Criminal negligence of medical workers under Article 293 of the Criminal Code of the Russian Federation

Negligence involves an official's dishonest or careless attitude to his work, resulting in harm to another person or his property. The reasons for negligence may be insufficient competence of a specialist, incorrect assessment of the seriousness of the situation, or simple laziness. Medical negligence is especially dangerous because it can lead to significant harm to a person's health or death.

What is included in the concept of negligence?

For improper performance of his duties, an official is punishable by Article 293 of the Criminal Code of the Russian Federation “Negligence”. Neglect of one's own service, employees or patients must result in significant harm or violation of the rights of a person or organization.

That is, if a doctor who has all the skills, professional education, equipment, funds, etc., did not provide assistance to the patient due to personal hostility, banal laziness, dishonesty, he falls under the article. An official may also be held accountable for inaction.

Physician's financial liability

The doctor’s actions are also qualified by the law “On the Protection of Consumer Rights”, since when contacting a medical institution, the patient becomes the customer, and the doctor becomes the performer. According to Article 14 of the Law “OZPP”, the doctor bears property liability for harm caused to the patient. For example, a dentist in a private clinic diagnosed a patient with mild caries and cured it, but in fact it was pulpitis - inflammation of the internal tissues of the tooth. The development of the disease led to the destruction of the tooth and it had to be removed. The dentist who diagnosed caries must pay for the removal of the tooth and installation of an implant for the patient.

In addition, the patient has the right to compensation for moral damage. The amount of compensation is determined by the court. Practice shows that the amount of compensation rarely exceeds 50% of the total cost of the claim.

The victim also has the right to receive a fine from the medical institution where he received poor-quality care. The fine is up to 50% of the cost of services.

How to spot a negligent doctor

The doctor’s indifferent appearance is not the reason for filing a complaint against him with law enforcement agencies - medical employees are often stingy with emotions due to the hard work with people. Negligence is determined by other factors, the most common of which are:

1. Rude attitude or ignoring . Speaking of indifference, it is worth considering the difference between “coldness” to personal views and beliefs during treatment (that is, unquestioningly fulfilling one’s duties with an awareness of responsibility, not paying attention to one’s feelings and experiences) and outright ignoring. In addition to neglecting the patient’s complaints, there is a rude and boorish attitude, the creation of conflicts and violation of personal space.
2. Incomplete treatment . There are cases when, due to lack of space or for some other reasons, the patient was discharged without completing treatment. Without proper medical supervision, a person simply died at home.
3. Death . Medicine cannot always cope with a disease, but it’s another matter when the death was not natural (an incorrectly performed operation, infection due to contaminated equipment/hands).
4. Lack of attention to diagnosis . This implies the inattention and unprofessionalism of the doctor. It happens that the disease is rare or manifests itself in a non-standard way, but if the medical worker himself did not put effort into proper diagnosis, that’s a different matter.
5. Inadequate treatment . This happens less often in paid clinics, where a certain amount is transferred for treatment, but this does not mean that even after payment the person will not end up with an incompetent doctor.

How to hold a doctor criminally liable in the event of a patient’s death in 2022

If a person dies in the hospital, what should you do? Relatives of an injured patient have two ways to hold unscrupulous doctors accountable.

The first of these is filing a complaint with the police. Then the decision to initiate a criminal case will be made based on the results of checking all the facts stated in the application.

Along with the demand to hold the doctor accountable, relatives of the deceased patient may raise the issue of collecting material and moral damages. Then the possibility of recovering the amounts will be considered in a civil lawsuit.

Attention is important! Do not rush to immediately file a claim in court for compensation. It is necessary to wait for the results of an inspection by the competent authorities regarding the death of a patient due to the negligent actions of a doctor or other medical workers.

When filing a claim, you need to describe in detail what exactly the negligence of the medical personnel consisted of. In addition, it is necessary to outline the range of actions that the doctor actually had to take.

Another way is to contact the prosecutor's office. Read how to do this in our next subsection.

Each case of medical errors is individual. Therefore, before contacting law enforcement agencies, you should consult with a lawyer in Moscow specializing in medical law.

Is medical negligence provable?

There is no separate article relating specifically to medical negligence. Any inaction or inattention is punishable by the same article (293 of the Criminal Code of the Russian Federation).

In order to initiate a case, a connection must be established between the accident and the healthcare worker. The court may acquit the culprit if it is proven that the clinic was not equipped with high-quality or necessary equipment, or if the culprit was in a state of severe fatigue due to the high number of operations and examinations performed.

Is a doctor always responsible for his mistakes?

Obviously, no. The doctor is not omnipotent and not omniscient - his capabilities have very specific boundaries, outlined by the achievements of modern medicine. Therefore, there is no question of liability if:

• — The doctor’s qualifications do not allow him to provide the help that the patient really needs;
• — Third parties interfere with necessary medical measures;
• — The manipulations were carried out in an emergency environment - the consequences of a natural disaster or terrorist act or in combat conditions;
• — Undoubted positive characteristics of the physician’s personality, which do not allow the court to make a decision accusing the physician of an error.

How to understand: medical error or negligence?

Medical error and negligence are two different things, they differ in criminal penalties. Medical error is punishable in rare cases; in most cases, the medical organization itself is punishable under an article of the civil law code. The accusation does not relate to a specific health worker. The most common medical errors for which law enforcement agencies are contacted are pregnancy management, disability determination, dental and therapeutic services, etc.

Medical error can be determined by the following criteria:

• Insufficient qualifications of employees, little experience in the field.
• Lack of quality honey. technology, outdated medical technique.
• The use of outdated methods of treatment, as well as the use of new, unapproved drugs and methods.
• The unpredictability of the human body.

Negligence is as follows:

• Inadequate diagnosis, superficial examination of patients.
• Inattention of hospital staff.
• Irresponsible performance of medical duties.
• Negligent nursing care.
• Rudeness, rudeness, creating conflict.
• Refusal of advice from colleagues, high self-confidence, unnecessary in this case.
• Non-compliance with standards for the provision of medical services.

The objective side of negligence

It is expressed in the fact that a citizen holding a certain position (in our case, a medical worker) does not fulfill the duties assigned to him or performs them incompletely or improperly. Manifestations of a doctor’s negligent attitude towards official activities may include:

• inattentive and indifferent attitude to one’s work;
• failure to comply with the rules of conduct prescribed by medical ethics;
• lack of interest in complaints about changes in well-being with which the patient applied to a medical institution;
• When making a diagnosis and prescribing treatment, only visible manifestations of pathology are taken into account; additional studies are not prescribed;
• an error in making a diagnosis that occurred due to the fact that the doctor, when making a conclusion, relied on data that was insufficient to draw any conclusions;
• failure to comply with the standards for the provision of medical services described in the provisions of regulations;
• refusal to listen to the advice of more qualified health workers.

It should be noted that not in all cases such actions are classified as crimes. They become a criminal offense only when negative consequences occur for the health and life of the patient. Serious harm to the patient’s health must be established or his death must be recorded.

Also, in order to recognize a doctor’s act as criminal, it is necessary that there be a cause-and-effect relationship between his actions (or inaction) and the serious consequences for the patient. If the doctor showed negligence, but the patient became worse for another reason that is not related to the actions of the doctor, then there are no grounds for opening a criminal case.

It is necessary to distinguish negligence from justifiable risk. However, a clear line between these concepts cannot always be established. Sometimes even experienced experts have difficulties here. As a rule, if there are doubts about the validity of a health worker’s actions, a decision is made in his favor.

Consequences for the medical professional

First, it is necessary to establish the involvement of a clinic employee in deteriorating health. To do this, it is better to contact a third-party, independent specialist who will help prove this with documentation.

Important! You should not seek help from the organization where the crime was committed. At best, all employees will simply deny the fact of the crime.

The case will be considered if the perpetrator is over 16 years of age, is a hospital employee, and was in a sane state at the time of committing the illegal actions (was aware of his actions).

How is negligence defined?

Negligent attitude towards the performance of their duties by medical workers has its own specific signs and characteristics.

So the most common ones include:

• erroneous diagnosis associated with insufficiently thorough diagnostic measures, lack of differential diagnosis, failure to prescribe certain procedures;
• insufficient initial examination of the patient, ignoring his immediate complaints;
• violation of professional standards of medical care and treatment protocols;
• ignoring the recommendations of other specialists.

Thus, the negligence of a medical worker is expressed both in the form of unprofessional actions and inaction, which ultimately leads to a significant deterioration in the patient’s health or even death.

It is also useful to read: Statement of beating

Corpus delicti

The combination of subjective and objective factors proves the evidence of the crime.

Subjective trait

This is the presence of the medical employee himself who committed illegal actions.

An object

This is a duty that the health worker did not fulfill due to his irresponsibility, laziness, and lack of seriousness towards his work. In this case, it is important to establish a cause-and-effect relationship, since without it the doctor is exempt from punishment. This point is explained by the fact that he could not predict in advance the patient’s reaction to treatment and took medical risks for the sake of his patient.

Signs of guilt

A doctor, being a medical professional and official who independently makes decisions that directly affect the life and health of patients, bears increased responsibility for his actions. It can have different degrees. In some cases, it is possible to be held accountable under the Criminal Code of the Russian Federation.

Reference! All categories of medical workers who directly carry out medical activities can be held criminally liable for negligence. First of all, this applies to doctors, paramedics, and nurses.

To hold a medical professional liable for negligence, it is necessary to establish his fault.

Signs of the latter include:

• availability of medical education and position in a health care institution that involves the implementation of medical activities;
• negligent performance of their professional duties associated with underestimation of a specific situation due to dishonest attitude towards them;
• a significant deterioration in the patient’s health or even his death, which must have a direct cause-and-effect relationship with the negligent actions (inaction) of a medical worker.

The last point is the most important, since without a relationship between the deterioration of the patient’s condition and the frivolous actions of a doctor or nurse, it is impossible in principle to bring a medical worker to criminal liability.

What consequences of irresponsibility are sufficient to initiate a case?

The legislation outlines clear consequences after which it is necessary to initiate a case under Article 293 of the Criminal Code of the Russian Federation:

• Major and especially major damage - from 1 million rubles to 7.5 million rubles.
• Violation of the rights and interests of a patient or organization protected by law and the state - based on the Constitution of the Russian Federation.
• Particularly serious damage to health, death.
• Fatal outcome of two or more persons.

Characteristics of the crime

There is no individual article or legal norm regarding the negligence of medical workers, and their causing damage to the physical well-being of patients or premature death must be considered as neglect of duty. The duties of any official mean actions and behavior patterns that are prescribed to him by various norms specified in laws, rules, regulations, instructions or other documents and regulating his professional activities.

As an official, a doctor can commit a crime in cases where the decision he makes is capable of adversely affecting the health of the patient or causing death. Based on this, the crime is characterized by a combination of the following facts:

1. Objectivity, expressed in the presence of an official duty that was not fulfilled by the doctor due to laziness, carelessness or underestimation of the seriousness of the situation, and this led to devastating consequences. The cause-and-effect relationship must be obvious and formalized, since the presence of an uncertainty factor during treatment frees medical staff from responsibility, because they could not know about the occurrence of negative consequences and took a justifiable medical risk.
2. Subjectivity, determined by the presence of a specific medical professional whose actions led to a deterioration in the physical well-being of the patient or his death.
3. Damage, which consists of a recorded event of deterioration in the patient’s well-being or death, which has a direct relationship with the treatment procedure due to known side effects of drugs or treatment procedures.

If all of the listed signs of a criminal act are present, it can be classified under Article 293 of the Criminal Code of the Russian Federation in its first part, if health is damaged, as well as the second or third when recording a single or multiple death of patients, respectively.

We will tell you further about how to punish a doctor for negligence, how to prove it and where to go.

Where to complain about medical negligence

To begin with, you can contact the chief doctor of the organization where the poor-quality treatment was performed, having first collected an evidence base. The head physician is required to either provide medical care again. services, or compensation for damage. Demands are not always answered adequately; in some cases, the victim is ignored.

Police

The police do not consider medical negligence a crime if the harm was caused due to laziness, rudeness and inattention. The application will be considered if the crime was committed by a medical worker intentionally, in order to specifically harm the applicant and other patients.

Prosecutor's office

The powers of the prosecutor's office are to conduct inspections of state and non-state organizations for violations and illegal actions. The statement indicates a complaint about the doctor’s negligence, which indicates the corpus delicti, after which an investigation is carried out into the fact of the damage, and then a criminal case is initiated. At the same time, the application is submitted to the local authority of Roszdravnadzor.

The application must indicate:

• The date of the crime that occurred, the period of treatment, the treatment procedures that were carried out and the list of medications, the name of the medical officer who made decisions in prescribing measures and medications that led to negative consequences.
• Description of interaction with the heads of the clinic, prof. Ministry regarding the negligence of a health worker and the application of administrative penalties to him.
• A request to conduct an inspection under Article 293 of the Criminal Code of the Russian Federation.
• A request for compensation for moral and physical harm, and for bringing the person who committed the crime to criminal liability.

Court

When the check and pre-trial investigation have been carried out, they go to court. Without an investigation and a cause-and-effect relationship, the application will not be accepted - there is no evidence.

Important! The court may accept an application in the case where the applicant was denied verification, as well as to appeal it.

How to punish a doctor for negligence - action plan

The fight for justice should begin with the chief physician of the institution where the perpetrator of the incident works. Even if you see that the hospital management does not protect the rights of patients, write a complaint against the attending physician to his boss. An unanswered statement will be an additional argument in your favor at trial.

If we are talking about causing serious harm to a patient, it is necessary to submit a statement of medical negligence to the investigative committee. They should initiate a criminal case under the above article. If law enforcement agencies are in no hurry to begin an investigation, you need to file an application with the prosecutor's office. At the same time, you can prepare a lawsuit.

Special cases

A special case is considered to be negligence resulting in death.

Patient's death

As a result of inaction or improper performance of his direct duties, due to which a death occurred, a medical employee is punished under Part 2 of Article 293 of the Criminal Code of the Russian Federation. The court sentences either to 5 years of imprisonment with a ban on treating people after release for 3 years, or to forced labor with a ban on working with sick people (also for 3 years).

Death of a child

The age of the deceased is not an aggravating circumstance and does not entail a different sentence. In this case, the person responsible for the death of a minor child is tried under the same article - 2 parts of Art. 293 of the Criminal Code of the Russian Federation.

Who should I contact to make a complaint?

There are several options for submitting a complaint:

1. To the management of the medical institution where the patient was located and treated.
2. Sending the document to a higher authority - the Ministry of Health. You can contact both the local and central authorities.
3. File a claim for medical negligence with the Prosecutor's Office.
4. Submit a statement of claim to the court.

Need to know! Complaining against a doctor to the police will not be accepted, as this is not part of the rules established by law.

Let's consider possible options for filing claims.

1. The initial stage will be to file a complaint against the doctor addressed to management , in this case, to the head doctor of the medical institution. The complaint can be drawn up in a free style, but must indicate the reason for the complaint and the circumstances of the tragic incident. The complaint is written in two copies, one for each party. On the version that the applicant keeps, it is necessary to put the date of acceptance of the complaint and the signature of the person responsible for registering the document.

Referral to management would be appropriate when the patient has suffered minor injuries. Here we are not talking about the material side of the matter; rather, it will be a matter of principle.

1. Contacting the Ministry will be a more effective way of contacting, since it involves real actions on the part of Ministry of Health employees. This is a higher authority of the medical institution where the patient was treated, which means that not only the doctor, but also the head of the health institution can bear responsibility.

The complaint is drawn up in the same way, only the recipient of the complaint will change.

Typically, such an appeal will take place when an appeal to the administration has had no effect and no punitive measures have been taken against the culprit.

1. Complaint to the Prosecutor's Office or Court

Despite the fact that the proceedings will not be quick, they will be the most effective.

The complaint must be drawn up in the prescribed form.

The document must include:

• name of the body to which the complaint is sent;
• personal information of the applicant, indicating contact details;
• a detailed statement of the essence of the appeal;
• description of previously undertaken methods of influence and their results;
• a written request to consider the tragic incident and identify the culprit;
• a specific listing of the demands put forward to the defendant;
• a list of attached certificates, documentary evidence related to the case under consideration;
• signature with transcript and date of filing the complaint.

It is important to know! You can appeal to the Court only when other forms of appeal have already been undertaken and have not brought satisfactory results.

Judgment gavel

How does judicial practice develop?

Often employees of clinics, educational institutions, and law enforcement agencies become involved in criminal cases. Moreover, they have not been previously convicted, are in good standing in their organization, admit their guilt and cooperate in every possible way with the investigation.

It is impossible to say exactly why this happens. Perhaps the official at such moments is confident that his activities (or inaction) will not attract attention and will remain behind the walls of the organization. It is possible that the culprit is a simple lack of qualifications and necessary training of the working staff.

These cases are known to judicial practice (names are not disclosed):

• Tolyatti. The neurosurgeon was sentenced to probation followed by a ban on treating people for 3 years. The doctor discharged the patient without completing the treatment, after which he died from the diagnosis.
• Novosibirsk region. The head of the children's health complex was careless about his duties, which included the safety of the lives and health of children. The consequence of negligence was several accidents involving a child who, as a result, lost his ability to work.

Introduction

Previously, in the articles “Medical error: should a doctor be held legally responsible for it?”
and “Medical malpractice: what legal liability can a health care professional face?” We examined in detail what is meant by a medical error, what consequences occur if such an error is made, and why ideas about the content of this concept are so different among, for example, practicing doctors and employees of the Investigative Committee. In this article, we will try to understand how medical errors are considered by the courts, and whether such controversial approaches to this term influence judicial practice in medical malpractice cases.

Difficulty in investigating cases of medical negligence

Investigating cases of negligence (including medical negligence) is very difficult, since the case has a large number of nuances. It happens that an investigation is being conducted against a professional doctor with a high rating, who previously had only positive reviews. If a health worker was in a state of severe fatigue due to a heavy workload, he may be acquitted. Often among honey. staff use the excuse of “they did what they could”, and it can work in their favor.

In order for the case to be closed in favor of the victim, it is necessary to prove the direct intent of the employee, as well as his unprofessional actions during diagnosis, treatment and treatment of the patient.

Referring to an examination will help prove an overdose of drugs, the presence of allergic reactions of a person to a particular medicine. Poisoning with drugs (carelessness during dosage) and ignoring test results also constitutes medical negligence.

What does negligence mean?

Negligence means an employee’s dishonest attitude towards his or her duties. This applies to any employee, including those in medical organizations. The result of doctor’s negligence can be harm to the patient’s health, even death. There are various reasons for dishonest performance of duties, including the incompetence of a specialist.

Patients may experience the following manifestations of medical negligence:

• incorrect diagnosis;
• superficial inspection;
• incorrectly prescribed treatment;
• violation of medical confidentiality;
• non-compliance with medical ethics, etc.

If the patient encounters any of these situations, then he has the right to hold the doctor liable for negligence. Various measures of punishment for medical workers are provided. Among them are the following:

• disciplinary liability;
• recovery of compensation for moral or material damage;
• criminal liability.

The punishment depends on the employee's misconduct.

Liability and consequences of medical negligence

What is the criminal liability of a doctor? If it was nevertheless proven, then the specialist will face the following penalties, dictated by Article 239:

1. A fine of up to 120 thousand rubles, arrest for up to 3 months and compulsory or corrective labor for up to 1 year - if the damage was minor.
2. Forced labor for up to 5 years, a ban on further medical practice for up to 3 years, or imprisonment for up to 7 years, if the consequence of the specialist’s negligence was the death of the patient or serious harm was caused to him.

Read what to do if your child is beaten at school.

And here’s where to complain if a husband beats his wife.

Definition of negligence - Article 293 of the Criminal Code of the Russian Federation

Why does a patient who is faced with poor medical care, illiteracy of a doctor, or simply his careless attitude towards the health of his sick ward need to familiarize himself with Article 293?

The fact is that any actions of a doctor that entailed any damage to the patient’s health, with the exception of when the doctor intentionally brought the person to death (the emphasis here is on the word “intentionally”), is automatically designated in further proceedings as medical negligence , article of the Criminal Code of the Russian Federation No. 293 will be the first under which such a case will be carried out.

So, the article of the Criminal Code of the Russian Federation defines medical negligence as skimping or poor performance of their work duties, which resulted in damage to the health of an innocent person.

Actually, Article 293 includes not only medical negligence, but also any other that entails harm to another person due to the failure of an official.