[Expert characteristic of fatal outcomes related to operative interventions in aesthetic plastic surgery]. / Ekspertnaya kharakteristika letal'nykh iskhodov, svyazannykh s operativnymi vmeshatel'stvami v esteticheskoi plasticheskoi khirurgii.

THE AIM OF THE STUDY: Is to investigate fatal outcomes related to operative interventions in aesthetic plastic surgery for the period from 2010 to 2022 yrs., and to analyze the defects in health care delivery (DHCD), revealed during forensic medical examinations of fatal outcomes. The number of fatal outcomes equal 36, related to operative interventions in aesthetic plastic surgery, was analyzed. The data were collected from the expert's archival opinions (forensic medical examinations of corpse, commission forensic medical examinations based on materials of medical cases and expert opinions), and from judicial acts. The most frequent cause of death (19% of cases) was postoperative development of pulmonary artery thromboembolia, that requires further screening to assess the relationship between denoted reason and type of performed operative intervention as well as the use of anticoagulant therapy. In addition, 19% of the causes of death were related to the toxic lidocaine effects, that shows the necessity of strict control while using anaesthesia during operative interventions. During the forensic medical examination in 55.5% of cases were found the defects in health care delivery (DHCD), with an average of about two DHCD cases. Cause-effect relationship between identified drawbacks of health care delivery and fatal outcome was established in 18 (90%) of the 20 cases. Among them, the DHCD, which are extremely rare in other types of surgical specialty (health care delivery in an inappropriate place and by unqualified persons), were reliably determined in 30% of cases. The necessity of strict control by the relevant competent organizations in health care delivery for plastic surgery specialty, the need for a single system collection of information about fatal cases, associated with operative interventions in aesthetic plastic surgery, and the study of fatality structure and causes in this field were proved. The above mentioned will make it possible to develop unified approaches for the commission forensic medical examinations in this type of cases, and will also contribute to the fatal outcomes' prevention.

[Review of forensic medical examination commissions for some specialties in aesthetic medicine]. / Analiz komissionnykh sudebno-meditsinskikh ekspertiz po nekotorym spetsial'nostyam v esteticheskoi meditsine.

The purpose of the study is to identify features inherent in the specialties included in «aesthetic medicine¼. There has been an increase in the number of citizens turning to law enforcement agencies regarding shortcomings in the provision of medical care in general and in the field of plastic surgery and cosmetology in particular. Currently there is no clear regulation of the provision of medical care in the field of plastic surgery and cosmetology. The difficulty in assessing medical care in these areas lies in the fact that they are subjective in nature, which makes it difficult to assess the correctness of the provision of appropriate medical care. The necessity of developing a unified approach to the implementation of forensic medical examinations in assessing the medical care provided by plastic surgeons and cosmetologists is shown.

[The identification of the drawbacks in the provision of medical assistance based on the so-called biased data].

The authors discuss a case of inadequate provision of emergency care encountered in expert practice. The analysis of the difficulties currently facing experts engaged in the verification of medical diagnoses is described as exemplified by the patient presenting with the obstetric and gynecological problems and the aggravated medical history. The case under consideration is characterized by the almost total absence of the relevant comprehensive medical documentation concerning a women pregnant with twins. The data are presented needed to perform the expert evaluation and formulate the objective and scientifically sound conclusions about the cause-and-effect relationships between the drawbacks in the provision of medical assistance and the unfavourable outcome of pathological conditions.