Sudebno-Meditsinskaya Ekspertisa最新文献

This study aimed to define the criteria for legal assessment of medical care violations. Today, medical incidents, particularly medical care violations, are not systematized and have no legal definitions. This complicates their legal assessment and does not allow for the necessary effectiveness of legal regulation of relations in the healthcare sector. The author proposes an original classification of medical care violations based on the attitude of the subject of medical activity to his professional duties. This classification divides violations into medical torts (offenses) and medical incidents (accidents and medical errors). A conceptual approach to the legal qualification of medical care violations is provided.

Forensic medical examination of the body of a dead person found in water gives the expert an additional task to determine the duration of his stay in the water. The answer to this question is of fundamental significance for the investigative authorities, since a dead person could have been submerged in the water to conceal the crime.

Objective: Objectification of experts' conclusions about the duration of corpse's stay in the water on indicators of dispersion of electrical conductivity of its skin.

Material and methods: Research aimed at objectifying the conclusions of experts about the duration of corpse's stay in the water on the indicators of dispersion of electrical conductivity of its skin was conducted using the experimental material from the corpses of 68 persons of different sex and age, who died for different reasons.

Results: Three temperature ranges (1-24, 25-30, 31-40 °C) have been identified on the basis of regression analysis and mathematical models, describing the dynamics of electrical conductivity dispersion coefficient change depending on the duration of corpse's skin contact with the water of specified temperatures, have been created.

Conclusion: Formulas for calculating the period of interest for the researcher have been developed and the boundaries of confidence intervals for each temperature range have been determined, taking into account its diagnostic applicability. A computer program has been written to facilitate routine calculations on the proposed method in order to simplify the practical application of the suggested procedure.

The assessment of majority age is important for determining legal responsibility. The definition of the 3rd molar maturity index (Im3) have proven to be a simple and effective method of majority age establishment, the accuracy of which has been tested in different populations. There is a clear lack of studies in this scientific area in Russia.

Objective: To test diagnostic accuracy of majority age assessment method by 3rd molar (Cameriere index) in the Ufa sample.

Material and methods: The number of orthopantomograms equal 120 from males and females aged from 14 to 23 years without apparent pathological changes of the pulp of teeth 38 and 48 was examined. The measures were conducted using the standard R. Cameriere method. The method of logistic regression, determination of predictive values of sensitivity and specificity were used.

Results: The Im3 cut-off point, that was equal 0.08, had a sensitivity of 89% and specificity of 95% in the male sample, accuracy of age group determination was 93%. In the female sample the method sensitivity was 93%, specificity - 97%, accuracy - 97%.

Conclusion: The study results confirmed the absence of population variability of the Cameriere index value, that makes it possible to use the majority age determination method by 3rd molar for practical application in the examination of a living person at the territory of the Russian Federation.

The article presents a review of scientific and educational activities of the Department of Forensic Medicine of Sechenov University in different historical periods of establishment and development. The information about founders of the domestic forensic medicine, who held the position of the head of the department in the period from 1804 to 2024, their contribution to the development of forensic medical science and the main scientific research directions is given. The modern stage of the department's existence under the leadership of Yu.I. Pigolkin is marked by new successes and scientific achievements based on continuity and preservation of the department's traditions for 220 years.

Objective: To assess the adequacy of linear function of calibration according to GOST R ISO 11095-2007 for ethanol mass concentration measurement using internal reference materials (RMs).

Material and methods: An experiment on calibration in accordance with the GOST R ISO 11095-2007 National standard of the RF was carried out using internal RMs, namely aqueous solutions of ethanol at different concentrations. Measurements were performed for two subbands of ethanol concentrations at RMs: 0.15-1.05 and 1.0-7.0 mg/ml - according to the certified methodology.

Results: The graphs of the calibration's functions based on experimental data are consistent with the assumption of the calibration function's linearity, as well as the assumption of the standard deviation's constance of residues is equitable for two subbands of RMs.

Conclusion: Proven linear models in the calibration experiment may be recommended for use in the ethanol mass concentration measurement.

Objective: Ensuring uniformity of forensic medical expertise in cases related to the improper provision of medical care; reducing the load on public forensic expert institutions by reducing the number of repeated examinations; raising the authority of forensic medical expertise service via introducing a unified approach to assessing the presence and nature of cause and effect relationship.

Material and methods: The authors provide expert and court practice examples to show fundamental differences in forensic medical assessment of causal relations of improper provision of medical care with an adverse outcome. A focus is given to the court's assessment of expert opinions in a criminal process.

Results: The authors emphasize the imperfection and inconsistency of methods for assessing the cause-and-effect relationship used by expert commissions. This leads to controversial expert opinions on the same facts in the case and results in administering repeated examinations and prolonging the duration of the preliminary investigation.

Conclusion: There is an objectively determined need to develop exact and clearly defined criteria for causal relations of improper provision of medical care with an adverse outcome.

Objective: To reveal statistical patterns in the localization of alterations in organs and tissues of the neck in hanging depending on the noose location.

Material and methods: In this study 222 forensic examination reports of corpses of those who died from hanging, conducted in the Bureau of Forensic Medical Expertise of Moscow Oblast for 2019, were investigated. Standard methods of mathematical statistics, including Mann-Whitney U Test and the Fisher's Exact Test, were used for calculations. Sex and age characteristics of hanging cases were given.

Results: Retrospective statistical analysis has shown that the pattern of injuries revealed in organs and tissues of the neck both depends (in cases of Amussat's sign) and does not depend (in cases of hemorrhages in the legs of sternocleidomastoid muscle, fractures of the hyoid bone and thyroid cartilage, Martin's sign) on the noose position.

Conclusion: The obtained results can be used to develop measures aimed at improving the quality of forensic examination of hanging cases.

The objective of the study is to analyze existing measures and identify problematic aspects of ensuring the organization of infectious safety activity in forensic medical expert institutions, to develop ways of their solution. Documents regulating the functional principles of forensic medical expert institutions in cases of detection or suspicion of infectious pathology have been examined. Specific proposals for the development of a system to ensure infectious safety in the organization of work in the bureau of forensic medical expertise have been formulated.

The objective of the study: Is to identify the effectiveness of cooperation between forensic expert institutions on the basis of approaches to determining their one-pointedness. Legislative and regulatory legal acts regulating forensic expert activity have been studied. Methods of synthesis, analysis and comparison have been used for their processing. The comparison of the carrying out of targeted diversified studies has been conducted. The article substantiates a necessity of uniform approaches to determination of one-pointedness of forensic expert institutions in order to increase the effectiveness of interdepartmental interaction.

The objective of the study: Is to identify the main communication problems encountered by forensic medical experts and specialists during the interdepartmental interaction, and to develop proposals to overcome them. A comprehensive approach was used to achieve the aim of the research, including the carrying out of a qualitative focus group interview of forensic medical experts and resident doctors. The main communicative problems have been determined and proposals for their elimination have been formulated, the types of communication trainings on interdepartmental interaction have been identified.