"Would have died anyway": court assessed the death of a patient at the hospital's doorstep at 300 thousand

      It is likely that, trying to explain to the plaintiff—the sister of the deceased—why a person's life, or rather death, is valued at 300,000 rubles, the district court without appeal asserted that Kochkin... would have died anyway.

      This is hard to deny due to universal human physiology, but considering the specific case of the young man's death, the court decided to take into account the oral opinion of Kirov experts. They found no causal link between the death of the patient, who died of a heart attack on the street—just a few meters from the Shabalinskaya hospital—and the diagnosis of "gastritis" (gastroduodenitis) given to him an hour earlier.

      So the late Vyacheslav Anatolyevich appeared before the witnesses of the tragedy and the Creator, clutching in his hand the "salvatory mixture"—a bottle of Almagel, as well as stomach tablets and a referral "for stool analysis."

      Quality elevated to the degree of death

      Let us recall that on February 17, Vyacheslav Kochkin arrived at the hospital by 8 a.m. complaining that at two o'clock in the morning he felt pain and burning in his chest. After sitting for nearly three hours outside the office of the attending physician—Nina Klepcha, who worked as an ophthalmologist before starting her therapeutic practice—the patient learned that he had "acute gastritis," which, according to the doctor, he developed by eating chips the day before.

      By the way, Nina Ivanovna did send Kochkin for an ECG, but rather as a formality than out of curiosity or a desire to establish the correct picture of his ailment—after all, she does not know how to use the computer where the electronic card indicates the "alarming diagnosis"—hypertension.

      Soon, closer to noon, after undergoing the ECG, the patient returned to the office, handing the doctor the tape with the interpretation of the heart impulses, which the emergency physician (at 1 p.m.) would determine as a heart attack and establish the patient's death within a few seconds. But Nina Ivanovna probably did not look at the results, throwing the ECG tape on the table, and wrote out several referrals for tests and a prescription. With the words: "If it gets worse—come back in a week," she sent Kochkin on his last journey.

      By the way, Vyacheslav Anatolyevich diligently trudged to the pharmacy, then, accompanied by his wife, headed home, but three minutes later "he staggered and fell." A friend of Kochkin, passing by in his car, took him to the hospital, where they reported that "it was already too late"...

      After the 40th day, Vyacheslav's wife Natalia—herself an employee of the same hospital—came to Dr. Klepcha's office to "look the doctor in the eye." To which Nina Ivanovna was not at all embarrassed, but offered "not to worry, as she herself lit a candle for the repose." By the way, the 76-year-old doctor, as a qualified specialist, continues to work in the same hospital where one, or perhaps more than one, of her patients was so "unlucky."

      Death from qualification

      In April, the sister of the deceased Kochkin—Olga Vorsina—filed a lawsuit against the Shabalinskaya Central District Hospital and the Kirov Ministry of Health for five million rubles in compensation for moral damages. At one of the first hearings, on June 19, the new chief physician of the Shabalinsk clinic came, immediately offering a "settlement," which he valued at 500,000 rubles.

      At the same time, the "chief Shabalinsk doctor," who combines work at the Central District Hospital with activities at the Kirov-Chepetsk polyclinic, claimed that neither of the two defendants was at fault here at all, as Dr. Klepcha acted... "competently and skillfully." Probably, making it clear to the participants in the process, and after the publication to all Kirov residents, that confusing gastritis with a heart attack confirmed by an electrocardiogram is a common occurrence for Kirov doctors. Not to say, a habitual one.

      By the way, the chief doctor's response to the plaintiff's question: "If no one is to blame, then why are you willing to pay half a million rubles?" was even more surprising, as the reason for the willingness to "splurge" turned out to be "compassion." There was no response to the next question: "So, for each deceased patient, are you ready to pay 500,000?"

      In December, the court process regarding Olga Vorsina's lawsuit concluded with a decision to award her compensation of 300,000 rubles, preceded by the announcement of an expert conclusion prepared in Kirov. By the way, the plaintiff's side actively opposed this, insisting on transferring the materials to Nizhny Novgorod or Komi, where expert bureaus are not dependent on the Kirov Ministry of Health and the personal curator of the medical sector.

      According to the "local conclusion," of course, there was a violation in Dr. Klepcha's work, which is hard to dispute given the results of the ECG that determined "clear signs of a heart attack." Therefore, the patient should not have been sent home and to the pharmacy, but should have been immediately hospitalized in the "vascular center" (the nearest one in Kirov). At the same time, the specialists found no causal link between the doctor's actions and the onset of death, due to the fact that the patient had "irreversible consequences" found during the autopsy, due to which he would have died anyway.

      With a song about a shaft

      By the way, in response to the question from lawyer Tatyana Bazhina, representing the interests of the applicant, about why to send a patient to a vascular center, two experts invited by the court explained: to determine the necessity and conduct of surgery (stenting, bypass surgery, heart transplantation). This did not cast doubt on their own assertion that "the patient would have died anyway." But they were caught off guard by a specific question: when?

      Further, the court debate developed in one direction: the deceased's sister insisted on an answer: could or could not medical assistance be provided to her relative, who sought help from doctors five hours before death. Could there have been hope for a normal outcome if her brother had not sat for three hours outside the doctor's office and had not gone to the pharmacy for stomach medications, but had been in a hospital ward receiving medications that slow the progression of a heart attack?

      The experts' answers were hardly specific: "One can only speculate" and "The heart was decomposing—there was no chance," which was countered by a new question: "Then what is the need for a vascular center?"

      By the way, the request for a repeat examination and the debate was cut short by the judge, who too loudly and aggressively remarked to the plaintiff: "What don't you understand? What is his (probably Dr. Nina Klepcha's) fault?"—which caused the deceased's sister to sob and prompted a response from Tatyana Bazhina. Who, citing the Code of Judicial Ethics, spoke about the inadmissibility of "such behavior," stating the "loss of the principle of adversariality" and the probable "taking of the side of the Ministry of Health."

      With this, those present in the hall found it hard to disagree, as the main theme of the court process regarding "the provision of low-quality medical services" transformed into discussions about the lack of meaning in treating a patient—so to speak—a terminal case, which Olga Vorsina disagreed with, insisting on conducting a repeat—non-Kirov—examination. Given that Dr. Nina Klepcha likely did not even attempt to provide any assistance to the dying Vyacheslav Kochkin.

      By the way, the sister of the deceased received the court's decision on January 13, but even before it was issued, she filed a complaint with the appellate instance, as she disagreed with the refusal to conduct a repeat examination and the amount of compensation determined by the October District Court.