DIAGNOSIS ERRORS ACCORDING TO THE MATERIALS OF THE FORENSIC MEDICAL SERVICE

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Abstract

According to the materials of the forensic medical service we have found out that inadequate medical care in the form of defects was revealed more often in the activity of obstetricians-gynecologists, as well as surgeons and traumatologists; defects of diagnosis and treatment prevailed in character; they occurred mainly due to subjective reasons, more often at the hospital stage and in the outcome they resulted in death and disability more often.

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80

Volume 04 Issue 03-2022


The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN

2689-1026)

VOLUME

04

I

SSUE

03

Pages:

80-83

SJIF

I

MPACT

FACTOR

(2020:

5.

286

)

(2021:

5.

64

)

(2022:

6.

319

)

OCLC

1121105510

METADATA

IF

7.569















































Publisher:

The USA Journals

ABSTRACT

According to the materials of the forensic medical service we have found out that inadequate medical care in the form
of defects was revealed more often in the activity of obstetricians-gynecologists, as well as surgeons and
traumatologists; defects of diagnosis and treatment prevailed in character; they occurred mainly due to subjective
reasons, more often at the hospital stage and in the outcome they resulted in death and disability more often.

KEYWORDS

Forensic medical examination, defects of medical care, character, cause of origin, places of admission, outcome.

INTRODUCTION

According to recent observations, the number of
citizens' applications to law enforcement agencies

concerning defective medical care has been growing
[3]. Both objective and subjective factors contribute to

Research Article


DIAGNOSIS ERRORS ACCORDING TO THE MATERIALS OF THE
FORENSIC MEDICAL SERVICE

Submission Date:

February 28, 2022,

Accepted Date:

March 20, 2022,

Published Date:

March 31, 2022 |

Crossref doi:

https://doi.org/10.37547/TAJMSPR/Volume04Issue03-16


Sadullaev Narzullo Norkelidievich

Assistant professor of forensic medicine and pathological anatomy at the Termez branch of the Tashkent
Medical Academy, Uzbekistan

Shavkat Eryigitovich Islamov

Associate Professor, Doctor of Medical Sciences, Department of Forensic Medicine and Pathological
Anatomy Samarkand State Medical Institute, Uzbekistan

Journal

Website:

https://theamericanjou
rnals.com/index.php/ta
jmspr

Copyright:

Original

content from this work
may be used under the
terms of the creative
commons

attributes

4.0 licence.


background image

81

Volume 04 Issue 03-2022


The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN

2689-1026)

VOLUME

04

I

SSUE

03

Pages:

80-83

SJIF

I

MPACT

FACTOR

(2020:

5.

286

)

(2021:

5.

64

)

(2022:

6.

319

)

OCLC

1121105510

METADATA

IF

7.569















































Publisher:

The USA Journals

the development of adverse outcomes in medical
practice [11].

At the same time, the right of citizens to receive
qualified medical care is enshrined in the Constitution
of the country. In this regard, the right of citizens to
receive qualified medical care is enshrined in the
Constitution of the country. The study of aspects of
this problem from forensic medical standpoint is
closely related to the study of medical, organizational,
and legal issues [2,12,13].

At the prehospital stage the first stage of diagnosis and
mainly outpatient treatment of patients with various
pathologies is carried out [4]. It is during this period
that health care workers should make a timely and
correct diagnosis of serious pathology requiring
mandatory hospitalisation [10], (although patients
treated in primary care are less likely to seek
emergency medical care and need hospitalisation) [5].
Unfortunately, there is a problem where medical
professionals

have a great desire to help the injured but lack
experience in emergency care [6]. This leads to a
reduction in pre-hospital care. In this case, victims are
exposed to additional risk due to defects in prehospital
treatment and diagnosis arising from subjective and
organizational reasons (abandonment of patients at
the site of illness, incorrect choice of emergency
treatment method) [ 8,9].

The aim of the study

is to identify the essence of

admissible

defects

in

medical

care

among

professionals of different profiles, according to the
materials of the forensic medical service.

MATERIALS AND METHODS OF THE STUDY

A retrospective analysis of the reports of the forensic
medical examinations conducted in Samarkand

regional branch of the Republican Scientific and
Practical Center of forensic-medical examination was
carried out.

RESULTS OF THE STUDY

The Samarkand regional branch carried out 58
examinations of malpractice cases of medical workers.
38 of them (65.5%) identified defects in medical care.
There were 16 cases (42.1%) of obstetrician-
gynaecologists, 4 cases (10.5%) of surgeons and
traumatologists, 3 cases (7.9%) of paediatricians,
internists and ENT doctors, 2 cases (5.3%) of
anaesthetists and intensive care specialists, and 1 case
(2.6%) of neurosurgeons, oncologists and toxicologists.
The following predominated by nature: failure to
recognize the underlying pathology 10 (26.3%) and its
complications 2 (5.3%), late hospitalization 3 (7.9%), as
well as errors in prescribing and carrying out medical
procedures (inappropriate delivery management) 14
(36.8%), violation of transportation rules, etc. by 1
(2.6%). The reasons were clearly predominantly
subjective - 28 (73.7%), including inattention to the
patient - 24 (85.7%), incomplete examination of the
patient - 4 (14.3%), late medical examination - 3 (7.9%),
and other - 7 (18.4%). At the pre-hospital stage, 3 (7.9%),
including 1 (2.6%) at SVP, district clinic and at home; at
the hospital stage, 35 (92.1%), including 25 (65.8%) at
CDH and maternity hospitals, 9 (23.7%) at the regional
hospital and 1 (2.6%) at self-supporting institutions.

Example. On 13 November, Ms. M.N. came to the
emergency room of the district medical association
complaining of weakness, abdominal distension, pain
in the right subcostal area, cough, lack of appetite and
darkened urine. She was admitted to the infectious
diseases department with a diagnosis of chronic viral
hepatitis

C,

jaundice

of

moderate

severity.

Consultation

with

specialists

(obstetrician-

gynecologist, internist, phthisiatrician, neurologist,


background image

82

Volume 04 Issue 03-2022


The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN

2689-1026)

VOLUME

04

I

SSUE

03

Pages:

80-83

SJIF

I

MPACT

FACTOR

(2020:

5.

286

)

(2021:

5.

64

)

(2022:

6.

319

)

OCLC

1121105510

METADATA

IF

7.569















































Publisher:

The USA Journals

oculist) and laboratory tests (general blood test, urine
test, biochemical blood test) were carried out. Three
days with a diagnosis of pyelonephritis she was treated
in the physiotherapy department. A week after
admission she was discharged. On 24.11. with
complaints of cough with sputum, pain in the left side
of the chest, fever, rapid fatigue, admitted to the
regional TB dispensary with a preliminary diagnosis of
left-sided tuberculous empyema. Sputum examination
did not confirm the diagnosis of tuberculosis. On the
following day a puncture of the left pleural cavity was
performed and 30.0 ml of purulent fluid was isolated.
On 28.12. he was discharged home after improvement
of his condition. On 04.01. she came to Republican
Specialized Research Center for Phthisiology and
Pulmonology, where she was diagnosed with left
pulmonary fibrotic-cavernous tuberculosis, left-sided
pyopneumothorax, viral hepatitis C, 2nd degree
cachexia and underwent surgical intervention "Left-
sided pleuropulmonectomy. The excised material was
subjected to pathohistological examination and an
inflammatory infiltrate with specific features was
detected. Expert analysis of the patient's X-rays from
the district association revealed the following: an
image from 13.11. - there is an infiltrative shadow on the
background of scapula shadow at the level of the 3rd
rib of the middle field of the left lung field, shadow
intensity is low, contours are uneven, uncertain, in the
upper and middle fields foci of high intensity are
revealed, disturbance of lung root structure,
deformation of lung pattern, presence of fluid shadow
in small amount in the left costophrenic sinus, heart
thalium is smoothed; on X-ray image from 27. 11. the
presence of an infiltrate on the left side and the
conclusion that such changes are characteristic of
tuberculosis.

In the opinion of the expert committee at the district
medical

association,

due

to

an

incomplete

examination, lack of consultation with narrow
specialists (general practitioner, phthisiatrician), the
correct diagnosis was not established in time. In the
outcome they resulted in 26 (68,4%) deaths, 3 (7,9%)
disabilities and had no significant impact on the
outcome in 9 (23,7%).

CONCLUSIONS

Thus, according to the materials of the forensic
medical service, defects in medical care were more
frequently identified in the activities of obstetrician-
gynaecologists, as well as surgeons and trauma
surgeons, and defects in diagnosis and treatment
predominated, mainly due to subjective reasons, more
often at the hospital stage, and in the outcome more
often resulted in death and disability.

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