Lawyer works to help patients who fall victim to medical malpractice

When in 2000 a client filed a lawsuit against Cabot, a private U.S.-Ukrainian dental clinic, the clinic’s young lawyer Serhiy Antonov was soon at his wits’ end.

The claimant was making harassing, threatening calls to him. She was demanding Hr 1 million in compensation for what she said was a botched dental treatment that was causing her lots of pain.

Even after an examination of experts showed there were no medical grounds for the client’s complaint, Antonov was close to admitting defeat in the case.

Then fate intervened: The client’s mother, who was involved in a property dispute with her daughter, testified that the medical complaint was a scam to swindle money out of the dental clinic, and Antonov won the case.

It had been the first case involving medical practice in his career, but far from the last.

Seventeen years on, Antonov, now 43, is a managing partner at the Verdys Law international legal bureau, a successful lawyer specializing in medical litigation, with clients in Ukraine, Russia, Belarus, Kazakhstan and the United Kingdom. He has hundreds of medical malpractice and compensation cases under his belt.

Patients unprotected

According to the World Health Organization, medical errors and malpractice cause at least one death every day and injure approximately 1.3 million people annually in the U.S. alone. Globally the cost associated with medical errors is estimated by the United Nations’ World Health Organization at $42 billion annually.

There are no official statistics on medical errors in Ukraine, but Antonov says there are numerous cases every year. But unlike in the U.S. or in Western Europe, where a patient can expect some compensation, patients in Ukraine who have been the victims of medical errors are in most cases on their own, says Antonov.

“In the West, a patient who suffered from a medical error can be offered free treatment or lifelong discounts on treatment, but in Ukraine it’s hard to even prove that a medical error occurred, not to mention get compensation,” Antonov says. “Usually doctors try to cover their tracks — they rewrite their notes on the course of the disease or the treatment procedures.”

He gives an example: One of Antonov’s toughest cases on behalf of a patient’s rights started eight years ago, and is still going on. A disabled man from Zaporizhzhya Oblast had hip-replacement surgery at the Institute of Traumatology and Orthopedics of the Academy of Medical Sciences of Ukraine. During the operation, the patient contracted two infectious diseases, and Antonov proved this in court. But the case goes on to this day as the hospital is still appealing against the court rulings.

“My client didn’t want to punish anybody,” Antonov said. “Unlike in many other countries, in Ukraine there is no forensic medical code that clearly specifies when a doctor can be held responsible for a particular error.”

He adds that in Ukraine it takes on average three years to prove in a court that a medical error occurred. The main hold up is conducting medical examinations or tests to provide evidence for a case, as this is usually very expensive.

Lack of lawyers

Around 10 higher educational institutions in Ukraine award diplomas in medical law, however it’s difficult to find a lawyer specializing in medical law nowadays, because lawyers don’t make a lot of money in this field. Antonov often provides legal assistance pro bono.

“There are many clients for whom paying Hr 100 for a legal consultation is a lot of money,” he says. “That’s why a lot of lawyers who start out specializing in medical law move to other spheres.”

So it’s a problem for patients even to find a professional lawyer. Many of the lawyers who claim to deal with medical errors don’t even bother to leave their offices to talk to the doctors, according to Antonov.

“They don’t know how medical institutions in Ukraine function and, therefore, can do little to help their clients,” Antonov says.

Antonov, who has obtained three degrees in law, medicine, and criminal forensics, says that Ukrainian lawyers specializing in medical law often lack a medical background. Antonov used to work as a surgical assistant at a Kyiv hospital and as the deputy director of the Lissod private hospital in Kyiv. This experience helps Antonov in his legal work — he knows all the tricks unscrupulous doctors use to conceal information about a patient’s treatment.

“If a lawyer knows how the system functions from the inside, he will be able to ask the right questions and make the doctors reveal the truth,” he says.

But even having all that experience, Antonov keeps studying. Last year he received a Master’s degree in Law from the University of New South Wales in Sydney, Australia. Now he is a student of the Faculty of Medicine of the same college.

Health reform

While Ukraine’s Acting Health Minister Ulana Suprun is plowing forward with sweeping health care reforms, Antonov is skeptical that much will change. The reform is to stipulate a range of medical services that are guaranteed by the state. Primary and urgent medical care will be provided free of charge, while specialized care will be partly funded by the state and partly by patients.

Antonov says that it contradicts the Ukrainian Constitution, which guarantees free health care for all citizens, and that the state simply won’t have the money even to provide partial funding.

“Suprun took the UK healthcare system as a basis,” Antonov said. “But Ukraine cannot afford to spend as much (on health care) as Britain does.”

Another problem is that the reform does not address the issue of doctors or patients’ rights.

“Because there are no clear protocols on how to treat one illness or another … it would be difficult for a doctor to prove they chose the best treatment option,” he said.

As for protection of patients’ rights, Antonov believes the best option would be to introduce the institution of the patients’ ombudsmen, who would assist patients in solving problems in each particular hospital.

“But there’s no such thing mentioned in the Ukrainian medical reform (bill),” he says.