Characteristics of cases with poor outcomes of rendering medical care to children in six regions of the Russian Federation

Objective: to determine the characteristics of the outcome of the improper care for children, established during the commission of forensic examinations. Material and Methods. The material of this study was commission a forensic medical examination of the archives department of complex expertise of the Bureaus of Forensic Medicine of Moscow; the Moscow, Penza, Samara and Ulyanovsk regions, and the Republic of Mordovia, conducted from 1996 to 2006. The method of this study was a statistical database processing using Excel software application package. Results. The article presents the results of the analysis of 279 forensic medical examinations conducted by committees in the Bureaus of Forensic Medical Examination of Moscow; the Moscow, Penza, Samara and Ulyanovsk regions, and the Republic of Mordovia from 1996 to 2006. The examinations were conducted in connection with poor outcomes of rendering medical care to children. Conclusion. The number of conducted examinations correlates with the population of the region. The parents of the children affected by poor treatment mostly demand the medical staff to be prosecuted and more often make legal claims to the quality of emergency medical care; dissatisfaction with the quality of medical care is more often expressed by the parents of children under 3 years old. Legal claims are more often made against obstetricians-gynecologists, pediatricians, surgeons, infectious disease specialists and anesthesiologists-resuscitators. If the conclusion of the forensic medical examination committee on the nature of the pathological process coincides with the final clinical diagnosis, the provided medical care often turns out to be adequate; in cases of inadequate medical care the risks of moderate and grievous bodily harm as well as the patient's death are high.</p

Clinical manifestations and forensic medical evaluation of hemothorax

Objtctive: to determine the degree of validity of the allocation of traumatic hemothorax as a medical criterion of a qualifying trait in respect of serious harm to health, which is life-threatening. Material and Methods. A retrospective analysis of 130 case histories of the patients of the Department of Thoracic Surgery was carried out at Penza Clinical Hospital n.a. N.N. Burdenko. The sex, age, severity of the patient's condition, the volume of blood in the pleural cavity, complications of hemothorax (GT), the time between trauma and seeking medical help, and other injuries were analyzed. Results. It was found out that among patients with HT men were 4,2 times more than women. HT developed after traumatic exposure to the thorax in patients of both gender groups. Conclusion. The severity of the condition of patients with HT is determined by the volume of blood in the pleural cavity, complications, the presence of concomitant damages, the number of days between receiving an injury and contacting a medical organization. In the formulation of p. 6.1.10 Order No. 194n of the Ministry of Health and Social Development of April 24, 2008, "On the Approval of Medical Criteria for Determining the Severity of Harm to Human Health" we should add the phrase: "...or a severe or medium hemothorax that causes a life threatening condition..." aiming at an objective forensic evaluation of traumatic h e moth о rax.</p