Disadvantages in the professional activities of anesthesiologists and intensive care physicians: contemporary review of forensic-medical and legal practice

Background. Currently, clinical and expert characteristics, legal consequences of inadequate medical care in anesthesio­logy and intensive care in Ukraine have been studied insufficiently. Objective: to analyze court decisions and conclusions of forensic medical examinations in criminal proceedings initiated in Ukraine in recent years against anesthesiologists and intensive care physicians for professional negligence. Materials and methods. Official statistical data from the Unified State Register of Court Decisions for 2018–2024 were analyzed in cases concerning improper professional activity of healthcare workers. In addition, 123 reports of forensic medical examination regarding the prosecution of anesthesiologists from various regions of Ukraine from 2007 to 2024 were reviewed. Statistical processing was performed using multivariate regression analysis. Results. Ukrainian courts proved the guilt of anesthesiologists and intensive care physicians in the professional negligence in 81.2 % of legal proceedings against these doctors. According to forensic medical conclusions, different lacks of health care provision were identified in 71.5 % of the cases examined. Professional errors were most often committed in severe clinical situations related to respiratory or cardiovascular pathology, as well as trauma. The main types of errors included diagnostic (32.0 %), low quality medical treatment (26.0 %), institutional (14.0 %) and ethical (6.0 %) mistakes. Errors in medical records were detected in 22.0 % of the cases. Inadequate medical care in anesthesiology was predominantly insufficient (49.0 %) or delayed (37.0 %). Diagnostic errors most frequently occurred during associated management of patients with therapists and resulted in failur6e to provide timely care. Tactical errors were one of the main causes leading to criminal liability. The study proposes to distinguish the following categories of errors in anesthesiology and resuscitation: technical defects in the performance of anesthesia, preoperative, medication, perioperative, and postoperative errors. Conclusions. Anesthesiologists and intensive care physicians belong to the group of medical professionals with the highest risk of criminal prosecution. Diagnostic errors and improper performance of medical procedures or medication errors seemed to be most frequent in malpractice cases against anesthe­siologists. Increasing clinicians’ awareness of the types, causes, and consequences of medical errors is crucial for preventing adverse outcomes of medical practice.