History
2024: Penalty for increasing mortality from acute cerebrovascular accident
In September 2024, the Efremov Interdistrict Court of the Tula Region issued a decision to impose a fine on the Efremov District Hospital named after A.I. Kozlov "in connection with the increase in mortality from acute cerebrovascular accident (ONMK). The audit found that the mortality rate for the year increased by more than 2%, and for the last quarter - by more than 10%. These indicators caused concern from regulatory authorities and led to an unscheduled inspection of the medical institution.
According to the "United Press Service of the Judicial System of the Tula Region and the Office of the Judicial Department in the Tula Region," the check was initiated on the instructions of the head of the Territorial Body of Roszdravnadzor in the Tula Region. The main subject of verification was documents and medical records of patients diagnosed with ONMK. During the control event, numerous violations were identified regarding both diagnosis and documentation of treatment.
According to the court, the medical records of some patients lacked an electrocardiogram (ECG), and in some cases did not carry out the necessary diagnostic procedures, such as a duplex scan of the vessels within the first three hours from the moment the patient was admitted. In addition, neurological status was not monitored, the results of mandatory laboratory tests were not recorded, and there were no translated epicrises when patients were transferred to the intensive care unit.
The audit also revealed shortcomings in the work of the consultation of doctors: in some cases there were no signatures of specialists, which violates the mandatory requirements for maintaining medical documentation. Particular attention was paid to the fact that the hospital did not provide evidence of internal quality control of medical care due to deaths among patients with ONMC. This indicates a lack of targeted checks on these cases and measures to address the issues identified.[1]