Iatrogenic death of a patient as a result of local anesthesia with the use of the drug “Naropin”

The article considers the clinical and forensic aspects of the possibility of establishing a causal relationship between the use of the drug “Naropin” and the death of a patient during local anesthesia. In this case, the patient sought outpatient medical care for paraproctitis. The decision made by the doctor the decision for local anesthesia is the use of the drug “Naropin”. At 20 minutes of administration of the drug in the required dosage, the patient suddenly developed convulsions and clinical death occurred, and later the patient died. When conducting a forensic examination of the corpse, the most significant was the following: a small pinpoint wound in the upper quadrant of the right buttock, pulmonary edema, liquid blood and small loose blood clots in the heart cavities, brain edema. During a post-mortem Toxicological examination of the blood, the presence of ropivacaine (a component of naropine) was found to exceed the threshold toxic concentration. Repeated expert research has found that led to the onset of death-the erroneous introduction of the anesthetic “Naropin” directly into the blood vessel, which is prohibited by the instructions for its use due to a very narrow zone of toxic action.

3 years of experience in distance teaching for doctors of forensic experts in general human pathology

The trends in the development of education include the trend of informatization of education and the trend of innovative education. In forensic medicine, the competence to learn to cognize compulsorily includes understanding of general pathological processes, and only through this prism should the ability to verify particular pathological changes occurring in the human body as a result of various types of injuries and diseases arise. To implement these trends, we use distance educational technologies, taking into account the following criteria: for an individual trajectory of professional formation and development of a cadet doctor; for the development of thinking in the process of professional development; of objectivity; of productive communication; of information support for the co-creation of teachers and cadets; feedback. In order to apply the indicated criteria in full, the process of perception and processing of visual information was divided into three stages. The first stage is the analysis of the structure of the information supplied. At the second stage, new images are created. The third stage is a search activity. The above-described structuring of the content of educational information and the principles of organizing the educational process using distance educational technologies have successfully taught doctors of forensic experts to apply knowledge of general human pathology in the production of examinations.

Taking into account the biological factor when conducting a special assessment of the working conditions of the teaching staff of departments of medical and biological profile

Special assessment of working conditions is a single set of consistently implemented measures to identify harmful and (or) dangerous factors of the production environment and the labor process and assess the level of their impact on the employee. Conducting a special assessment of working conditions is regulated by certain normative documents (Federal law, labor code, orders of departments). The greatest difficulty is caused by the attribution of working conditions in the workplace of medical and other workers to the class (subclass) of working conditions under the influence of a biological factor. Teachers can carry out medical activities, while they are subject to the rights, duties and responsibilities of medical professionals. The implementation of the components of the concept of medical activity is the basis for assigning working conditions based on the influence of a biological factor, taking into account pathogenicity groups, to a class (subclass) of working conditions without conducting research (tests) and measurements.

Forensic evaluation of the rate of development of ARDS in cases of poisoning with clozapine and baclofen

Acute respiratory distress syndrome (ARDS) is a syndrome of severe respiratory failure. Its etiology is associated with the impact of various aggression factors, which can be divided into direct and indirect. The aim of our study was to identify and compare histomorphological changes in the lungs in clozapine (150 mg/kg) and Baclofen (85 mg/kg) administration, depending on the conditions of use of these drugs. Experiments were conducted on outbreed male rats weighing 250–290 g and 20 weeks old. The animals were divided into 5 groups: the controls, Baclofen (85 mg/kg), clozapine (150 mg/kg), Baclofen (85 mg/kg and ethanol), clozapine (150 mg/kg) and ethanol.

Some medical and forensic features of diagnostics of the damage of clothes of the person caused by shots from the hunting weapon of 12 caliber cartridges with a wad-the container and without it in criminal proceedings

In the article based on the analysis of investigative practice, the article examines the most common situations associated with medical and forensic features of diagnosing damage to human clothing caused by shots from a 12-gauge hunting weapon with or without a wad container. A brief description of the damage to a person's clothing caused by shots from a 12-gauge hunting weapon with or without a wad of ammunition in criminal proceedings is given. The issues of medical and forensic diagnostics, wound infection, and gunshot injury are considered.

Legitimate harm by a doctor to a patient’s health with medical intervention. Inevitability. Risk. Randomness

Medical intervention is often associated with some harm to the patient’s health. At the same time, the very concept of “harm to health” does not mean the wrongfulness of a doctor’s act. The inevitable harm to health, without which medical intervention itself is impossible, is legitimate when there is the consent of the patient. The risk of causing more than unavoidable harm to health also requires consent and compliance with reasonable risk conditions. Harm to health, the infliction of which could not be foreseen, is an accident. Accident — innocent harm that does not imply criminal prosecution. Outside of consent, harm to health can be done legitimately in an emergency.

Verification of the severity of damage to health with damage to the organ of vision

The eye-damage is one of the most significant causes of disability and blindness. In this study the possibilities of practical use of harm to health severity criteria in cases of eye-damages are considered and the illustration of their application is presented.

The daily load on the staff as the cause of diagnostic and medical-tactical defects in the work of ambulance

The urgency of the problem is because work on the prehospital stage, especially on the ambulance, implies the difficulty of diagnosing various diseases. This is because in patients who call an ambulance, as a rule, there is a huge range of various diseases and their complications, as well as injuries. Therefore, the purpose of this study was to identify patterns of increase in the main diagnostic and therapeutic tactical defects in the work of ambulance in the conditions of daily workload. The materials of the study were the coupons to the accompanying sheet, since they reflect the continuity in the work of the ambulance and hospitals. Based on the obtained results, conclusions are formulated and goals for further research are indicated.

Patient dissatisfaction with medical dental care

The article provides information on the results of studying the materials of 150 commission of forensic medical examinations on the facts of patient dissatisfaction with the provision of medical care. The relevance of the problem of the legal relationship between a doctor and a patient is revealed and shown. The lack of information on these issues leads to a high probability of disputed situations in the providing dental care, so there is an urgent need for an integrated approach to the implementation of legally defined rights of patients. Media coverage of the above-mentioned problems plays an important role in improving the level of legal competence of patients. At the same time, the direct relationship between the doctor and the patient is the most important mechanism for implementing the patient's rights at the dental appointment and preventing conflicts. Behavior of doctors in such cases should be strictly regulated by normative legal acts. The process of information sharing with patients and transfer of information to the patient's relatives should receive in medical preventive institution specific legal basis under sections 30, 31, 48, 61 “Principles of legislation of the Russian Federation about health protection of citizens”, to be fixed in job descriptions with the designation of responsibility.

Medical errors in therapeutic practice

We often currently hearing from various media sources about improving of healthcare system and providing high-tech medical care. According to the analysis, many factors have been identified that affect the increase in the number of defects in medical care, which also lead to negative consequences in the development of diseases, the development of complications, and sometimes even death. According to the analysis, a number of factors were identified that affect the increase in the number of mistakes in the development of medical care, as well as leading to a great mistrust to the doctors from the population, to more serious and negative consequences in the form of worsening the course of the disease, the development of complications, and sometimes even death.