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Tuesday, March 20, 2018

Data on deaths due to medical errors are just the tip of the iceberg

Published criminal statistics the number of Russians who died as a result of medical errors and substandard care. The only proven deaths from medical errors last year were about 700. In fact, judging by indirect signs, they are at times more. Are there legal and effective mechanisms to punish negligent physicians?

The statistics were published by the head of the Investigative Committee Alexander Bastrykin, speaking at the Board on the organization of work for the investigation of iatrogenic (i.e., associated with poor medical care) of crime. It turns out that the number of deaths from medical errors in the hundreds.

“Of the ten who died one did not have the disease, which he was treated. But this does not mean that he died”

“In 2015, the iatrogenic victims of crimes recognized by 888 people. Of them due to medical errors and poor medical care killed 712 people, including 317 children. In 2016, of the 352 people who died due to medical errors and inappropriate medical care or 142 of the child,” Bastrykin was quoted by TASS.

All in all, this year, the investigating authorities received about 2.5 million reports of crimes related to medical errors, the result of which was filed about 400 criminal cases.

According to the President of the League of defenders of patients Alexander Saversky, these data reflect only “the tip of the iceberg – a small part of a big problem. “These hundreds of cases – only that law enforcement authorities failed to prove in accordance with the norms of the Criminal procedure code, conducting an independent examination and obtaining relevant data. About the statistics of the phenomenon, these figures can not be judged” – categorically said he was in conversation with the newspaper LOOK.

Objective statistics are difficult to obtain, according to objective circumstances. Corresponding member of the Russian Academy of medical Sciences, President of Russian society of pathologists Leo Kanjorski noted in conversation with the newspaper VIEW that the percent discrepancies of in vivo and post-mortem set autopsy, diagnoses from year to year remains stable and ranges from 10 to 15.

However, he cautioned that, in order to record all the cases in the category of medical crimes. “Of the ten who died one did not have the disease, which he was treated. But this does not mean that he died,” says Kanjorski. Cases where an error has played a fatal role in the fate of the patient, according to him, very little in Moscow – one percent outside of it – probably about one percent.

However, it is worth to mention that all of these data are held on the basis of autopsies. And their is relatively little. “We need, of course, a greater percentage of autopsies. Once in the Soviet time it was almost 90-95 per cent of the total number of deaths in hospitals. Now the national average it is about 50 percent,” said Kanjorski. A similar indicator is the same as in most Western European countries. However, according to Kanjorski, in this case Russia compared to Europe is not necessary, as there the quality of medical service much higher.

A relatively small number of autopsies is due not only to the fact that the relatives of the deceased all too often have the right to refuse a post-mortem autopsy, but a catastrophic shortage of pathologists members of the very non-prestigious and poorly paid even by medical standards, specialty.

Saversky speaks to the lack of interest of doctors to “wash dirty linen in public”. “Mechanism of punishment of doctors for malpractice is not” – he said. Saversky believes that this area should not be regulated only by the criminal law or the activities of insurance companies, which often are not interested in truth. In his opinion, should be amended the Code of administrative offences, allowing to punish the doctors for errors not resulting in death. “Then the doctor will know what is good and what is bad, will learn not to fall next time get a fine or deprivation of the right to engage in medical activities”, – said Saversky.

However, while this idea remains just an idea. Meantime, the most effective instrument for punishment of doctors who commit errors, – civil action. However, the defendant by these acts clinic, and, of course, the payout on the claim depends on the financial capacity of the facility. So, it is not always a reliable guarantee that the negligent doctor will be punished. If the provider is not insured, the court generally turns into a problem.

In 2013 the Ministry of health published a bill on insurance of responsibility in the provision of medical care under which health care was charged to be the responsibility insurance of their patients. Moreover, the cost of insurance should affect the quality of medical services – the level of professional qualification of doctors, as medical technology and equipment, etc. And most importantly, the law introduced a clear definition of what constitutes a medical error and what is an honest mistake of a doctor. However, this bill has not yet passed.


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