RESUMEN
A 50-year-old surgeon was working with his electrical circle saw as a do-it-yourselfer. He was alone, nobody witnessed his mishap when he amputated his left index finger. He claimed high financial compensation from two accident insurance companies because of his disability. A long series of medical expertises followed. The juridical procedures took 12 years in total. All higher authorities had to deal with the forensic medical implications. Finally, the high court (Bundesgerichtshof) decided that the complainant would receive no compensation because he gave two very different descriptions. Concerning the reconstruction of the accident, the first version was unlikely from a biomechanical point of view. The decision of the court was solely based on the violation of the obligation to give a clear presentation of the course of events (Obliegenheitsverletzung).
Asunto(s)
Accidentes/legislación & jurisprudencia , Amputación Traumática/etiología , Testimonio de Experto/legislación & jurisprudencia , Traumatismos de los Dedos/etiología , Fraude/legislación & jurisprudencia , Seguro por Accidentes/legislación & jurisprudencia , Automutilación/diagnóstico , Amputación Traumática/diagnóstico , Compensación y Reparación/legislación & jurisprudencia , Traumatismos de los Dedos/diagnóstico , Alemania , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The case of a self-amputation of the left-sided forefinger is presented. It was an isolated smooth amputation near the basic ankle of the finger without any accompanying injury of other fingers. The victim (a physician) claimed financial compensation from his accident-insurance; his contract included special disability taxes for finger injuries. However, the insurance company did not pay but was able to demonstrate--by means of a medico-legal reconstructive expertise--that the amputation was voluntary and self-inflicted. The argumentation concerning self-mutilation is presented (including the so-called execution-position of the finger and ergonometric aspects). Concerning the surgical care, intervention and diagnostic procedures a detailed documentation of the case history and the morphology of the injury pattern are recommended (especially in isolated finger-amputations of the non-working hand.
Asunto(s)
Amputación Traumática/diagnóstico , Traumatismos de los Dedos/diagnóstico , Fraude/legislación & jurisprudencia , Seguro por Accidentes/legislación & jurisprudencia , Automutilación/diagnóstico , Anciano , Testimonio de Experto/legislación & jurisprudencia , Humanos , Seguro por Discapacidad/legislación & jurisprudencia , Masculino , Inhabilitación Médica/legislación & jurisprudenciaRESUMEN
27 cases of questionable self-mutilation among physicians (concerning finger and hand injuries) were analyzed retrospectively. The evaluation based on files of the insurance companies, reconstructive examinations and experimental investigations. Three typical cases are described in detail, the "victims" were suspected to have committed a special kind of fraud in order to claim financial compensation from their accident-insurance companies; the contract included special invalidity payments for finger injures (so-called "Gliedertaxe"). Many of these physicians had worked in the surgical field: apart from one 38-year-old female all of them were males, aged between 41 and 66 years. The mutilating instruments were often circular saws, sometimes chain saws and a great variety of other tools, for example hatchet, big scissors and other sharp instruments. By means of forensic-medical expertise and criminalistic investigations the insurance companies were able to demonstrate clearly that the amputation was voluntarily self-inflicted. The forensic-medical argumentation concerning intentional self-mutilation included the so-called execution position of the finger, the injury pattern, the investigations of blood stains and ergonometric aspects.