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Mogilevsky case: procurements, restaurants, hospitalization of psychiatric dispensary resident

25.04.2023 @ 21:18 – 22:18 Europe/Helsinki Timezone
Mogilevsky case: procurements, restaurants, hospitalization of psychiatric dispensary resident

About the case: Dmitry Mogilevsky – Deputy Director of (PNI-9) Psychoneurological Dispensary № 9, is being accused of receiving bribes at the institution.

The case is being considered by the Krasnoselsky District Court of St. Petersburg, judge – Anton Nikolaevich Ulanov.

The court session started 44 minutes late. Judge Ulanov asks the defendant Mogilevsky whether he considers it possible to consider the case in the absence of defense counsel Skurtu – Mogilevsky does not object. 

The prosecutor proposes to question the witnesses who appeared.

The first witness, Galina Ilyushina, born in 1965, is the head of the 5th department at Psychoneurological Internat № 9. She has known the accused since 2016 when he started working as the chief doctor – deputy director for the medical part.

Galina Ilyushina states that in 2016-2017 at Psychoneurological Dispensary № 9, they purchased specialized nutrition for incapacitated residents. Due to the physical condition of the “patients”, there arose a need for nutritional support. Protein nutrition was prescribed to those who had medical indications and sufficient funds to purchase it. Mogilevsky was responsible for organizing the purchases and liaising with the supplier. They’ve been buying the nutrition from the company “Nutricia” through a representative named Maria.

The witness also believed that this was a good product and started prescribing it to the “patients.” There was a positive clinical effect, and nutrition was in demand. Ilyushina compiled a list of her department’s “patients,” which she passed on to the head nurse, and ultimately it went to the guardianship council. The question of prescribing nutrition was raised by the attending physician, then brought to the medical commission, which approved the prescription. The commission’s conclusions were sent to the guardianship council, which considered the appropriateness of spending on incapacitated individuals and then sought permission from the Municipal District “Krasnoye Selo.” All decisions were made collectively.

Mogilevsky did not raise questions about the need to increase the amount of purchases. The witness herself participated in the guardianship council and insisted on prescribing nutrition. An instruction was issued to purchase one month’s worth of protein nutrition for 5,800 rubles, but Ilyushina doesn’t remember whose instruction it was. The amount was based on the cost of one can, with the average price being 270-300 rubles. Purchasing through a medical representative was more cost-effective, and the witness calculated that it was cheaper in this way.

Together with other employees of the dispensary, she visited restaurants “Mamalyga” and “Bakhroma” a couple of times, which were paid for by the supplier company. This was part of the marketing efforts of all pharmaceutical companies that interacted with doctors: “They invite you to a restaurant, feed you, offer drinks, and at the same time, they give presentations.” The witness received such invitations every week from different companies.

At the request of the prosecutor and with the consent of the defense, the written testimony of Ilyushina is presented due to contradictions. Protocol of interrogation dated December 28, 2020:

She characterizes Mogilevsky as knowledgeable, cheerful, reckless, and sociable. The suspect was loud, used jokes and humor, and occasionally employed certain slang, but during meetings with her, he didn’t raise his voice at employees or insult anyone. The suggestion to visit restaurants came from Mogilevsky himself. She didn’t hear him express any complaints to employees who didn’t attend. There are no known facts of the suspect receiving bribes from Maria Zhdanova for organizing food purchases by Ilyushina. The witness herself did not receive money from Mogilevsky for preparing and signing documents.

The rest of her testimony pertains to the mechanism of food procurement: the treating physician, medical commission, guardianship council, and municipal district, as well as the chronological sequence of events. There are no clear contradictions or discrepancies between her statements, which both she and Mogilevsky acknowledge at the end of the testimony. The witness confirms the reliability of the disclosed testimony.

Next, Alexander Spassky is being invited, born in 1990, the head of the department at the Psychoneurological Internment № 9 and a psychiatrist. He has known Mogilevsky since April 2017, when he started working at the Psychoneurological Dispensary № 9, and he does not harbor any ill feelings toward the defendant.

Mogilevsky addresses the witness informally and calls him “Sasha.” Throughout the interrogation, the defendant whispers and gestures to the witness, which the judge reprimands once but ignores on other occasions.

Regarding the food purchases, Spassky’s testimony aligns with Illyushina’s statements. He personally prescribed the high-protein diet, participated in the medical commission and the guardianship council. He didn’t know who the supplier was and had no interest in it. The food had a positive effect; it was within its shelf life, and the residents gained weight. The attending doctor recommended the use of this food, and the issue was brought before the commission, which assessed the appropriateness of the prescription. After approval by the commission, the guardianship council considered whether it was financially feasible for the residents and requested permission from the guardianship authority to use their funds. Spassky was not aware of the details of how the institution interacted with the supplier or the flow of funds. He assumed senior nurses handled it by exchanging money for checks and goods. On average, they purchased food worth around 5,000 rubles each month. The quantity of food was determined in accordance with the doctor’s recommendations.

Spassky mentioned that he visited a restaurant once in 2017, and he later learned that it was organized by a representative from the supplying company named Maria. They had a meal and chat, and nothing out of the ordinary occurred.

At the request of the prosecutor and with the consent of both parties, the court decides to disclose the testimony given during the preliminary investigation due to discrepancies.

Interrogation Record of Spassky 25 January 2021.

The witness provides the same information about the procedure for prescribing and approving the use of food. In the medical history records, was written “specialized high-protein food” without specifying the name, as the witness was unsure of the exact type of food that would be provided. Don’t recall anyone giving instructions to write “high-protein food” without specifying the name. The food had a positive effect: some residents became calmer, some gained weight, and some did not worsen their bedsores. A detailed analysis of the effectiveness was not conducted due to the lack of appropriate resources at the institution.

The witness visited a restaurant once in 2017 but doesn’t remember who paid for it. Apart from them, Maria, Mogilievsky, the director of the institution, Chistyakov, other employees, and some children were present. He doesn’t recall Mogilievsky expressing any complaints about those who did not attend the restaurants. The witness is unaware of Mogilievsky receiving bribes from Zhdanova. There were no statements about the ineffectiveness of the food from the heads of departments.

In response to additional questions from Mogilievsky, the witness says that the standardized food prescription form was created to simplify the work of doctors, as the massive amount of paperwork was hindering their primary responsibilities. He also mentions that in 2017, the institution’s in-house staff was responsible for trimming patients’ mustaches and beards.

The witness provides a positive characterization of Mogilevsky as a good person who participated in solving departmental issues and when interacting with supervisory authorities.

Before questioning the next witness, Mogilievsky suggests taking a break due to the expected lengthy testimony. However, the judge decides that there is no need for a break and prefers to continue, stating, “The sooner we start, the sooner we finish.”

Testimony is given by Elizabeth Petrova, born in 1977, the head of the 3rd department at Psychoneurological Dispensary № 9.

She has known Mogilevsky since he became the Deputy Director for Medical Affairs. In 2016, Maria, a representative from the company, visited the institution and gave a presentation on protein nutrition. Following this presentation, Mogilevsky proposed official procurement during a meeting. Heads of departments compiled lists of individuals in need of dietary supplements and forwarded them to the social department, which “wasn’t particularly enthusiastic about handling this”, so Mogilevskiy assigned this to the witness.

Petrova created a list and verified the availability of funds in the patients’ accounts. The lists were subsequently passed on to the Social Department for further verification and then sent to the accounting department. The decision regarding procurement was made by the Guardianship Council and was coordinated with the Ministry of Health. Mogilevsky oversaw the interaction with the supplier and would inform the senior nurses when permission to withdraw funds from the accounts was granted.

On two occasions, she attended restaurants when Mr. Mogilevsky invited her and other colleagues. Maria organized these events and covered the expenses. They socialized, ate, and drank. There were no questions or issues raised; it was seen as typical advertising and management practice, something that has been happening for several decades. In the past, even trips to theaters were organized, and back in the 90s, they were even taken to other cities.

The trimming of mustaches and beards for residents is included in the list of social services and is funded by the budget. The witness has not heard of the involvement of Individual Entrepreneur Urikh. There was one year when the information about the trimming service was not included in the report on the services provided, but she does not recall the reason for this omission.

In her department, there was a severely ill patient named Smirnov. In 2018, he was hospitalized at the Kaschenko Hospital, and after some time, he returned in a terrible condition, having undergone surgery after consuming some pillows. He was no longer the same person they had sent to the hospital. In 2019, he was again sent to Kaschenko [note: psychiatric hospital named after Kaschenko] due to a severe psychosis, and upon return, he had bedsores and remained bedridden. Before Kaschenko, Smirnov had only had macerations (skin abrasions), which did not require surgical intervention. In 2019, when the witness went on vacation for some time, she returned and found a report stating that Smirnov had been taken to a surgeon for treatment of bedsores. Mr. Mogilevsky said, “Everything is done for you; now go and supervise.” Later, when she went away again, there was a need to hospitalize Smirnov due to pneumonia. They called the on-duty doctor, who organized Smirnov’s hospitalization. Subsequently, Smirnov spent about one and a half months in the therapeutic department, and he was transferred to the surgical department just three days before his discharge. When the witness inquired about his condition at the hospital, she was told that he was going to be discharged. However, some kind of catastrophe occurred at the hospital, likely due to his progressive psychophysical deterioration, which affected both his brain cortex and all his organs.

Prosecutor: Why was the phrase used that “the work has been done for you”?

Petrova: Well, those were Dmitry Alexandrovich’s expressions.

Prosecutor: So you didn’t give it much thought?

Petrova: None at all.

At the request of the prosecutor and with the consent of the defense, the written testimonies of the witness are disclosed due to the presence of contradictions.

The content of the interrogation record of Petrova dated 29.01.2021 concerns the circumstances of the organization of catering purchases and predominantly duplicates the disclosed protocols.

[During the disclosure of evidence, the judge unexpectedly announces a 10-minute recess without explaining the reasons and leaves the courtroom quickly. The session resumes 44 minutes later, with no explanation given for the long delay.]

During the preliminary investigation, information was obtained that on January 9, 2018, a contract was concluded between PNI № 9 (psychiatric dispensary № 9) and the individual entrepreneur “Urikh” for trimming the beards and mustaches of the residents of the institution. The investigator presents Petrova with the document showing the execution of the said contract bearing her signature and asks under what circumstances it was signed. Petrova responds that the signature on the document appears to be hers, but she does not remember the circumstances of its preparation and signing. It is possible that Mogilevsky or someone at his request presented her with this document along with others, and she signed it. She is not aware of Mogilevsky receiving monthly bribes from Urikh in 2018. She also did not receive any money from Mogilevsky for actions related to the execution of the contract and has never seen Urikh in person.

Additional interrogation record of Petrova dated 12 of February, 2021.

In response to the investigator’s questions, Petrova explains that due to her high workload upon returning from vacation on October 21, 2019, she did not have time to fulfill the surgeon’s prescription for Smirnov, which involved a comprehensive medical-surgical treatment, including the excision of necrotic tissues, and referral to the surgical department. This was because Smirnov had been hospitalized by the on-duty physician on October 25, 2019, in her absence. During this time, his treatment was conducted under the supervision of a general practitioner, which included the administration of antibiotics.

Regarding the information received on January 21, 2019, about the presence of purulent necrotic discharges in Smirnov’s bedsores, which required surgical treatment, Petrova did not issue an immediate referral for hospitalization. She explains that her focus was on following the surgeon’s recommendations and the patient’s observation by other doctors. There were no direct indications for urgent hospitalization at that time. Smirnov was receiving therapy prescribed by the general practitioner and other medical professionals. Petrova believes that she did not make a medical error by not deciding on hospitalization between October 21, 2019, and October 24, 2019. She considers the medical care provided to be complete and of high quality. She hesitates to answer whether the presence of purulent necrotic masses in bedsores is always an indication for immediate hospitalization, as she believes it may not be the case in all situations.

Additional interrogation record of Petrova dated 8 of February, 2021.

During the investigation, it was established that on October 18, 2019, Mogilievsky held a meeting with the staff of PNI No. 9 to discuss Smirnov’s deteriorating health condition. Mogilievsky instructed them to record in Smirnov’s medical history information about the examination by a surgeon and the decision not to hospitalize him due to possible future consequences resulting from the delayed hospitalization.

Petrova explains that on October 21, 2019, when she returned from vacation and after the meeting when everyone had dispersed, Mogilievsky told her, “We’ve taken care of everything for you regarding the situation with resident Smirnov. He should stay in your department. We had a medical consultation about him, and a surgeon examined him.” When Petrova asked the department staff what had happened while she was on vacation, they couldn’t provide clear details. They mentioned that someone from the institution’s staff had photographed Smirnov’s bedsores, then took his medical history records, and later returned them.

After disclosing her testimony, Petrova is asked additional questions.

Mogilevsky: When you came to my office, did you happen to see two bundles of five-thousand-ruble banknotes in packaging on my desk, with a total amount of one million rubles, and did I shout and scold you for it?

Petrova: I don’t remember such a thing.

Mogilevsky: That’s all I have; they’re just referring to you as the source.

The deposition is ended, and Petrova is released from further participation in the hearing.

The prosecutor presents the protocols of interrogations in absence of witnesses Shushkova from January 29, 2021, and Kuzmina from December 24, 2020, who are heads of departments at PNI № 9 (psychiatric dispensary). Their testimonies revolve around the circumstances of food allocation and procurement, interaction with the supplier, money withdrawals from accounts, payment for goods, receipt of receipts, and visits to restaurants, echoing the statements of previous witnesses and the previously presented testimonies.

The judge decides to once again call the witnesses and adjourns the hearing until May 6, 2022.

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