Medicolegal assessment of the correctness of treatment in the long-term care facilities

One of the challenges of the modern medicine is to care for the chronically ill patients. Historically, care for such patients was conducted in the home environment, and duration of disease was usually relatively limited. Currently, these patients require even many years of supervision by professional staff and provide hour or day health services. Such care is conducted in the long-term care facilities (ZOL), where, as in other medical facilities, there is a possibility of malpractice with full legal consequences. Therefore, this paper attempts to analyse the correctness of medical care and treatment in ZOL based on the cases evaluated in the Department of Forensic Medicine and Forensic Toxicology of Medical University of Silesia in Katowice. We performed an analysis of thirtymedicolegal opinions issued in years 2007-2012. Observed medical errors were qualified into following groups: diagnostic decision errors, therapeutic decision errors, executive errors in nursing care and formal errors in preparing of medical records. In seventeen cases inmates finally died. Malpractice (on the diagnosis, therapy and nursing care) was found in thirteen cases, but only one of them showed a high probability of a causal link between them and the patient's health condition. So there were dominated so-called errors without results. Attention was paid to problems of frequent lack of preventive treatment of bedsores despite existence of indications, incorrect preparing of medical records and negative phenomena of avoiding of more detail diagnostics and in the case of patient's death - avoiding of autopsy' performing.