摘要
目的通过对涉及死亡的医疗损害案件进行分析,探讨医疗损害案件的鉴定思路和方法。方法收集南方医科大学司法鉴定中心2012年1月-2017年12月受理并结案的291例涉及死亡的医疗损害案件,对被鉴定人的年龄、性别、医院等级、临床科室、是否尸检、死亡原因、医疗过错原因、因果关系及原因力大小等方面进行统计分析。结果涉及死亡的医疗损害案件中,男性多于女性,青壮年及儿童居多。涉及三级医院的案件数最多,临床科室以内科最多,其次为外科、妇产科、儿科等。尸检率具有逐年增加的趋势。大多数患者的死亡为自身疾病的自然转归或治疗无效。大部分医院都存在一定的医疗过错行为,与患者的死亡有间接的相关性,以轻微因素为主。结论医疗损害鉴定应遵循多因一果的原则,需综合考虑自身疾病、自身体质、疾病自然转归、目前的医疗技术以及就诊医院的诊疗水平等。
Objective To study the medical malpractice cases involving death, and discuss the identification ideas and methods of medical malpractice cases. Methods A total of 291 medical malpractice cases involving death accepted and settled from January 2012 to December 2017 at the Judicial Appraisal Center of Southern Medical University were collected. Based on the age, gender, hospital level, clinical department, whether or not autopsy was performed, cause of death, cause of medical mistakes, causality and causative potency of the appraised person, statistical analysis was made. Results There were more males than females in medical malpractice cases involving death. Mostly young adults or children were involved in these cases. The number of cases involving tertiary hospitals was the highest;among the clinical departments, the internal medicine department had the largest number of cases, followed by surgery, obstetrics and gynecology, pediatrics, etc. Autopsy rate has a trend of increasing year by year. Most patients die from the natural outcomes of their disease or ineffective treatment. Most hospitals have certain medical mistakes, and have an indirect correlation with the patient’s death, mainly slight factors. Conclusion Judicial appraisal of medical malpractice should follow the principle of"oneeffect and multi-cause", and comprehensively consider various factors such as, the diseases and constitution of the patient, natural outcomes of the diseases, the current medical technology and the level of diagnosis and treatment of the hospital, etc.
作者
陈莉坚
练勇伶
李丽增
岳霞
乔东访
李冬日
王慧君
王起
CHEN Li-jian;LIAN Yong-ling;LI Li-zeng;YUE Xia;QIAO Dong-fang;LI Dong-ri;WANG Hui-jun;WANG Qi(School of Forensic Medicine,Southern Medical University,Guangzhou 510515,China)
出处
《法医学杂志》
CAS
CSCD
2019年第6期701-705,共5页
Journal of Forensic Medicine
基金
国家自然科学基金资助项目(81871526)
关键词
法医病理学
回顾性研究
死亡原因
医疗损害
案例分析
forensic pathology
retrospective studies
cause of death
medical malpractice
cases analysis
