Christian Jabłoński

Publications of Christian Jabłoński

• [Smuggling of the cocaine in the gastrointestinal tract ended in sudden death--the first case report from the Upper Silesia].

  Authors: Rafał Celiński, Christian Jabłoński, Rafał Skowronek, Małgorzata Korczyńska, Joanna Kulikowska, Joanna Nowicka, Czesław Chowaniec, Anna Uttecht-Pudełko

  Wiadomości lekarskie (Warsaw, Poland : 1960). 01/2011; 64(2):109-12.

  Fifty-year old man was found dead in the bathroom of his apartment. Forensic autopsy was ordered to determine the cause and manner of death. Autopsy revealed the presence of 55 latex "balls" in theFifty-year old man was found dead in the bathroom of his apartment. Forensic autopsy was ordered to determine the cause and manner of death. Autopsy revealed the presence of 55 latex "balls" in the stomach and foregut. In the past the victim was suspected of drug's dealing and smuggling. The content of "balls" and biological material (blood, urine, bloody fluid from internal organs) were analysed with LC MS/MS in the Chair and Department of Forensic Medicine and Forensic Toxicology, Medical University of Silesia in Katowice. The range of cocaine' concentration in the "balls" was 91.2-96.1%, whereas concentration in blood - 107.50 microg/ml, in urine - 284.60 microg/ml and in bloody fluid - 192.30 microg/ml. The cause of death was acute cocaine intoxication.

• Case-study of fatal gunshot wounds from non-lethal projectiles.

  Authors: Czesław Chowaniec, Mariusz Kobek, Christian Jabłoński, Stanisława Kabiesz-Neniczka, Weronika Karczewska

  Forensic science international. 08/2008; 178(2-3):213-7.

  The authors present a case of the death of a 60-year-old man shot using rubber projectiles that were fired by a police officer from a Mossberg smooth-bore shotgun in an enclosed space from a distanceThe authors present a case of the death of a 60-year-old man shot using rubber projectiles that were fired by a police officer from a Mossberg smooth-bore shotgun in an enclosed space from a distance of a few metres. The post-mortem examination revealed that death had been due to gunshot wounds in the chest which had caused heart and lung damage with subsequent massive internal haemorrhaging.

• [The risk of medical error occurrence on holidays in the material of the Forensic Medicine Department, Medical University of Silesia, Katowice, in the years 2000-2005]

  Authors: Czesław Chowaniec, Małgorzata Chowaniec, Agnieszka Nowak, Christian Jabłoński

  Archiwum medycyny sa̧dowej i kryminologii. 57(1):95-100.

  The issue of medical error is relatively often discussed at forensic congresses or conferences. The authors carried out a medico-legal analysis of records of proceedings related to the appraisal ofThe issue of medical error is relatively often discussed at forensic congresses or conferences. The authors carried out a medico-legal analysis of records of proceedings related to the appraisal of medical procedures investigated in the Forensic Medicine Department, Medical University of Silesia, Katowice, in the years 2000-2005. In 88 cases, where expert teams from the Department recognized medical errors to have been committed, 90% of such errors were demonstrated to have occurred on weekends and holidays. The majority of errors were associated with the decision-making process or diagnostic management and committed in hospital admission rooms or the so-called operative departments (orthopedic surgery, general surgery, gynecology, obstetrics). Evaluating the above presented cases, the authors drew attention to factors affecting the risk of medical error and the most common causes of inappropriate patient management.

• [Problems in medical certification of posttraumatic neuropsychiatric disorders for the purpose of criminal and civil law proceedings]

  Authors: Christian Jabłoński, Czesław Chowaniec, Mariusz Kobek, Dorota Kowalczyk-Jabłońska

  Archiwum medycyny sa̧dowej i kryminologii. 57(1):101-3.

  In the past several years, in the material of Forensic Medicine Department, Medical University of Silesia in Katowice, a significant increase has been noted in the number of cases associated with CNSIn the past several years, in the material of Forensic Medicine Department, Medical University of Silesia in Katowice, a significant increase has been noted in the number of cases associated with CNS dysfunctions, either as isolated conditions or in association with posttraumatic disorders. In the majority of cases, such dysfunctions were causally related to a head trauma. The Faculty of the Department are also requested with an increasing frequency to estimate the association between the observed neuro-psychiatric abnormalities and complaints and the undue exposure to a stress factor. In the present publication, the authors have emphasized difficulties in assessing the complaints reported by the claimants and the possibilities of objectivization of such complaints by neuro-psychiatric examinations. They also stress problems in application of obligatory ICD 10 terms denoting dysfunctions of the central nervous system in medico-legal opinions.

• [Permanent essential defacement--remarks on the possibilities of verification of the accepted criteria in medico-legal certification in criminal and civil law proceedings]

  Authors: Czesław Chowaniec, Agnieszka Nowak, Christian Jabłoński, Stanisława Neniczka

  Archiwum medycyny sa̧dowej i kryminologii. 57(1):111-4.

  Despite the fact that some criteria of medico-legal certification in criminal and civil proceedings have been established, there are still some topics which are controversial and thus requireDespite the fact that some criteria of medico-legal certification in criminal and civil proceedings have been established, there are still some topics which are controversial and thus require modification. This is also true of the notion of "permanent essential defacement". In the opinion of the authors, changes in social conventions that are occurring nowadays, as well as a highly diversified, subjective perception of esthetic values indicate the need for discussing a possible modification of the presently obligatory criteria. Apart from the assessment of posttraumatic changes, an important problem is posed by defining the notion of "a part of the body customarily open to the view ". Additionally, the authors bring up for discussion the issue of experts taking into consideration the age and sex of the victims while assessing damages. A separate problem lies in difficulties in assessing the degree of detriment to health because of defacement due to the fact that official tables for evaluating permanent or long-term detriment to health do not include relevant information.

• [Exposure to the risk of loss of life or detriment to health as a consequence of an organizational error--a case report]

  Authors: Czesław Chowaniec, Christian Jabłoński, Mariusz Kobek, Małgorzata Chowaniec

  Archiwum medycyny sa̧dowej i kryminologii. 57(1):78-80.

  Frequent changes in organization of the Polish health care sector observed over the past few years may lead to disruption of work in health care institutions, particularly in tertiary, highlyFrequent changes in organization of the Polish health care sector observed over the past few years may lead to disruption of work in health care institutions, particularly in tertiary, highly specialist centers. Such a situation may result in decreasing the quality of services, what may potentially cause exposing the patient to the risk of death or severe detriment to health. To illustrate the problem, the authors present a case of a 45-year old man, where some organizational errors led to a delay in rendering medical care and in consequence to a poorer therapeutic outcome and poorer prognosis.

• [Thromboembolic complications in orthopedic surgery--medico-legal assessment in evaluation of correctness of medical treatment in selected cases]

  Authors: Christian Jabłoński, Mariusz Kobek, Czesław Chowaniec, Małgorzata Chowaniec

  Archiwum medycyny sa̧dowej i kryminologii. 58(2-3):93-5.

  Thromboembolic events continue to account for a high percentage of complications after orthopedic surgery. Of significance in prevention of these diseases is appropriate pharmacotherapeuticThromboembolic events continue to account for a high percentage of complications after orthopedic surgery. Of significance in prevention of these diseases is appropriate pharmacotherapeutic prophylaxis, both pre and postoperative, as well as orthopedic and trauma surgeons being aware of the risk of such complications and of possibilities of avoiding or minimizing thromboembolic events. The authors present some cases that were certified in Chair of Forensic Medicine, Silesian Medical University in Katowice, in which thromboembolic complications did develop after conservative or surgical orthopedic treatment, emphasizing possible difficulties in unequivocal assessment of the cause-effect relationship between the employed treatment and the thromboembolic event in the aspect of medico-legal certification.

• [A remarkable case of diagnostic difficulties in chronic hepatic pathology caused by a metabolic disorder (Wilson's disease)--evaluation of medical management]

  Authors: Christian Jabłoński, Czesław Chowaniec, Mariusz Kobek, Agnieszka Nowak

  Archiwum medycyny sa̧dowej i kryminologii. 58(2-3):126-8.

  Wilson's disease is a rare genetic disorder. It is characterized by excessive copper deposits--mainly in parenchymal organs--leading to their damage and serious dysfunction. Because of itsWilson's disease is a rare genetic disorder. It is characterized by excessive copper deposits--mainly in parenchymal organs--leading to their damage and serious dysfunction. Because of its uncommonness, slow and insidious course and diversified clinical manifestation, diagnosing the condition is not easy, even for experienced physicians. As it is indicated by medical practice, such a situation may occur even in tertiary care centers, which have at their disposal extensive and highly specialist diagnostic tools and vast clinical experience in diagnosing such diseases. As an example, the authors present a case of a 38-year-old man, suffering from Wilson's disease, who was misdiagnosed and treated for another metabolic disease. Although the presented case was difficult and diagnostically complex, it should be emphasized that a diagnostic error led to inappropriate therapeutic decisions and in consequence delayed proper treatment.

• [Injuries of the vertebral column--differentiating between natural illnesses manifested at work and illnesses caused by work accidents. Opinionating problems in cases associated with recognizing an event as a work accident in the analysis of materials of the Chair and Department of Forensic Medicine, Medical University of Silesia]

  Authors: Czesław Chowaniec, Agnieszka Nowak, Małgorzata Chowaniec, Christian Jabłoński

  Archiwum medycyny sa̧dowej i kryminologii. 58(2-3):80-5.

  In opinionating practice of the Department of Forensic Medicine, Medical University of Silesia, a substantial problem is posed by cases associated with qualifying an event as a work accident or aIn opinionating practice of the Department of Forensic Medicine, Medical University of Silesia, a substantial problem is posed by cases associated with qualifying an event as a work accident or a "natural" illness manifested at work, when the consequence is spinal injury, especially of the overwork (surcharge; overstrain) character. Between 1998-2007, among all 284 medicolegal opinions concerning work accidents and their consequences, 76 opinions (27%) referred to vertebral column injuries or radicular pain syndromes. This has prompted the authors to investigate the problems of spinal injuries analyzed in the context of recognizing an event as a work accident. The paper constitutes a preliminary report and material for more extensive deliberations, demonstrating problems faced by experts passing opinions in cases of this type. In addition, the authors present their observations addressing legal regulations in force and common opinionating practices.

• [Estimation of incapacity to work in medico-legal opinions given by clinicians and forensic medicine specialists from the Department of Forensic Medicine, Medical University of Silesia, Katowice--comparative analysis]

  Authors: Czesław Chowaniec, Christian Jabłoński, Mariusz Kobek, Małgorzata Chowaniec

  Archiwum medycyny sa̧dowej i kryminologii. 55(4):261-3.

  After amending the rules obligatory for decision making about the incapacity to work and social insurance in district courts observed in the practice of the Department of Forensic Medicine MedicalAfter amending the rules obligatory for decision making about the incapacity to work and social insurance in district courts observed in the practice of the Department of Forensic Medicine Medical University of Silesia, Katowice. Our Department is usually appointed for a second opinion in legal pension proceedings. In the first place courts appoint physicians being experts in particular fields of clinical medicine. Irrespective of all differences in the accepted conclusion a comparative analysis of medico-legal opinions given by forensic medicine specialists or groups of experts from the Department of Forensic Medicine, Medical University of Silesia, Katowice, showed flaws in the way opinions were handed down by individual experts relating to the lack of the state of general health estimation in people contesting for pensions as well as ignorance of the obligatory rules and procedures when deciding about incapacity to work in pension proceedings. It is known that physicians appointed by the court establish only whether the examined person can work or not, but do not give any information about the character of incapacity and do not consider the possibility of therapeutic rehabilitation within the extent of the pension prevention by the Social Insurance Department nor a chance to change ones profession due to the incapacity to work in the present occupation. While presenting their opinions, physicians very often suggest the need of additional opinions given by other physicians being experts in particular fields of clinical medicine. On the basis of the above mentioned remarks the authors show the necessity for greater control over all medico legal opinions and by the court decision making process as well as the verification of experts qualifications taking into consideration of economy and the need to make the proceedings shorter.

• [Medico-legal assessment of selected cases of perinatal complications resulting in death of the woman during childbirth. Medical error or therapeutic failure?]

  Authors: Małgorzata Chowaniec, Czesław Chowaniec, Christian Jabłoński, Agnieszka Nowak

  Archiwum medycyny sa̧dowej i kryminologii. 55(2):115-9.

  Medico-legal estimation of therapeutic management in cases of perinatal complications, especially those resulting in death of the women during childbirth is usually very difficult. The authors haveMedico-legal estimation of therapeutic management in cases of perinatal complications, especially those resulting in death of the women during childbirth is usually very difficult. The authors have investigated medical documentation supported by the results of autopsies of cases chosen from the casuistry of the Forensic Medicine Department, Medical University of Silesia, Katowice. Considering the limits of professional liability and legal responsibility of physicians, close attention was paid to standard therapeutic management and increased risk in treatment with regard to that relating to typical salubrious complications. The presented cases of deaths of women during childbirth can be the succeeding opinion in broad discussion on medical errors as well as an attempt to standardise and differentiate the medical error from therapeutic failure which occurred within the reach of risk in the undertaken treatment.

• [Use of intraocular fluid in the medico-legal practice in diagnosing fatal poisoning with various psychoactive substances]

  Authors: Christian Jabłoński, Halina Sybirska

  Archiwum medycyny sa̧dowej i kryminologii. 52(2):85-97.

  In this paper results of the research on the usefulness of toxicological analysis relating to narcotics in intraocular fluid have been presented. The examined material comprised intraocular fluidsIn this paper results of the research on the usefulness of toxicological analysis relating to narcotics in intraocular fluid have been presented. The examined material comprised intraocular fluids and blood samples collected from 332 deceased suspected of being intoxicated or poisoned with psychoactive agents. The cases in which death resulted from injuries and those where an individual took drugs before his or her death were also considered. Drug analysis was carried out by fluorescence polarization immunoassay (FPIA). In both biological fluids the degree of hydratation was determined. Ethyl alcohol, opiates, barbiturates and benzodiazepines were found in all the examined cases. In few cases ethanol substitutes such as isopropyl alcohol, ethylene glycol and methyl alcohol were indicated. Results of the quantitative examinations were divided into sets according to the kind of xenobiotic and then on the basics of concentration of the substance found in the blood and vitreous body 2 different groups were separated in each set. Statistic analysis of the correlations among xenobiotic concentrations in both organic fluids was also performed. The obtained findings allow to assume that intraocular fluid can be used for toxicological diagnosis of poisonings with psycho-active agents. The analytical results for intraocular fluid not only confirms the result for blood but also makes it credible. In single cases it can be a sufficient basis to determine and recognize psychoactive agents in the deceased.

• [An unusual case of gunshot wounds caused with an air gun].

  Authors: Mariusz Kobek, Czesław Chowaniec, Krystian Rygol, Christian Jabłoński

  Archiwum medycyny sa̧dowej i kryminologii. 61(1):58-61.

  A 28-year-old woman was shot in the face with an air gun while driving a car. The patient was examined in the Department of Forensic Medicine in Katowice. An inconspicuous scar was found near theA 28-year-old woman was shot in the face with an air gun while driving a car. The patient was examined in the Department of Forensic Medicine in Katowice. An inconspicuous scar was found near the medial angle of the right eye. Further ophthalmological and radiological examinations revealed the presence of small foreign bodies in the vitreous body of the right eye, the sphenoid sinus and the ethmoid cells. The authors issued an expert opinion, in which they stated that the sustained injuries had not caused any significant organ dysfunction.

• [Neurosis as a mental disease--controversies surrounding insurance certification].

  Authors: Christian Jabłoński, Mariusz Kobek, Dorota Kowalczyk-Jabłońska

  Archiwum medycyny sa̧dowej i kryminologii. 61(1):62-4.

  In the years 2008-2009, experts from the Department of Forensic Medicine in Katowice issued a dozen of expert opinions on the nature of the neurosis, addressing the question whether neurosis is aIn the years 2008-2009, experts from the Department of Forensic Medicine in Katowice issued a dozen of expert opinions on the nature of the neurosis, addressing the question whether neurosis is a mental disease as understood under the general insurance conditions or whether neurosis is a mental disease as such. All the submitted cases involved policemen who had been diagnosed as neurotic and were refused insurance payments since the insurance company claimed payments could not have been effected due to the diagnosis of mental disease, meaning neurosis in the discussed cases. The plaintiffs invoked the fact that medical terminology describes such states as "mental disorders". In the article, the authors present the adopted model of opinionating, make an attempt at explaining the controversy and discuss the subtleties of medical terminology and the core differences between the terms "mental disorder" and "mental disease" as employed in medico-legal opinionating in such cases.

• [Differentiation possibilities in posttraumatic neuropsychiatric disorders in medico-legal certification]

  Authors: Christian Jabłoński, Czesław Chowaniec, Mariusz Kobek, Dorota Kowalczyk-Jabłońska

  Archiwum medycyny sa̧dowej i kryminologii. 57(2):245-7.

  This paper is a continuation of the previous work entitled "Difficulties in estimation of posttraumatic neuropsychiatric disorders for the purpose of criminal and civil law proceedings" presentedThis paper is a continuation of the previous work entitled "Difficulties in estimation of posttraumatic neuropsychiatric disorders for the purpose of criminal and civil law proceedings" presented during the 5th National Symposium "Days of Medical Certification", Poznan 2005. Referring to the then mentioned problem, the authors present in a greater detail the possibilities of objectivization of claims using simple psychiatric and psychological diagnostic tools

• [A rare case of internal carotid artery injury during palatine tonsillectomy in a religious sect believer (a Jehovah's Witness)]

  Authors: Christian Jabłoński, Mariusz Kobek, Agnieszka Nowak

  Archiwum medycyny sa̧dowej i kryminologii. 56(4):274-6.

  The report presents the case of a 35-year-old woman, a Jehovah's Witness, who died due to undiagnosed internal carotid artery injury and subsequent exsanguination following a palatine tonsillectomy.