Fundaments of the medical-forensic expertise. Medical qualification of bodily injuries. Immaterial damage - moral property (right to compensation for the violation of personal rights in the cases of patients injured in traffic accident).

Abstract

Trauma i.e. injury is not the same as an accident, because the
former is defined and it has a specific risk of occurrence which means
that it can be prevented, unlike the accident (flood, earthquake, fire)
which is unexpected, accidental and surprising.
Trauma is a violent damage of the tissue, organ, one or more
systems of the human body, under the influence of external force. In
the cases of trauma, the kinetic energy causes damage to the part of
the body which absorbs the energy.
Trauma can be isolated when one organ or tissue is injured
and damaged. Multiple trauma refers to several injuries of the same or
different systems which does not affect the vital functions, and, in
principle, it does not endanger the life of the wounded. Politrauma
represents brutal and violent damaging of the body, complex of severe
anatomical and functional impairments of two or more organs, or
different systems, with direct repercussions on the vital functions of
the organism. It results with high mortality. The medical science
dealing with the treatment and care of these injuries is called trauma,
and the doctor who treats and heals the wounded is a surgeon –
traumatologist.

The trauma does not refer only to the local tissue damage, but
it mobilises the entire organism. The activation of the multiple
mechanisms, such as neural, vegetative, endocrine and metabolic
occurs as a response to the trauma. Primarily, many impulses are sent
from the place of injury to the brain, which is the centre for pain,
awareness, the centre responsible for cardiac action to pituitary gland,
and thereof to other glands, such as the adrenal gland. The contraction
of blood vessels in place of their disruption occurs, coagulation factors
are activated and there are other defence reactions, as well.
According to the type of fracture, the trauma can be simple,
easy dispersion of bone tissue without dislocation of fracture
fragments, or fracture with various dislocations (latin: ad-latus, adlongitudinem, cum contractionem, cum axim, etc). The force itself, as
well as the bone which is broken may cause a local damage of the
surrounding tissues, blood vessels, neural structures, ligaments. These
may threaten the vitality of the extremity. The healing of the fracture
is an original process that leads to reconstruction of the impaired
tissue. At the place of fracture, a local bleeding occurs. Later, first
fibrous callus (Reactive Phase), as well as solid bone callus
(Reparative Phase) may be formed. Immediately after the injury, the
proliferation of cells occurs. The last phase is the remodelling of the
existing callus, which is most active 8-12 months after the injury
(Remodelling Phase).

When the patient suffers injuries of his moral property (pain,
fear, ugliness and reduced activities of daily living - ADLs ) and these
are not measurable through the employment of special medical
equipment - their evaluation and estimation can be objectified by a
doctor who deals with these cases in his everyday practice - the
traumatologist. Nobody besides the traumatologist can evaluate these
relevant facts in front of the court.