Rare Medico Legal Cases of Pediatric Intensive Care Unit Medico Legal Cases

Main Article Content

Serbülent Kılıç
Arzu Oto


Objective: While Multiple Life-threatening Conditions (MLCs) admitted to the Pediatric Intensive Care Unit represent a substantial healthcare burden, the risk factors, epidemiological data, and clinical manifestations of these cases have yet to be systematically and comprehensively documented.

Material and Methods: This study was conducted in the Pediatric Intensive Care Unit at Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey, between January 1, 2017, and January 1, 2022. The study included 31 males (35.4%) and 17 females (64.6%) with an average age of 4.7 ± 4.1 years. MLCs were classified into nine groups, including Foreign Body Aspiration (FBA), Blunt Trauma (BT), Asphyxia (ASP), Firearm Injury (FI), Sharp and Penetrating Object Injury (SPOI), Electric Injury (EI), Sports-Related Injury (SRI), Animal Bite Injury (ABI), and Home Accident (HA).

Results: Foreign Body Aspiration (FBA) was the most prevalent type of MLC in this study (29.1%). The average hospital stay for FBA cases in the general ward was 3 days (range: 1-11 days), and in the Pediatric Intensive Care Unit was 2 days (range: 1-8 days). Blunt Trauma (BT) cases had an average hospital stay of 4 days (range: 1-12 days) in the general ward and 3 days (range: 1-10 days) in the Pediatric Intensive Care Unit. Surgical intervention was required for 29.1% of patients (n=14). The mean cost of treating a case in our study was calculated to be 5744 ₺ (approximately US$308.57). The majority of MLCs were attributed to FBA (n=14, 43%), followed by BT (n=9, 18%), and ASP (n=8, 16%).

Conclusion: The predominance of Multiple Life-threatening Conditions (MLCs) in the Pediatric Intensive Care Unit, with Foreign Body Aspiration (FBA) being the most common cause, underscores the need for heightened awareness and prevention efforts. Understanding the risk factors, clinical presentations, and healthcare costs associated with these cases is essential for healthcare professionals and policymakers in their pursuit of reducing the incidence of MLCs. 


Download data is not yet available.

Article Details

How to Cite
Kılıç, S., & Oto, A. (2023). Rare Medico Legal Cases of Pediatric Intensive Care Unit: Medico Legal Cases . Medical Science and Discovery, 10(10), 849–854. https://doi.org/10.36472/msd.v10i10.1078
Research Article
Received 2023-10-17
Accepted 2023-10-21
Published 2023-10-22


Madadin M, Alqarzaie AA, Alzahrani RS, Alzahrani FF, Alqarzea SM, Alhajri KM, Al Jumaan MA. Characteristics of Medico-Legal Cases and Errors in Medico-Legal Reports at a Teaching Hospital in Saudi Arabia. Open Access Emerg Med. 2021 Dec 2;13:521-526. PMID: 34880689; PMCID: PMC8648094. DOI: https://doi.org/10.2147/OAEM.S341893

Bellocchi G, Acquaviva G, Giammona Indaco F, Eibenstein A. Foreign bodies in the pediatric age: the experience of an Italian tertiary care hospital. Acta Biomed. 2020 Feb 17;91(1-S):60-64. PMID: 32073563; PMCID: PMC7947743.

Fasseeh NA, Elagamy OA, Gaafar AH, et al. A new scoring system and clinical algorithm for the management of suspected foreign body aspiration in children: a retrospective cohort study. Ital J Pediatr. 2021 Sep 28;47(1):194. PMID: 34583774; PMCID: PMC8480080. DOI: https://doi.org/10.1186/s13052-021-01147-9

Mohsen F, Bakkar B, Melhem S, et al. Foreign body aspiration in a tertiary Syrian centre: A 7-year retrospective study. Heliyon. 2021 Mar 17;7(3):e06537. PMID: 33817384; PMCID: PMC8010408. DOI: https://doi.org/10.1016/j.heliyon.2021.e06537

Ding G, Wu B, Vinturache A, Cai C, Lu M, Gu H. Tracheobronchial foreign body aspiration in children: A retrospective single-center cross-sectional study. Medicine (Baltimore). 2020 May 29;99(22):e20480. PMID: 32481458. DOI: https://doi.org/10.1097/MD.0000000000020480

Liu B, Ding F, An Y, et al. Occult foreign body aspirations in pediatric patients: 20-years of experience. BMC Pulm Med. 2020 Dec 9;20(1):320. PMID: 33298020; PMCID: PMC7724703. DOI: https://doi.org/10.1186/s12890-020-01356-8

Zhu Y, Fan Q, Cheng L, Chen B. Diagnostic Errors in Initial Misdiagnosis of Foreign Body Aspiration in Children: A Retrospective Observational Study in a Tertiary Care Hospital in China. Front Pediatr. 2021 Oct 15;9:694211. PMID: 34722414; PMCID: PMC8555661. DOI: https://doi.org/10.3389/fped.2021.694211

Nasir ZM, Subha ST. A Five-Year Review on Pediatric Foreign Body Aspiration. Int Arch Otorhinolaryngol. 2021 Apr;25(2):e193-e199. Epub 2020 Jun 23. PMID: 33968219; PMCID: PMC8096496. DOI: https://doi.org/10.1055/s-0040-1709739

Goh PL, Lim EH, Teo DSHM, Sairin ME. Challenges in Diagnosing Foreign Body Aspiration in Children. Cureus. 2022 Jan 23;14(1):e21519. PMID: 35223295; PMCID: PMC8862753.

Arslan İ, Demir Kİ. Evaluation of forensic cases presented to the pediatric emergency department. Turk J Emerg Med. 2022 Jul 1;22(3):137-142. PMID: 35936954; PMCID: PMC9355077. DOI: https://doi.org/10.4103/2452-2473.348432

Kim KH, Kim JS, Kim WW. Outcome of children with blunt liver or spleen injuries: Experience from a single institution in Korea. Int J Surg. 2017 Feb;38:105-108. Epub 2016 Dec 30. PMID: 28043928. DOI: https://doi.org/10.1016/j.ijsu.2016.12.119

Araki T, Yokota H, Morita A. Pediatric Traumatic Brain Injury: Characteristic Features, Diagnosis, and Management. Neurol Med Chir (Tokyo). 2017 Feb 15;57(2):82-93. Epub 2017 Jan 20. PMID: 28111406; PMCID: PMC5341344. DOI: https://doi.org/10.2176/nmc.ra.2016-0191

Kafadar H, Kafadar S. Assessment of cases with sharp and penetrating object injuries. Niger J Clin Pract. 2019 Jun;22(6):777-781. PMID: 31187761. DOI: https://doi.org/10.4103/njcp.njcp_625_18

Saunders NR, Moore Hepburn C, Huang A, et al. Firearm injury epidemiology in children and youth in Ontario, Canada: a population-based study. BMJ Open. 2021 Nov 18;11(11):e053859. PMID: 34794997; PMCID: PMC8603258. DOI: https://doi.org/10.1136/bmjopen-2021-053859

Omoke NI, Lasebikan OA. Firearm Injury Among Children and Adolescents in Nigerian Civilian Trauma Setting: Prevalence, Pattern, and Implications for Prevention. Yale J Biol Med. 2021 Mar 31;94(1):55-63. PMID: 33795982; PMCID: PMC7995932.

Stokes SC, McFadden NR, Salcedo ES, Beres AL. Firearm injuries in children: a missed opportunity for firearm safety education. Inj Prev. 2021 Dec;27(6):554-559. Epub 2021 Jan 12. PMID: 33436448; PMCID: PMC8273181. DOI: https://doi.org/10.1136/injuryprev-2020-044051

Salas Ballestín A, Frontera Juan G, Sharluyan Petrosyan A, et al. Drowning Accidents in a Spanish Pediatric Intensive Care Unit: An Observational Study for 29 Years. Pediatr Emerg Care. 2022 Oct 1;38(10):e1631-e1636. Epub 2021 Dec 23. PMID: 36173436. DOI: https://doi.org/10.1097/PEC.0000000000002583

Davies D, Lang M, Watts R. Paediatric hanging and strangulation injuries: A 10-year retrospective description of clinical factors and outcomes. Paediatr Child Health. 2011 Dec;16(10):e78-81. PMID: 23204911; PMCID: PMC3225483.

Rothe K, Tsokos M, Handrick W. Animal and Human Bite Wounds. Dtsch Arztebl Int. 2015 Jun 19;112(25):433-42; quiz 443. PMID: 26179017; PMCID: PMC4558873.

Esposito S, Picciolli I, Semino M, Principi N. Dog and cat bite-associated infections in children. Eur J Clin Microbiol Infect Dis. 2013 Aug;32(8):971-6. Epub 2013 Feb 14. PMID: 23404346. DOI: https://doi.org/10.1007/s10096-013-1840-x

Medeiros MM, Marson FAL, Marques LS, Peixoto AO, Fraga AMA. Epidemiological profile of dog attacks to patients under 14 years old assisted at the pediatric referral emergency unit of a tertiary hospital in Campinas, Brazil. Front Pediatr. 2022 Aug 3;10:963803. DOI: https://doi.org/10.3389/fped.2022.963803

Duramaz BB, Yıldırım HM, Kıhtır HS, Yeşilbaş O, Şevketoğlu E. Evaluation of forensic cases admitted to pediatric intensive care unit. Turk Pediatri Ars. 2015 Sep 1;50(3):145-50. DOI: https://doi.org/10.5152/TurkPediatriArs.2015.2399

Jariwala N, Kratimenos P, Eng D, Gaughan J, Koutroulis I. Foreign body injuries in children: Are the younger siblings doomed? Int J Pediatr Adolesc Med. 2016 Mar;3(1):7-11. Epub 2016 Jan 27. DOI: https://doi.org/10.1016/j.ijpam.2015.12.004

Kaur A, Jayashree M, Prinja S, Singh R, Baranwal AK. Cost analysis of pediatric intensive care: a low-middle income country perspective. BMC Health Serv Res. 2021 Feb 23;21(1):168. DOI: https://doi.org/10.1186/s12913-021-06166-0

de Oliveira C, Macpherson A, Hepburn CM, et al. Healthcare utilization and costs following non-fatal powdered and non-powdered firearm injuries for children and youth. Eur J Pediatr. 2022 Jun;181(6):2329-2342. Epub 2022 Mar 5. DOI: https://doi.org/10.1007/s00431-022-04429-4

Most read articles by the same author(s)