It's a woman, Mrs. Reed.
A, 39 years old, who has been cited in a programmed manner by a judge, in order to educate if he was victim or not of medical negligence.
As a prolegomenon of the case, she came to the hospital emergency department referring to having suffered what was subsequently catalogued as a dislocation of the left knee, which resolved spontaneously.
A conservative approach is used after two weeks of inguino-pedic immobilization, which does not correspond to the perception of the injured person.
Since then it manifests as a clinical picture of knee ankylosis, being subjected to rehabilitation treatment without any success.
The evolution of the process was torpid, finally proposing surgical intervention of the knee under the clinical diagnosis of "artrofibrosis", which is suspended at the discretion of the surgeon, for not finding clinical basis to justify the symptoms.
After this last episode, the interested party decides to issue a complaint for medical negligence, making it feasible for all those specialists who have been attending it since the beginning.
He came to the Forensic Medicine consultation two years after the first attendance received in the emergency room, shortly after the complaint was issued, being cited in a programmed way in the offices of the Institute of Legal Medicine of Huelva, where he came.
Physical examination revealed moderate global hypotrophy of the musculature of the left lower limb and a total lack of mobility of the ipsilateral knee in flexion and extension.
There is no associated inflammatory component and presents bilateral genu valgum.
A marked conductive component was detected during the interview.
The initial diagnosis is made by semi-structured interview under the criteria proposed by the DSM IV-TR classification.
After agreeing on a detailed interview and exploration by the Forensic Psychologist it was decided to pass the MMPI test (Multiphasic Personality Inventory of Minessotta), highlighting in it a marked repressive profile and a
It was decided to corroborate the diagnosis by programmed hip fracture session, with the consent of the interested party, in order to achieve ankylosed knee flexion.
1.
Method:
The hypnotic process takes place in the very offices of the Institute of Legal Medicine of Huelva, after a preparatory session in which the bases of the same are explained and it is necessary to achieve an adequate doctor-explored link.
That's why you put Mrs. Reed on.
A in the supine position, on a standard consultation stretcher, whose base was collected, so that the healthy knee would fall in flexion due to the effect of gravity on the left knee, completing the limits of extension.
The process was developed under an empathetic atmosphere and fixed, with a good predisposition to collaboration by the patient.
The hypnotics was initiated from directed to favor the relaxation of the patient, using for this a technique of muscle relaxation (body visual or "imaging"), followed by "visualization of the final stage of the hypnotic process".
These techniques are focused on both greater predisposition to suggestion and its evaluation.
Once the Hypnotic Induction has achieved that the patient focuses his attention on the instructions issued by the psychologist and other sources of information become secondary instructions (environmental noises, presence of other people, etc.), has become more suggestive.
After achieving the desired state of suggestion, we proceeded to guide the suggestions for the motor symptom, linking elements of muscle relaxation with positive messages focused on knee flexion [12, 13].
After approximately one hour, starting with the relaxation technique and ending with the recovery of the state of wakefulness, the patient responded to an initial relaxing process on the left knee, recovering the abnormal position.
Subsequently, two additional interviews were conducted with Mrs. Fairfax.
A, as well as another to his spouse, in order to better understand the psychobiographical environment and properly contextualize the psychogenic process.
