Paediatric Surgery (Ukraine). 2025. 3(88): 95-111. doi: 10.15574/PS.2025.3(88).95111
Толстанов О. К., Марциняк С. М., Рибальченко В. Ф.
Національний університет охорони здоров’я України імені П.Л. Шупика, м. Київ

 Для цитування: Толстанов ОК, Марциняк СМ, Рибальченко ВФ. (2025). Лікарські помилки і хірургічна недбалість у ХХІ сторіччі – виклики для світової системи охорони здоров’я. Хірургія дитячого віку (Україна). 3(88): 95-111. doi: 10.15574/PS.2025.3(88).95111.
Стаття надійшла до редакції 25.04.2025 р., прийнята до друку 16.09.2025 р.

Наведено огляд сучасної літератури, присвяченої проблемі лікарських помилок і хірургічної недбалості у ХХІ столітті.
Мета – узагальнити сучасні наукові дані щодо природи, причин і наслідків лікарських помилок і хірургічної недбалості у XXI столітті; визначити шляхи їх профілактики та мінімізації ризиків для пацієнтів.
Аналіз джерел свідчить, що показники цих явищ із часом практично не зменшуються. Науково-технічний прогрес, за даними більшості публікацій, не призводить до істотного скорочення кількості помилок і клінічних прорахунків. Основною причиною лікарських помилок найчастіше є порушення комунікації між пацієнтом, його родичами і медичним персоналом – як лікарями, так і середнім медичним персоналом. Важливим є системний розгляд не лише самих помилок, але й чинників їхнього виникнення в діяльності професійних асоціацій, зокрема американських і німецьких, які не лише ведуть облік лікарських помилок, але й вивчають причини їхньої появи і розробляють шляхи подолання.
Вважаємо, що в Україні доцільно створити об’єднання медичних асоціацій, яке б не лише констатувало факти лікарських помилок, але й аналізувало їхні причини, розробляло заходи профілактики та забезпечувало фаховий і правовий захист медичних працівників у судових справах.
Автори заявляють про відсутність конфлікту інтересів.
Ключові слова: лікарські помилки, хірургія і загальна практика, дитяча хірургія, ортопедія і травматологія, медична експертиза.

ЛІТЕРАТУРА

1. Abowitz R. (2018). The Ink Must Go Where the Knife Will Cut. There'll be less wrong-site surgery if your surgeons cut through their initials. Journal "Outpatient Surgery". Published: 09.04.2018. URL: https://www.aorn.org/outpatient-surgery/the-magazine/article/2018-april-the-ink-must-go-where-the-knife-will-cut.

2. Aerztekammern schlichten. Frequently asked questions to expert committees and arbitration boards at medical associations.URL: https://www.aerztekammern-schlichten.de/faq.

3. Aerztekammern schlichten. Medical negligence statistics from expert committees and conciliation boards in Germany. URL: https://www.aerztekammern-schlichten.de/statistik (Bund)

4. Ahmed SA, DeFroda SF, Naqvi SJ, Eltorai AEM, Hartnett D, Ruddell JH et al. (2019, Apr 3). Malpractice Litigation Following Traumatic Fracture. J Bone Joint Surg Am. 101(7): e27. https://doi.org/10.2106/JBJS.18.00853; PMid:30946201

5. Auerbach AD, Lee TM, Hubbard CC et al. (2024). Diagnostic errors in hospitalized adults who died or were transferred to intensive care. JAMA Intern Med. 184: 164-173.

6. Barber C. (2024, Apr 26). Drug and Alcohol Rehab for Doctors Near Me. Edited by: Wendy Manwarren Generes Updated. URL: https://americanaddictioncenters.org/healthcare-professionals/rehab-for-doctors.

7. Bartz-Kurycki MA, Anderson KT, Pham DH, Hebbally NB, Thomas EJ, Matuszczak ME et al. (2018, Oct). Errors and Adverse Events in the Setting of Neonatal Surgery Performed in the Neonatal Intensive Care Unit. Journal of the American College of Surgeons. 227(4): e159. dhttps://doi.org/10.1016/j.jamcollsurg.2018.08.434

8. Basques BA, Lukasiewicz AM, Samuel AM, Webb ML, Bohl DD et al. (2017, Sep). Which Pediatric Orthopaedic Procedures Have the Greatest Risk of Adverse Outcomes? J Pediatr Orthop. 37(6): 429-434. https://doi.org/10.1097/BPO.0000000000000683; PMid:26558959

9. Болдіжар СО, Булеца СБ, Валах ВВ, Гербут ВС, Гревцова РЮ, Дешко ЛМ та інш. (2021). Медичне право. Підручник. За заг. ред. д-ра юрид. наук, проф. С.Б. Булеци; д-ра юрид. наук, доц. М.В. Менджул. Ужгород: ТОВ «РІК-У»: 720.

10. Bolwell JS. (2025). A Review of Healthcare Challenges in the UK and the US: Medical Errors, Aging, Private Healthcare and Governance. Health Sciences Review. 14: 100211. https://doi.org/10.1016/j.hsr.2025.100211

11. Bulun M. (2009). Patients safety practices 1. Ankara, Turkey: Sage Press: 1-214.

12. Chen Q, Liu X, Liu X, Song P, Quan X, Xiong H et al. (2024, Dec 10). Improving surgical quality of care: learning from 8,331 surgical medical malpractice cases. Front Med (Lausanne). 11: 1486451. https://doi.org/10.3389/fmed.2024.1486451; PMid:39720654 PMCid:PMC11667895

13. Cobb TK. (2012, Jun). Wrong site surgery-where are we and what is the next step? Hand (N Y). 7(2): 229-232. https://doi.org/10.1007/s11552-012-9405-5; PMid:23730251 PMCid:PMC3351519

14. Dumitrascu CI, Mannes PZ, Gamble LJ, Selzer JA. (2014). Substance use among physicians and medical students. Medical Student Research Journal. 3 (Winter): 26-35. URL: https://msrj.chm.msu.edu/winter-2014-26-35/.

15. Ey JD, Kollias V, Lee O, Hou K, Herath MB, North JB et al. (2025, Mar 28). Non-technical error leading to patient fatalities in the Australian surgical population. Br J Surg. 112(4): znaf083. https://doi.org/10.1093/bjs/znaf083; PMid:40296657

16. Faucher C. (2011). Differentiating the elements of clinical thinking. Optom Educ. 36: 140-145.

17. Graber ML. (2013). The incidence of diagnostic error in medicine. BMJ Qual Saf. 22: 21-27. https://doi.org/10.1136/bmjqs-2012-001615; PMid:23771902 PMCid:PMC3786666

18. Geuijen PM, Pars E, Kuppens JM, Schene AH, de Haan HA, de Jong CAJ et al. (2022). Barriers and Facilitators to Seek Help for Substance Use Disorder among Dutch Physicians: A Qualitative Study. Eur Addict Res. 28(1): 23-32. Epub 2021 Jun 30. https://doi.org/10.1159/000517043; PMid:34192705

19. Gruppen LD. (2017). Clinical reasoning: defining it, teaching it, assessing it, studying it. West J Emerg Med. 18: 4-7. https://doi.org/10.5811/westjem.2016.11.33191; PMid:28115999 PMCid:PMC5226761

20. Hawks MK, MacIuba JM, Merkebu J et al. (2023). Clinical reasoning curricula in preclinical undergraduate medical education: a scoping review. Acad Med. 98: 958-965. https://doi.org/10.1097/ACM.0000000000005197; PMid:36862627

21. Hosseinzadegan F, Salamatbakhsh M, Salehzadeh M, Nournezhad H, Mohammadpour Y. (2025, May 26). Hospital errors and their consequences among healthcare professionals a: descriptive correlational investigation. Ann Med Surg (Lond). 87(7): 4026-4033. https://doi.org/10.1097/MS9.0000000000003280; PMid:40852022 PMCid:PMC12369720

22. James JT. (2013, Sep). A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf. 9(3): 122-128. https://doi.org/10.1097/PTS.0b013e3182948a69; PMid:23860193

23. Jhawar BS, Mitsis D, Duggal N. (2007). Neurosurgery of the wrong place and the wrong level: national experience. J Neuro Surg Spine. 7(5): 467-472. https://doi.org/10.3171/SPI-07/11/467; PMid:17977186

24. Kamath D, McIntyre S, Byerly S, Agarwal N, Kamath P, Peskin E et al. (2020, Jul). Descriptive Analysis of Federal and State Interventional Pain Malpractice Litigation in the United States: A Pilot Investigation. Pain Physician. 23(4): 413-422. PMID: 32709176. https://doi.org/10.36076/ppj.2020/23/413

25. Knaak JP, Parzeller M. (2014, Nov). Court decisions on medical malpractice. Int J Legal Med. 128(6): 1049-1057. Epub 2014 Mar 28. https://doi.org/10.1007/s00414-014-0976-2; PMid:24676889

26. Kohn LT, Corrigan JM, Donaldson MS; Institute of Medicine (US) Committee on Quality of Health Care in America. (2000). To Err is Human: Building a Safer Health System. Editors. Washington (DC): National Academies Press (US). PMID: 25077248.

27. Laukkavirta M, Blomgren K, Väärämäki S, Nikulainen V, Helmiö P. (2022, Mar). Compensated Patient Injuries in the Treatment of Abdominal Aortic and Iliac Artery Aneurysms in Finland: A Nationwide Patient Insurance Registry Study. Ann Vasc Surg. 80: 283-292. Epub 2021 Nov 7. https://doi.org/10.1016/j.avsg.2021.08.055; PMid:34758376

28. Lenworth M. Jacobs Jr. (2023). Study Analyzes Wrong-Site Surgery Data in Medical Malpractice Complaints Jt Comm. June 7, 2023. J Qual Patient Saf. 49(5): 265-273. URL: https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2023/june-2023-volume-108-issue-6/study-analyzes-wrong-site-surgery-data-in-medical-malpractice-complaints/.

29. Li H, Li L, Liu T, Tan M, He W, Luo Y et al. (2024, Apr 25). Risk management and empirical study of the doctor-patient relationship: based on 1790 litigation cases of medical damage liability disputes in China. BMC Health Serv Res. 24(1): 521. https://doi.org/10.1186/s12913-024-10952-x; PMid:38664671 PMCid:PMC11044444

30. Li Y, Gao D, Liang W, Qiu L, Liu X et al. (2018, Feb). A comparison of malpractice lawsuits mediated and judged in court in China. J Forensic Leg Med. 54: 109-113. Epub 2018 Jan 31. https://doi.org/10.1016/j.jflm.2018.01.002; PMid:29413951

31. Liu P, Cheng J, Yang Y, Zhu H. (2024, Feb 21). Medical errors, affected sites, and adverse consequences among patients in the orthopaedic department: Does age matter? Front Public Health. 12: 1306215. https://doi.org/10.3389/fpubh.2024.1306215; PMid:38450134 PMCid:PMC10914940

32. Mahler S, Gianicolo E, Muensterer OJ. (2021, Sep). A detailed analysis of pediatric surgical malpractice claims in Germany: what is the probability of a pediatric surgeon to be accused or convicted? Langenbecks Arch Surg. 406(6): 2053-2057. Epub 2021 Jan 8. https://doi.org/10.1007/s00423-020-02069-6; PMid:33416989 PMCid:PMC8481175

33. Mainberg EG, Stern PJ. (2003). Types of surgical delivery on the wrong place, carried out by surgeons on the hand. J Bone Joint Surg AM. 85: 193-197. https://doi.org/10.2106/00004623-200302000-00002; PMid:12571293

34. Marsh KM, Fleming MA, Turrentine FE, Levin DE, Gander JW et al. (2022, Apr). Pediatric surgical errors: A systematic scoping review. J Pediatr Surg. 57(4): 616-621. Epub 2021 Jul 27. https://doi.org/10.1016/j.jpedsurg.2021.07.019; PMid:34366133 PMCid:PMC8792106

35. Marsh KM, Turrentine FE, Jin R, Schirmer BD, Hanks JB, Davis JP et al. (2024, May 1). Judgment Errors in Surgical Care. J Am Coll Surg. 238(5): 874-879. Epub 2024 Apr 17. https://doi.org/10.1097/XCS.0000000000001011; PMid:38258825 PMCid:PMC11023767

36. Mattiuzzi C, Plebani M, Lippi G. (2024, May 20). Recent mortality rates due to complications of medical and surgical care in the US. Diagnosis (Berl). 11(4): 443-445. https://doi.org/10.1515/dx-2024-0071; PMid:38756092

37. McGlynn EA, Asch SM, Adams J et al. (2003). The quality of health care delivered to adults in the United States. N Engl J Med. 348: 2635-2645. https://doi.org/10.1056/NEJMsa022615; PMid:12826639

38. Mouton J, Gauthé R, Ould-Slimane M, Bertiaux S, Putman S, Dujardin F. (2018, Feb). Litigation in orthopedic surgery: What can we do to prevent it? Systematic analysis of 126 legal actions involving four university hospitals in France. Orthop Traumatol Surg Res. 104(1): 5-9. Epub 2017 Dec 11. https://doi.org/10.1016/j.otsr.2017.11.002; PMid:29241815

39. Ng IKS, Goh WGW, Teo DB, Chong KM, Tan LF, Teoh CM. (2024, Dec 23). Clinical reasoning in real-world practice: a primer for medical trainees and practitioners. Postgrad Med J. 101(1191): 68-75. https://doi.org/10.1093/postmj/qgae079; PMid:39005056

40. Nkpang LE, Yta EM, Enyia JE II et al. (2025). Interprofessional Communication: Fostering Collaboration and Minimizing Errors in Neonatal Surgical Care at the University of Calabar Teaching Hospital. Journal of Neonatal Surgery. 14; 27: 2226-0439. URL: https://www.jneonatalsurg.com.

41. Oreskovich MR, Shanafelt T, Dyrbye LN, Tan L, Sotile W, Satele D et al. (2015, Jan). The prevalence of substance use disorders in American physicians. Am J Addict. 24(1): 30-38. https://doi.org/10.1111/ajad.12173; PMid:25823633

42. Pesapane F, Gnocchi G, Quarrella C, Sorce A, Nicosia L, Mariano L et al. (2024, Jul 23). Errors in Radiology: A Standard Review. J Clin Med. 13(15): 4306. https://doi.org/10.3390/jcm13154306; PMid:39124573 PMCid:PMC11312890

43. Prieto JM, Falcone B, Greenberg P, Sykes AG, Sisson WB et al. (2022, Nov). Trial and Error: Learning From Malpractice Claims in Childhood Surgery. J Surg Res. 279: 84-88. Epub 2022 Jun 18. https://doi.org/10.1016/j.jss.2022.05.033; PMid:35728277

44. Rich BS, Shelton K, Glick RD. (2020, Apr). Litigation involving pediatric surgical conditions. J Pediatr Surg. 55(4): 602-608. Epub 2019 Aug 31. https://doi.org/10.1016/j.jpedsurg.2019.08.047; PMid:31575412

45. Rodziewicz TL, Houseman B, Vaqar S et al. (2024, Feb 12). Medical Error Reduction and Prevention. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing: 2025 Jan-. URL: https://www.ncbi.nlm.nih.gov/books/NBK499956//

46. Rorat M, Jurek T. (2016, Jan). Sepsis: Medical errors in Poland. Med Sci Law. 56(1): 30-35. Epub 2015 Jun 24. https://doi.org/10.1177/0025802415588989; PMid:26113542

47. Rougereau G, Kavakelis T, Sailhan F, Chanzy N, Zadegan F et al. (2021, Nov). Postoperative pain and infection are the most frequent reasons for legal action after knee arthroscopy: a 5-year review based on two private insurance French companies after arthroscopy. Knee Surg Sports Traumatol Arthrosc. 29(11): 3551-3559. Epub 2021 Apr 25. https://doi.org/10.1007/s00167-021-06586-9; PMid:33895879

48. Рибальченко ВФ. (2013). Аналіз роботи дитячої хірургічної служби України у 2012 році. Хірургія дитячого віку. 3: 24-107.

49. Rynecki ND, Coban D, Gantz O, Gupta R, Ayyaswami V, Prabhu AV et al. (2018, Sep 1). Medical Malpractice in Orthopedic Surgery: A Westlaw-Based Demographic Analysis. Orthopedics. 41(5): e615-e620. Epub 2018 Jun 26. https://doi.org/10.3928/01477447-20180621-06; PMid:29940053

50. Sailhan F, Bouché PA, Delaunay C, Hamadouche M, Chatellard R. (2024, Sep). Reasons for malpractice claims after primary total hip arthroplasty in France: Insurance data from 240 claims from 2014 to 2017. Orthop Traumatol Surg Res. 110(5): 103885. Epub 2024 Apr 12. https://doi.org/10.1016/j.otsr.2024.103885; PMid:38615886

51. Salimi M, Heidari MB, Ravandi Z, Mosalamiaghili S, Mirghaderi P, Jafari Kafiabadi M et al. (2023, Feb 16). Investigation of litigation in trauma orthopaedic surgery. World J Clin Cases. 11(5): 1000-1008. https://doi.org/10.12998/wjcc.v11.i5.1000; PMid:36874422 PMCid:PMC9979292

52. Santiesteban L, Hutzler L, Bosco JA, Robb W. (2016, Jan 26). Wrong-Site Surgery in Orthopaedics: Prevalence, Risk Factors, and Strategies for Prevention. JBJS Rev. 4(1): e3. https://doi.org/10.2106/JBJS.RVW.O.00030; PMid:27490006

53. Савченко ВО. (2009). Лікарська помилка: Історико-правовий аспект. Вісник медичного факультету ХНУ ім. В.Н. Каразіна. 879: 101-106. URL: https://ekhnuir.karazin.ua/server/api/core/bitstreams/3e755905-fe9e-419c-bf2a-db0c338365ee/content.

54. Scott IA. (2009). Errors in clinical reasoning: causes and remedial strategies. BMJ. 339: 22-25.

55. Scott IA, Crock C. (2020). Diagnostic error: incidence, impacts, causes and preventive strategies. Med J Aust. 213: 302-305.e2. https://doi.org/10.5694/mja2.50771; PMid:32951211

56. Scott IA, Crock C, Twining M. (2024). Too much versus too little: looking for the "sweet spot" in optimal use of diagnostic investigations. Med J Aust. 220: 67-70. https://doi.org/10.5694/mja2.52193; PMid:38146617

57. Shahbodaghi A, Moghaddasi H, Asadi F, Hosseini A. (2024). Documentation Errors and Deficiencies in Medical Records: A Systematic Review. Journal of Health Management. 26(2): 351-368. https://doi.org/10.1177/09720634241229545

58. Shen Y, Lei S, Wang Q, Wang H, Hao X, Cai H. (2023, Jun 29). Analysis of the characteristics and risk factors affecting the judgment results of medical damage liability disputes in 3172 second-instance and retrial cases in China. Hum Resour Health. 21(1): 53. https://doi.org/10.1186/s12960-023-00832-6; PMid:37386560 PMCid:PMC10308770

59. Sendler DJ. (2018, Apr). Physicians working under the influence of alcohol: An analysis of past disciplinary proceedings and their outcomes. Forensic Sci Int. 285: 29-37. Epub 2018 Feb 5. https://doi.org/10.1016/j.forsciint.2018.01.019; PMid:29428450

60. Сенюта ІЯ. (2017). Дефекти надання медичної допомоги: поняття і види. Med. pravo. 1(19): 55-66. https://doi.org/10.25040/medicallaw2017.01.055.

61. Silverman M. (2013, Jun 27). Practicing Under the Influence. URL: https://epmonthly.com/article/practicing-under-the-influence/.

62. Singh H, Meyer AND, Thomas EJ. (2014). The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf. 23: 727-731. https://doi.org/10.1136/bmjqs-2013-002627; PMid:24742777 PMCid:PMC4145460

63. Srivastava AB. (2018). Impaired physicians: obliterating the stigma. American Journal of Psychiatry Residents. 13; 3: 4-6. https://doi.org/10.1176/appi.ajp-rj.2018.130303

64. Thyoka M. (2015, Feb). Clinical negligence claims in pediatric surgery in England: pattern and trends. Eur J Pediatr Surg. 25(1): 66-70. Epub 2014 Dec 19. https://doi.org/10.1055/s-0034-1395485; PMid:25526607

65. Толстанов ОК. (2013). Лікарськи помилки в хірургії: історія і сьогодення. Хірургія дитячого віку. 3: 16-107.

66. Topol EJ. (2024, Jan 26). Toward the eradication of medical diagnostic errors. Science. 383(6681): eadn9602. Epub 2024 Jan 25. https://doi.org/10.1126/science.adn9602; PMid:38271508

67. Ugur E, Kara S, Yildirim S, Akbal E. (2016, May). Medical errors and patient safety in the operating room. Journal of the Pakistan Medical Association. 66; 5: 593-597. URL: https://www.researchgate.net/publication/301657073.

68. UNIAN. (2013). V Ukrajini cherez pomilki likariv shchodnya pomiraye bilshe 30 lyudey. Doslidzhennya. URL: https://www.unian.ua/health/country/10439652-v-ukrajini-cherez-pomilki-likariv-shchodnya-pomiraye-bilshe-30-lyudey-doslidzhennya.html

69. Waters PM, DeMaso DR, Horgan JJ, Frick SL. (2025, Mar 28). How Surgeons and Surgical Leaders Manage Complications, Medical Errors, Malpractice, and Second Victim Syndrome. J Pediatr Soc North Am. 11: 100186. https://doi.org/10.1016/j.jposna.2025.100186; PMid:40432873 PMCid:PMC12088224

70. Wiig S, Hibbert PD, Braithwaite J. (2020, Jun 17). The patient died: What about involvement in the investigation process? Int J Qual Health Care. 32(5): 342-346. https://doi.org/10.1093/intqhc/mzaa034; PMid:32406494 PMCid:PMC7299194

71. Wong DA, Herndon JH, Canale ST, Brooks RL, Hunt TR, Epps HR et al. (2009, Mar 1). Medical errors in orthopaedics. Results of an AAOS member survey. J Bone Joint Surg Am. 91(3): 547-557. https://doi.org/10.2106/JBJS.G.01439; PMid:19255214

72. World Health Organization. (2019). Patient Safety. URL: https://www.who.int/news-room/facts-in-pictures/detail/patient-safety.

73. Yamamoto N, Watari T, Shibata A, Noda T, Ozaki T. (2023, Mar). The impact of system and diagnostic errors for medical litigation outcomes in orthopedic surgery. J Orthop Sci. 28(2): 484-489. Epub 2021 Dec 7. https://doi.org/10.1016/j.jos.2021.11.006; PMid:34887150

74. Zejnullahu VA, Bicaj BX, Zejnullahu VA, Hamza AR. (2017, Mar 15). Retained Surgical Foreign Bodies after Surgery. Open Access Maced J Med Sci. 5(1): 97-100. Epub 2017 Jan 5. https://doi.org/10.3889/oamjms.2017.005; PMid:28293325 PMCid:PMC5320916

75. Zhang JK, Alimadadi A, ReVeal M, Del Valle AJ, Patel M, O'Malley DS et al. (2023, Jan). Litigation involving sports-related spinal injuries: a comprehensive review of reported legal claims in the United States in the past 70 years. Spine J. 23(1): 72-84. Epub 2022 Aug 23. https://doi.org/10.1016/j.spinee.2022.08.012; PMid:36028214

76. Zhang JK, Del Valle AJ, Alexopoulos G, Patel N, Van Nispen J, Patel M et al. (2022, Aug). Malpractice litigation in elective lumbar spinal fusion: a comprehensive review of reported legal claims in the U.S. in the past 50 years. Spine J. 22(8): 1254-1264. Epub 2022 Apr 3. https://doi.org/10.1016/j.spinee.2022.03.015; PMid:35381361

77. Zhang L, Wen X, Li JW, Jiang X, Yang XF, Li M. (2023, Oct 2). Diagnostic error and bias in the department of radiology: a pictorial essay. Insights Imaging. 14(1): 163. https://doi.org/10.1186/s13244-023-01521-7; PMid:37782396 PMCid:PMC10545608