Medical negligence: its consequences for the patient and the health worker

Negligent performance by an official of his duties is a criminal offense. At the same time, it is considered a crime only if there is a combination of certain characteristics that are established by the Criminal Code.

Negligence (Article 293 of the Criminal Code of the Russian Federation) is the most difficult element of crime to prove, because the line between the objective impossibility of performing a certain action and a careless attitude to work is quite thin. Let's try to figure out in what cases an official can be held criminally liable for negligence.

Art. 293 of the Criminal Code of the Russian Federation - main features

This crime is less common than, say, theft, battery, fraud and other intentional acts against the property or person of the victim. Negligence refers to a number of careless crimes that can be expressed in the form of both action and inaction.

The essence of the act is the improper performance (or non-performance) of one’s official duties, as a result of which significant negative consequences occurred, expressed in material damage or harm to people.

Signs of negligence are as follows:

1. careless, dishonest attitude towards official duties. The key point of this behavior is that the duty is performed without following the necessary rules or is not performed at all.

Example No. 1 . The architect of the state organization, who is also the chairman of the approval commission, considered it unnecessary work to thoroughly check the project according to the points of the methodology created specifically for the construction of children's institutions. He approved the project without a thorough check, as a result of which, 2 years after commissioning, part of the constructed building collapsed, seriously injuring 1 student.

The example shows that the official, vested with organizational and administrative functions, “carelessly” fulfilled his duties related to checking the data received by him about the project. As a result, consequences ultimately occurred in the form of harm to the child’s health.

2. a cause-and-effect relationship between actions (inactions) and the onset of consequences that can occur both in the distant future (as in our example) and immediately.

Example No. 2 . The fire brigade commander did not show due attention to the emergency situation, as a result of which he incorrectly assessed the situation at the fire site. Instead of starting to extinguish the fire from the place where the people were, the commander ordered that all forces be devoted to fighting the fire in the warehouse. This negligence resulted in the death of two men.

3. consequences can be in the form of:

  • causing large (more than 1,500,000 rubles) or especially large (more than 7,500,000 rubles) damage to citizens, the state, organizations, etc. For example , when, as a result of the actions of an official, in the absence of signs of theft and abuse of power, federal budget money is spent for other purposes. Or, in another case, if a police officer, negligent in fulfilling his duty to properly store material evidence, lost the citizen’s seized money, etc.
  • significant violation of the rights and legitimate interests of citizens or organizations. The Supreme Court of the Russian Federation explained that such consequences should be considered violations of constitutional rights - such as the right to freedom of movement, privacy of correspondence, work, etc. A significant violation of rights, for example, would be a restriction of the right of access to justice - when, due to the negligence of police officers, a citizen cannot obtain justice, claim compensation for damage, etc.
  • causing serious harm to human health or death. An expert must determine the severity of the damage caused to health; for this, the investigator must order a forensic medical examination. Most often, serious harm to health is recognized as the loss of a limb, organ (hearing or vision), loss of function of one of the organs (for example, a person stops hearing), etc. In cases where a person’s death occurs as a result of negligence, an official can also be accused of improper performance of his duties only based on the results of an examination that will determine the existence of a cause-and-effect relationship between his careless actions and the occurrence of death. For example , a doctor who performed an operation that resulted in the death of a patient can be prosecuted for negligence only if there is a categorical expert opinion that it was the doctor’s actions that led to the death. If such a connection is not established, liability under Art. 293 of the Criminal Code of the Russian Federation cannot exist.
  • a significant violation of the interests of society and the state protected by law - here we mean the creation of certain obstacles due to which a citizen or organization is deprived of the opportunity to lead a normal lifestyle, plan vacations, or treatment. For example , when a medical commission does not find grounds to recognize a person as disabled due to the insufficient severity of the disease, due to persistent remission, etc., while in reality there are indications for recognition as disabled. As a result of an incorrect conclusion, a person loses the opportunity to purchase free medications of a certain range, use vouchers for sanatorium treatment, etc.

The listed types of consequences of negligence are alternative for qualifying a crime under Art. 293 of the Criminal Code of the Russian Federation, either causing damage or causing death, etc. is sufficient. In some cases, several consequences may occur as a result of the same actions (inaction).

Types and examples

The types of crime in question are many, and such disastrous results are achieved both intentionally and without malice, viz.

Misunderstanding, neglect or lack of competence

For example, citizen N., without the necessary knowledge and skills, got a job as an expert in the field of technical safety at one large plant thanks to his good friends, that is, in simple terms, through connections. One working day, an employee approached him with a complaint about possible malfunctions of the machine at the workplace and indicated that these breakdowns could lead to bad consequences. Citizen N., not having the necessary technical knowledge, ignored the employee’s statement and did not go to carry out an inspection, the implementation of which was entirely within his competence and responsibilities. On the same day, the previously mentioned applicant, while working on a problematic machine, received an injury that caused his death.

As can be seen from the example, there was no malicious intent on N.’s part, but his lack of the skills necessary for his position and refusal to perform his direct work led to the death of the person.

Condescension and connivance

Citizen P. was responsible for compliance with safety regulations at the shooting club. His friends approached him with a request, which was to provide assistance in clarifying and resolving the dispute that had arisen. The dispute, in turn, was to determine who was bolder and more accurate. Having waited until the moment when only P. and his friends remained in the club, he agreed to provide them with weapons and open the gates of the shooting range. The friends' dispute was whether one of them could knock an apple off the other's head with a shot from an air gun. Accused P. did not check the weapons given to the disputants and instead of an air pistol, he gave out a firearm. As a result, one of the debaters died from a bullet wound.

In this example, there is evidence of leniency towards his friends, since the accused, taking advantage of his official position, allowed them to go to the shooting range, as well as a negligent attitude towards checking the weapons issued, which is his direct responsibility.

Incorrect assessment of the situation

The fire brigade received a call due to a fire in one of the garages. Having arrived at the scene, the responsible duty officer, seeing that the garage was almost completely burned out, did not give the command to extinguish and cordon off. But in this garage there were several gas cylinders, which detonated, killing one member of the team and one eyewitness watching the development of the situation.

These deaths could have been avoided if the person in charge had correctly assessed the situation, put out the fire in time, and put in place an appropriate cordon. Unfortunately, negligence is a fairly common phenomenon in two very important structures for the safety of human life - in medical institutions and law enforcement agencies. Similar cases due to the fault of unscrupulous employees arise every day.

Who is liable


The subject of a crime under Art. 293 of the Criminal Code of the Russian Federation can only be an official , the definition of which is given by the Criminal Code of the Russian Federation in the note to Art. 285 of the Criminal Code of the Russian Federation. Such a person is a citizen who performs the functions of a government representative or exercises administrative, economic, organizational powers:

  • in government organizations and institutions (schools, hospitals, socially-oriented foundations, etc.);
  • in local government bodies (municipality, city Duma, regional chamber of control and accounts, etc.)
  • in state corporations (for example, Rosatom, Russian Technologies, etc.);
  • in the Armed Forces of the Russian Federation, armed Russian formations, etc.

A person involved in a case of negligence can also be a law enforcement official - a police officer, a prosecutor, an employee of the penal system, etc.

In order to draw a conclusion about the failure to fulfill certain powers, you need to have reliable information about exactly what official functions the accused had and whether he should have performed them.

Investigators must attach job descriptions, orders, charters, etc. to the materials of each case of negligence, from the contents of which it is possible to understand what responsibilities were assigned to a specific official.

Example No. 3 . If, according to the order, the guard was obliged to use special equipment (handcuffs) on the detainee, which was not done and an escape occurred, the guard is liable for negligence. At the same time, if the job description does not contain an obligation to use special means in a given situation, they will not be able to blame the official of the convoy unit.

Responsibilities and functions can be assigned to a person temporarily (for example, when an order is issued to perform duties for a person on vacation) or on a permanent basis.

How to identify a negligent doctor?

Such a capacious concept as negligence includes a lot of both professional and universal qualities of an employee in any field:

  1. Doctor's irresponsibility;
  2. Caring attitude;
  3. Caring for too many patients increases the risk of errors due to inattention and fatigue;
  4. Quick examination without bringing up old medical records.

In medicine, as elsewhere, this means a combination of incompetence, laziness, and neglect of one's work. But in some places this may not have such negative consequences. For example, laziness and dishonesty of an accountant can result in financial losses, and the negligence of a gardener can result in the death or disease of a plant.

If we are talking about human health and life, then the consequences carry a much larger social aspect. Damage is caused to the physical or mental state of a person, and sometimes leads to his death. Therefore, pay attention to how:

  1. A patient is being admitted;
  2. How many examinations and analyzes are carried out before the circumstances are determined;
  3. Doctor's appearance. Especially if he looks tired, very bruised, or, much worse, drunk.
  4. Reviews from patients about his work;
  5. Reviews about the clinic in general.

Negligence can be expressed both in certain, obviously unprofessional, actions, and in the inaction of a doctor, leading to a deterioration in the patient’s condition or his death. Inaction is understood as ignoring the requirements of medical discipline, either purposefully or as a result of laziness or frivolity.

Unprofessional actions must be understood as medical, obstetric, or nursing care for a patient that occurs in violation of prescribed standards, or manipulations that are incomplete, untimely, or half-hearted.

Punishment for negligence of an official

In accordance with Article 293 of the Criminal Code of the Russian Federation, the following types of punishment may be imposed on the perpetrator:

  • a fine of up to 120,000 rubles or compulsory work for up to 360 hours, as well as corrective labor for up to 1 year - if major damage is caused (from 1,500,000 to 7,500,000 rubles);
  • a fine from 200,000 to 500,000 rubles, compulsory work for up to 480 hours or corrective labor for up to 2 years - if particularly large damage was caused (from 7,500,000 rubles or more). In addition, the court may impose an additional punishment in the form of deprivation of holding certain positions for a period of up to 3 years (for example, if the negligence of medical workers is proven, an additional ban on practicing medicine may be imposed);
  • imprisonment for up to 5 years if, as a result of negligent actions, serious harm to health or death of a person was caused. In such cases, a penalty in the form of a ban on holding positions may also be imposed;
  • imprisonment for up to 7 years, with an additional ban on holding positions if the death of two or more people occurs.

Agree, the punishment for negligence in dealing with the consequences cannot be called too severe. Criminal legislation in general is focused on the application of long terms of imprisonment to convicted persons for daring, dangerous crimes of an intentional nature. Consequences arising from improper performance of duties, in the absence of a direct desire to cause significant harm or major damage, entail a less severe punishment.

You should also be aware of the statute of limitations for negligence. Thus, a person cannot be held criminally liable if the following has passed since the onset of the consequences:

  • 2 years (for all criminal cases of negligence, except those when a person’s death or harm to health occurred);
  • 6 years in cases where the death of one person occurred or harm was caused to health;
  • 10 years in cases where the death of several (two or more) persons occurred.

If the specified deadlines have expired, the criminal case against the accused is terminated (in the case where it was initiated earlier). Meanwhile, representatives of victims can, even after the termination of the case, recover moral damages from the guilty official in a civil manner.

Peculiarities

The legislator has defined three factors included in the crime, the presence of which is necessary for qualification under Article 293 of the Criminal Code of the Russian Federation, namely:

  1. Objectivity - characterized by the presence of a cause-and-effect relationship, that is, certain actions or inaction of a person led to the death of a person.
  2. Subjectivity is the identification of a specific person whose actions or inactions led to the death of a person.
  3. Damage is an assessment of the specific consequences that occurred as a result.
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