David Leo Ranson

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Verified

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• BMedSci BM BS LLB FRCPath FRCPA FACLM FFFLM FFCFM FFPMI DMJ(Path)
• Clinical Professor at Monash University (Australia)

Aim: To catalogue and compare the pattern of metastatic disease in germline BRCA1/2 pathogenic mutation carriers and non-carriers with breast, ovarian and prostate cancer from a rapid autopsy programme. Methods and results: The number of metastases in the major body systems and the proportion of participants with metastases were documented in 50...

Around the world, death investigation takes place utilising a variety of medical, scientific, administrative and legal systems that are specific to the particular legal jurisdiction within which the death occurred. While an internationally agreed approach might be desirable, in practice the vicissitudes of the political, legal, educational and fisc...

A vital component of disaster management is the identification of the deceased. This chapter discusses the processes created by the International Criminal Policing Organization (INTERPOL) to undertake and standardize the disaster victim identification (DVI) process. Following a brief description of the basics of personal identification which involv...

Background Asthma epidemics associated with thunderstorms have had catastrophic impacts on individuals and emergency services. Seasonal allergic rhinitis (SAR) is present in the vast majority of people who develop thunderstorm asthma (TA), but there is little evidence regarding risk factors for TA among the SAR population. Objective We sought to i...

As the world's population ages, a question of who can be trusted to look after the increasing elderly population arises. Health care professionals are commonly considered one of the group of people we entrust with our health care and maintenance of a good quality of life. Unfortunately, some abuse this trust. Harold Shipman, Elizabeth Wettlaufer an...

Geriatric Forensic Medicine and Pathology - edited by Kim A. Collins September 2020

The COVID-19 pandemic has affected the community in multiple ways. These include direct health impacts on those infected and indirect health impacts on others who may, through fear of infection, not avail themselves of available "face-to-face" health care services. The impact of COVID-19 on the legal system and the related medico-legal services it...

Cambridge Core - Medical Law, Ethics and forensic Medicine - Geriatric Forensic Medicine and Pathology - edited by Kim A. Collins

The Royal Commission into Aged Care Quality and Safety's Interim Report entitled Neglect, identified multiple failings in meeting Australia's care needs of older people. Many of these have been examined from both health and regulation-based perspectives. However, although some of the issues uncovered relate to potential criminal acts, relatively fe...

Open disclosure is a valuable process which has the potential to benefit both the patients who receive the open disclosure and the health care professionals (or organisations) who provide it. The benefits from open disclosure will most often be seen when open disclosure is performed in an ‘ideal’ manner. When open disclosure is suboptimal, it can l...

Objectives To describe the characteristics of deaths reported to the Coroners Court of Victoria (CCOV) during Victoria’s last heatwave (14–17 January 2014) and subsequent 4 days (18–21 January) using medicolegal data obtained from both the police investigation report and the pathologist’s report. Design, setting and participants A single-jurisdict...

This study reviews the circumstances and medical causes of death of motor vehicle drivers who died in circumstances of sudden illness whilst behind the wheel in Victoria, Australia 2012-13. The driver's fitness to drive assessment history was also examined to identify prevention opportunities. Deaths included in the study were those referred to a p...

The Gosport Independent Panel was established to review the care of older patients at the Gosport War Memorial Hospital in England over some 20 years. There had been a number of internal and external investigations that included police investigations, clinical care audits, GMC investigations and inquests. The Panel provided a means of public disclo...

The rise in the population and the growth in the proportion of the elderly in our population are changing the structure of many of our communities and placing increasing demands on our social and health care services. "Scandals" regarding conditions and standards of care in residential aged care facilities have raised concerns about the regulation,...

Objectives To examine the impact of changes to the reporting requirements in coronial legislation on the nature and frequency of nursing home resident deaths reported to Coroners. Design National retrospective study of a population cohort of nursing home resident deaths. Setting Accredited Australian nursing homes between July 2000 and June 2013....

Data from both medical and legal investigation can provide significant opportunities for legal and regulatory policy development that in some sectors are often ignored or missed. The provision of safe and high-quality care for the vulnerable, frail older people who live in residential aged care services (often termed nursing homes) in Australia con...

The medicolegal death investigation in Victoria, Australia is a traditional coroner system based on the model in England and Wales in the early 20th Century. In 1985, the first of a series of legislative amendments were made that proved the vanguard of reform of the coroners' jurisdictions in Australia. The Victorian Institute of Forensic Medicine...

The National Coronial Information System (NCIS) is the world's first national Internet-based database of coronial information. It was established in Australia following the recognition by coroners that their mandate for public health and safety could be improved if they could identify previous similar deaths. The NCIS is funded from state, territor...

Background Coroners are tasked with the investigation of unnatural and unexpected deaths. In Australia, the coroner’s role also includes making recommendations for promoting interventions to improve public safety. However, the coroners’ role in public health and safety in the aged care setting is an underexplored area of research. Objectives To de...

Objectives: To conduct a descriptive epidemiological analysis of external cause deaths (premature, usually injury-related, and potentially preventable) of nursing home residents in Australia. Design: Retrospective study of a cohort of nursing home residents, using coronial data routinely recorded by the National Coronial Information System. Set...

Objectives: To determine the risk associated with mortality among nursing home residents within 6 months following an evacuation because of man-made or natural disasters. Design: A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Statement. Setting: All peer-reviewed...

There is a paucity of research examining the utility of forensic toxicology in the investigation of premature external cause deaths of residents in nursing homes. The aim of this study is to describe the frequency and characteristics of toxicological analysis conducted in external cause (injury-related) deaths amongst nursing home residents in Vict...

Designer or synthetic drugs of abuse are a growing problem for legislators, law enforcement and health care providers. The rapidly modified chemical structure of such substances means that not only are their legislative categorisations uncertain and fluid but their health effects remain largely unclear with little opportunity for timely research th...

Methodology: Literature Review and medico-legal commentary. Results: Fatal one-punch assaults have been reported extensively in the media. This article provides a commentary on recent policy developments and legislative amendments in Australia regarding so called 'one-punch' assaults. Comparisons are made with the situation in other jurisdiction...

The recent national focus on family violence has had an impact on many areas within the Australian community. The setting up of a Royal Commission into Family Violence in Victoria is just one of these responses and in turn the recommendations of this Royal Commission have implications for government, the courts as well as a range of State and Terri...

The concept and potential implications of a premature death of an older person are under-recognised and misunderstood by society. Clinical, forensic and public health practitioners need to redress this gap to prepare society better for a future where an increasing proportion of the population are vulnerable older people. Reliable and valid informat...

Background Medico-legal death investigations are a recognised data source for public health endeavours and its accessibility has increased following the development of electronic data systems. Despite time and cost savings, the strengths and limitations of this method and impact on research findings remain untested. This study examines this issue u...

This chapter explores the relationship between the law and forensic medical practice. It discusses the reasons why we have laws that regulate our community and the importance of law for medical and dental practice. Different types of laws are considered including case law as well as statute-based law. In particular the coroner's jurisdiction is dis...

This chapter outlines the role of the forensic pathologist in death investigations with particular reference to legal coroners' jurisdictions. The purpose and conduct of medico-legal autopsies is described and the key aims of autopsies from both the medical and legal perspective is discussed. The role of radiological examination of deceased persons...

In September 2016, the President’s Council of Advisors on Science and Technology (PCAST) in the United States published its report to the President entitled Forensic Science in Criminal Courts: Ensuring Scientific Validity of Feature-Comparison Methods. The need for this report arose out of the highly critical 2009 National Research Council report...

Australia's population is ageing and it is likely that there will be a threefold increase in the number of people living with dementia in the next 30 years. Caring for these individuals will incur a significant burden on our community both fiscal and personal. How we provide this care will say much about our compassion for and commitment to caring...

While forensic medical tasks are usually associated with supporting the criminal justice system, there are a range of forensic medical skills that can be brought to bear on addressing humanitarian activities. Disaster victim identification is a procedure that has achieved international standardisation through the work of a multinational Interpol St...

Objectives To describe the nature and extent of external-cause deaths of residents of nursing homes in Victoria, Australia.DesignA retrospective cohort study of all decedents using routinely collected data contained within the National Coronial Information System.SettingAccredited nursing homes in Victoria.ParticipantsNursing home residents who had...

resident-to-resident aggression (RRA) is an understudied form of elder abuse in nursing homes. the purpose of this systematic review was to examine the published research on the frequency, nature, contributing factors and outcomes of RRA in nursing homes. in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Stat...

The Coroners Prevention Unit at the Coroners Court of Victoria (CCV) is a multidisciplinary team that investigates deaths referred by the state's coroners, with a view to identifying prevention opportunities. The death of a woman from acute aortic dissection (AAD) after an emergency department attendance prompted the coroner to request a roundtable...

Objectives To systematically review published research characterizing the nature and circumstances surrounding the death of older people in nursing homes specifically using information generated for medicolegal death investigations.DesignSystematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Stat...

The care of older people in residential aged care services could be improved by optimising the use of existing information gathered for medico-legal death investigations. The authors address three myths contributing to underuse of this information: deaths are not preventable; public health gains are too small; and it is someone else's charter or re...

It is clear from recent media reporting that serious issues have come to light regarding sexual misbehaviour matters within the Australian Defence Force. Subsequent reviews have indicated that these behaviours appear to have been more widespread than the initial media reports suggested and a number of reviews have been undertaken to better understa...

To better understand the non-reporting of reportable deaths by determining the frequency and nature of reportable deaths referred to the Coroners Court of Victoria (CCOV) by the Registry of Births, Deaths and Marriages (BDM). Review of referrals from BDM to the CCOV between 2003 and 2011 where an external cause of death was recorded on the death ce...

This article presents evidence for the existence of a common trajectory from work-related musculoskeletal injury to suicide. Specifically, it is argued that the pathway from injury to suicide is typically mediated by three critical events: unsuccessful return to work; the development of chronic pain or disability; and suicidal ideation in the conte...

This column discusses the issues encountered when courts attempt to determine if an individual who has no reliable age at birth documentation has reached adulthood, or is still a legal minor. This issue has recently received a high level of public interest due to the wrongful imprisonment in Australian adult prisons of Indonesian minors accused of...

"Excited delirium" has become increasingly recognised as a medical entity that is typically associated with individuals suffering from a mental illness and/or affected by a variety of stimulant-type drugs. Because the diagnostic label has been used in association with situations of violence on the part of the person affected, and this has included...

The output of the work of a forensic pathologist could be distilled into the delivery of information to a range of justice agencies and in particular to the forum of a court or other judicial or quasi judicial tribunal. The increasing complexity and knowledge base of forensic and medical science and the growing emphasis on ‘evidence based medicine’...

Recent studies and a review in the United States have identified that tens of thousands of used but untested sexual assault examination kits containing medical examination specimens are to be found in police station evidence rooms, forensic science laboratories, hospitals and rape crisis centres. A 2007 survey undertaken by the National Institute o...

Sudden death in association with minor or otherwise insignificant head injury is increasingly being recognised in the forensic medical literature. While the exact mechanism of the cardiorespiratory arrest that appears to occur in these cases is unclear, a number of mechanisms have been postulated. Animal studies have provided evidence that alcohol...

Suicide and intentional self-harm are issues of major importance in public health and public policy, with rates widely used as progress indicators in these areas. Accurate statistics are vital for appropriately targeted prevention strategies and research, costing of suicide and to combat associated stigma. Underreporting of Australian suicide rates...

The legal basis of the medical investigation of deaths for the coroner has changed with the implementation of the Coroners Act 2008 (Vic) in Victoria. For the first time in Australia the notion of "preliminary examinations" has been created whereby medical investigators, for the most part forensic pathologists, have authority to carry out their own...

This chapter gives an educational overview of: * Management implications of information technology in research, public health and policy development * Modern developments in death investigation, injury prevention and disaster management * The dangers of applying global analysis to individual health care situations and vice versa * Mechanisms that c...

The care and protection of children in our community is usually given one of the highest priorities by governments and service providers. Similarly, we respond severely to those proven to have abused or caused deliberate harm to children. Acceptance of these high standards is predicated on our ability to correctly identify and appropriately investi...

Suicide and intentional self-harm are issues of major importance in public health and public policy, with rates widely used as progress indicators in these areas. Accurate statistics are vital for appropriately targeted prevention strategies and research, costing of suicide and to combat associated stigma. Underreporting of Australian suicide rates...

Patients suffer preventable harm from their medical treatment. The traditional approaches to investigating medical treatment related deaths are the 'hospital mortality audit' and legal or coroners investigation. The aim is to describe how the patient safety movement in the late 1990s is changing traditional approaches to the investigation. The prev...

There is growing government awareness of the increasing incidence of obesity in the Australian community and its potential impact on health policy issues. This column considers the appropriateness of the WHO definition of the term "obesity" and analyses its use by Australian forensic pathologists and coroners as a cause of death in "medical cause o...

The delivery of medical services through the use of modern technology is proving of significant benefit, particularly in remote communities where transportation of patients and medical practitioners is problematic. Technical systems supporting telemedicine-based consultations have been available for some years and more recently diagnostic services...

Legal liability of doctors as a result of decisions regarding the fitness to drive of their patients, and the issue of mandatory reporting have emerged as major concerns following several recent cases in Australia. Driver Licensing Authorities rely on medical advice from the professions in order to exercise their statutory responsibility to ensure...

Formal medical discipline-based regulation and professional support for legal medicine practitioners have been a long time coming. While informal associations and societies of like-minded doctors and dentists have existed for some time, they have not had the sort of "establishment credibility" that is required to influence policy-makers and drive f...

'Under-reporting' of deaths to the coroner has significant implications for the identification and investigation of preventable deaths. In extreme cases, it may even be a symptom of the system failures that allowed cases such as Harold Shipman, Australia's King Edward Memorial Hospital, the alleged incidents at the Bundaberg Hospital and the Bristo...

Safety in health care has increasingly become a key focus of health care providers. Data on "patient outcomes" and evidence-based clinical decision-making have led to real changes in health care policy and care provision. Specialist groups such as the National Patient Safety Agency which operates the National Confidential Enquiry into Patient Outco...

Fly pupae and puparia may contaminate forensic entomology samples at death scenes if they have originated not from human remains but from animal carcasses or other decomposing organic material. These contaminants may erroneously lengthen post-mortem interval estimates if no pupae or puparia are genuinely associated with the body. Three forensic ent...

Moral or ethical codes of practice represent one of the oldest forms of medical regulation. Legislation such as the Medical Practice Act 1992 (NSW) enables regulatory bodies to create codes of practice for medical practitioners. Such codes can become an important aspect of disciplinary proceedings by providing the yardstick against which practition...

To ascertain the frequency of in-hospital deaths after urological surgery in a compulsory reporting setting, and to identify the contributing and potentially reversible factors involved in patients who had had transurethral resection of the prostate (TURP). We reviewed all hospital deaths reported to the State Coroner from Coronial Services Victori...

A professional world without borders would allow for more appropriate collaboration between the Coroner's office and the healthcare sector in their endeavours to improve patient safety. In Victoria (Australia), the Clinical Liaison Service draws on the distinct experiences and expertise of medical, nursing and research personnel to evaluate clinica...

Western philosophical and political thought has focussed on the significance of individual relativism. The legal system's approach to the investigation and regulation of medical practice is generally ad hoc and based on case law. In contrast, medical knowledge and understanding is progressively shifting towards a system of taxonomies and norms. Cli...

Following formulation of a new definition for SIDS, a workshop was convened in Canberra Australia, in March 2004, by SIDS and KIDS, Australia. Attendences included forensic and pediatric pathologists representing major institutions from all Australian States and Territories. The issues of the adoption of a uniform definition of SIDS and a standardi...

Carrion insects originating from infested bodies may establish small mortuary populations. Two Victorian Institute of Forensic Medicine cases are presented to illustrate how these insects can potentially contaminate forensic entomology samples collected in the mortuary. The first case proves that bodies can be colonised in the mortuary: when a deco...

Carrion insects originating from infested bodies may establish small mortuary populations. Two Victorian Institute of Forensic Medicine cases are presented to illustrate how these insects can potentially contaminate forensic entomology samples collected in the mortuary. The first case proves that bodies can be colonised in the mortuary: when a deco...