Author: Medical Law Exchange
Reprint please indicate the source: Medical Law Hui WeChat public account
Fact sheet
Patient Mr. Gao (79 years old) went to the county hospital for treatment due to headache and was admitted to the neurology department on the 6th floor of the inpatient department of the hospital. After treatment, Mr. Gao’s headache improved, no fever, chills, and no convulsions. , generally in good condition.
On the second day of hospitalization, around 1:00 pm, during the nurse’s rounds, the patient got up and attacked the nurse by himself. After being dissuaded by the family members of other patients in the ward, he stopped the aggressive behavior. Then the patient asked to go to the toilet, accompanied by a nurse and immediately notified the hospital security department, the patient’s family and the doctor on duty by telephone, but the patient jumped out of the bathroom window quickly during the process, and it was too late to stop it. After the county hospital’s all-out rescue efforts were ineffective, the patient died at 1:30 that day.
The family believes that the county hospital failed to perform its duties as agreed in the medical contract, failed to fulfill its security obligations, and was at fault, and sued the county hospital to compensate for various losses totaling more than 100,000 yuan.
Court hearing
The court of first instance held that the patient who entered the toilet and locked the toilet door and jumped from the window was at fault and should bear the main civil responsibility; If the security obligation causes damage to others, it should bear the corresponding tort liability. Considering the degree of fault liability in this case, 20% of the compensation liability is appropriate. The county hospital was ordered to compensate the patient for more than 20,000 yuan.
The doctor and the patient both disagreed and filed an appeal. The patient believes that the county hospital should bear 40% of the compensation liability. The county hospital believes that the patient has never shown suicidal tendencies since being admitted to the hospital, and the medical staff has not had any conflicts with him.
The court of second instance held that during the patient’s stay in the county hospital, the two parties established a legal relationship of medical service contract. The family believes that the county hospital has not fulfilled its safety guarantee obligations, and chose to file an infringement lawsuit to require the county hospital to bear the liability for compensation. Therefore, this case should be characterized as a liability dispute for breach of safety guarantee obligations.
From the facts found by the court, there is no evidence to prove that the patient is mentally abnormal and needs special care, and the limit of the hospital’s security obligation can only be determined according to the general patient’s care, and It cannot be required to meet a one-to-one standard of care. In addition, the hospital fulfilled the obligation to accompany the patient, go out, and other reminders related to their own safety when they were admitted to the hospital. The patient died after jumping out of a bathroom window higher than his height. There is no evidence that the county hospital was at fault and the county hospital should not be held responsible.
The original judgment was reversed and all claims of the patient were dismissed.
Legal Brief
A medical service contract refers to a contract agreed upon by both parties that one party (a medical institution) provides medical services, and the other party receives medical services and pays medical expenses. Treatment is equivalent to signing a medical service contract with a medical institution, which does not require both doctors and patients to sign a contract in writing. Medical service contract disputes belong to the fourth-level cause of action under service contract disputes, and the litigants of medical service contract disputes must have a doctor-patient relationship.
Security obligation refers to the obligation of managers of business premises and public places to actively act for personal safety and property safety within the scope of their management. Disputes over liability for breach of safety and security obligations are three-level causes of action, and the fourth-level causes of action are disputes over the liability of operators and managers of business premises and public places; and disputes over the liability of mass event organizers. The object of the medical institution’s fulfillment of the security obligation includes not only the patients who have established a medical service contract relationship, but also other personnel who have not established a medical service contract relationship with the medical institution, such as accompanying personnel.
In this case, the patient committed suicide during hospitalization. In the case of co-occurrence of tort liability and breach of contract liability, the patient can choose either a breach of contract or a tort lawsuit. The infringement lawsuit also includes two cases: medical damage liability disputes and violation of safety guarantee obligations. The court of second instance based on the patient’s claim that “the county hospital has not fulfilled its safety guarantee obligations, and chose the infringement lawsuit to require the county hospital to bear the liability for compensation”. , so as to determine that the cause of this case is a dispute over liability for breach of security obligations.
According to the principle of proof, the parties should provide evidence to prove the facts on which their own claims are based or the facts on which they refute the other party’s claims. Before the court makes a judgment, the parties failed to If evidence is provided or the evidence is insufficient to prove its factual claim, the party who bears the burden of proof shall bear the adverse consequences.
In this case, the patient needed to prove that the county hospital failed to fulfill its safety obligations within a reasonable limit, causing the patient to jump off the building to his death. However, as a person with full civil capacity,There is no evidence to prove that he is mentally abnormal and needs special care, and the county hospital, as a general hospital, cannot restrict the free activities of patients with full capacity for civil conduct. The patient entered the toilet and locked the toilet door and jumped out of the window beyond his height, which also clearly exceeded the county hospital’s safety and security duties within the reasonable limits of the county hospital.
The patient’s condition improves and he chooses to commit suicide by jumping off the building is a waiver of his right to life and health. If the judgment of the court of first instance is upheld, it will form a bad value orientation in the society, which will not only fail to demonstrate The rule of law is fair and just, and it will lead others to pursue improper interests. There is a saying in the law that “if the law is not strong, what is difficult for the man”, no matter how superb medical technology is, it cannot cure those who are bent on death. Therefore, on the basis of ascertaining the facts of the case, the court of second instance changed the judgment that the county hospital was not liable and rejected all the claims of the patient, demonstrating the fairness and justice of the law.
Although the county hospital in this case did not take responsibility, it should also attract the attention of various medical institutions, actively prevent, continuously improve, vigorously promote hospital safety management, and avoid legal risks.
(This article was originally written by the Medical Law Institute, adapted from a real case, using a pseudonym to protect the privacy of the parties)