Reproductive losses: "the doctors’" cases, expert assessment of unfavorable obstetric outcomes, responsibility, prospects for the development of juridical practice
Objective of the study – to familiarize practicing obstetricians/gynecologists with the criteria of criminal, civil, and administrative responsibility for adverse outcomes of medical care and related reproductive losses; to show how it is possible to avoid repeating other people's mistakes; to "analyze" the most striking clinical cases of maternal and perinatal mortality through the eyes of a lawyer and a doctor at the same time; to demonstrate positive and negative foreign experience, to look into the future and to search for the best way to develop legislation (in a broad sense, including clinical recommendations) and judicial practice.Mateykovich E.A., Mateykovich M.S., Sholomov I.F., Shevlyukova T.P., Abramova A.V.
When writing this paper, the authors used open sources of publication of impersonal court decisions: databases of the state automated system "Justice" (https://bsr.sudrf.ru/bigs/portal.html), the portal "Judicial and regulatory acts of the Russian Federation" (https://sudact.ru), the legal reference system "Consultant plus". The selected court decisions were evaluated according to their informative value for the medical community, the accuracy and completeness of the reflection of medical documentation, the topical belonging to obstetric issues. The literature sources were sought for, by using the Russian and foreign electronic libraries (https://www.elibrary.ru), Elsevier (https://www.elsevier.com), PubMed (https://pubmed.ncbi.nlm.nih.gov).
Conclusion: Within the framework of the stated topic, the authors do not pretend to provide detailed coverage of all aspects of the raised problem and they propose together with the participants of the First International Congress “The Right to Life” held at the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation on April 18–20, 2023, to continue a frank conversation about medical errors and their consequences on the largest scientific platforms and, above all, with the participation of the medical community.
Authors' contributions: Mateykovich E.A., Mateykovich M.S., Shalomov I.F. – concept and design of the investigation; Mateykovich E.A., Abramova A.V., Mateykovich M.S. – material collection and processing; Shevlyukova T.P. – statistical data processing; Mateykovich E.A., Mateykovich M.S. – writing the text; Shevlyukova T.P., Mateykovich M.S. – editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Mateykovich E.A., Mateykovich M.S., Sholomov I.F., Shevlyukova T.P., Abramova A.V. Reproductive losses: "the doctors’" cases, expert assessment of unfavorable
obstetric outcomes, responsibility, prospects for the development of juridical practice.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (8): 112-122 (in Russian)
https://dx.doi.org/10.18565/aig.2023.113
Keywords
medical care
medical service
reproductive losses
unfavorable obstetric outcomes
medical errors
juridical responsibility
forensic medical examination
References
- Kohn L.T., Corrigan J.M., Donaldson M.S., eds. Institute of Medicine (US) Committee on Quality of Health Care in America. To err is human: building a safer health system. Washington: National Academies Press; 2000.https://dx.doi.org/10.17226/9728.
- Loder N. Physician healthy systems. Econ. Int. 2018; 427: 53.
- Горбачев В.И., Козлов А.И., Нетесин Е.С., Ершова Ю.В., Горбачева С.М. Обзор уголовных дел против врачей акушеров-гинекологов за последние пять лет по статье 109 УК РФ (причинение смерти по неосторожности вследствие ненадлежащего исполнения лицом своих профессиональных обязанностей). Акушерство и гинекология. 2021; 1: 5-11. [Gorbachev V.I., Kozlov A.I., Netesin E.S., Ershova Yu.V., Gorbacheva S.M. Review of criminal cases against obstetricians and gynecologists during the last five years under article 109 of the criminal code of the Russian Federation (causing death by negligence due to improper performance by a person of his/her professional duties). Obstetrics and Gynecology. 2021; (1): 5-11. (in Russian)].https://dx.doi.org/10.18565/aig.2021.1.5-11.
- Место, где появляется жизнь. Интервью с академиком Геннадием Сухих. Электронное периодическое издание «Научная Россия».[The place where life appears. Interview with Academician Gennady Sukhikh. Electronic periodical "Scientific Russia". (in Russian)]. Available at:https://scientificrussia.ru/articles/mesto-gde-poavlaetsa-zizn-intervu-s-akademikom-gennadiem-suhih
- Guerra F., Guzzo A.S., La Rosa P., Miatto I., Vergati D., Miredi F. et al. Risk management and Healthcare responsibility. How to guarantee legal protection in medicine. Clin. Ter. 2021; 171(1): e63-6. https://dx.doi.org/10.7417/CT.2021.2285.
- Гнатюк О.П. Врачебные ошибки и профессиональные правонарушения. Ответственность медицинских работников и меры предупреждения. Вестник Росздравнадзора. 2016; 2: 16-21. [Gnatyuk O.P. Medical errors and professional misconduct. Responsibility of health workers and preventive measures. Bulletin of Roszdravnadzor. 2016; (2): 16-21.(in Russian)].
- Hershey N. The defensive practice of medicine: myth or reality. Milbank Quarterly. 1972; 50: 69-98.
- Сергеев В.В., Захаров С.О. Медицинские и юридические аспекты врачебных ошибок. Здравоохранение Российской Федерации. 2000; 1: 7-9. [Sergeev V.V., Zakharov S.O. Medical and legal aspects of medical errors. Health Care of the Russian Federation. 2000; (1): 7-9.(in Russian)].
- Матейкович Е.А. Качество оказания акушерско-гинекологической помощи и защита интересов врача в судебном разбирательстве. Акушерство и гинекология. 2018; 6: 92-8. [Mateykovich E.A. The quality of obstetric and gynecologic care and the protection of a physician’s interests in judicial proceedings. Obstetrics and Gynecology. 2018; (6): 92-8. (in Russian)].https://dx.doi.org/10.18565/aig.2018.6.92-98.
- Гридчик Л.А. Два взгляда на врачебные ошибки и качество оказания акушерской помощи. Российский вестник акушера-гинеколога. 2015. 15(6): 76-81. [Gridchik L.A. Two outlooks on medical errors and obstetric care quality. Russian Bulletin of Obstetrician-Gynecologist. 2015; 15(6): 76‑81.(in Russian)]. https://dx.doi.org/10.17116/rosakush201515676-81.
- Clement J.P., Lindrooth R.C., Chukmaitov A.S., Chen H.-F. Does the patient's payer matter in hospital patient safety? A study of urban hospitals. Med. Care. 2007; 45(2): 131-8. https://dx.doi.org/10.1097/01.mlr.0000244636.54588.2b.
- Bergamin E., Fiorillo A., Grassi V.M., Lodise M., Vetrugno G., De-Giorgio F. Medical professional liability in obstetrics and gynecology: a pilot study of criminal proceedings in the public prosecutor's office at the Court of Rome. Healthcare (Basel). 2023; 11(9) :1331. https://dx.doi.org/10.3390/healthcare11091331.
- Pollett G.L., Shah C.P., McConnon J.K. Consultant obstetricians/gynecologists' practice profiles in an ontario community. Can. Fam. Physician. 1984; 30: 343-7.
- Koto P.S., Fahey J., Meier D., LeDrew M., Loring S. Relative effectiveness and cost-effectiveness of the midwifery-led care in Nova Scotia, Canada: a retrospective, cohort study. Midwifery. 2019; 77: 144-54.https://dx.doi.org/10.1016/j.midw.2019.07.008.
- Crosbie C., McDougall A., Pangli H., Abu-Laban R.B., Calder L.A. College complaints against resident physicians in Canada: a retrospective analysis of Canadian Medical Protective Association data from 2013 to 2017. CMAJ Open. 2022; 10(1): E35-42. https://dx.doi.org/10.9778/cmajo.20210026.
- Медицина в Канаде: обзор эксперта. Официальный портал РАМН. 14 июля 2017 г. [Medicine in Canada: An Expert review. Official portal of RAMS. July 14.2017]. Available at: https://portalramn.ru/information/meditsina-v-kanade-obzor-eksperta
- Knaak J.P., Parzeller M. Court decisions on medical malpractice. Int. J. Legal Med. 2014; 128(6): 1049-57. https://dx.doi.org/10.1007/s00414-014-0976-2.
- Zhang K., Li Y., Fan F., Liu X., Deng Z.H. Court decisions on medical malpractice in China after the new tort liability law. Am. J. Forensic Med. Pathol. 2016; 37(3): 149-51. https://dx.doi.org/10.1097/PAF.0000000000000242.
- Bergamin E., Fiorillo A., Grassi V.M., Lodise M., Vetrugno G., De-Giorgio F. Medical professional liability in obstetrics and gynecology: a pilot study of criminal proceedings in the public prosecutor's office at the Court of Rome. Healthcare (Basel). 2023; 11(9): 1331. https://dx.doi.org/10.3390/healthcare11091331.
- Лебедев В.М., ред. Комментарий к Уголовному кодексу Российской Федерации. 14-е изд. М.: Юрайт; 2014. 1077с. [Lebedev V.M., ed. Commentary on the Criminal Code of the Russian Federation. 14th ed. Moscow: Yurayt; 2014. 1077p. (in Russian)].
- Матейкович М.С., Матейкович Е.А. Юридическая характеристика медицинских ошибок и минимизация рисков их совершения. Журнал российского права. 2021; 9: 61-77. [Mateykovich M.S., Mateykovich E.A. Legal characteristics of medical errors and minimizing the risks of their commission. Journal of Russian Law. 2021: 25(9): 61-77. (in Russian)].https://dx.doi.org/10.12737/jrl.2021.111.
- Smith A.M. Criminal or merely human?: the prosecution of negligent doctors. J. Contemp. Health Law Policy. 1995; 12(1): 131-46.
- Федеральй закон от 21 ноября 2011 года № 323-ФЗ «Об основах охраны здоровья граждан в Российской Федерации». Официальный интернет-портал правовой информации. [Federal Act dated November 21, 2011 No. 323-FZ "On the fundamentals of protecting the health of citizens in the Russian Federation". (in Russian)]. Official internet portal of legal information. http://actual.pravo.gov.ru/text.html#pnum=0001201111220007
- Постановление Пленума Верховного Суда Российской Федерации от 28 июня 2012 года № 17 «О рассмотрении судами гражданских дел по спорам о защите прав потребителей». Бюллетень Верховного Суда Российской Федерации. 2012; 9. [Plenum of the Supreme Court of the Russian Federation Statement dated June 28, 2012 No. 17 "On consideration by the courts of civil cases on disputes on the protection of consumer rights." Bulletin of the Supreme Court of the Russian Federation. 2012; 9.(in Russian)].
- Определение Судебной коллегии по гражданским делам Верховного Суда Российской Федерации от 15 июля 2019 года по делу№ 44-КГ19-7. Официальный сайт Верховного Суда Российской Федерации в сети Интернет. [Supreme Court of the Russian Federation ruling dated July 15, 2019 in case No. 44-KG19-7. (in Russian)]. Official website of the Supreme Court of the Russian Federation on the Internet. Available at:http://vsrf.ru/stor_pdf.php?id=1793322
- Решение Верховного Суда РФ от 12 июля 2021 года по административному делу № АКПИ21-339. Официальный сайт Верховного Суда Российской Федерации в сети Интернет. [Supreme Court of the Russian Federation ruling dated July 15, 2019 in case No. AKPI21-339. (in Russian)]. Official website of the Supreme Court of the Russian Federation on the Internet. Available at: http://vsrf.ru/stor_pdf.php?id=2016818
- Постановление Конституционного Суда Российской Федерации от 27 мая 2008 года № 8-П. Официальный сайт Конституционного Суда Российской Федерации в сети Интернет. [Constitutional Court of the Russian Federation Statement dated May 27, 2008 No. 8-P. (in Russian)]. Official website of the Constitutional Court of the Russian Federation on the Internet. Available at: http://doc.ksrf.ru/decision/KSRFDecision19724.pdf
- Письмо Следственного комитета Российской Федерации от 26 июня 2019 года № 224-8-19 «О рассмотрении обращения по вопросу упразднения отделов по расследованию ятрогенных преступлений». Справочная правовая система «Консультант Плюс» (онлайн-версия). [Letter of the Investigative Committee of the Russian Federation dated June 26, 2019 No. 224-8-19 "On consideration of an appeal on the abolition of departments for the investigation of iatrogenic crimes." (in Russian)]. Reference legal system "Consultant Plus" (online version). Available at: https://dsm.consultant.ru/cgi/online.cgi?req=doc&cacheid=A95A59AC1644C5E149A722459C92E028&SORTTYPE=0&BASENODE=1-1&ts=d7bnBdTuYwY6KrIz&base=LAW&n=350342&rnd=52Tdsg#oyjnBdTEHSpRDsiD1
- Матейкович Е.А., Новикова В.А., Радзинский В.Е., Матейкович М.С. Структура репродуктивных потерь девушек-подростков и женщин репродуктивного возраста в Тюменской области. Медицинский совет. 2022; 16(14): 154-63. [Mateykovich E.A., Novikova V.A., Radzinsky V.E.,Mateykovich M.S. Structure of reproductive losses of adolescent girls and women of reproductive age in the Tyumen. Medical Council. 2022; 16(14): 154-63. (in Russian)]. https://dx.doi.org/10.21518/2079-701X-2022-16-14-154-163.
- Шишов М.А. О коллизиях конфликта интересов в сфере здравоохранения. Административное право и процесс. 2019; 12: 49-51. [Shishov M.A. On collisions of the conflict of interests in healthcare. Administrative Law and Process. 2019; 1(2): 49-51. (in Russian)].
- Кассационное определение Судебной коллегии по уголовным делам Верховного Суда Российской Федерации от 29 сентября 2022 года по делу № 5-УД22-91-К2. Официальный сайт Верховного Суда Российской Федерации в сети Интернет. [Supreme Court of the Russian Federation cassation ruling dated July 15, 2019 in case No. 5-UD22-91K2. (in Russian)]. Official website of the Supreme Court of the Russian Federation on the Internet. Available at: http://vsrf.ru/stor_pdf.php?id=2016818
- Постановление Пленума Верховного Суда Российской Федерации от 15 ноября 2022 года № 33 «О практике применения судами норм о компенсации морального вреда». Бюллетень Верховного Суда Российской Федерации. 2023; 2. [Plenum of the Supreme Court of the Russian Federation Statement dated November 15, 2022 No. 33 “On the practice of application by courts of the norms on compensation for moral damage”. Bulletin of the Supreme Court of the Russian Federation. 2012; 9. (in Russian)].
- Постановление Пленума Верховного Суда Российской Федерации от 21 декабря 2010 года № 28 «О судебной экспертизе по уголовным делам». Бюллетень Верховного Суда Российской Федерации. 2011; 2. [Plenum of the Supreme Court of the Russian Federation Statement dated December 21, 2010 No. 28 "On Forensic Expertise in Criminal Cases". Bulletin of the Supreme Court of the Russian Federation. 2011; 2. (in Russian)].
- Кассационное постановление Второго кассационного суда общей юрисдикции от 22 сентября 2022 года по делу № 77-3341/2022. Справочная правовая система «Консультант Плюс» (онлайн-версия). [The Second Cassation Court of General Jurisdiction cassation ruling dated September 22, 2022 in case No. 77-3341/2022. Reference legal system "Consultant Plus" (online version). Available at: https://dsm.consultant.ru/cgi/online.cgi?req=doc&cacheid=AE62CEBFBEEB2ADB5827E4BA7D585500&SORTTYPE=0&BASENODE=32839-5&base=AOSZ&n=2821200&rnd=X1awSQ#kkd7BdTSAQXPbqLO1
- Российское общество акушеров-гинекологов, ООО «Ассоциация анестезиологов-реаниматологов» (ААР), Ассоциация акушерских анестезиологов-реаниматологов. Клинические рекомендации «Роды одноплодные, самопроизвольное родоразрешение в затылочном предлежании (нормальные роды)». 2021. [Russian Society of Obstetricians-Gynecologists, Association of Anesthesiologists-Resuscitators, Association of Obstetrics Anesthesiologists-Resuscitators. Clinical guidelines "Singleton birth, spontaneous delivery in the occipital presentation (normal birth)". 2021. (in Russian)]. Available at:https://cr.minzdrav.gov.ru/recomend/636_1
- Апелляционное определение Ленинградского областного суда от 26.04.2018 по делу № 33-2682/2018. Справочная правовая система «Консультант Плюс» (онлайн-версия). [The Leningrad Regional Court Appeal ruling dated April 26, 2018 in case No. 33-2682/2018. (in Russian)]. Reference legal system "Consultant Plus" (online version). Available at:https://dsm.consultant.ru/cgi/online.cgi?req=doc&cacheid=AE62CEBFBEEB2ADB5827E4BA7D585500&SORTTYPE=0&BASENODE=32839-5&base=AOSZ&n=2821200&rnd=X1awSQ#kkd7BdTSAQXPbqLO1
- В Госдуме подтвердили намерение отказаться от понятия «медицинская услуга». Интернет-портал Медвестник. 14 апреля 2023 г. [The State Duma confirmed its intention to abandon the concept of "medical service". Internet portal Medvestnik. April 14. 2023. (in Russian)]. Available at:https://medvestnik.ru/content/news/V-Gosdume-podtverdili-namerenie-otkazatsya-ot-ponyatiya-medicinskaya-usluga.html
- Андрей Турчак: «Единая Россия» договорилась с Минздравом о поэтапном снижении бюрократической нагрузки на медиков. Официальный сайт партии «Единая Россия» в сети Интернет. [Andrei Turchak: "Edinaya Russia" agreed with the Ministry of Health on a phased reduction in the bureaucratic burden on doctors. Official website of Edinaya Russia party on the Internet. (in Russian)]. Available at: https://er.ru/activity/news/andrej-turchak-edinaya-rossiya-dogovorilas-s-minzdravom-o-poetapnom-snizhenii-byurokraticheskoj-nagruzki-na-medikov
- Kaldjian L.C., Jones E.W., Wu B.J., Forman-Hoffman V.L., Levi B.H., Rosenthal G.E. Disclosing medical errors to patients: attitudes and practices of physicians and trainees. J. Gen. Intern. Med. 2007; 22(7): 988-96.https://dx.doi.org/10.1007/s11606-007-0227-z.
- Henneman E.A. Unreported errors in the intensive care unit: a case study of the way we work. Crit. Care Nurse. 2007: 27(5): 27-34.
- Reporting Patient Safety Events. September 7, 2019. Agency for healthcare research and quality. Available at: https://psnet.ahrq.gov/primer/reporting-patient-safety-events Accessed 28.04.2023.
- Wu A.W., Cavanaugh T.A., McPhee S.J., Lo B., Micco G.P. To tell the truth: Ethical and practical issues in disclosing medical mistakes to patients. J. Gen. Intern. Med. 1997; 12: 770-5. https://dx.doi.org/10.1046/j.1525-1497.1997.07163.x.
- Vetrugno G., Foti F., Grassi V.M., De-Giorgio F., Cambieri A., Ghisellini R. et al. Malpractice claims and incident reporting: two faces of the same coin? Int. J. Environ. Res. Public Health. 2022; 19(23): 16253. https://dx.doi.org/10.3390/ijerph192316253.
Received 10.05.2023
Accepted 09.08.2023
About the Authors
Elena A. Mateykovich, PhD (Med.), Director of the Institute of Motherhood and Childhood, Associate Professor of the Department of Obstetrics and Gynecology,Tyumen State Medical University, Ministry of Health of the Russian Federation; obstetrician-gynecologist, Perinatal Center (Tyumen), +7(3452)20-25-63,
mateykovichea@tyumsmu.ru, 625023, Russia, Tyumen region, Tyumen, Odessa str., 54, https://orcid.org/0000-0002-2612-7339
Maxim S. Mateykovich, Dr. Sci. (Law), Professor, Chairman of the Judiciary, Second Court of Cassation of General Jurisdiction, Tyumen State University, +7(495)870-51-55, m.s.matejkovich@utmn.ru, 121357, Russia, Moscow, Vereiskaya str., 29 building 34, https://orcid.org/0000-0003-3113-3191
Igor F. Sholomov, PhD (Med.), Adviser to the Administration, Acting Head of the Department of Medical Deontology with the UNESCO Bioethics Network Section,
Tyumen State Medical University, Ministry of Health of the Russian Federation, +7(3452)20-21-97, sholomovigor@rambler.ru,
625023, Russia, Tyumen Region, Tyumen, Odessa str., 54.
Tatyana P. Shevlyukova, Dr. Med. Sci., Professor of the Department of Obstetrics and Gynecology, Tyumen State Medical University, Ministry of Health of the Russian Federation, +7(3452)20-25-63, tata21.01@mail.ru, 625002, Russia, Tyumen region, Tyumen, Daudelnaya str., 1, https://orcid.org/0000-0002-7019-6630
Anastasia V. Abramova, Clinical Resident, Department of Obstetrics and Gynecology, Tyumen State Medical University, Ministry of Health of the Russian Federation, +7(3452)20-25-63, abramova_av23@mail.ru, 625002, Russia, Tyumen Region, Tyumen, Daudelnaya str., 1, https://orcid.org/0000-0002-2779-2824
Corresponding author: Elena A. Mateykovich, mateykovichea@tyumsmu.ru