In 2018, hematologist Elena Misyurina was sentenced to two years in a general regime colony for the death of a patient. On Thursday, March 4, the Moscow City Court overturned this sentence, and the criminal case against the doctor was dismissed for lack of a crime.
The trial was held without the presence of journalists, but after it was over, the press service of the Moscow City Court distributed video footage of the hearing. You can see that the doctor reacted emotionally to the court’s decision: she couldn’t hold back tears and wiped her eyes with her hand.
BBC Russian recalls how the most high-profile prosecution of a doctor in recent years unfolded. The events that served as the basis for the investigation, which lasted several years, took place in 2013. At that time, Misurina, a former doctor at the National Medical Hematology Research Center of the Ministry of Health, was working at the private clinic and diagnostic center “GenoTechnology”. Later, in 2014, she became the head of the hematology service at the Moscow City Hospital No. 52.
In the summer of 2013, a patient came to “Genotechnology”. Shortly before, a 55-year-old man had been diagnosed with prostate cancer. An operation was scheduled in the near future under a quota. A man needed to undergo a trepanobiopsy – a puncture of the bone marrow in the pelvic area. According to one of the patient’s daughters, whose indications were reviewed by “Kommersant”, in order to perform the examination for free, time was needed, so he turned to the paid basis in the center “GenoTechnology”.
During her medical practice, Misurina has performed trepanobiopsy about 8,000 times. “For a specialist of this caliber, this procedure cannot cause any problems,” noted Mariana Lysenko, chief physician of the 52nd hospital, in a conversation with “Meduza”.
The surgery was performed on the morning of July 25, 2013. After the procedure, the man went to work. According to “Kommersant” and “Meduza”, his colleagues told investigators that throughout the day he complained of pain in the area where the biopsy was performed. However, in the evening, when he was already at home, the patient’s condition worsened: he experienced abdominal pain.
Emergency services admitted a man to one of the clinics of the “Medsi” network with a suspicion of acute appendicitis. Despite the presumed diagnosis, he was not operated on immediately. But in the morning his condition worsened: signs of internal bleeding appeared. Then the patient was put on the operating table. The surgeon was able to stop the bleeding, but only temporarily. On the morning of July 28, the man died in intensive care.
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The autopsy of the corpse also took place at “Medsi” – despite the fact that, according to the Moscow Health Ministry’s order, all deceased in non-state clinics are referred to state institutions for forensic examination, as “Meduza” clarified. In addition, according to Mishurina’s defense, “Medsi” did not have a license for such activity at that time. The press service of “Medsi” did not respond to the publication’s question about the existence of a special license in 2013 and did not comment on the treatment of the deceased patient and the autopsy, citing doctor-patient confidentiality.
In 2014, the relatives of the deceased patient approached the prosecutor’s office and asked it to investigate the causes of his death. Investigators began questioning the medical professionals who had assisted the deceased in the last days of his life. They also interviewed Misurina and concluded that she may have made a mistake during the biopsy. In early 2015, the Investigative Committee opened a case against the hematologist for causing death through negligence. However, the accusation was later reclassified as a violation of “providing services that do not meet safety requirements.”
The case against Missyurina was considered by the Cheremushkinsky court of Moscow. One of the main witnesses of the prosecution was a forensic pathologist who performed the autopsy of the patient at the “Medsi” clinic. During the hearing, he suggested that during Misyurin’s biopsy, the needle was not inserted into the iliac bone, as required by the procedure, but into the sacral area. According to him, this led to “transverse damage to the sacrum and blood vessels,” as reported by Meduza.
At the same time, as the publication makes clear, the expert’s testimony was based solely on his own conclusion: no photographs were taken, and the witness showed the approximate location of the biopsy on a pelvic diagram downloaded from the Internet. Misyurina did not admit guilt. She insisted that she had performed the procedure correctly and that with the injuries described by the forensic pathologist in court, the patient would have lost consciousness within the next hour. According to Misyurina, it was technically impossible to cause such damage to the patient because the needle was not long enough. The nurse who was present during the trepanobiopsy confirmed the doctor’s words.
On her side, an academician of the Russian Academy of Sciences, hematologist Andrey Vorobiev, who believes that the cause of the bleeding was a violation of blood clotting in the presence of existing diseases, testified in court. The court did not believe Vorobiev’s arguments and doubted the objectivity of the witness due to his acquaintance with the defendant.
The nurse’s testimony was also questioned: her claim that the needle was not injected into the coccyx, the court interpreted as an attempt to help Elena Misyurina avoid responsibility for her actions, since she works as a procedural nurse at LLC “GenoTechnology”, has known Misyurina for a long time, and is interested in the outcome of the case, “the Cheremushkinsky court ruling quoted by Kommersant.
In January 2018, Misurin was sentenced to two years in a general regime colony, despite the fact that even the prosecutor did not insist on a real term. The court concluded that the hematologist inserted the needle “in the sacral region, instead of the crest of the right iliac bone”, “violating the methodology, tactics and technique of performing trepanobiopsy”. Elena Misyurina was taken into custody right in the courtroom: she was under house arrest throughout the investigation and continued to work. After the verdict was announced, she was sent to the investigative isolation ward.
The court’s decision and Misyurina’s arrest shocked the medical community. She was defended not only by her colleagues at the City Clinical Hospital No. 52, but also by employees of other medical institutions, medical trade unions and the National Chamber of Doctors.
Soon, the prosecutor’s office itself suggested changing the preventive measure. At the meeting of the Moscow City Court, which was considering this issue, the head of the National Medical Chamber, Leonid Roshal, suggested “putting himself in a cage” instead of the convicted Misurina. He called her prosecution “persecution of the medical community,” Kommersant reported. As a result, the court released Misurina on bail with travel restrictions.
In April of the same year, 2018, the Moscow City Court overturned the verdict and returned the case to the prosecutor’s office “for the correction of procedural violations.” However, in December 2020, the Second Cassation Court of General Jurisdiction in Moscow overturned the decision of the Moscow City Court. As a result, the case was sent to the appellate court for reconsideration.