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Source: Voice of Medicine
Because of intestinal obstruction A 36-day-old baby in Hebei went to the Second Affiliated Hospital of Hebei Medical University in the early morning of May 28. While waiting for the nucleic acid test results, he was suspected of falling ill and died because he did not receive timely treatment. This incident has attracted widespread attention recently.
On May 28th, because the child had vomiting and poor appetite, the family took the child to the hospital for medical treatment. After arriving at the hospital at 2:00 in the morning, due to fever symptoms , emergency refusal.
02:50 The doctor said that he had fever and needed to stay in the cabin.
At 04:15, I entered the cabin and thought that the child would be treated, but the doctor told me that we would need to wait until the day shift doctor went to work before treatment.
The medical diagnosis at that time was:
1 , abdominal distension to be investigated: enterocolitis?
2. Intestinal obstruction.
Condition assessment: stable condition, free movement, no malnutrition, and stable vital signs.
But around 7:50, the baby was in a state of shock with feces pouring out of his mouth and nose. The family requested treatment 11 times before and after, but only received the doctor. “Waiting” response.
The doctor refused to transfer the child to the PICU (Pediatric Intensive Care Unit) for rescue on the grounds that there was no nucleic acid report.
During the period, the doctor did not follow the treatment measures for neonatal intestinal obstruction.
The gastric tube operation was not performed until 9:09, and the enema was given at 9:21. At this time, 6 hours have passed since the hospital admission time. over an hour.
At around 11:51, the nucleic acid results were released. After being contacted by the hospital leadership, the baby was transferred to the PICU. , declared dead.
This matter has been fermented on the Internet.
The Second Hospital of Hebei Medical University issued a statement: “Recently, some media published a report on the diagnosis and treatment of a child in our hospital. We attach great importance to the incident and conduct a special investigation. After investigation, the child was born on April 23, 2021. He visited our hospital 3 days after birth and was diagnosed with suspected Hirschsprung’s disease. He was hospitalized for 17 days of hypoalbuminemia. 5 In the early morning of May 28th, due to abdominal distension and fever, he came to our hospital again for diagnosis and treatment. The child’s condition progressed rapidly and was in critical condition. Despite active treatment and rescue, he unfortunately died at 7:24 on May 29th. Regret!”
At the same time, the Second Hospital of Hebei Medical University stated: In June 2021, the family of the patient will file a lawsuit in the territorial court, and in May 2022 The Medical Association held a medical malpractice appraisal meeting and issued the appraisal results. The case is still under trial. Our court will actively cooperate with the investigation and deal with it in accordance with the court’s trial results.
Source: Hebei Medical University The official website of the Second Hospital
But the family member said: “What we didn’t expect is that the identification result is one Class A medical malpractice, but the second hospital of the province bears secondary responsibility, and we bear the main responsibility. Shijiazhuang Medical Association Medical Malpractice Technical Appraisal Office and relevant appraisal experts ignore the factual basis, confuse black and white, avoid the important, and openly protect the medical malpractice identification. There is no fairness and justice in the Second Provincial Hospital. We firmly disagree with the results of the Shijiazhuang Medical Association.”
Regardless of the results, This is a tragedy in the post-pandemic era.
Let’s try to analyze a few issues, everyone can discuss together.
What disease did the child die of?
Obviously, the child went to the hospital because of intestinal obstruction, and suffered from Hirschsprung’s disease, abdominal distension for three days I went to the hospital for treatment, but I had to wait for the nucleic acid report due to fever symptoms, and finally I could not get it in time.It is very regrettable that he died after being rescued.
Source: Weibo of the family of the child
The medical malpractice identification report showed that the initial diagnosis of intestinal obstruction was established.
In this report, it is determined that the medical negligence of the doctor has a certain causal relationship with the death of the child: given that the child has “congenital” Hirschsprung?” Medical history, swimming before the onset (stimulation of water and exertion) may reduce bowel motility and increase the risk of infection, increased CRP and decreased white blood cells at the time of consultation, and also participated in the aggravation of the child’s condition and eventually death. Therefore, the medical party bears the secondary responsibility for the medical accident”.
The medical party bears the secondary responsibility?
The death of a child who has just turned one month is undoubtedly a major blow to parents, and it is a normal phenomenon that it is difficult to accept. A case, of course, is a medical damage compensation dispute. For such cases, the “Civil Code” clearly stipulates that 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 be liable for compensation. As long as the institution is at fault and causes damage to the patient, of course, it needs to be liable for compensation. Here, the burden of proof that the medical institution is at fault lies with the patient. However, the medical behavior is extremely professional, neither the patient nor the court has the same It is very difficult to require patients to prove that the hospital is at fault through their own behavior. Therefore, the Supreme Court’s judicial interpretation also specifically stated, “If the parties apply for identification of specialized issues in medical damage liability disputes in accordance with the law, The people’s court shall grant permission. “In judicial practice, the court is also obliged to explain to the patient that whether the hospital is at fault can be determined through forensic identification. Now, after the medical malpractice identification, it has been determined that the hospital is at fault. But what is difficult for the child’s parents to accept is that the expert identification believes that the hospital is at fault. The hospital only has secondary responsibility, that is, it is unacceptable for the size of the hospital’s fault. When some media reported this result, they expressed that the hospital bears the secondary responsibility, and the baby’s parents bear the primary responsibility. I don’t know if this is a misunderstanding or intentional misleading. Jiazi looked at the photo of the medical accident identification report in the report, which said that the medical side bears the secondary responsibility, and did not mention that the parents of the child bear the primary responsibility. In a traffic accident, the party with the secondary responsibility must be The party who is primarily responsible. But the difference between a medical accident and a traffic accident is that it is not the patient or the patient’s parents that the medical institution needs to fight, but the disease. In addition to the death directly caused by the medical behavior, the damage to the patient is overwhelming. In some cases, even if the hospital has a certain fault, it is not only the development of the patient’s own disease, but also the cause of improper medical treatment. Therefore, the Supreme People’s Court also clearly stipulated in the relevant judicial interpretations that in the identification of medical damage liability disputes, The scope of patient identification includes: “Whether there is a causal relationship between the diagnosis and treatment behavior and the consequences of damage, and the magnitude of the causal force”, the magnitude of the causal force is used here, rather than the magnitude of the fault, to show that the patient is not at fault. It is possible that the patient’s disease also has a certain role in the final damage.
Therefore, if the media deliberately uses the child’s parental account when reporting The main responsibility, so there is suspicion of guiding public opinion, and it is not appropriate to express it objectively.
What can be learned from this case Lessons learned?
The biggest contradiction in this case is that the child has no nucleic acid because of fever, so he did not have nucleic acid for up to 9 hours. The contradiction of getting treatment.
In this regard, the lessons brought by the tragedy of “newborns cannot be treated in time due to nucleic acid” are far more than just In the medical field, other aspects should be inferred from one another.
Accountability is not the purpose, let alone a period.
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The principles of “people first” and “life first” must be reiterated again. Epidemic prevention measures that violate this principle need to be held accountable and efficiently reviewed and resolved.
END
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