66-year-old Kirov resident Alevtina Kuznetsova was admitted to the Northern Hospital with ordinary pneumonia, and after ten days of treatment she died in intensive care. The hospital itself and the regional Ministry of Health are confident that they are not to blame for the patient’s death. Svoykirovsky studied the situation and found out what typical problems the relatives of deceased patients face.
Alevtina Mikhailovna fell ill on November 22, 2016. As her daughter Yulia says, the temperature jumped above 39 degrees, there were no other symptoms. The next day the temperature did not subside, a doctor was called to the house. Instead of a doctor, a girl intern came and, after examining the patient, suggested a viral infection. She prescribed an antiviral drug and left. The next day, Yulia says, my mother felt worse, the temperature was already below 40, and her consciousness began to become clouded.
I was scared, I thought I was having a stroke. I called an ambulance, the doctor listened, heard something in the left lung, my mother was taken to the Northern Hospital for an x-ray,” the girl recalls. - And she had pneumonia back in 1998 with the same symptoms: only high fever and nothing else - no cough, no runny nose. X-ray showed focal opacification in the upper lobe of the left lung. To the question “What is this?” They said that it was probably pneumonia and that I needed to be hospitalized. Mom didn’t really want to go to the hospital, but I persuaded her.
Hospital epic
On Thursday, November 24, Alevtina Mikhailovna was admitted to the therapeutic department of the Northern Hospital. Yulia, recalling the words of the attending physician, says that my mother was prescribed anti-inflammatory and antibacterial therapy. She was taking some pills and was on IV drips. She does not know what medications she was prescribed. Yulia says that even then, during hospitalization, doctors mentioned cancer and tuberculosis among possible diagnoses, but they did not explain why they had such concerns.
Three days passed, and the woman’s condition did not improve; she continued to have a fever every now and then.
On Monday, November 28, I went to see my doctor again, she said that they suspected a malignant process, because tests showed some changes in the composition of the blood, and that it was necessary to perform a tomography of the lungs, an ultrasound abdominal cavity and bronchoscopy. All these examinations were done only on Tuesday, and the results were not ready until Wednesday, November 30th. They diagnosed a “polysegmental infiltration bilateral process in the lungs.” As I understand it, this means that the pneumonia has worsened and has spread throughout all the lungs. And only after that they made adjustments to the antibiotics. That is, a week has passed! Although I read that x-rays should be taken three days after treatment is prescribed to find out whether the antibiotic is working or not. Then, on Wednesday, my mother was shown to a hematologist and a sternal puncture was performed because she was suspected of acute leukemia. The results of this puncture were ready only a week later, when my mother had already died. And I still didn’t understand what was there. At the Northern Hospital they told me that the puncture was not informative, some cells were missing. And the hematologist said that they did not find any leukemia there.
On Friday, December 2, Alevtina Mikhailovna was taken to the tuberculosis clinic to see a phthisiatrician to make sure she didn’t have tuberculosis. By that time, the woman was already having difficulty getting up and such a “journey” to the other end of the city was not easy for her. As a result, the phthisiatrician did not detect tuberculosis. An X-ray of the lungs taken at the Northern Hospital on the same day, according to Yulia, again showed negative dynamics. At the same time, doctors informed relatives that Alevtina Mikhailovna had a low level of leukocytes in her blood. But again, they received no explanation.
It turns out that leukocytes were critically reduced even during the first blood test. But no one told us about this at all,” says Yulia. - I started surfing the Internet, reading what a decrease in leukocytes is and what this condition is fraught with. This is called agranulocytosis. It occurs with leukemia, with radiation damage, with drug poisoning, with infectious diseases and there may be many more reasons. Reduced leukocytes in a serious condition are dangerous because the person has no immunity. Where did he go? Later, the resuscitator told me that with such leukocytes, pneumonia is very difficult to treat. And you can raise them only if you know the reason why they fell. Doctors have never determined this reason.
The next time Yulia came to the hospital to see her mother was on the evening of Sunday, December 4th. The woman was lying on her bed, conscious, but it was clear that she was very ill, she could hardly sit up and could barely speak. The roommate said that mother wheezed all night and did not let them sleep.
I looked at my mother and realized that if I left now, I wouldn’t see her again. I asked what the doctors said. She replied: “I don’t know, there was a doctor, he didn’t say anything.” I ran to look for a doctor. Sunday, evening, the department is empty, both nursing stations are empty, there are no medical personnel in the wards or the treatment room. I barely found the rest room, I ran in, there was a crowd of nurses sitting there, talking. I say: “Do you see that Kuznetsova is completely unwell? What to do?". They answered me: “Tomorrow morning you should come to the attending physician and ask what’s wrong with her.” And one nurse said: “Well, yes, she has become heavy.” I was shaking all over, I tried to get from them what I should do. As a result, I was told to go to the emergency room and look for the doctor on duty there. I ran downstairs to look for the emergency room, found no one there and returned upstairs. There was already a doctor on duty there, three nurses around, and the doctor already had my mother’s documents in his hands. He said: “Well, let’s transfer her to intensive care.” Immediately a nurse arrived with a wheelchair, and my mother was taken to the intensive care unit.
The girl went home, since she was still not allowed to see her mother in the intensive care unit. At half past eight in the morning she received a call from the emergency room and was asked to urgently call her doctor back.
I immediately understood why. I called back. It was actually a song, as I was told. They said: “Your mother has died, the cause of death is unknown. Go to Tikhaya, get a death certificate there, and there will be an autopsy there.” No condolences, no explanations, nothing,” says Yulia. - And she died in intensive care at 3.45 in the morning. She was transferred there at half past seven in the evening, three hours later her lungs began to fail, and acute pulmonary failure began. She was put on a ventilator, and after a few hours her heart began to fail. And in the end it completely failed.
Walking around the offices
An autopsy showed that Alevtina Mikhailovna died from acute subtotal interstitial pneumonia against the background of acute agranulocytosis. According to the autopsy report, the pneumonia was believed to be viral. Doctors were unable to determine the cause of agranulocytosis.
The day after her mother’s death, Yulia Kuznetsova went for clarification to the head doctor of the Northern Hospital, Andrei Andronov. She admits that she was not herself - in Andronova’s office she screamed and cursed heavily, expressed everything she thought about both the hospital and the doctors. She was asked to write a statement. According to Yulia, neither the chief doctor nor the head of the department brought her any condolences.
More than a month later, a short response came from the hospital (the document is at the disposal of the editors) with the results of the internal investigation. In it, the chief doctor named the probable cause of pneumonia as hypothermia, which occurred two days before the onset of fever, when the patient plunged into a bath of ice water. Probable reasons Andrei Andronov named the critical decrease in the level of leukocytes as drugs, a viral infection or chronic leukemia. A more precise reason, he admitted, could not be established. As well as the age of agranulocytosis, since, according to the chief physician, the patient has not been to the clinic for the past 15 years.
“The medical staff of the institution carried out diagnostic tests and therapy to a sufficient extent. Patient management tactics comply with generally accepted standards. “No obvious violations were identified in the actions of the medical workers providing assistance to the patient,” the letter concluded.
Yulia Kuznetsova believes that this answer does not stand up to criticism. Firstly, her mother really plunged into the font of the Trifonov Monastery, but she did it regularly, once every one or two weeks over the past ten years.
It was systematic hardening. Yes, we can admit that swimming in the ice hole that day could have weakened the immune system, but this is not an excuse for the fact that the person died, she is perplexed.
Secondly, according to Yulia, her mother has been visiting the clinic every year for at least the last three years:
She went to an ENT specialist because at one time she complained that she was hearing poorly. In addition, she was tormented by her neck, she went to a therapist with cervical osteochondrosis and was examined. The tomography showed neurology, so she also went to see a neurologist. She even had sick leave issued. She worked in the civil service, where all sick leave was official. I cannot prove this yet; all my mother’s medical documents are in the hospital and they are not given to me.
"You will explain if you have an explanation"
Even before receiving the letter from the hospital, Yulia Kuznetsova wrote a complaint to the prosecutor's office. She forwarded the appeal to the Investigative Committee and the Ministry of Health. The Investigative Committee conducted an investigation and refused to initiate a criminal case due to the absence of an event and corpus delicti. At the same time, a forensic medical examination was ordered to clarify whether there was a violation of the rules for providing medical care and whether there is a cause-and-effect relationship between the actions of medical workers and the death of the patient. The examination was carried out by the Kirov Bureau of Forensic Medicine, its results became known only in May: experts did not find any defects in the provision of medical care.
At the same time, there was correspondence with the regional Ministry of Health. The department responded to the request of the prosecutor's office, twice exceeding the legal deadline for a response, and responded briefly and dryly: medical care was provided in full, the unfavorable outcome of the disease was due to the development of severe pneumonia. During the treatment period, medical workers made violations in documentation, but they did not affect the choice of treatment tactics and the outcome of the disease.
It was clean water unsubscribe,” Yulia is convinced. - They say, they checked, everything is fine, the medical standard was met. And at the same time, not a word about why the patient was lying in serious condition in the ward and none of the medical staff was next to him. After all, if it weren’t for my intervention, it seems to me that they would not have even thought of transferring her to intensive care. What measures have you taken to identify the cause of agranulocytosis? Why, if you suspect leukemia, do you perform a sternal puncture only a week later, and its results take another week to prepare and ultimately turn out to be uninformative. And finally, why did you assume the worst, including cancer, but did not check the most obvious version - viral pneumonia? I outlined all these questions in my repeated appeal.
The repeated response from the Ministry of Health was not much more detailed than the previous one. In addition to the above arguments, it said that it was not possible to confirm the fact that medical workers were absent from the workplace on the evening of December 4, since there are no supporting documents, there is no video surveillance, and the staff denies everything. The Ministry of Health also reported that a consultation with an oncologist was planned, and testing for the presence of a viral infection is not included in the standard of specialized medical care for moderate pneumonia.
Yulia was also not satisfied with this response from medical officials. She went to the Ministry of Health in person. Make an appointment with i. Acting Minister Andrei Chernyaev did not succeed; the head of the department for organizing medical, pharmaceutical and high-tech assistance, Natalya Leushina, spoke with her.
She told me that they could not establish the facts of negligence, but she would talk to the chief physician so that he could better monitor the staff. She said that people are dying from pneumonia. Will you explain why the person died without any particular illness, where did the agranulocytosis come from, and why were they unable to establish its cause? After all, it could well have developed due to some drugs. Wrong antibiotic, wrong dosage, late adjustment. There can be a lot of mistakes. I understand if a person entered and died two days later, and they would not have time to understand anything. And here she lay for 10 days, she got worse and worse, and they never found out what was wrong with her. In the end, you, as a doctor, explain that you did such-and-such and such-and-such because you suspected such-and-such, such-and-such. Don’t write unsubscribes and don’t answer that “people are dying.” I am aware that people are dying. I am aware that people die from pneumonia, I have read a lot of information on this topic. But they usually die if the pneumonia is advanced, because they begin to treat it too late, or it is very fleeting and affects all the lungs in two days. Or from complications, from diabetes or something like that. She had none of this. No neglect, no transience, no complications. Well, just at least someone would explain in human language why a person without serious chronic diseases, who was admitted in a state of moderate severity and was under the supervision of doctors for ten days, suddenly “died.” You will explain if you have an explanation. And if not, then it is either negligence or some kind of blatant unprofessionalism.
Now Yulia wants to order a repeat forensic medical examination, but only in a non-resident bureau. She says that she has heard a lot about mutual responsibility and that examinations carried out in different cities can have opposite results. Now she will try to ensure that the hospital gives her her mother’s medical documents.
Since all the documents are now in the hands of the hospital, they can theoretically send and write whatever they want there,” the girl notes. - What do I want? First, I want to get to the bottom of the truth. Secondly, such cases must be stopped. What kills me most is the attitude: a person died, so what? Such cynical indifference. When you come across this yourself, you understand that you can’t just leave it like that. But here everyone is silent, like what are you going to do now - you can’t resurrect a person. And thirdly, punish the doctors if they are still to blame.
Ministry of Health says
The press service of the Ministry of Health of the Kirov Region, when asked by the Svoykirovsky portal to comment on the situation with the death of Alevtina Kuznetsova, responded that according to Article 13 federal law No. 323 “On the basics of protecting the health of citizens in Russian Federation» all information about a citizen’s state of health, his diagnosis, as well as information obtained during his medical examination and treatment are medical secrets. Therefore, they cannot provide journalists with information about a specific patient, his diagnoses and the course of the disease, even if the patient’s daughter agrees to the disclosure of this information.
We understand that the woman is in grief and that she may not agree with the position of the doctors and our department. If she still has any questions, she can contact the Ministry of Health again for clarification, the press service commented.
Gap in legislation
A well-known lawyer in Kirov, Yan Chebotarev, says that this situation really raises many questions. If doctors are not ready to openly and in detail explain to relatives the logic of the patient’s treatment and at the same time do not provide medical documentation, this is an indicator that either there is some kind of flaw that is hidden, or it is simply the inertia of the system.
Doctors cannot be accused of outright negligence if the relatives have not yet received the medical documents of the deceased: a card, a discharge summary, what medications were used to treat her, what medical procedures were performed, what diagnoses were given to her,” he notes. - Such cases happen regularly. Hospitals refuse to provide documentation, citing the protection of personal data. Question “We are relatives, the person has died, what data protection are you talking about and from whom?” - remains unanswered. The medical corporation is very closed. They all say that their salaries are small, that they are incredibly busy and do not have time to keep medical records on time, and very often say, asking not to be named, that when something happens to a patient, the stories are rewritten in an emergency illness, so that there is not a hitch or a hitch. Medicines are prescribed that no one has injected, and so on.
According to Chebotarev, there is a huge gap in the legislation, which allows doctors to unreasonably refuse to issue medical documents to relatives and makes it difficult to monitor the activities of doctors. There is only one way out of this situation - to submit an application to the Investigative Committee or the police to conduct an inspection regarding the timeliness and quality of medical care. Then, through the police, it will be possible to gain access to medical documentation in order to then be able to conduct a normal examination.
You just need to verify the conclusions of these experts. This is still a Kirov examination, it was done by the Kirov bureau, which is also under the jurisdiction of the Ministry of Health,” the lawyer emphasizes. - I have a practice of litigation with medical institutions, and in my practice there have been cases when several consecutive examinations came to diametrically opposite conclusions. In my opinion, the main problem is that we have one system provision of medical care and quality control of these services. Who monitors the quality of hospital work and performs autopsies? A pathologist who belongs to the same structure of the Ministry of Health. And I personally encountered - not in this particular case - when the chief doctors of hospitals went to negotiate with pathologists in order to obtain a post-mortem diagnosis that would exactly coincide with the diagnosis that was given to the patient during his lifetime. Therefore, forgive me, I personally have no confidence. This is very bitter and very regrettable, but that is why relatives should obtain primary documents in order to be able to double-check the conclusions of those experts and those doctors who made these conclusions. And consult with doctors, for example, from St. Petersburg. So that independent doctors can look and say whether everything possible was done to save the woman’s life. If independent experts say she was treated incorrectly, the story could develop further.
Photo: from the personal archive of the Kuznetsov family.
On July 3, a farewell ceremony was held in Salekhard for the director of the department of natural resource regulation, forest relations and development of the oil and gas complex of the Yamal-Nenets Autonomous Okrug Yulia Chebotareva. The district governor offered his condolences to the relatives Dmitry Kobylkin : “On behalf of the Government of the Yamalo-Nenets Autonomous Okrug and on my own behalf, I express my deep condolences to family and friends, friends and colleagues in connection with the untimely death of Yulia Pavlovna. We will always remember her as a person with an active life position, a competent and wise leader, a kind and sensitive person. Bright memory she will forever remain in our hearts. We share all the bitterness of loss, we mourn with you.”
Deputy Governor came to say goodbye to Yulia Chebotareva Alexander Mazharov, Deputy Chairman of the Legislative Assembly of the Yamal-Nenets Autonomous Okrug Sergei Kharyuchi, head of the city of Salekhard Ivan Kononenko, members of the regional government.
Yulia Chebotareva was born on August 26, 1975 in the Sverdlovsk region. Graduated from Vladimir State University majoring in "Jurisprudence". Since 2005 - worked in the department of natural resource regulation, forest relations and development of the oil and gas complex of the Yamal-Nenets Autonomous Okrug. She went from leading specialist to manager. Since 2010 – Director of the Department of Natural Resource Regulation, Forest Relations and Oil and Gas Complex Development. She was awarded a letter of gratitude from the President of the Russian Federation Vladimir Putin and a certificate of honor from the governor of the Yamal-Nenets Autonomous Okrug.
Latest news from the Yamalo-Nenets Autonomous Okrug on the topic:
“The fond memory of her will forever remain in our hearts.” In Salekhard, they said goodbye to the director of the department of natural resource regulation of the Yamal-Nenets Autonomous Okrug, Yulia Chebotareva
“The fond memory of her will forever remain in our hearts.” In Salekhard, they said goodbye to the director of the department of natural resource regulation of the Yamal-Nenets Autonomous Okrug, Yulia Chebotareva- Salekhard
On July 3, a farewell ceremony was held in Salekhard for the director of the department of natural resource regulation, forest relations and development of the oil and gas complex of the Yamal-Nenets Autonomous Okrug, Yulia Chebotareva.
14:50 03.07.2017
Administration of the Yamal-Nenets Autonomous Okrug
07/14/2017 IA Sever-Press The day before, the director of the Department of Education of the Autonomous Okrug, M.V. Kravets, as well as the first deputy director of the Department of Education of the Autonomous Okrug,
15.06.2017 Department of Education The day before, a sports competition for pre-conscription-age youth, dedicated to the 75th anniversary of the liberation of Leningrad from the siege, started at the Regional Center for Patriotic Education.
04/24/2019 Noyabrsk-Inform.Ru
On July 3, a farewell ceremony was held in Salekhard for the director of the department of natural resource regulation, forest relations and development of the oil and gas complex of the Yamal-Nenets Autonomous Okrug Yulia Chebotareva. The district governor offered his condolences to the relatives Dmitry Kobylkin : “On behalf of the Government of the Yamalo-Nenets Autonomous Okrug and on my own behalf, I express my deep condolences to family and friends, friends and colleagues in connection with the untimely death of Yulia Pavlovna. We will always remember her as a person with an active life position, a competent and wise leader, a kind and sensitive person. The bright memory of her will forever remain in our hearts. We share all the bitterness of loss, we mourn with you.”
Deputy Governor came to say goodbye to Yulia Chebotareva Alexander Mazharov, Deputy Chairman of the Legislative Assembly of the Yamal-Nenets Autonomous Okrug Sergei Kharyuchi, head of the city of Salekhard Ivan Kononenko, members of the regional government.
Yulia Chebotareva was born on August 26, 1975 in the Sverdlovsk region. Graduated from Vladimir State University with a degree in Jurisprudence" Since 2005 - worked in the department of natural resource regulation, forest relations and development of the oil and gas complex of the Yamal-Nenets Autonomous Okrug. She went from leading specialist to manager. Since 2010 – Director of the Department of Natural Resource Regulation, Forest Relations and Oil and Gas Complex Development. She was awarded a letter of gratitude from the President of the Russian Federation Vladimir Putin and a certificate of honor from the governor of the Yamal-Nenets Autonomous Okrug.
Latest news from the Yamalo-Nenets Autonomous Okrug on the topic:
“The fond memory of her will forever remain in our hearts.” In Salekhard, they said goodbye to the director of the department of natural resource regulation of the Yamal-Nenets Autonomous Okrug, Yulia Chebotareva
“The fond memory of her will forever remain in our hearts.” In Salekhard, they said goodbye to the director of the department of natural resource regulation of the Yamal-Nenets Autonomous Okrug, Yulia Chebotareva- Salekhard
On July 3, a farewell ceremony was held in Salekhard for the director of the department of natural resource regulation, forest relations and development of the oil and gas complex of the Yamal-Nenets Autonomous Okrug, Yulia Chebotareva.
14:50 03.07.2017
Administration of the Yamal-Nenets Autonomous Okrug
07/14/2017 IA Sever-Press
The day before, the director of the Department of Education of the Autonomous Okrug, M.V. Kravets, as well as the first deputy director of the Department of Education of the Autonomous Okrug,15.06.2017 Department of Education The day before, a sports competition for pre-conscription-age youth, dedicated to the 75th anniversary of the liberation of Leningrad from the siege, started at the Regional Center for Patriotic Education.
04/24/2019 Noyabrsk-Inform.Ru
