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A court has recognized the evidence gathered by the investigating bodies of the Russia’s Investigative Committee for the Sverdlovsk Region sufficient to convict two nurses of surgical department No 2 of Regional Children’s Clinical Hospital No 1. They were found guilty of crimes under part 2 of article 109 of the RF Penal Code (reckless homicide due to improper discharge by a person of their professional duties) and part 2 of article 118 (infliction of grievous bodily harm by negligence due to improper discharge by a person of their professional duties).

The court and investigators have found that on 27 February 2014, being in the surgical department of the said hospital, one of the nurses – the 26-year-old defendant, while performing preoperative preparation through her negligence made an incorrect solution not having made sure of the name of the medicine used. After that she asked another nurse to perform preoperative preparation on several minor patients. This resulted in the fact that on 27 February the second nurse used the incorrect solution and caused a 4-year-old boy acute toxic exposure, of which the boy died in the morning of 28 February 2014 in the resuscitation department of the hospital. According to a forensic medical examination of the boy’s body, he died as a result of use of incorrect medicine resulting in intoxication and subsequent death. The investigators found that in a similar way, careless actions of the two nurses inflicted grievous bodily harm to a 7-year-old boy.

It has to be noted that during the investigation both defendants released on recognizance pleaded guilty.

The investigators found no guilt on the pharmacy supplying medicines to the hospital as both formalin and other drugs (namely, canisters with physical solution) were supplied properly labeled and without any violations in marking.

The mistake was basically due to the fact that the nurses did not notice the label on the canister and accidentally used formalin instead of physical solution. Even strong smell of formalin did not daunt on them. Only after performing preoperative preparation with wrong solution, one of the nurses (the 26-year-old defendant) realizing her mistake and scared by the consequences, tore off the label from the canister with formalin and attached to it the one from the canister with physical solution.

After that the woman took the formalin label, tore it in pieces and threw them away in a dustbin next to her home. The investigators believe that the defendant from the very beginning tried to make it look like the canister with formalin had the wrong label and that is why subsequent event with wrong solution did take place.

To consolidate the evidence members of the investigating team took urgent measures to find the traces of the crime. They examined the crime scene in present of the 26-year-old defendant and found fragments of the formalin label in an empty kefir carton. A forensic analysis then showed that the fragments were parts of the same label.

It should also be noted that the experts of the Sverdlovsk Region Forensic Medical Examination Bureau urgently, basically at nighttime, ran necessary analyses very quickly which confirmed the mistake with the medicines and determined that it was exactly formalin used in treating the children. The rapidity allowed avoiding graver consequences as the victims received urgent resuscitation immediately after the wrong medicine had been identified.

To establish absolutely all circumstances of the tragedy, the investigators carried out a considerable number of operations. This way, they questioned over 100 witnesses, ran forensic medical expert examinations of the victims and the killed boy, a forensic traceological analysis of the formalin label fragments and a DNA test. There are 16 volumes of files in the case.

The court has sentenced the first defendant to 2 years and 3 months of limitation of freedom, the second one to 2 years and 4 months of limitation of freedom. Both of them were banned from working as nurses for 3 years.