Victims of medical errors, of which there are more in the world than it seems, most often do not know how to defend their innocence and achieve an adequate punishment for the person in the gown, who not only failed expectations, but also demonstrated dishonesty, self-confidence or ignorance.
The punishment for “medical error” as such is not defined by law; there are several articles of the criminal code on this subject. But it’s not so easy to bring to justice a doctor who ruined someone’s life. At a minimum, independent expertise and persistent patience are required.
Fear of visiting a doctor's office is a completely healthy phenomenon. It is worse if this fear is well founded, when patients know from the media about the terrible mistakes that occur in hospitals around the world - even in developed countries With the best devices and high incomes for doctors. Many people have heard stories about medical instruments forgotten by specialists in the bodies of patients. Every year, similar embarrassments and even misfortunes happen to tens of thousands of inhabitants of the Earth who have had the misfortune of ending up in a hospital of any level. There are other medical errors in surgery and beyond, leading to disability or death of a patient who falls into the hands of an errant specialist.
Approximately every third medical error causes complications for the patient’s health and well-being. In addition, in Russia at least two patients die every day due to such errors, and some social activists claim that up to 50 thousand a year (in America - up to 250 thousand, if that).
Such cases could be described as comical if they were fixable. Not a single decent hospital wants to spoil its reputation with operations performed at the wrong address. However, even with strict control and protocols here and there, surgeons make mistakes that should never happen. For example, in one of the US clinics, biopsy samples were once mixed up in the laboratory prostate gland, and, therefore, a sick client with a healthy one. As a result, the patient, who lived without any hint of cancer, had his entire healthy prostate removed by surgeons. This is a complex and responsible procedure. Meanwhile, the real cancer patient was sent home, unaware of his true diagnosis.
In another overseas case, a patient died from pathological process in the lung after an intern inserted a breathing tube into the wrong place in a seriously ill patient.
Errors in patient selection make up, according to a number of studies, up to 0.5% of all medical errors in question.
Among the most horrifying examples of patient “switching” is the story of 41-year-old Colleen Burns, who suffered a head injury in a fall and woke up on operating table a minute before... seizure internal organs, started by surgeons. The fanatics involuntarily not only confused the sick, but also confused a living person with sedatives with a lifeless body. Fortunately, the operation was stopped in time, and the doctors remembered the curious incident for the rest of their lives. It happened in 2009 in New York state. The doctors were fined $22,000 for dangerous negligence, but could not explain why this happened. Well, after 11 months, Mrs. Burns still committed suicide by swallowing pills, despite her three daughters.
Errors during blood transfusion
It is believed that every tenth surgery in a hospital setting is accompanied by blood transfusions, of which millions are performed annually. The procedure seems to be routine, but there is also room for medical mistakes, and very dangerous ones at that.
According to statistics, out of 10 thousand packages of donated blood, at least one will contain blood that is not the one indicated on the label. Many tens of thousands of transfusion errors occur every year, with every 500th patient dying. Blood may be incorrectly signed during collection, samples may be mixed up in the laboratory, data may be entered incorrectly into the computer, etc. It also happens immune system the patient refuses to accept foreign blood components or.
In 2013, in St. Petersburg, Russia, a one-year-old girl, tasting everything, swallowed 6 magnets from an “educational” toy, so the little one needed emergency surgery, during which the patient’s condition became very serious. Due to anemia, the girl was urgently transfused with red blood cells from... an HIV-positive donor, dooming the child to long and expensive treatment. It turned out that the head of the department received a message that the blood was contagious, but he initially ignored it. By the time the error was discovered, the child had been given 50 ml of dangerous liquid. A similar high-profile case with viruses in donor blood occurred in 2006 in Kostroma. The reason is carelessness.
Air embolism
Atmospheric air, without which a person cannot live, becomes a cause of death in a hospital environment if it enters the bloodstream. In this case, venous air embolism – special case gas embolism. Emboli are defined as gas bubbles that can block the work of circulatory system. IN modern surgery Air embolism is a rare phenomenon, but it occurs more often than we would like. Gas embolism of the blood causes pulmonary embolism, when the vessels of the lungs suffer from air “plugs”. Death from pulmonary embolism is one of the leading preventable hospital deaths.
The mortality rate from air bubbles entering a patient's vein through a catheter reaches 30 percent. Even those who survive often remain disabled for life. Consequences include permanent brain damage. What is especially frightening is that air embolism can occur during routine surgical procedures, making them deadly. For example, during dental prosthetics. In 1987, a certain dentist, while “doing teeth” on clients, managed to let air into the blood of five of them. Three victims, turning blue, died right in the office from heart attack. The problem turned out to be the hollow drill of the drill, which supplied the patients’ bloodstream with a mixture of water and air. The clients had little time to feel anything, because they were under anesthesia - general or local.
Incorrect surgical operations
It happens that victims medical errors go to court, bringing would-be doctors to justice. In 25%, it concerns cases where patients undergo operations that are not indicated for them. Even in America, the number of such claims exceeds a hundred per year, and if the problem is successfully resolved, the compensation received by the plaintiff averages 232 thousand dollars (reaching 7 million).
Despite all the procedures designed to eliminate gross mistakes by surgeons, incorrect operations happen more often than one might think. For example, one woman had her fallopian tube removed instead of her appendix, and another patient had heart surgery that he did not need at all. One of the most terrible cases occurred in 2011, when a 32-year-old resident of England, who was carrying fourth child and suffered from appendicitis, the right ovary was removed instead of the appendix. The operation was performed by a young surgeon of Pakistani origin, and his senior colleague and mentor chose to go home (early). The inflamed appendix did not go away; after 3 weeks the woman was again admitted to the hospital with abdominal pain. It was then that doctors from Romford learned about the mistake of the inexperienced doctor. Four days later, the patient gave birth to a still premature baby; her appendix was removed, but then she died on the operating table from multiple organ failure, which resulted from blood poisoning.
Wrong medications or incorrect dosage
People tend to believe that the medicine their doctor prescribes is the medicine they need. the right dosage. Yet millions of people are given incorrect prescriptions every day. Let's say that Americans annually purchase more than three billion recipes, of which 51.5 million contain errors. That is, if a pharmacy processes 250 medical orders per day, then four of them will be incorrect. This phenomenon is doubly dangerous. Firstly, the patient can receive harmful remedy, unnecessary to him; secondly, he will not get what he really needs.
Mistakes with prescription drugs occur in both pharmacies and clinics. One day, a nurse accidentally poisoned a pair of twins who were born prematurely - at 27 weeks of pregnancy - with morphine. The boys were injected with lethal doses of the drug - 650-800 micrograms, when only 50-100 micrograms were supposed to be injected. The disaster happened in 2010.
In another case, a 79-year-old pensioner on dialysis was given pancuronium bromide instead of an antacid. Pancuronium is a paralyzing agent used to complex operations or lethal injections, but my grandfather needed an antacid for heartburn. The nurse mixed up the packaging. After 30 minutes, the patient became unresponsive and died from cardiac arrest.
In 2009, in Kazakhstan, an 85-year-old patient who suffered a myocardial infarction nurse introduced heart drug korglykon in a dose ten times higher than prescribed by the doctor. She allegedly imagined that the ampoules indicated a lower dosage. The old woman began to suffer and by the time the ambulance arrived she was already dead. The health worker, who made a fatal mistake, resigned from the clinic of her own free will - with a diploma and a “clean” work record.
Hospital infections and dirty medical equipment
Usually people go to the hospital to get rid of illnesses, not suspecting that hospitals themselves are a source of illnesses and infections. They are hidden in unsterile instruments and devices, on the unwashed hands of staff. So, rare disease Creutzfeldt-Jakob, fraught with brain destruction (“ mad cow disease") in 2012-2014 was transferred to dozens of patients of American neurosurgeons. The reason is insufficient sterilization of surgical instruments used in the treatment of carriers of a dangerous disease.
Statistics say that every 25th hospital patient becomes a victim of a hospital infection. Hundreds of thousands of people die from such diseases every year. Having been in a hospital bed, they run the risk of acquiring pneumonia first, followed in the list by inflammation of the urethra and infectious diseases digestive system, primary infections circulatory system (from dirty catheters).
The manifestations of diseases are so diverse and dissimilar that the most attentive and conscientious attitude sometimes leads to an incorrect diagnosis. Therefore, when making a decision, the court will take into account whether the specialist has taken all possible and available measures to prevent negative consequences. So, if the doctor carried out the necessary diagnostic measures, which should have shown the problem, but did not, then the likelihood of being held accountable for an erroneous diagnosis is minimal. In this case, the doctor most likely did everything in his power, and unless the contrary is proven, he will not be held legally responsible for an incorrect diagnosis.
Medical error
Attention
Considering that the damaged eye needed to be removed, he mistakenly removed the boy’s absolutely healthy organ. We can only guess what kind of punishment doctors suffered for their mistakes more than a hundred years ago.
9. Radiation and treatment An even greater misfortune befell the patient suffering from tongue cancer. Jerome Parks - that was the patient's name - was mistakenly receiving radiation aimed at others for several days. healthy organs, in particular on the brain.
The consequence of this was the complete loss of hearing and vision of the patient. The unbearable torment of the unfortunate man was alleviated only by death.
10. Disinfected patient Also, the mistake of nurse Virginia Mason ended in a fatal outcome. She, having inattentively read the inscription on the package, gave the patient an injection of a disinfectant solution.
Mary McClinton, 69, did not survive such negligence. 11.
Medical errors and liability for them
Info
Path: → Lectures (continued) →→ Medical errors An unfavorable treatment outcome associated with a doctor’s honest mistake is usually referred to as medical errors. The term “medical error” is used only in medical practice.
The variety of medical errors, their causes and conditions of occurrence has led to the fact that until now there is no single concept of medical error, which naturally complicates the medical and legal assessment of erroneous actions of medical workers. The main criterion for medical error is the doctor’s conscientious error arising from certain objective conditions without elements of negligence, negligence and professional ignorance.
The concept and statistics of medical errors in Russia First of all, the victim should understand that the law will be on his side, since a medical error is criminal offense. However, it has a number of features, many of which you need to know:
- Since this error often occurs accidentally and involves an act without bad intentions, the responsibility on the part of the doctor is mitigated.
In order for the punishment to be serious, it will be necessary to prove that the error was malicious.
- The objective causes of medical error are negligence, inattention and lack of experience. They are taken into account to reduce the sentence.
- Subjective causes of medical error are negligence during examination and medical procedures, neglect of modern medical supplies etc.
What is medical error (concept and examples)?
Therefore, solving the problem at the legal level is very difficult. And yet, expert conclusions about the presence of a medical error (and it is better to appoint such an examination away from the region of the incident) can fail a particular person. medical worker under one or another criminal article.
Important
Then a court decision will probably follow on the ban on practicing medicine in certain period. And for the death of a patient, doctors can even be sentenced to imprisonment.
And even if no crime is found in the doctor’s actions based on the results of the investigation or trial, he may be subject to disciplinary liability. Bail does not always work and not everywhere. Somewhere, the administration of a hospital or clinic can independently punish an employee.
Compensation to a patient for harm resulting from a medical error Obviously, the consequences of a medical error can vary, and significantly.
Examples of medical errors
Part 3 of Art. is being considered. 123 CC.
- The patient contracted HIV infection due to the negligence of the doctor. Part 4 art. 122 of the Criminal Code provides for imprisonment for up to 5 years.
- If, as a result of illegally carried out medical or pharmaceutical activities, the patient suffered serious harm to health, the perpetrator is punishable by Part 1.
1 tbsp. 235 CC. Fatal cases are considered under Part 2 of Art. 235 CC.
- If the patient was not provided with assistance, as a result of which he received harm of moderate or mild severity, the punishment is established by Art. 124 CC. If the harm is more significant or irreparable, then Part 2 of Art. 124 CC.
- If the fact of medical negligence is established, the result of which is the infliction of serious harm to human health or the death of the patient, then Part 2 of Art.
What is medical negligence, how to define it and bring criminals to justice?
Therefore, he has the right to present the amount he needs, but within reasonable limits.
- Criminal liability. It is established for harm caused to life and death due to medical error.
In the event that the patient receives poor quality medical care, but no significant harm was caused to his health, criminal liability is impossible. A forensic examination is carried out to determine the extent of the damage.
Often, victims have to make certain efforts to receive moral harm, because usually doctors do not agree to admit the fact of a mistake and prove their own innocence by all means.
13 creepy examples of medical negligence
Subjective reasons are used in legal practice to aggravate a sentence. According to a statement by a representative of the Investigative Committee of the Russian Federation, latest statistics according to medical errors it looks like this:
- In 2015, 712 people, including 317 children, suffered from medical errors and poor quality services medical care.
- In 2016, 352 patients died as a result of medical errors, of which 142 were children. At the same time, the Investigative Committee received more than 2,500 reports of crimes related to medical negligence.
Based on them, more than 400 criminal cases were opened.
To date, there is no precise definition of medical error. That is why during the proceedings the situation is quite difficult, because it is necessary to prove the fact of a medical error.
Medical errors: the “dark” side of medicine
“Medical error” refers to the actions or inaction of a doctor that led to a deterioration in the patient’s condition, and in the most tragic cases, to his death. It is often difficult to prove that a medical error occurred (this is due to the incompetence of interested parties, criminal corporate solidarity, and other factors), but nevertheless, citizens have such an opportunity at the legal level.
The child looked bad, was lethargic, drowsy, ate without appetite, and coughed. On January 29, 1998, at 1 p.m., Klava B., along with other children, was put to bed in the bedroom. The child slept peacefully and did not cry. When the children got up at 3 p.m., Klava B. showed no signs of life, but was still warm.
The nursery's older nurse immediately began performing artificial respiration on her, gave her two injections of caffeine, and the child's body was warmed up with heating pads. The arriving emergency doctor performed mouth-to-mouth artificial respiration and chest compressions.
However, it was not possible to revive the child. During a forensic medical examination of Klava B.’s corpse, the following were discovered: catarrhal bronchitis, common serous-catarrhal pneumonia, interstitial pneumonia, multiple foci of hemorrhages into the lung tissue, which was the cause of the child’s death.
This article will discuss insurance issues, liability and punishment for medical errors. It is shown which article of the Criminal Code of the Russian Federation is provided for, i.e. What is the criminal liability for medical error?
Statistics and examples of medical errors are given. Recommended where to go and how to avoid medical errors. Examples are given from life during childbirth, dentistry, and surgery. How to prove a doctor's negligence.
Quite often, medical errors in Russia lead to serious and sometimes irreversible consequences. In judicial practice, the attitude towards such cases is ambiguous, and it is sometimes not possible to prove the fact of a medical error. The reasons, types and examples of doctors’ errors are very diverse, and unfortunately, the annual statistics of medical errors are not encouraging and each of us can face this problem.
As you know, “Forewarned is forearmed,” so we recommend that you carefully read this article in order to have an idea in what cases you can achieve the truth and hold doctors accountable for the medical errors they have made.
General information: causes, examples and types of medical errors
A medical or medical error is a non-malicious error of a medical worker (doctor) in the process of carrying out his professional activities in the case where dishonest performance of his duties, as well as negligent attitude towards them, are excluded.
Every person has the right to medical care. This fact enshrined in the Constitution Russian Federation(Part 1, Article 41 of the Constitution of the Russian Federation).
The most important principle of health care in our country is the quality and availability of medical care.
High-quality medical care can only be called if it meets the following requirements:
1) Timely delivery.
2) The correct choice of preventive methods.
3) Correct choice of diagnosis, treatment and rehabilitation.
4) Achieving the result that was planned.
The above requirements are reflected in paragraph 21 of Article 2 of the Law “On the Fundamentals of the Protection of Citizens”.
Nevertheless, quite often we have to deal with medical errors that arise due to various circumstances. The consequence of such medical errors is harm to the health and life of citizens.
A medical or medical error can be encountered both at the stage of diagnosis and during treatment or even surgical intervention.
Most common reasons medical errors are as follows:
1) Uncoordinated actions of doctors. Especially if the patient is being treated by several doctors.
2) Improper handling of medical equipment.
3) Disregard for established sanitary standards.
4) Inattentive assignment medicines. For example, if they were prescribed in the wrong dosage or do not correspond to the diagnosis.
Criminal liability for medical error, article of doctor's fault
The Criminal Code of the Russian Federation does not provide for a special crime in relation to medical error. Actions, as well as inaction of a doctor, as a result of which he may be brought to criminal liability are described in the Special Part of the Criminal Code of the Russian Federation.
Note: A medical malpractice lawyer can advise you. The form for contacting him is given at the end of the article.
In this case, the following conditions must be met:
- Illegal behavior of a doctor.
- Causing serious harm to health or death.
- The presence of a cause-and-effect relationship between harm and the doctor’s unlawful behavior.
- The doctor's fault.
At first glance, it may seem that bringing a doctor to criminal liability in the presence of the conditions described above is not difficult. But in reality, everything is not so simple. It is often quite difficult, and sometimes simply impossible, to prove the fact that illegal actions or inaction of a doctor took place.
Unlawful actions are those that violate established by law norms regulating medical activities. Violations of customs and rules are also considered illegal in the medical field. medical practice in the process of carrying out a complex of therapeutic, diagnostic and preventive measures. Moreover, they can exist not only in written form, but also in unwritten traditions medical activities.
It is worth noting that the treatment process for each individual patient differs from all previous ones, even with a single diagnosis. In other words, the methodology for carrying out procedures (diagnostic and therapeutic), the treatment regimen and prescription of drugs, as well as monitoring the patient’s health status may be different in each individual case.
Simply put, if three patients are given the same diagnosis, but the first one has allergic reaction for some medical supplies, the second one has concomitant diseases, and the third is in old age, then individual treatment will be prescribed for each of them, taking into account all associated factors.
As a result of the situations described above, it is often not possible objective assessment illegality of a doctor’s actions in relation to a specific patient. The thing is that there are different approaches to treating the same disease.
It is also not easy to prove that the patient was harmed as a result of the doctor’s negligent behavior. This is explained by the fact that what is subject to punishment is not the fact that the doctor did not cure the patient, but the fact that in the process of treatment he significantly deviated from generally accepted norms, which led to a deterioration in the patient’s condition.
In case of a medical (medical) error, the doctor’s fault can exist solely in the form of negligence (negligence or frivolity).
A medical professional’s mistake in the form of frivolity occurs when he foresaw the possibility of undesirable consequences, but groundlessly hoped that it was in his power and competence to prevent them. In other words, he understood that his actions or inaction could harm the patient, but he thought that he could cope with the situation that arose, and in the end he did not have enough experience and knowledge.
Malpractice in the form of negligence occurs when a physician does not foresee the possibility of undesirable consequences as a result of his actions or inactions. Although if he had been more attentive and prudent to this situation, then such consequences could have been avoided.
Essentially, negligence is a significant discrepancy with generally accepted norms of action by medical workers with identical and similar education and experience, which led to harm to the health of the patient.
We also note that criminal liability in the event of a medical error is provided only in cases where the patient’s health has been seriously harmed. If the patient received medical care of inadequate quality and as a result his health was damaged minor harm(light and moderate severity), then the guilty doctor will not be held criminally liable. The severity of the harm is determined during the investigation based on the results of a forensic medical examination.
This mandatory conditions conducting an investigation. After all, it is in the process of conducting a forensic medical examination of medical errors that it will be determined to what extent the nature of the treatment in relation to the patient complied with the standards. For example, if a doctor made a mistake during a surgical procedure, then the court will hear the opinion of an independent expert doctor regarding how and under what conditions this operation was performed.
Thus, resolving disputes regarding the medical cases described above is often quite difficult. This can be explained by the fact that each individual case is unique in its content, and it is not possible to reflect all standards at the legislative level.
As mentioned above, the Criminal Code of the Russian Federation does not provide for a separate crime for committing a medical error. If as a result of unlawful actions or inaction medical personnel If severe harm to the patient’s health was caused or death occurred, then criminal liability arises for certain elements of the crime that are provided for in the Special Part of the Criminal Code of Russia. The conditions under which this is possible were described above.
According to Part 2 of Article 109 of the Criminal Code of the Russian Federation, a medical error that led to the death of a patient can be punishable by imprisonment for up to three years with or without deprivation of the right to engage in medical activities for the same period.
If the patient’s health was seriously harmed as a result of improper performance of the doctor’s duties, then this doctor may be held criminally liable in the form of imprisonment for up to one year with or without deprivation of the right to engage in medical activities for the same period.
In addition to the above-mentioned crimes, there are the following types of medical errors that are subject to criminal punishment:
1) Illegal abortion as a result of which the death of the patient occurred or serious harm was caused to her health. (Part 3 of Article 123 of the Criminal Code of the Russian Federation).
2) Infection of a patient with HIV infection as a result of improper performance of professional medical duties. (Part 4 of Article 122 of the Criminal Code of the Russian Federation). A sentence of up to 5 years in prison is provided.
3) Engagement in private pharmaceutical activities or medical practice without a license for these types of activities in the case where this led to harm to health as a result of negligence. (Part 1 of Article 235 of the Criminal Code of the Russian Federation). If these types of activities led to the death of the patient, then the perpetrators will be punished in accordance with Part 2 of Article 235 of the Criminal Code of the Russian Federation.
4) Not helping the patient(Article 124 of the Criminal Code of the Russian Federation). In this case, it is enough to cause moderate harm to the patient’s health as a result of negligence. If, as a result of the doctor’s negligence, serious harm was caused to the patient’s health or even death occurs, then the doctor’s act will be considered a qualified one (Part 2 of Article 124 of the Criminal Code of the Russian Federation).
5) Negligence. It represents improper performance or complete failure to perform his duties by an official as a result of a careless and dishonest attitude towards his work. If the doctor’s negligence led to serious harm to health or death of the patient as a result of negligence, then it will be qualified in accordance with Part 2 of Article 293 of the Criminal Code of the Russian Federation.
Let us note that after a criminal case has been initiated and before the judicial investigation, the victim has the right to file a civil claim and demand compensation for property damage that was caused by the crime, as well as compensation for moral damage. These rights are noted in Article 44 of the Criminal Procedure Code of the Russian Federation.
If the patient does not exercise this right, then after the verdict against the doctor is passed, claims for compensation for harm and compensation for moral damage can be filed in civil proceedings. According to Part 2 of Article 306 of the Code of Criminal Procedure of the Russian Federation, if the doctor’s guilt is not recognized, the court will refuse to satisfy the civil claim.
Medical risk
According to Article 41 of the Criminal Code of the Russian Federation, justified medical risk can exclude criminal liability.
But in order to this risk was declared lawful, the following conditions must be met:
1) Medical risk should be aimed at preserving the health and life of the patient.
2) The goal specified in the previous paragraph cannot be achieved by other means that do not involve risk. If there is an alternative treatment method that is less risky or does not involve risk at all, then the doctor should give preference to it.
3) The doctor is obliged to take measures sufficient from a professional point of view in order to prevent possible harm as much as possible.
If harm to the patient’s health was caused within the framework of the conditions described above, then no crime will be found in the doctor’s actions. If these conditions were not met and, as a result, harm was caused to the health and life of the patient, then if the doctor is guilty, it will be possible to prosecute him criminally.
Nobody keeps official statistics on medical errors. According to calculations public organizations, medical errors claim the lives of 50 thousand people every year. According to the Center for Independent Medical and Legal Expertise, dentists take first place in professional errors. The death or injury of a woman in labor or a newborn in a maternity hospital is in second place. Third place is occupied by surgeons of all specialties.
So we've covered some very important questions.
According to judicial practice, medical omissions occur about 700 times a year. Slightly less than half of the cases of poor-quality medical care concern the treatment of minors. The country's Investigative Committee recorded about 350 fatal cases, 150 of which involved children.
Punishment may be in the form of restriction or deprivation of will for up to 
