Forensic Investigation of Rare Complications of Endoscopic Sinus Surgery: Two Case Reports.

Abstract

This article describes two cases of rare surgical complications during functional endoscopic sinus surgery (FESS) and the resulting forensic investigations. The first case involved damage to the skull base and intracerebral artery, leading to a fatal cerebrovascular event, while the second case involved destruction of the medial orbital wall. The clinical and pathological findings are described in detail for each case. In Russia, in cases of disputes regarding medical malpractice, a commission-based expert examination is appointed by the civil court, criminal court, or investigator. This commission includes, in addition to a forensic pathologist, a practicing physician specializing in the field related to the case under consideration. Single-expert examinations for such cases are not provided; the investigation is always conducted jointly by a forensic pathologist and a clinician. It is important to investigate whether the mistake was due to preventable causes or deviations from accepted standards. This can only be done through the joint work of clinicians and forensic pathologists. These two cases are important because they demonstrate how different forensic conclusions can be for patients who undergo the same operation and experience similar severe complications. Despite the similarities, the forensic and legal outcomes were entirely different due to different reasons for the mistakes.