medicolegal aspects of life-threatening late hemorrhage after tonsillectomy; a report of three cases

Aims: secondary bleeding after tonsillectomy is unavoidable. if it leads to a life-threatening event, it will likely be associated with a malpractice claim against the surgeon. very few reports have addressed this event from a medicolegal point of view. therefore, the present report aimed to investigate litigations following secondary post-tonsillectomy hemorrhage leading to death or life-threatening events in three patients. patients & methods: here, we report three cases of life-threatening secondary post-tonsillectomy hemorrhage referred to the legal medicine organization by the prosecuting attorney to give an expert opinion about any medical negligence. findings: two cases resulted in death and underwent medicolegal autopsy. the third one caused a cardiopulmonary arrest followed by neurological deficits after successful resuscitation. all three were children between 8 and 9 years old, and the time from surgery to post-tonsillectomy hemorrhage was between 30 hours to 13 days. no vascular anomaly or iatrogenic vascular injuries were found at autopsy. a review of the literature revealed that post-tonsillectomy hemorrhage is common and unpreventable conclusion: in none of the cases medical malpractice was found as a contributing factor, and the complication was regarded as unpreventable.