[Facts of the case].
On May 15, 2017, the patient, Ms. H, went to Hospital A for a week with cough and white sputum for no obvious cause, and the chest CT showed that the anterior mediastinal mass was considered. For further surgery**, he was transferred to Hospital B**.
On May 16, 2017, after being admitted to Hospital B, an associate professor inspected the patient and instructed that the patient's anterior mediastinal mass was considered, thymoma was considered, there was no muscle weakness, and there was an indication for surgery, and the examination was perfect.
On May 19, the hospital informed the patient and his family that the department discussed the opinions and the risks related to the surgery, signed the informed consent form for the operation, and underwent the surgery on an elective date**.
On May 22, the surgical exploration and separation process ** showed total trunk hemorrhage in the left pulmonary artery, at 12:00, the patient suddenly suffered cardiac arrest, and was immediately given intracardiac compressions and intracardiac defibrillation, 15 minutes later, cardiac cardioversion, continued to strengthen sutures to stop bleeding, no obvious active bleeding was seen, and the patient suffered cardiac arrest again at 12:30 in the process. After 3After 5 hours of rescue, the patient's heart failed to rebeat, the pupils were dilated, and the aortic pulse disappeared, and he was declared clinically dead at 15:30.
[Rights Protection History].
After the patient filed a lawsuit, the court of first instance entrusted a judicial appraisal in accordance with the law according to the patient's application, and came up with an appraisal analysis opinion
1.When the nature of the anterior mediastinal mass is not clear, the hospital should take a variety of measures such as imaging examination, surgical pathology, serum AFP and -HCG to further confirm the diagnosis of the nature of the anterior mediastinal mass. However, the hospital did not conduct relevant examinations before the operation, and there were certain deficiencies.
2.The review of the medical records submitted for examination showed that the choice of the two options and the interpretation of the pros and cons were not reflected in the written record, so the hospital had deficiencies in the notification of the surgical plan.
3.In this case, the intraoperative exploration showed that the mass was closely adhered to the innominate vein, the aortic arch, the left pulmonary artery common trunk and the pericardium, and the free mass was tried to adhere to the aortic arch, and the local area could be barely separated. When the common trunk of the left pulmonary artery, which is tightly adhered to the mass, separates, the arterial hemorrhage is fatal. The hospital's intraoperative operation behavior did not meet the requirements of clinical norms, and there was medical negligence, which had a causal relationship with the patient's eventual death.
The causal relationship between the hospital's medical fault and the death of the person being evaluated, and the degree of causal force is analyzed from the standpoint of technical appraisal, and it is suggested that it is in the range of the same to the main degree.
[Court Decision].
The court of first instance held that both parties did not raise any objection to the appraisal qualification and appraisal procedures of the appraisal center, so the court adopted the appraisal opinion in accordance with the law, and determined that Hospital B should bear 65% of the liability according to the appraisal opinion within the same range as the main causal force.
After the judgment was rendered, the defendant hospital was not satisfied, arguing that the first-instance judgment was unfair. Patients have advanced tumours and have a limited life expectancy. In the first instance, Hospital B was held liable for 65%, of which the death compensation was calculated for 19 years, assuming that the opinion of the appraisal opinion that malignant lymphoma invaded the large blood vessels could be established, it was obviously unfair to receive a huge amount of compensation for such a serious advanced tumor because of the controversial medical acts.
The patient argues that as long as the doctor handles this case properly, the patient can get the correct and appropriate **, and it is entirely possible to get a good ** effect and prognosis, and even **. The medical fault of the doctor increases the unreasonable medical risk of the patient's bleeding in the left common pulmonary artery, and the rescue of the hemorrhage of the large mediastinal vessel is very difficult, so there is a causal relationship with the patient's death.
The court of second instance held that the focus of the dispute in this case was: the determination of the fault participation of Hospital B. The key issues in this case are analyzed and determined as follows:
As pointed out in the appraisal opinion, there are two options for the patient's diagnosis and treatment plan, and for these two ** plans, the patient should choose after hospital B has fully informed the patient, but it is not seen in the written materials that hospital B has fulfilled the obligation to inform, so this hospital believes that hospital B has insufficient notification, and the insufficient notification also has a causal relationship with the patient's damage results. With regard to the issue of the determination of the fault participation of Hospital B, after review, the appraisal and analysis opinions were scientific and reasonable, and sufficient analysis and response were made to the questions raised by both the doctor and the patient, and the appraisal procedure was legal, and the court of first instance found that Hospital B bore 65% of the liability, which was not improper and within a reasonable range, so the grounds of appeal against Hospital B were not adopted. The original judgment was affirmed.
The first-instance judgment is that Hospital B shall compensate 719461 the patient in a lump sum within seven days from the date on which this judgment takes legal effect35 yuan.
The original verdict was upheld in the second instance.
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