Russian Federation
UDK 34 Право. Юридические науки
BBK 58 Прикладные отрасли медицины
The article highlights the issues of establishing cause-and-effect relationships in cases of death and injury to human health in the provision of medical care. The theoretical foundations and practical problems of determining the severity of harm to the patient's health in severe infectious diseases and the development of complications caused by surgical infection are considered. The article presents a brief description of the main provisions of the legislation and methods of forensic medical expert assessment of infectious processes in the patient's body associated with both the disease and the consequences of medical interventions, including improper medical care. It is noted that the fact of occurrence of infectious complications cannot be regarded as harm to the patient's health in the absence of data confirming the presence of a direct cause-and-effect relationship between the admitted defects (shortcomings) of medical care and the adverse outcome of the disease or injury. An example from practice is given and a rare case of a combination of botulism with a brain infarction is analyzed. Simultaneous ischemic and toxic damage to the nervous system caused difficulties both in the clinical diagnosis during the patient's lifetime and in the process of expert evaluation of the medical care after his death. The authors of the article come to the conclusion that the procedure for establishing causal relationships and the severity of harm to human health caused during medical care needs to be further improved from the standpoint of legislation and methods of conducting forensic medical examination. Special attention should be paid to fatal cases of nosocomial infection, as well as infectious complications of surgical interventions. Determining the severity of a patient's health injury should be based on an analysis of the causal relationship between deficiencies in medical care and an adverse outcome.
forensic medical examination, defects in medical care, infection, harm to health, cause-and-effect relationship
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