Dawn L. Broce, IV-A Forensics Final Exam 1-A.

What are the signs and symptomacology of typhoid fever infection? Recurring fever and chills. B. What are the possible complications of Typhoid Fever as an infectious disease? Perforation, hemorrhage, as well as liver and cerebral complications. C. What is medical malpractice? This is a particular form of negligence which consists in the failure of a physician or surgeon to apply to his practice of medicine that degree of care and skill which is ordinarily employed by the profession generally, under similar conditions, and in like surrounding circumstances. D. What were the allegations about medical malpractice? Petitioners contended that: (1) Dr. Marlyn Rico hastily and erroneously relied upon the Widal test, diagnosed Jorges illness as typhoid fever, and immediately prescribed the administration of the antibiotic chloromycetin;[21] and (2) Dr. Marvie Blanes erred in ordering the administration of the second dose of 500 milligrams of chloromycetin barely three hours after the first was given.[22] E. Why was Dr. Vacallares testimony refuted by another physician? His testimony was refuted because the Court did not count him as an expert witness since he does not specialize on infectious diseases like Typhoid Fever. And although he may have had extensive experience in performing autopsies, he admitted that he had yet to do one on the body of a typhoid victim at the time he conducted the postmortem on Jorge Reyes. It is also plain from his testimony that he has treated only about three cases of typhoid fever. F. Res Ipsa Loquitur the doctrines application to the case of Reyes vs. Sisters of Mercy Hospital.

The Court ruled that the petitioners contention that all the requisites for the application of res ipsa loquitur was present because while it is true that the patient died just a
few hours after professional medical assistance was rendered, there is really nothing unusual or extraordinary about his death. Prior to his admission, the patient already had recurring fevers and chills for five days unrelieved by the analgesic, antipyretic, and antibiotics given him by his wife. This shows that he had been suffering from a serious illness and professional medical help came too late for him. 2. Describe the content details done in a medico legal certificate. The patients personal details have to be enumerated like her name, age, address, civil status, time of admission, and the attending physicians diagnosis of her. Then the patients complaint must be stated in detail followed by a description of the lacerations on the vagina, if there are any, and the conditions of the lacerations (whether they are healing or not). 3-A. What are the possible reasons for Irene Dulays alleged feeling of headache and dizziness after intake of 3 tablets of aspirin? The headaches as well as the stomachaches that Irene Dulay allegedly felt could have been present even before the accused and his sister supposedly forced her to take 3 tablets of aspirin, as

according to witnesses, she was already suffering from said headache when she returned home from a week long vacation. B. Discuss the hymenal lacerations. The medical examination showed that the lacerations wide at 2 o'clock and 10 o'clock hymen were healing at the time of the medical examination. Assuming that the victim was raped between 2 and 3 o'clock p.m., April 22, 1973 (the same day she was admitted in the hospital), then the lacerations of the hymen at 2 o'clock and 10 o'clock would not have been described and indicated to be Healing in the clinical case record. It would be described as "laceration fresh" or by similar words like "bloody or new lacerations." There is no instant formula, technique or process known to medical science or by human experience to hasten the healing of a lacerated hymen within three (3) hours or so after defloration. Superficial laceration of the hymen may heal in two or three days. More extensive tear may require longer time, usually seven to ten days. Complicated types and those with intervening infection may cause delay in the healing depending upon the extent of the involvement of the surrounding tissue and the degree of infection. Complicated laceration may even require surgical intervention." Since there was found laceration, wide, at 2 o'clock and 10 o'clock of the hymen which was then already healing on April 22, 1973, it follows reasonably that the defloration occurred several days before C. Differentiate menstrual blood from blood due to hymenal lacerations. 4-A. What were the pertinent findings of the genital examination on the victim? Pubic hair, no growth. Labia majora and minora, gaping and congested. Hymen, moderately tall, thick with fresh lacerations, complete at 3:00, 6:00 and 9:00 oclock positions, edges with blood clots B. Discuss the forensic significance of the appearance of hymenal lacerations and stage of healing. The examination of the stage of healing against the appearance of hymenal lacerations is important in determining the approximate time the lacerations were created. C. What is the probative value of DNA testing? DNA tests are now considered as admissible evidence as they are, in most cases, the most accurate way of pinpointing the person who committed the crime using DNA traces left behind in the scene of the crime or on the victim himself. 5-A. Discuss the Battered Woman Syndrome theory. A battered woman has been defined as a woman who is repeatedly subjected to any forceful physical or psychological behavior by a man in order to coerce her to do something he wants her to do without concern for her rights. Battered women include wives or women in any form of intimate relationship with men. Furthermore, in order to be classified as a battered woman, the couple must go through the battering cycle at least twice. Any woman may find herself in an abusive relationship with a man once. If it occurs a second time, and she remains in the situation, she is defined as a battered woman. Battered women exhibit common personality traits, such as low self-esteem, traditional beliefs about the home, the family and the female sex role; emotional dependence upon the dominant male;

the tendency to accept responsibility for the batterers actions; and false hopes that the relationship will improve. More graphically, the battered woman syndrome is characterized by the so-called cycle of violence, which has three phases: (1) the tension-building phase; (2) the acute battering incident; and (3) the tranquil, loving (or, at least, nonviolent) phase. During the tension-building phase, minor battering occurs -- it could be verbal or slight physical abuse or another form of hostile behavior. The woman usually tries to pacify the batterer through a show of kind, nurturing behavior; or by simply staying out of his way. What actually happens is that she allows herself to be abused in ways that, to her, are comparatively minor. All she wants is to prevent the escalation of the violence exhibited by the batterer. This wish, however, proves to be double-edged, because her placatory and passive behavior legitimizes his belief that he has the right to abuse her in the first place. However, the techniques adopted by the woman in her effort to placate him are not usually successful, and the verbal and/or physical abuse worsens. Each partner senses the imminent loss of control and the growing tension and despair. Exhausted from the persistent stress, the battered woman soon withdraws emotionally. But the more she becomes emotionally unavailable, the more the batterer becomes angry, oppressive and abusive. Often, at some unpredictable point, the violence spirals out of control and leads to an acute battering incident. The acute battering incident is said to be characterized by brutality, destructiveness and, sometimes, death. The battered woman deems this incident as unpredictable, yet also inevitable. During this phase, she has no control; only the batterer may put an end to the violence. Its nature can be as unpredictable as the time of its explosion, and so are his reasons for ending it. The battered woman usually realizes that she cannot reason with him, and that resistance would only exacerbate her condition. At this stage, she has a sense of detachment from the attack and the terrible pain, although she may later clearly remember every detail. Her apparent passivity in the face of acute violence may be rationalized thus: the batterer is almost always much stronger physically, and she knows from her past painful experience that it is futile to fight back. Acute battering incidents are often very savage and out of control, such that innocent bystanders or intervenors are likely to get hurt. The final phase of the cycle of violence begins when the acute battering incident ends. During this tranquil period, the couple experience profound relief. On the one hand, the batterer may show a tender and nurturing behavior towards his partner. He knows that he has been viciously cruel and tries to make up for it, begging for her forgiveness and promising never to beat her again. On the other hand, the battered woman also tries to convince herself that the battery will never happen again; that her partner will change for the better; and that this good, gentle and caring man is the real person whom she loves. A battered woman usually believes that she is the sole anchor of the emotional stability of the batterer. Sensing his isolation and despair, she feels responsible for his well-being. The truth, though, is that the chances of his reforming, or seeking or receiving professional help, are very slim, especially if she remains with him. Generally, only after she leaves him does he seek professional help as a way of getting her back. Yet, it is in this phase of remorseful reconciliation that she is most thoroughly tormented psychologically. The illusion of absolute interdependency is well-entrenched in a battered womans psyche. In this phase, she and her batterer are indeed emotionally dependent on each other -- she for his nurturant behavior, he for her forgiveness. Underneath this miserable cycle of tension, violence and forgiveness, each partner may believe that it is better to die than to be separated. Neither one may really feel independent, capable of functioning without the other.

B. The postmortem findings on the body of the victim? Dra. Cerillo said that there is only one injury and that is the injury involving the skeletal area of the head which she described as a fracture. And that based on her examination, Ben had been dead 2 or 3 days. Dra. Cerillo did not testify as to what caused his death. C. The cause of death as opined by Dra. Racquel Fortun. Fracture, open, depressed, circular located at the occipital bone of the head, resulting in laceration of the brain, spontaneous rupture of the blood vessels on the posterior surface of the brain, laceration of the dura and meningeal vessels producing severe intracranial hemorrhage. Blisters at both extremities, anterior chest, posterior chest, trunk w/ shedding of the epidermis. Abdomen distended w/ gas. Trunk bloated which caused his death. D. Post Traumatic Stress Disorder as cited by Dr. Pajarillo. In psychiatry, the post-traumatic stress disorder is incorporated under the anxiety neurosis or neurologic anxcietism. It is produced by overwhelming brutality, trauma. Dr. Pajarillo explained that with neurotic anxiety, the victim relives the beating or trauma as if it were real, although she is not actually being beaten at that time. She thinks of nothing but the suffering. Dr. Pajarillo said that a woman suffering post traumatic stress disorder try to defend themselves, and primarily with knives. Usually pointed weapons or any weapon that is available in the immediate surrounding or in a hospital because that abound in the household. He said a victim resorts to weapons when she has reached the lowest rock bottom of her life and there is no other recourse left on her but to act decisively.