摘要
目的:旨在对涉及骨科的医疗损害责任纠纷进行分析,并为减少此类纠纷以及相关鉴定工作提供思路。方法:搜集下载河南省“2017-2021”年中国裁判文书网公布的二审判决书1024例,其中涉及骨科的医疗损害责任纠纷案例共168例,对医疗损害责任过错、原因力大小及赔偿等进行分析。结果:168例中判定医方赔偿153例,涉及医院178家且以三级医院居多46.63%(83/178)。四肢(胫腓骨、股骨、膝关节、踝关节、尺桡骨等)相关的医疗损害责任纠纷占64.89(109/168),与躯干(腰椎、胸椎等)相关的占33.33%(56/168)。其中,手术操作不足22.62%(38/168)和术后并发症(感染、延迟愈合、血栓形成等)控制不佳19.01%(32/168)是纠纷的主要原因。骨科医疗损害责任后果与残疾相关的案例居多57.74%(97/168),以七级以下为主64.95%(63/97),院方赔偿总额占索赔总额的28.62%(3562.58万元/12445.89万元)。司法鉴定94.74%(198/209)较医学会鉴定54.50%(6/11)、采信率高(P<0.05)。结论:骨科治疗风险较高,赔偿责任重;临床骨科应加强术中操作、术后并发症的风险防范;骨科医疗损害责任纠纷7级以下伤残为主,司法鉴定在骨科医疗损害责任纠纷案件审判中发挥重要作用。
Objective:To analyze medical malpractice involving orthopedics for reducing such disputes and retrial appraisal work.Method:A total of 1024 files of second instance verdict Published on the China Judgment Document Network from 2017 to 2021 in Henan Province were collected,including 168 cases of medical malpractice of orthopedics.An analysis was conducted on medical fault,causality,causal factors,and compensation.Results:Among the 168 cases,153 were awarded medical compensation involving 178 hospitals and 46.63%(83/178)being tertiary grade hospitals.64.89%(109/168)were related to the limbs(tibia,fibula,femur,knee joint,ankle joint,radius and ulna,etc.)accounted for,and 33.33%(56/168)were related to the trunk(lumbar vertebrae,thoracic vertebrae,etc.)in the medical malpractice.22.62%(38/168)of surgical Procedures were insufficient,and19.01%(32/168)of postoperative complications(infection,delayed healing,thrombosis,etc.)were difficult to control in the main reasons for medical malpractice.Disability of orthopedic medical malpractice was 57.74%(97/168),and disability below seven level was 64.95%(63/97).The total compensation from the hospital accounts was 28.62%of the total claims(35.62 million yuan/124.45 million yuan).The acceptance rate of judicial appraisal94.74%(198/209)had a higher than the rate of medical association appraisal 54.50%(6/11)(P<0.05).Conclusion:Orthopedic treatment carries high risks and heavy liability for compensation;Clinical orthopedics should strengthen the risk Prevention of intraoperative operations and postoperative complications;The disability of orthopedic medical malpractice is mainly below seven level,and judicial appraisal Plays an important role in the retrial of orthopedic medical malpractice.
作者
马壮壮
梁白薇
张俊涛
翟仙敦
姚业伟
李超
潘新民
Ma Zhuangzhuang;Liang Baiwei;Zhang Juntao;Zhai Xiandun;Yao Yewei;Li Chao;Pan Xinmin(College of Basic Medicine and Forensic Medicine,Henan University of Science and Technology,Luoyang,Henan Province 471023,China;Henan Academy of Social Sciences,Zhengzhou 450002,China;Special Medical Research Institute of Henan University of Science and Technology,Luoyang,Henan Province 471023,China;Judicial Appraisal Center of Henan University of Science and Technology,Luoyang,Henan Province 471003,China)
出处
《卫生法学》
2024年第6期114-120,共7页
Health Law
基金
2021年最高人民检察院资助课题“刑事检察技术性证据专门审查监督纠错作用研究”(GJ202159)
河南省科技攻关计划项目“基于转录组学的急性药物肝损伤生物标志物筛选研究”(222102310398)。
关键词
医疗损害
骨科
司法鉴定
二审判决
赔偿
Medical malpractice
Orthopedics
Judicial appraisal
Second instance judgment
Compensation
