Natural Death After a Recent Medical Consultation: Frequency and Nature of Medical Errors Found by Forensic Autopsy

Abstract

We carried out a study to determine the frequency and the nature of medical errors related to natural deaths
occurring less than 2 weeks after a medical consultation. About 1,019 autopsy cases of natural death were performed
between January 1995 and December 2007. In 4.3% of the cases, a recent medical consultation before death was
found (n=43).
In most of the cases, the general physician was involved (65%). In 50% of the cases, autopsy showed a pathology
which was overlooked before death. In these cases, cardiac and acute abdominal diseases were most frequently
overlooked. Diagnosis established during medical consultation were often abdominal diseases, which are known
to be classical differential diagnosis in cardiac diseases (such as gastritis versus myocardial infarction). In 28%
of the cases, death was secondary to the natural evolution of a disease correctly diagnosed by the physician. In
these cases, pulmonary infection was the most frequent cause of death. In 7% of the cases, two pathologies were
associated. Minor pathology whose diagnosis was carried out by the physician led to decompensation of a pathology
found at autopsy.