A.I. BURNASYAN FMBC CLINICAL BULLETIN

ISSN 2782-6430 (print)

State Research Center −Burnasyan Federal Medical Biophysical
Center of Federal Medical Biological Agency

The journal is published in Russian.
Format – A4.
The periodicity of the journal is 4 times a year.

Issue №2 2025 год

A.I. Burnasyan  FMBC clinical bulletin. 2023 № 1

 

Yu.G Grigoriev

Medical Errors in Diseases of the Bronchopulmonary System in the Light of the Use of New Technologies

A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia

Contact person: Grigoriev Yu.G.a: ftivazid@mail.ru

Abstract
Analysis of the literature has shown that the progress of early and timely diagnosis of major lung diseases, including tuberculosis, pneumonia and oncology depends on the level of professional knowledge of doctors, the correct use of modern diagnostic technologies. Unfortunately, not all actions of medical workers to provide medical care lead to positive results. The article describes the most common mistakes made by doctors in the diagnosis and treatment of phthisiopulmonology. For each nosological form, there are a number of diagnostic and treatment defects that reduce the clinical effectiveness of care. The vast majority of professional mistakes are made not out of ignorance, but due to inattention or self-confidence of the doctor, lack of legal literacy. Despite the ubiquitous computerization of medical institutions, the availability of state-of-the-art diagnostic equipment, the latest methods of treatment, errors in the activities of doctors of all directions do not disappear without solving the main problems of regulatory regulation. The work is of interest to novice interns, clinical residents of various specialties. Annotation The analysis of scientific publications devoted to the causes of medical errors and ways to overcome them is of increased relevance and practical significance. According to the literature, many authors sought not only to show errors in establishing a clinical and morphological diagnosis, but also to pay special attention to changes in the diagnosis of lung diseases, the impact of new innovative technologies on the effectiveness of therapeutic and surgical treatment, and tried to reflect the deontological side of the error problem. Focusing on errors in the diagnosis of pulmonary tuberculosis, pneumonia, and lung cancer recognition, it is advisable to conduct a comparative study of the diagnostic value of a number of new methods and studies that have been used in clinics for many years, to evaluate the possibilities of using modern technologies.

Keywords: medical error, medical error, new technologies, radiation diagnostics, computed tomography, MBT, PCR, biochipping, pneumonia, lung cancer

For citation: Grigoriev Yu.G. Medical Errors in Diseases of the Bronchopulmonary System in the Light of the Use of New Technologies. A.I. Burnasyan Federal Medical Biophysical Center Clinical Bulletin. 2023.1:27-39. (In Russian) DOI: 10.33266/2782-6430-2023-1-27-39


REFERENCES

  1. Aksenova V.A., Klevno N.I., Baryshnikova L.A. Vyyavleniye i Diagnostika Tuberkuleza u Detey. Postupayushchikh i Obuchayushchikhsya v Obrazovatelnykh Organizatsiyakh = Detection and Diagnosis of Tuberculosis in Children Entering and Studying in Educational Institutions. Clinical Guidelines. Moscow Publ., 2021. 40 p. (In Russ.).
  2. Avdeyev S.N., Chuchalin A.G. Severe Community-Acquired Pneumonia. RMZH (Russkiy Meditsinskiy Zhurnal). 2001;9;5:177-181 (In Russ.).
  3. Belova O.S., Komarov I.G. Differential Diagnosis of Lung Cancer and Tuberculosis: Review. Sovremennaya Onkologiya = Journal of Modern Oncology. 2018;20;3:56-61 (In Russ.).
  4. Bobrov О.Ye. Medical Error or Professional Ignorance? Myths, Illusions, Reality. Lekar. 2008;1-2:6-12 (In Russ.).
  5. Vasilyeva I.A., Samoylova A.G., Bagdasaryan T.R., Zimina V.N., Chernousova L.N. Dependence of the Results of Treatment of Patients with Pulmonary Tuberculosis on the Spectrum of Drug Resistance of the Pathogen. Tuberkulez i Bolezni Legkikh = Tuberculosis and Lung Diseases. 2011;10:28-33 (In Russ.).
  6. Vlasov P.V., Gurevich L.A., Fedchenko G.G. Clinical and Radiological Diagnosis of Central Cancer of the Apical and Upper Posterior Segments of the Upper Lobes of the Lungs. Vestnik Rentgenologii i Radiologii = Journal of Radiology and Nuclear Medicine. 1982;1:7-13 (In Russ.).
  7. Vlasov P.V. X-Ray Diagnosis of Lung Cancer. Meditsinskaya Vizualizatsiya = Medical Visualization 2005;2:49-55 (In Russ.).
  8. Voronina G.A. The Effectiveness of Chemotherapy in Patients with Acutely Progressive Forms of Pulmonary Tuberculosis. Diss. Candidate’s thesis in Medicine. Мoscow Pudl., 1999. 152 с. (In Russ.).
  9. Volkov A.N., Nacheva L.V. Molecular Genetic Techniques in Current Biomedical Research. Part I: Theoretical Basis of PCR – Diagnostics. Fundamentalnaya i Klinicheskaya Meditsina = Fundamental and Clinical Medicine. 2020;5;4:133-140 (In Russ.).
  10. Voyno-Yasenetskiy M.V., Zhabotinskiy Yu.M. Istochniki Oshibok pri Morfologicheskikh Issledovaniyakh = Sources of Errors in Morphological Studies. Leningrad, Meditsina Publ., 1970. 318 p. (In Russ.).
  11. Grin E.N. The Role of Screening Fluorography in the Detection of Pulmonary Tuberculosis. Vestnik Klinicheskoy Bolnitsy No. 51. 2016;5;7-2:30-34 (In Russ.).
  12. Grigoryan K.V. Criminological Concept of Medical Error. Nauchnyy Portal MVD Rossii = Scientific Portal of the Russia Ministry of the Interior. 2011;4:56-59 (In Russ.).
  13. Golovin D.I. O Podgotovke i Provedenii Kliniko-Anatomicheskikh Konferentsiy = On the Preparation and Holding of Clinical and Anatomical Conferences. Kishinev Publ., 1955. P. 31 (In Russ.).
  14. Golyshevskaya V.I., Puzanov V.A., et al. Achievements and prospects of microbiological diagnostics of tuberculosis. Problemy Tuberkuleza. 2001;7:55-59 (In Russ.).
  15. Davydovskiy I.V. Experience in Comparing Clinical and Pathoanatomical Diagnoses. Klinicheskaya Meditsina = Clinical Medicine. 1928;1:2-19 (In Russ.).
  16. Davydovskiy I.V., Permyakov N.K., Avdeyev M.I. Medical Errors T.4. Bolshaya Meditsinskaya Entsiklopediya = Big Medical Encyclopedia. Ed. Petrovskiy B.V. Moscow Publ., 1976. P. 1037 (In Russ.).
  17. Dvoretskiy L.I., Yakovlev S.V., Karnaushkina M.A. Community-Acquired Pneumonia. Clinical Recommendations. Yesterday, Today and Tomorrow. Consilium Medicum. 2019;21;3:9-14.16 (In Russ.).
  18. Dorozhkova I.R., Makarova M.V., Freyman G.E. Accelerated Screening for Tuberculosis and Mycobacteriosis in the Centralized Mycobacteriological Laboratory of the Megapolis. Tuberkulez i Bolezni Legkikh = Tuberculosis and Lung Diseases. 2011;884:131 (In Russ.).
  19. Deykina O.N., Mishin V.Yu., Demikhova O.V. Differential Diagnosis of Pulmonary Tuberculosis and Community-Acquired Pneumonia. Problemy Tuberkuleza i Bolezney Legkikh. 2007;84;1:39-42 (In Russ.).
  20. Erokhin B.B., Mishin V.Yu., Chukanov V.I. Kazeoznaya Pnevmoniya = Caseous Pneumonia. Guide for Doctors. Moscow Publ., 2005. P. 204 (In Russ.).
  21. Zaretskiy M.M. Medical Error Is Avoidable or Not?Тherapia. 2009;33;1:63-66 (In Russ.).
  22. Ionycheva N. What Mistakes Do Doctors Make when Making Diagnoses. Vesti, January 28, 2015. (In Russ.).
  23. Kassirskiy I.A. O Vrachevanii. Problemy i Razdumya = About Healing. Problems and Thoughts. Moscow Publ., 1970. 271 p. (In Russ.).
  24. Kayfova A.A., Mamedov M.K. To the 100th Anniversary of the BCG Vaccine: Live Vaccine as the most Important Tool in the Fight Against Tuberculosis. Biomeditsina (Baku). 2021;1;2:24-28 (In Russ.).
  25. Kolendo S.E., Antoshina Yu.A., Dvoretskiy L.I. Certain Problems of Lung Tuberculosis Diagnostics in Multi-Profile Hospital. Pulmonologiya = Russian Pulmonology Journal. 2000;1:35-41 (In Russ.).
  26. Kozulitsyna T.I. Microbiological Studies. Tuberkulez Organov Dykhaniya = Tuberculosis of the Respiratory Organs: A Guide for Physicians. Moscow Publ., 1981. P. 136–149 (In Russ.).
  27. Komarov I.G. Video Surgery in Oncology. Problemy Klinicheskoy Meditsiny. 2008;5-6:26-29 (In Russ.).
  28. Kostitsin K.A. Otsenka Effektivnosti Sovremennykh Metodov Pervichnoy i Utochnyayushchey Diagnostiki Raka Legkogo = Evaluation of the Effectiveness of Modern Methods of Primary and Clarifying Diagnosis of Lung Cancer. Candidate’s thesis in Medicine. 14.01.12. 2014 (In Russ.).
  29. Krichevskaya N.A. The Role of Molecular Genetic Methods for Studying the Drug Resistance of the Causative Agent of Tuberculosis in the Treatment of Patients with a Destructive Specific Lung Process. Sovremennyye Problemy Nauki i Obrazovaniya = Modern Problems of Science and Education. 2014;2 (In Russ.).
  30. Krasnoborova S.Yu. Trudnosti i Prichiny Oshibok v Diagnostike Tuberkuleza Legkikh Zonalnoy (Dolevoy) Protyazhennosti = Difficulties and Causes of Errors in the Diagnosis of Zonal (Lobar) Pulmonary Tuberculosis. Candidate’s thesis in Medicine. 14.00.26. 2004 (In Russ.).
  31. Kucherenko V.Z. Safety Is the Most Important Criterion for the Quality of Medical Care. Vestnik Ivanovskoy Meditsinskoy Akademii = Bulletin of the Ivanovo Medical Academy. 2006;11;1-2:7-11. (In Russ.).
  32. Tyulkova T.Ye., Lugovkina T.K., Kutuzova D.M., Khabibullina N.F. Diagnosis of Bacteriologically Unconfirmed Pulmonary Tuberculosis (Literature Review). RMZH (Russkiy Meditsinskiy Zhurnal) = RMJ (Russian Medical Journal). 2022;6;7:387-392 (In Russ.).
  33. Lozinskiy Ye.Yu., Shmykova I.I., Lozinskiy M.Ye. Errors in Drug Therapy. Tikhookeanskiy Meditsinskiy Zhurnal = Pacific Medical Journal. 2006;4:41-44 (In Russ.).
  34. Lesnyak V.V., Zhuravleva V.A., Averianov A.V. The Capabilities of MRI in the Lung Lesions Diagnosis in Patients with COVID-19. Klinicheskaya Praktika = Journal of Clinical Practice. 2020;11;2:51-59 (In Russ.).
  35. Лекманов А.У. Medical Error and Our Attitude Towards It. Comments on the Article «Structure of Medical Errors and Survival of Patients in the Intensive Care Departments». Vestnik Anesteziologii i Reanimatologii = Messenger of Anesthesiology and Resuscitation. 2015;12;4:49-50 (In Russ.).
  36. Lukyanenko N.Ya., Shoykhet Ya.N. Comparative Aspects of Medical Errors in the Diagnosis of Patients with Pneumonia and Central Lung Cancer. Sibirskiy Meditsinskiy Zhurnal = The Siberian Medical Journal. 2010;4:4 (In Russ.).
  37. Magomedov R.M., Shevchenko S.V., Gasanguseynova P.A. Medical Error: Problems of Legal Definition. Mezhdunarodnyy Studencheskiy Nauchnyy Vestnik = European Student Scientific Journal. 2016;6 (In Russ.).
  38. Makhambetchin M.M. Vrachebnyye Oshibki: Prichiny. Analiz i Preduprezhdeniye = Medical Errors: Causes, Analysis and Prevention. Moscow, GEOTAR-Media Publ., 2020. 240 p. (In Russ.).
  39. Mirzabekov A.D. Biochips: from Academic Research to Molecular Medicine. Molekulyarnaya Biologiya = Molecular Biology. 2007;41;5:755-756 (In Russ.).
  40. Mateykovich Ye.A., Shevlyukova T.P., Kukarskaya Ye.Yu., Galiyeva G.D. Medical Errors in the Provision of Obstetric and Gynecological Care. Sovremennyye Problemy Nauki i Obrazovaniya = Modern Problems of Science and Education. 2018;5 (In Russ.).
  41. Mishin V.Yu. Caseous Pneumonia: Diagnosis, Clinic and Treatment. Problemy Tuberkuleza. 2001;3:22-29 (In Russ.).
  42. Mishin V.Yu., Deykina O.N., Nazarova N.V. Differential Diagnosis of Pulmonary Tuberculosis and Community-Acquired Pneumonia. Consilium Medicum. 2004;6;4:232 (In Russ.).
  43. Merabishvili V.M., Dyatchenko O.D. Lung Cancer Statistics. Morbidity, Mortality, Survival. Prakticheskaya Onkologiya = Practical Oncology. 2000;3:3-7 (In Russ.).
  44. Novikov Yu.K. Ommunity-Acquired Pneumonia. RMZH (Russkiy Meditsinskiy Zhurnal) = RMJ (Russian Medical Journal). 1999;7;17:825-828 (In Russ.).
  45. Nekrasov Ye.V., Filinyuk O.V., Buynova L.N., Kolokolova O.V., Anastasov O.V. Features of Teaching Phthisiology on the Example of the Analysis of Medical Errors. Bulletin of Siberian Medicine = Byulleten Sibirskoy Meditsiny. 2009;4;2:111-113 (In Russ.).
  46. Pospelova S.V., Kuznetsova M.V. Polimeraznaya Tsepnaya Reaktsiya = Polymerase Chain Reaction. Guidelines. Perm Publ., 2007. 35 p. (In Russ.).
  47. Perelman M.I., Koryakin V.A., Bogadelnikova I.V. Ftiziatriya = Phthisiology: Textbook. Moscow, Meditsina Publ., 2004. P. 264-269 (In Russ.).
  48. Pecherey I.O. Ekspertnaya Otsenka Diagnosticheskikh i Lechebnykh Meropriyatiy pri Vyyavlenii Tuberkuleza Legkikh = Expert Evaluation of Diagnostic and Therapeutic Measures in the Detection of Pulmonary Tuberculosis. Candidate’s thesis in Medicine. 2007. P. 128 (In Russ.).
  49. Rubinshteyn G.R. Differentsialnaya diagnostika zabolevaniy legkikh = Differential diagnosis of lung diseases. Moscow Publ,, 1954. 376 p. (In Russ.).
  50. Rudnov V.A. Improving Patient Safety in the Intensive Care Unit. Comments on the Article «Structure of Medical Errors and Survival of Patients in the Intensive Care Departments». Vestnik Anesteziologii i Reanimatologii = Messenger of Anesthesiology and Resuscitation. 2015;12;4:51-52 (In Russ.).
  51. Sokolov V.A., Kartashov V.M., Mezhebovskiy V.R., et al. On the Role of Diagnostic Departments of Tuberculosis Dispensaries in Modern Conditions. X Vsesoyuznyy Syezd Ftiziatrov = X All-Union Congress of Phthisiatricians: Proceedings. Report. Moscow Publ., 1986. P. 360-361 (In Russ.).
  52. Solodun Yu.V., Zlobina O.Yu. Role of a Specialist in Forensic Medicine in Obtaining Evidence of Violent Crimes (Historical Aspect). Vestnik Sudebnoy Meditsiny = Bulletin of Forensic Medicine. 2019;8;1:38-40 (In Russ.).
  53. Sinopalnikov A.I. Bacterial Pneumonia. T.1. Respiratornaya Meditsina = Respiratory Medicine. Ed. Chuchalin A.G. Moscow, GEOTAR-Media Publ., 2007. P. 474-509 (In Russ.).
  54. Sultanov I.Ya. Oshibki Diagnostiki v Klinike Vnutrennikh Bolezney = Diagnostic Errors in the Clinic of Internal Diseases. Candidate’s thesis in Medicine. Moscow Publ., 1994 (In Russ.).
  55. Sumin S.A. Legal Consequences of an Unfavorable Treatment Outcome. Anesteziologiya i Reanimatologiya = Russian Journal of Anaesthesiology and Reanimatology. 2018;1: 4-8 (In Russ.).
  56. Tereshin B.C. To the Question of the Diagnosis of Tuberculosis in the General Medical Network. Problemy Tuberkuleza. 2003;5:23-26 (In Russ.).
  57. Trubnikov G.A. Rak Legkogo. Osnovy Klinicheskoy Pulmonologii = Lung Cancer. Fundamentals of Clinical Pulmonology. 1998. P. 154-165 (In Russ.).
  58. Tyurin I.Ye. Kompyuternaya Tomografiya Organov Grudnoy Polosti = Computed Tomography of the Chest Organs. S. Petersburg Publ., 2003. P. 168-276 (In Russ.).
  59. Criminal Code of the Russian Federation of May 24, 1996 (In Russ.).
  60. On the Strategy for the Development of Healthcare in the Russian Federation for the Period up to 2025: Decree of the President of the Russian Federation of June 6, 2019 No. 254 (In Russ.).
  61. Fedoseyev G.B. Medical Errors: Character, Causes, Consequences, Ways of Prevention. Terapiya = Therapy. 2018. № 5. С. 109-115. (In Russ.).
  62. Kharchenko V.P., Kuzmin I.V. Rak Legkogo = Lung Cancer. Moscow, Meditsina Publ., 1994. 450 p. (In Russ.).
  63. Khomenko A.G. Tuberkulez = Tuberculosis: A Guide for Physicians. Moscow, Meditsina Publ., 1998. 493 p. (In Russ.).
  64. Khudushina T.A., Maslakova M.G. Characteristics of the Tuberculous Process in Newly Diagnosed Patients from Different Social Groups, Depending on the Methods for Detecting the Disease. Problemy Tuberkuleza. 1998;1:12-14 (In Russ.).
  65. Chernyayev A.L., Mikhaleva L.M., Nikonova Ye.V. Errors in the Diagnosis of Lung Pathology According to Autopsy Data. Pulmonologiya = Russian Pulmonology Journal. 1996;2:75-78 (In Russ.).
  66. Chernousova L.N., Larionova Ye.Ye., Sevastianova E.V., Golyshevskaya V.I. The Role of PCR Analysis in Complex Bacteriological Analyzes in Phthisiology. Problemy Tuberkuleza. 2001;3:58–60 (In Russ.).
  67. Chuchalin A.G. Topical Issues of Diagnosis in Pulmonology Pulmonologiya = Russian Pulmonology Journal. 2001;1:6-11 (In Russ.).
  68. Elshteyn N.V. Modern View on Medical Errors. Terapevticheskiy Arkhiv = Therapeutic Archive. 2005;8 (In Russ.).
  69. Yudin A.L., Afanasyeva N.I., Abovich Yu.A., Georgiadi S.G. High-Resolution Computed Tomography in the Diagnosis of Interstitial Pneumonia. Meditsinskaya Vizualizatsiya = Medical Visualization. 2002;4:21–28 (In Russ.).

Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 05.12.2022.. Accepted for publication: 10.01.2023.

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