetration has been correctly understood by 20.3% in Sinhala while it is 7.8 % in English. CONCLUSION: Statements made in native language are approximately three times better understood than the ones made in English. However, overall understanding of the remarks made by doctors was very poor. It is high time we take necessary actions to intervene if our goal is effective administration of justice.
A Sudden death of a prisoner a rere case of adult presentation of Bochdalec hernia
(College of Forensic Pathologists of Sri Lanka, 2011) Perera, U.L.M.S.; Perera, W.N.S.; Wijerathne, N.A.S.P.