Fatal exsanguination from hemodialysis vascular access sites.
Summary of "Fatal exsanguination from hemodialysis vascular access sites."
Exsanguination from hemodialysis vascular sites may cause a rapid death. Due to extensive blood loss at the scene, investigators may initially suspect a homicide or suicide. We reviewed 100 deaths due to hemorrhage from hemodialysis shunt sites. The majority (81%) of these hemorrhages occurred at home and 44% subsequently died at home. Recognition of this medical complication at the scene is important to prevent the dispatch of the crime scene or homicide unit. In these instances, the common causes of kidney failure included hypertensive cardiovascular disease and diabetes mellitus. The manners of death were certified as therapeutic complication (93%), accident (5%), and suicide (2%). These fatal shunt hemorrhages are rapid and large due to their superficial subcutaneous locations and elevated shunt pressures from the arterial-venous anastamosis. The cause of death statement must include the proximate cause of death, which is usually the disease that resulted in kidney failure, if it is known.
New York City Office of Chief Medical Examiner, 520 First Avenue, New York, NY, 10016, USA, JGILL@OCME.NYC.GOV.
This article was published in the following journal.
Name: Forensic science, medicine, and pathology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22160736
- DOI: http://dx.doi.org/10.1007/s12024-011-9303-0
A patent vascular access is the lifeline of end-stage renal disease patients depending on hemodialysis treatment. Once a functioning vascular access has been established, maintaining its patency is of...
Vascular access complications are a major cause of excessive morbidity and mortality in the dialysis population. Moreover, there is not sufficient research regarding the factors correlated with vascul...
Longevity in end-stage renal disease (ESRD) is dependent on adequacy of renal replacement therapy. Over 85% of the global ESRD population is hemodialysis dependent. Preoperative evaluation is the corn...
Maintaining vascular access in patients undergoing chronic hemodialysis is a challenging process, especially in patients enduring multiple central line placements and in whom peripheral options have b...
This study is designed to confirm the safety of the proposed dose and schedule of ABI-007 for hemodialysis patients with vascular access device failure, and to obtain preliminary data on t...
The purpose of this study is to compare the safety and effectiveness of the HeRO Vascular Access Device in access challenged (e.g., catheter-dependent) hemodialysis patients. It is hypothe...
The Boston Scientific ACCESS trial seeks to study the safety and to evaluate the success of the Fusion™ Vascular Access Graft for patients in need of early vascular access for hemodialys...
The aim of the present study was to investigate patients free of active infection and/or thrombosis to assess if the type of vascular access (AVF, AVG, TCC), could influence: 1. the lev...
The purpose of this study is to determine whether the long term use of the experimental Vascular WrapTM Paclitaxel-Eluting Mesh is safe in the treatment of subjects needing hemodialysis ac...
Medical and Biotech [MESH] Definitions
Hospital units in which care is provided the hemodialysis patient. This includes hemodialysis centers in hospitals.
Long-term maintenance hemodialysis in the home.
The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes.
Solutions prepared for hemodialysis. The composition of the pre-dialysis solution may be varied in order to determine the effect of solvated metabolites on anoxia, malnutrition, acid-base balance, etc. Of principal interest are the effect of the choice of buffers (e.g., acetate or carbonate), the addition of cations (Na+, K+, Ca2+), and addition of carbohydrates (glucose).
Rapid and extreme blood loss leading to HEMORRHAGIC SHOCK.