Death following spontaneous recovery from cardiopulmonary arrest in a hospital mortuary: 'Lazarus phenomenon' in a case of alleged medical negligence

Hitoshi Maeda, Masaki Q. Fujita, Bao Li Zhu, Hidekazu Yukioka, Mitsuo Shindo, Li Quan, Kaori Ishida

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23 Citations (Scopus)

Abstract

We report a possibly first forensic autopsy case of death following a spontaneous recovery from cardiopulmonary arrest (CPA) after clinical declaration of death: 'Lazarus phenomenon'. A 65-year-old male with congenital deafness and dumbness was found unconscious in his room at a public home. During pre-hospital and clinical resuscitation including defibrillation and medications for about 35min, CPA persisted under electrocardiographic (ECG) monitoring and therefore, his death was pronounced. However, about 20min later, a police officer who had been called for the postmortem investigation found the patient moving in the mortuary. The patient subsequently showed typical ECG signs and laboratory findings of early inferior wall myocardial infarction and died 4 days later. The forensic autopsy, due to alleged medical negligence, revealed myocardial infarction with thrombotic occlusion of the right coronary artery and secondary hypoxic brain damage. The present case and the related clinical literature suggest that, especially in cases of acute myocardial infarction in elderly patients, a careful observation to confirm death after discontinuation of resuscitation is recommended to provide appropriate medical care, irrespective of the quality or duration of advanced life supporting efforts.

Original languageEnglish
Pages (from-to)82-87
Number of pages6
JournalForensic Science International
Volume127
Issue number1-2
DOIs
Publication statusPublished - 2002 Jun 25
Externally publishedYes

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Keywords

  • Alleged medical negligence
  • Cardiac arrest
  • Diagnosis of death
  • Lazarus phenomenon
  • Myocardial infarction
  • Resuscitation

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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