The Investigative Committee began criminal prosecution for every third patient complaint against a doctor

In 2022, every third patient complaint led to the initiation of criminal proceedings against doctors. This was announced by the former head of the department for the investigation of iatrogenic crimes of the main investigative department of the Investigative Committee of Russia (ICR), and now the head of the consulting company “Yustum” Dmitry Zinin at the conference “Regional Healthcare 2023”. At the same time, according to him, out of 1,860 criminal cases, 174 reached the court; charges were brought against 193 medical workers, and only 19 of them were able to receive an acquittal. Experts say that iatrogenic crimes have long been one of the priority areas of work of the Investigative Committee, as evidenced by the creation of specialized units in both the central and regional divisions of the investigative agency.

In 2022, 1,860 criminal cases were initiated against medical workers—almost every third of the 5,747 patient complaints. These statistics were presented by the former head of the department for the investigation of iatrogenic crimes of the main investigative department of the Investigative Committee of Russia, the head of the consulting company “Yustum” Dmitry Zinin at the conference “Regional Healthcare 2023”, reported the publication “Medvestnik”. At the same time, 174 cases reached the court, charges were brought against 193 medical workers, and only 19 of them (10%) were able to obtain an acquittal.

Over the past seven years, the number of reports of medical crimes has ranged from 4,947 (2016) to 6,623 (2018). The number of criminal cases on them first grew (in 2016 there were 878, in 2017 – 1791, in 2018 – 2229), and then began to decrease (in 2019 – 2168, in 2020 – 1639, in 2021 – 2095).

Over the course of seven years, approximately the same number of cases reached the court. The jump occurred in 2019, when investigative authorities sent 274 cases against doctors to court. In the same year there was a maximum number of accused – 307. In 2018 there were 305, in 2017 – 199, in 2016 – 185, in 2020 – 230, in 2021 – 196. In 2019, the trial also issued the largest number of acquittals – 27. In 2016 there were only 3, in 2017 – 8, in 2018 – 21, in 2020 – 19, in 2021 – 19. Dmitry Zinin noted that Doctors as a social group receive the most acquittals—the national average varies from 0.01% to 0.1%.

Most often, criminal cases were initiated against doctors for causing death by negligence due to improper performance of professional duties (Part 2 of Article 109 of the Criminal Code of the Russian Federation) – 1396 cases. This is less than in 2021 (1565) and 2018 (1600), but more than in 2017 (1280). In second place is the provision of medical services that do not meet safety requirements (Part 1 of Article 238 of the Criminal Code of the Russian Federation – 138 cases; Part 2 of Article 238 of the Criminal Code of the Russian Federation – 136 cases). In 2018, there were 232 and 145 such cases, respectively. Last year, 57 criminal cases were initiated due to negligence, which negligently resulted in the infliction of serious harm to health or the death of a person (Part 2 of Article 293). In 2017 there were 80 such cases, and in 2019 – 84.

Mr. Zinin calls one of the reasons for the persecution of doctors “patient extremism” – a deliberate attempt by a patient or his relatives to get money from a medical institution through threats (contact the media, write a statement about a crime to the Investigative Committee) or actual lawsuits. “Medvestnik” quotes Mr. Zinin as saying that “the rights of the patient are protected by many laws, but the rights of the doctor are protected only by God and the doctor himself.”

Managing partner of the Mill Law Office, Oleg Sopotsinsky, says that iatrogenic crimes have long been one of the priority areas of work of the Investigative Committee, which is under the close attention of its leadership, as evidenced by the creation of specialized units in both the central and regional divisions of the investigative body. And it is precisely this close attention, according to Mr. Sopotsinsky, that entails the high proportion of criminal cases initiated. Criminal Defense Firm lawyer Daniil Gorkov confirms the trend. Thus, Art. 290, 291, 291.2, providing for criminal liability for bribery. A partner in the law firm Timofeev, Gusev and Partners notes a “huge gap” between the number of criminal cases initiated and those actually brought to court. “Unfortunately, from these statistics it is not clear how many doctors in criminal cases that did not end up in court suffered as a result of the use of criminal procedural coercive measures,” says Mr. Gusev.

Lawyer of the legal group “Yakovlev and Partners”, teacher of the Department of Medical Law and Bioethics of SamSMU Evgenia Ryzhkova points out the importance of forensic medical examination proceedings. “The legislation on this issue is quite balanced – whether the doctor committed a crime or not, experts determine that it is difficult for a lawyer to argue with,” comments Ms. Ryzhkova. “The patient is the weaker party in relations with the hospital, but he has all the powers of the investigative authorities on his side. In my practice, most cases end in refusal to initiate a criminal case, but satisfaction of the claim in civil law.”

Deputy Chairman of the State Duma Committee on Health Protection Sergei Leonov (LDPR) associates the increase in the number of criminal prosecutions of doctors with the creation of a special department in the Investigative Committee for their investigation. Even if the case doesn’t end up going to trial, the investigation causes “serious hassle” for doctors, he said. “We have three blocks of risk specialties: surgery, anesthesiology-reanimatology, obstetrics-gynecology. These doctors face criminal charges every day. And the more such cases there are, the fewer graduates of medical universities will choose these areas. And the shortage of anesthesiologists is already colossal throughout the country,” says Mr. Leonov.

Co-chairman of the All-Russian Patients’ Union Yuri Zhulev believes that the presence of clear rules for compensation of damages, including through the mechanism of doctor’s liability insurance, can reduce the number of claims from patients. “Yes, there are cases of outright abuse of rights by patients. But a comprehensive policy can help here: a balance of rights of both doctors and patients must be maintained,” concludes Mr. Zhulev.

Natalia Kostarnova