Biology Reference
In-Depth Information
Comments
As detailed in Section 4.5, although the victim/author attempted to provide a case
account, the report is typically flawed due to a lack of formal medical review, subjec-
tivity, and incorrect misinterpretation of factors influencing the outcome of the bite as
well as the described symptoms/signs. It is noted that several features of the case
are similar to some that have been formally reported (see Section 4.2; Weinstein &
Keyler, 2009). Regardless, the case cannot be acceptably analyzed as it lacks the
minimal standard of any appropriate clinical case report (Section 4.5). Evidence-
based analyses of clinical cases must be held at an acceptable standard, whether
the case involves a colubroid snakebite, myocardial infarction, diverticulitis, and so
on. For instance, it is not possible to confidently analyze a case of haematuria posted
on the Internet. Such a case requires formal medical history, examination, investi-
gation, and documentation. The nature of any presentation must not change, lower,
or in any way alter the standard expected in formal reporting of a clinical case.
The identity of the snake in this case is not in question, as the victim posted pho-
tos of the specimen biting his finger. This should not encourage similar experimen-
tation as the effects can, on occasion, be significant. Clearly, the victim allowed the
snake to remain engaged on his finger in order to observe the effects of a protracted
bite (Section 4.5). The victim's previous exposures, bites, and possible medical
comorbidities are unknown. Obviously, at the least, the victim has had regular expo-
sure to this snake for the period of ownership of the specimen (reportedly 8 years).
In the USA, the medical history and, if applicable, documented details regarding pre-
vious snakebite incidents are personal medical data protected by Health Insurance
Portability and Accountability Act (HIPAA)
2
statutes, and these constitute another
reason (medicolegal) for the low evidence value of such cases posted on the Internet.
Case 2. Jackson's Black Tree Snake,
Thrasops jacksoni
Websites
Features of Case
Described by the victim/author (presumably male, age unknown), this case involved
a bite inflicted by an approximately 48-inch captive
T. jacksoni
. Photos of the snake
2
The HIPAA of 1996 provides security and privacy rules that establish US national standards for the pro-
tection of individually identifiable health information and security of electronically stored personal medical
records. The implications of this Act also accentuate the need for competent medical evaluation and profes-
sional reporting of any clinical presentation, including medically significant snakebites. Such information
publically posted on the Internet can be subject to misuse, whether purposely or unintentionally. See
http://
www.hhs.gov/ocr/privacy/
for further information regarding the medico-legal issues related to this Act.