As the crime progresses: the court announced the verdict in the "Barium case"

A court in St. Petersburg issued a verdict in the "barium case" - in 2022, eight people died after undergoing CT scans, and 44 more were injured. Alexandra Feofanova and Elena Medvedeva, Deputy head physician and head of the Department of the Consultative and Diagnostic Center, received 4.5 years and 5 years in a penal colony. The victims are satisfied with the verdict, but not with the investigation, they told Izvestia. Former patients and their relatives insist that other employees of the medical institution, as well as city officials, should be punished. The details of the case are in the Izvestia article.

How patients died after CT scan

On June 20, the Vyborg District Court of St. Petersburg announced the verdict of Elena Medvedeva and Alexandra Feofanova, employees of the city's Consultative and diagnostic Center (CDC). They were charged with negligence, which resulted in the deaths of eight and injuries to 44 people.

The mass poisoning at the KDC occurred at the end of 2022. First, it became known about three dead patients who underwent X-ray examinations of the stomach using barium sulfate as a contrast agent. Later it became known about the death of five more people.

The investigation and the court found that the employees of the KDC accepted the supply of barium sulfate, which was not intended for medical purposes. The clinic purchased a batch of counterfeit barium back in July 2021, Izvestia found out.

— Women (Medvedeva and Feofanova. — Ed.) from July 13, 2021 to January 26, 2022, the institution allowed the purchase of the drug "Barium sulphate 0.10%, GOST 3158-75", in the amount of 109.5 kg, which is a chemical reagent, the court's press service reported.

They stressed that this barium could not be used for medical purposes, as it is intended only for analytical and production purposes. It is not subject to use in the field of circulation of medicines, therefore it posed a danger to life and health.

— Negligently treating their duties in office, not anticipating the possibility of socially dangerous consequences of their inaction, (defendants. — Ed.) allowed its use by the medical staff of the Department of radiation diagnostics as a contrast agent drug, did not identify this violation and did not stop its further use, the court added.

According to the case file, the nurse informed Medvedeva that the barium from the last delivery did not mix to a homogeneous mass — lumps remained. But in the end, the medical institution only made a claim to the supplier. No one checked the purchased drug for compliance with the state register of medicines.

"The inaction of Feofanova and Medvedeva inadvertently discredited the authority of the healthcare system and undermined citizens' faith in the quality and safety of medical care," the press service said.

At first, the case was initiated under articles on causing death by negligence and providing services that do not meet safety requirements. Such an accusation was brought against Feofanova and Medvedeva in January 2022. But two years later, the charge was commuted.

How was the trial held

In January 2022, the chief physician of the center, Evgeny Popov, and his deputy for medical and expert work, Natalia Surovenko, were detained. On the eve of his detention, Popov told Izvestia that earlier in the medical facility, stomach X-rays were repeatedly performed using barium sulfate, but no complications occurred.

— This is a tragedy for us and our team, we are shocked. Such a study has been carried out since the start of the center's work," said the head physician of the KDC.

All the defendants were sent to jail, and six months later they were placed under house arrest. The case of the head physician Popov and his deputy Surovenko was separated into a separate proceeding. At the end of June 2024, the Investigative Committee of St. Petersburg announced the completion of the investigation into the criminal case of Feofanova and Medvedeva. The women were reassigned the charge to an article on negligence that caused the death of two or more people.

During the debate, the prosecution insisted that the defendants' duties included monitoring which purchases were made by the medical organization and what exactly the patients took. The defense and the defendants insisted that the defendants had taken up positions shortly before the tragedy, and the procedure for purchasing barium had been established long before them.

They also did not receive complaints from patients about feeling unwell after using barium. Feofanova did not admit guilt, Medvedeva agreed only that she should have better controlled the actions of her subordinates.

According to their lawyers, the deaths were caused by a combination of multiple factors and a long chain of people, not the defendants themselves. They noted that if "a laboratory assistant, a nurse, a doctor, a manager, lawyers, employees of the procurement department, the chief physician had paid close attention to barium, then people could be alive."

Almost all the victims, whose relatives died from barium poisoning, also took part in the debate. They noted that no one apologized to them after the tragedy, and called the incident not a tragic incident, but a mass murder.

— I am convinced that they knew perfectly well what they were doing and were clearly aware of the consequences. They tried to convince me that my mother was an old sick woman and that her blood clots had just come off because of vomiting," said one of the victims.

Medvedeva, in response to the victims, explained that she could not express her condolences to them, as she was first in jail, and then under house arrest. In her last words, she apologized to the relatives of the victims. A representative of the KDC, who was present in the courtroom, added that the management of the center changed after the start of the IC audit and "victims can find their apologies from the new head of the medical institution on the Internet."

"In no case should you be afraid to seek timely help from medical organizations," she said. We have provided and are providing high-quality and safe assistance. This is a tragedy for everyone, and for the employees too. We are suffering together with you about this, so we are waiting for you, dear patients.

The court sentenced Medvedeva to five years in prison, Feofanova was sentenced to four and a half years. They will serve their sentences in a general regime penal colony. Women were also banned from practicing medicine for a period of two and a half years.

In addition, the court recovered 4.1 million rubles from St. Petersburg GBUZ GCDC No. 1 in favor of the victims as compensation for moral and material damage.

One of the victims, Victoria Andreeva, told Izvestia that she was generally satisfied with the verdict.

"This is a fair term for these defendants specifically," she stressed. — But globally, the UK's work on this case does not suit me. Half of the accused escaped punishment. In addition to those identified by the investigation, there should be as many people on this list as there are employees of the KDC who have used this non-medical drug for many years in a row and did not consider it necessary to report it to the regulatory authorities. So are the regulatory authorities themselves, namely representatives of the city Health Committee.

All of them, according to Victoria, should also be criminalized for complete failure to perform control work.

"I don't know what's next yet," the victim said. — The defendants will certainly appeal, we need to wait for it and give our objections so that the court does not overturn the verdict in any case.

Lawyer Maria Ahn, who represented several victims in the case, also called the verdict fair and appropriate.

"Unfortunately, not all the defendants involved in the case reached the verdict, but we are pleased that justice has prevailed," she stressed.

Why was the investigation delayed

Currently, there is no stable law enforcement practice to bring employees of medical institutions to criminal responsibility, said Miroslava Brizitskaya, a lawyer at the Sokolov, Trusov and Partners Law Office in Moscow. She explained that it is difficult for the investigation to determine the cause-and-effect relationships between the actions of specific individuals and the consequences when the violation is of a long-term nature, there are several victims and a large number of patients have suffered damage to their health.

"Most often, doctors are involved in a certain list of articles of the Criminal Code: causing death by negligence, providing services that do not meet safety requirements, and negligence," the expert recalled. — The application of the article on negligence is justified when medical care was provided improperly or was not provided at all.

The length of trials, especially in such complex criminal cases, can be determined by a number of factors, said Vladimir Kuznetsov, chairman of the All-Russian Trade Union of Mediators. In particular, the volume and complexity of the evidence base, the need for numerous examinations, the interrogation of a large number of witnesses and victims, as well as the study of an extensive body of documentation.

For example, it was necessary to accurately determine the composition of different batches of barium, to prove the presence of toxic impurities and their direct connection with poisoning and deaths, said Albert Khaleyan, a lawyer and partner of the Vector Prime Moscow Bar Association. Analyzing supply chains and documentation is also time-consuming.

— In addition, the terms of consideration may be influenced by the procedural actions of the parties, such as petitions for postponement of meetings, appeals against interim decisions, as well as the state of health of the participants in the process, — said Vladimir Kuznetsov.

It is likely that in this case there was a combination of these circumstances, which led to a delay in the trial for several years, experts believe.