CHARACTERISTICS OF CLINICAL AND MEDICO-LEGAL DIAGNOSIS IN CASES OF DISCREPANCY

A. Bondarev, A. Pădure, E. Lungu

Abstract: Although technical possibilities of diagnosis in modern medicine are incomparably greater, even nowadays, diagnostic mistakes are identified during autopsy in a considerable number of cases. Moreover, in the last decades, the frequency of discrepancies not only stayed at the same level but also increased. The present research is a selective retrospective analytical study based on 152 medico-legal reports regarding the corpses of patients who died in hospitals, as well as their medical records for a period of 5 years (2009–2013). All the dead bodies were examined in the territorial departments of the Center of Forensic Medicine of Republic of Moldova. The study aimed to analyze and classify discrepancies between clinical and medico-legal diagnoses in mechanical traumas. Brain injuries were most frequently diagnosed (clinical and morphological) in the researched sample, this kind of trauma was also most frequently under- and overdiagnosed. All the nosological units in the study were more frequently underdiagnosed than overdiagnosed. Most of the discrepancies were found in the main diagnosis, manifested by underdiagnosis and attributed to the 2nd category.
Keywords: discrepancy, clinical diagnosis, medico-legal diagnosis, medical care quality, underdiagnosis, overdiagnosis, misdiagnosis.