Pediatric Cardiology & Healthcare

Biography

Biography: Guy Hugues Fontaine

Abstract

A 5 years old child died suddenly beside his father watching television. The immediate appeal of the EMS and Fire Brigade did not allow resuscitation practiced under ideal conditions. The child has a bipolar, epicardial, dual-chamber PM, for Complete AV Block detected in utero. A fracture led to unipolarized atrial lead system because a fracture was discovered during follow-up. However, another lead fracture was also visible at the bifurcation of the ventricular lead system. Nevertheless pacing of both atrial and ventricular chambers was OK. LVEF was borderline lower limit can be explained by abnormal area of contraction near the LV apex. The case is still in Court after failure of two conciliation committees. Two university hospitals, eight lawyers with one PM technician, 17 doctors and cardiologists, four experts including two super-experts (including GF) were involved. Up to now this case has been presented to 25 doctors and cardiologists who have not found the solution. Seven half-days to study a 500-pages file were necessary to completely elucidate the mechanism of this irreversible death. The conclusion which needs knowledge in Medicine, Cardiology, PM technology and heart Pathology (despite absence of autopsy) suffers no alternative. The case will be presented step by step asking participation of the audience. The first document is the last standard ECG recorded before the catastrophe; the second are laboratory data concerning an asymptomatic lupus detected in the mother by specific antibodies which may explain AV block. The third is the standard X-Ray showing the two leads fracture. The last is the post-mortem interrogation of PM memories. Analysis and interconnection of all these elements have led a final diagnosis explaining the catastrophe which has no alternative. Up to now no correct solution has been proposed by 212 Drs and cardiologists who attended the presentation of this case.