Introduction:Recently, a case of medical malpractice in a health center was pronounced!
Coughing to hospital after visiting doctorpregnant woman dies
September 25, 2018 at 9:45 am Minutes, Zhong Mou went to the defendant’s Xinzhou Town Xinx Health Center in Danzhou City for a diagnosis of “cough and expectoration for 5 days, aggravated with shortness of breath for 8 hours”:
1 , Pulmonary infection; 2. Acute left heart failure; 3. At 8+ months of pregnancy, Zhong was short of breath.It was suggested to be transferred to a higher-level hospital for treatment, but Zhong insisted on treatment and observation at the defendant’s place. .
During the treatment, Zhong developed severe pain in the lower back and his face was pale. The defendant immediately transferred him to the emergency room, where he was given oxygen inhalation, diazepine, and epinephrine. Rescue measures such as cardiopulmonary resuscitation were performed, and the 120 emergency number was called at the same time, but Zhong’s condition was not under control.
Around 12:50, 120 ambulances arrived at the defendant’s place for rescue. The electrocardiogram showed: ventricular pause (straight line), and Zhong was declared clinically dead. .
After the death of Zhong Mou, on September 25, 2018, Zhong Mou’s husband Gan Moujia voluntarily reached an agreement with the defendant, and the defendant paid the plaintiff personal damages in advance The economic compensation is 40,000 yuan. The People’s Government of Xinzhou Town gave 20,000 yuan of humanitarian assistancethe pregnant woman was diagnosed with acute respiratory failureinsisted on being discharged and returned to the local hospital for treatment
On July 21, 2018, Zhong was hospitalized in the ICU ward of the Department of Critical Care Medicine, Hainan Provincial People’s Hospital. The admission diagnosis: 1. Sepsis, 2. Acute respiratory failure, 3. Tsutsugamushi disease? 4. Urinary tract infection, 5. Intrauterine pregnancy 26 weeks+. On July 31 of the same year, Zhong was hospitalized for 10 days and asked to return to the local hospital for further treatment. The Hainan Provincial People’s Hospital informed Zhong and his family that the current use of relevant therapeutic drugs and examinations may lead to fetal malformations. Zhong and his family expressed their understanding, but they did not make a decision on whether to induce labor or not. Discharge diagnosis: 1. MODS (acute respiratory failure, distributive shock, acute left heart failure?), 2. Urinary tract infection, 3. Intrauterine pregnancy 27 weeks+, 4. Hepatitis B surface antigen carriers. Discharge doctor’s order: It is recommended to return to the local hospital for further treatment. The court ruled:The health center is 50% liable and compensates 440,000 yuan
The Danzhou court held that according to the Hainan Medical The Institute of Forensic Clinical Forensic Appraisal issued the appraisal opinion of Qiong Medical Association Si Jian [2019] Lin Jian Zi No. 1 “Forensic Appraisal Opinion”:
“Danzhou New Zhou Zhenxin × Health Center had negligence in the process of diagnosis and treatment of Zhong, and there was a causal relationship between his negligent behavior and Zhong’s damage. The damage was caused by both the doctor and the patient. Medical negligence participation is 41%-50%”.
According to the above appraisal opinions, The hospital determined that the defendant was at fault in the diagnosis and treatment of Zhong, and decided that the defendant should pay 50% of the compensation for his negligence in the diagnosis and treatment of Zhong. responsibility. Accordingly, the court made a judgment in accordance with the law, Defendant, Danzhou Xinzhou Town, Xinx Health Hospital should compensate plaintiffs Gan A and Gan B ( The total losses of Zhong Mou’s daughter), Zhong Mouwei (Zhong Mou’s father), and Wan Mou (Zhong Mou’s mother)444858.56Meta.
Wake up!
The patient refuses to be referred, what should the health center do?
During this medical accident, the patient repeatedly proposed “return to the local area for treatment and refuse referral” due to family circumstances.
Although the final court ruled that the health center was responsible for 50% of the accident, it still had to pay more than 440,000 yuan! For a township health center, this may be more than half a year’s worth of diagnosis and treatment income!
Because of medical conditions and technical limitations, township health centers do not have certain ability to deal with some intractable diseases, but After a patient refuses to be referred to a superior, how should the health center deal with it, so as to avoid encountering the “unintentional disaster” like the peers in the case?
1. “High-risk” patients, please refuse admission
As the first doctor in the hospital, you must Keep in mind that patients who are beyond the capacity of the hospital’s diagnosis and treatment must learn to refuse admission and actively contact the higher-level hospital for admission.
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Anything that goes beyond the scope of practice of the health center must not be Do!
Surgery, anesthesia, blood transfusion and blood products, tumor chemotherapy, hemodialysis, various invasive Examination or treatment, moderate to deep sedation, anyone who receives this type of care is a high-risk patient. Generally, these diagnosis and treatment are beyond the scope of practice of the health center, so they must not be done.
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If it exceeds the personal ability of the first-diagnosing physician, please contact the referral doctor with all my heart Consult!
The patient’s condition or constitution is special, and any diagnosis and treatment operation has a higher risk, such as Elderly patients over 65 years old, children under 6 years old, emergency patients, obstetric patients, immunosuppressed patients, critically ill patients, high-sensitivity patients, etc. You should check carefully and deal with it carefully. The first doctor should provide necessary and limited treatment according to their ability.Contact and transfer the hospital wholeheartedly and wholeheartedly, even a small amount of money is worth it >, because we think about patient safety.
2. Be vigilant! These patients cannot refuse admissionDoes the medical institution have the right to refuse admission? The 2019 China Health Talent Network has made it clear that medical institutions must not refuse to accept medical referrals:
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Emergency high-risk situations
Article 24 of the Law on Medical Practitioners: In critically ill patients, physicians should take emergency measures to diagnose and treat them in a timely manner; emergency treatment should not be refused.”
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< span>Public Health Emergencies
Article 50 of the Regulations on Public Health Emergencies : “If a medical and health institution commits any of the following acts, the competent health administrative department shall order it to correct, circulate criticism, and give a warning; if the circumstances are serious, the “Practice License of Medical Institution” shall be revoked; and other directly responsible persons shall be given disciplinary sanctions of demotion or dismissal in accordance with the law; if it causes the spread or epidemic of infectious diseases or other serious harm to the public health, and constitutes a crime, criminal responsibility shall be investigated according to law.
3. Under the circumstance that the patient cannot be rejectedHow should the health center avoid liability as much as possible?
In Under the circumstance that the health center shall not refuse the patient, it should do the following:
1. Maximize the risk, span>Multiple timesinform the patient and his family members and keep the evidence of notification.
2. The health center should inform the patient of the hospital that has the ability to deal with the patient’s condition, and keep the evidence.
3. Under the circumstance that the facilities of the health center are limited and it is difficult to provide adequate treatment, the health center should be cautious in its own medical behavior, and provide necessary assistance to patients in terms of transfer and other aspects, and retain evidence.< /strong>
The ancients said that “there are six diseases that cannot be cured”, we grassroots doctors may wish to learn a lesson, “Pride and arrogance are irrespective of reason, and one will not be cured; If food and clothing are not suitable, the three cannot be cured; the yin and yang are not stable, and the fourth cannot be cured; the body cannot take medicine, and the fifth cannot be cured; the belief in witchcraft or medicine cannot be treated, and the sixth cannot be cured.”
Grading diagnosis and treatment is by no means a decoration!
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