The business of doctors begins from the end

In Moscow, one of the most resonant medical malpractice trials in recent years is being completed – the case of I. about. head physician of maternity hospital No. 4 in Kaliningrad, Elena Belaya, and neonatologist Elina Sushkevich, who are accused of killing a baby. On Tuesday, the court is likely to move on to the debate of the parties. Elina Sushkevich’s lawyer, Kamil Babasov, commenting on the course of the trial for Kommersant, complained about the “accusatory bias of the court”: the judge did not accept a single defense petition, including the speech of neonatologists and toxicologists before the jury. In December 2020, a jury already found the doctors not guilty. The prosecution, although it did not present new evidence during the retrial, this time is counting on a guilty verdict. In this case, doctors can face from 8 to 20 years in prison.

And about. the head physician of the maternity hospital No. 4 in Kaliningrad Elena Belaya and neonatologist Elina Sushkevich are accused of killing a baby in November 2018. According to investigators, since the child was born prematurely with severe pathologies, Ms. Belaya, fearing a deterioration in the statistics of the maternity hospital, instructed Ms. Sushkevich to inject him with a lethal dose of magnesium sulfate. After that, “deliberately false information was entered into the history of childbirth that there had been a fact of fetal death.” The defense side insisted that for several months the investigation had not presented evidence of the truth of this version. The defense found that the child’s mother had taken a magnesium supplement during pregnancy. On December 10, 2020, the jury found the doctors not guilty. However, representatives of the injured party and the Prosecutor General’s Office filed an appeal, pointing out that the public and the media put pressure on the jury.

In May 2021, the First Court of Appeal of General Jurisdiction in Moscow overturned the acquittal of the Kaliningrad Regional Court. Later, the Supreme Court of the Russian Federation, at the request of Deputy Prosecutor General Igor Tkachev, transferred the retrial of the criminal case from Kaliningrad to the Moscow Regional Court. On November 5, at the very first hearing in the Moscow Regional Court, Elina Sushkevich and Elena Belaya were taken into custody, explaining the decision, among other things, by the fact that they do not have registration in the Moscow region. Since then, they have been in pre-trial detention center No. 6 in Pechatniki.

On August 16, the seventeenth hearing on the case will be held. As the lawyer of the victims, Larisa Guseva, told Kommersant, the prosecution has already presented all the evidence and is ready for debate. However, the defense petitions for the interrogation of the last witness – the nurse of maternity hospital No. 4, who was on duty on the night of November 6, 2018, Alena Sukhar (Kiyanenko). During the two previous hearings, Mrs. Sukhar did not appear for interrogation. Elina Sushkevich’s lawyer, Kamil Babasov, does not exclude that the nurse will not appear this time either, and then the court will finish the investigation and move on to debate.

Mr. Babasov told Kommersant that the trial is proceeding, “to put it mildly, with an accusatory bias.” According to him, the judge rejected all the motions of the defense, including the request to hear the jury experts – neonatologists and a toxicologist, deeming them unfounded. “The court said that everything is clear to everyone. But we still have a lot of questions for the experts, primarily for calculations (the concentration of magnesium sulfate in the blood of an infant.— “b”). We believe that the expert opinions in the case file are unreliable,” the lawyer complained.

According to Mr. Babasov, the prosecution in the “Moscow” process did not provide new evidence, with the exception of a letter from the Deputy Minister of Health of the Kaliningrad Region, Elena Semenova. In it, Ms. Semyonova “makes her judgment” that the worsening infant mortality rates could affect the prospects for the appointment of Elena Belaya to the post of chief physician.

The lawyer of the family of the victims, Larisa Guseva, in turn, is satisfied with the course of the process and is awaiting a guilty verdict from the jury. “I believe that the actions of Belaya and Sushkevich are correctly qualified, and it is unacceptable to talk about whether the child was in an agonal state,” Ms. Guseva told Kommersant. “There is no such concept in the legislation. There are only concepts “liveborn” and “stillborn”. He was born alive, and the doctors had to save him anyway.” She referred to the words of the head of the group of forensic experts: even at the beginning of the trial in Kaliningrad, he told the court that the child “was alive and would die for the next few hours, or maybe days, or maybe he wasn’t going to die at all.”

It should be noted that the trial of Elena Belaya and Elina Sushkevich has become one of the most high-profile and resonant cases of medical errors. The Russian Society of Neonatologists, the National Medical Chamber headed by Leonid Roshal, and a number of chief freelance specialists from the Ministry of Health of the Russian Federation stood up for the doctors, primarily for Ms. Sushkevich. Initiative doctors launched the #YaElinaSushkevich campaign on social networks, and a petition in defense of the neonatologist gained more than 270,000 signatures. Colleagues of Ms. Sushkevich reacted sharply negatively to the annulment of the acquittal and the return of the case to court, calling the trial “demonstrative”. “We, as a community, support Elina and are absolutely confident in her innocence, as we have sorted out every letter of the case materials that were available. And we believe that the verdict can only be acquitted, ”said Diana Mustafina-Bredikhina, lawyer of the Russian Society of Neonatologists, senior lecturer at RUDN University, to Kommersant.

At the same time, not everyone in the professional community is sure of the innocence of Elina Sushkevich and Elena Belaya. Igor Artyukhov, editor-in-chief of the Medical Russia portal on the relationship of doctors with patients, the media and law enforcement agencies, conducted his own analysis of the conclusions of forensic experts, the arguments of the defense and the prosecution and found “a number of contradictions.” He noted the audio recording of a fragment of a conversation between Elena Belaya and her subordinates, on the morning of November 6, 2018, made by Tatyana Sokolova, head of the maternity ward of maternity hospital No. 4. On the recording, Mrs. Belaya reprimands doctors for providing resuscitation care to a child in serious condition: “… You are setting everyone up, including the chief freelance obstetrician-gynecologist. Therefore, we sit down and rewrite history and do antenatal (antenatal death – the death of the fetus during pregnancy.— “b”)”. “It was after the publication of this record that the defense suddenly began to publicly accuse the duty shift of negligence. It is only unclear where now the lawyers should put all the statements about the lack of examination of the woman in labor and the negligible chances of the baby to survive, ”Mr. Artyukhov told Kommersant. According to him, a large number of doctors, including neonatologists, “understood what really happened to the child.”

It should be noted that Elina Sushkevich and Elena Belaya are charged under Part 2 of Art. 105 of the Criminal Code of the Russian Federation “Murder of a minor or other person, knowingly for the guilty person who is in a helpless state.” If convicted, they could face 8 to 20 years in prison.

Natalya Kostarnova