Series of Special Topics on Tort Liability Disputes | Analysis of Legal Relationships in Medical Injury Liability Disputes
In recent years,doctor-patient disputes have emerged one after another,and the doctor-patient conflict has become increasingly acute.Due to the wide range and relative sensitivity of conflicts in doctor-patient dispute cases,it is difficult for patients to protect their rights and there are many obstacles.How should patients protect their legitimate rights and interests in the event of personal injury during the diagnosis and treatment process?Interpret the law by caseBasic case detailsZhao was admitted to Hospital A for treatment due to repeated chest tightness with palpitations and shortness of breath.The next day,he underwent femoral vein puncture for dialysis and experienced discomfort.The hospital immediately stopped dialysis and urgently requested an ICU consultation and transfer to another department for ultrafiltration treatment.Later,due to a pseudoaneurysm of the right femoral artery,the emergency department was transferred from Hospital A to Hospital B for vascular surgery treatment.Three surgeries were performed on it the following year.After discharge,Zhao was admitted to the hospital for treatment twice due to chronic renal insufficiency,uremia,elevated blood creatinine for one year,and hemodialysis.He passed away in May of the same year.His family believed that the two hospitals were at fault for Zhao's death,so they sued the court and requested that the Second Hospital bear the compensation responsibility.In the first instance,the plaintiff applied to the court for appraisal on whether the diagnosis and treatment behavior of Zhao by two hospitals was at fault,whether there was a causal relationship,and if there was a causal relationship,how much participation was made.The judicial appraisal conclusion is that the pseudoaneurysm of the right femoral artery is a iatrogenic injury caused by hospital A,with the main fault and direct causal relationship.There is no fault or causal relationship in the diagnosis and treatment process at Hospital B.The court held thatAfter the court's trial,it was found that Hospital A caused the rupture of the right superficial femoral artery and the formation of a pseudoaneurysm during the diagnosis and treatment process,which was not clearly recorded in the medical records,and was a fault of not fulfilling the obligation to inform.Three days later,the patient was transferred to another hospital for treatment due to abnormal vital signs,and there was a fault of delaying treatment.Therefore,Hospital A has a major fault in the diagnosis and treatment process of the patient,and there is a direct causal relationship with the damage caused.All losses incurred by Zhao during his early diagnosis and treatment at two hospitals shall be compensated by Hospital A.During Zhao's later diagnosis and treatment at Hospital A,there was an indirect causal relationship between the late treatment at Hospital A and the early iatrogenic injury and death consequences,but it was not the direct result of the patient's death caused by the iatrogenic injury.The participation rate of iatrogenic injury was 20-40%.Therefore,for the losses incurred by patient Zhao during his later diagnosis and treatment at Hospital A,Hospital A should bear 40%of the compensation liability.Based on this,the court subsequently ordered Hospital A to compensate the plaintiff for losses of over 90000 yuan.After the first instance judgment was made,both the plaintiff and defendant appealed against it.After the second instance trial,the appeal was rejected and the original judgment was upheld.Lawyer InterpretationThis case is a medical injury liability dispute.According to Article 1218 of the Civil Code,"If a patient suffers damage during diagnosis and treatment activities,and the medical institution or its medical staff is at fault,the medical institution shall bear the liability for compensation.";Article 1219 stipulates that"medical personnel shall explain their condition and medical measures to patients during diagnosis and treatment activities.If surgery,special examination,or special treatment are required,medical personnel shall promptly provide specific medical risks,alternative medical plans,etc.to patients and obtain their explicit consent.If it is impossible or inappropriate to explain to patients,medical personnel shall explain to their close relatives and obtain their explicit consent.If medical personnel fail to fulfill the obligations mentioned in the preceding paragraph and cause damage to patients,medical institutions shall bear compensation responsibility.Medical institutions have the obligation to explain,and patients have the right to informed consent.".The medical party shall not be held responsible for fulfilling the obligation of disclosure.It should be noted that although medical personnel have fulfilled the obligations stipulated in the first paragraph of this article and obtained the consent of patients or their close relatives,if they fail to fulfill the corresponding medical obligations in subsequent diagnosis and treatment activities,resulting in damage to patients,medical institutions shall still be liable for compensation.Medical institutions may use informed consent forms,notification forms,and other medical records signed and recognized by the patient as necessary evidence to prove that medical personnel have fulfilled their obligations.On the contrary,it is sufficient to determine that medical institutions have not fulfilled their obligations and caused damage to patients,and medical institutions should bear compensation liability.PostscriptAfter the implementation of the Civil Code of the People's Republic of China,medical accident appraisal is no longer a requirement for medical litigation.If a patient suffers damage,medical institutions should bear the responsibility for compensation as long as they are at fault.However,patients should actively cooperate with medical institutions to carry out diagnosis and treatment in accordance with diagnostic and treatment standards during the process of receiving medical treatment.In the event of a medical accident,medical institutions should be promptly requested to review and copy hospitalization records,medical orders,inspection reports,surgical and anesthesia records,pathological data,nursing records and other medical records.Reasonable appeals should be expressed through mediation,litigation and other means,and extreme measures should not be taken.Otherwise,if it interferes with medical order,hinders the work and life of medical personnel,and infringes on the legitimate rights and interests of medical personnel,legal responsibilities should be borne in accordance with the law.Of course,as a medical institution,it is necessary to manage medical personnel and require them to provide reasonable diagnosis and treatment for patients in accordance with laws,administrative regulations,rules,and other relevant diagnostic and treatment norms.Medical institutions and their medical staff should fulfill their duty of explanation during the diagnosis and treatment process,safeguard the patient's right to informed consent,and pay attention to the protection of patient privacy and personal information.Both doctors and patients should fulfill the above-mentioned obligations and exercise their respective rights reasonably,which can greatly avoid the occurrence of doctor-patient conflicts.Team IntroductionThe Xianwei Personal Injury Rights Protection Team is a young lawyer team with excellent professional quality and rich experience in handling cases.The team adheres to the service concept of"rigorous,efficient,professional,and responsible",forming a professional,standardized,and standardized case handling model.It is committed to handling various types of personal injury infringement liability disputes and providing customers with higher quality and efficient legal services.The team members have many years of work experience and rich practical experience.In recent years,they have dealt with more than 100 cases of personal injury infringement of various types,including disputes over liability for labor service providers,liability for voluntary assistance workers,liability for motor vehicle/non motor vehicle traffic accidents,and liability disputes for educational institutions.The team adheres to the principle of"maximizing the protection of the legitimate rights and interests of the parties involved",ensuring that every client's commission receives the most professional and accurate legal services.