First, the scope of medical service contracts and medical disputes
According to Modern Chinese Dictionary, medical treatment is the treatment of diseases. Generally speaking, the explanation of this word should be said to be correct. No disease, no medicine, no disease, no cure. However, with the development of the times, the types of diseases have changed, and whether they are diseases is also changing. For example, when people get old, bags under their eyes appear, which was not a disease before; When people get old, they lose a lot of hair, which is not a disease. Not to mention the elderly, some young people grow white hair prematurely, which is called "white hair" at most. Others don't take it seriously, and some don't. However, times have changed and people are pursuing beauty. What they used to take for granted may now be considered as a disease or need treatment. That is to say, in some ways, it becomes a part of medical treatment to improve a person's body or parts, such as plastic surgery. So, can it be said that the so-called medical care should be expanded, that is, it includes medical care, including hospitalization surgery, seeking medical advice and cosmetic surgery; Treatment: Treatment, including recuperation, physical therapy and massage. Therefore, the scope of medical service contract should include its due scope.
1, medical dispute. Some patients, who have not recovered from a long illness, don't trust the hospital and are dissatisfied with the finished medicine, and look for remedies everywhere. Some were found by friends, some were read in newspapers and magazines, and some were turned out from medical books. So I took the medicine according to the prescription, and there was a poisoning accident. Some of the reasons for the accident are that the prescription published in the newspaper is wrong, some toxic components exceed the standard, some are not serious, and the prescription is wrong; Some pharmacy pharmacists misread the dose or the palm; Some drugs are incompatible with taboos.
2. Various disputes during hospitalization. The patient is hospitalized due to illness, which has a lot to do with the hospital. The more relationships there are, the greater the possibility of disputes. The medical contract relationship between the patient's hospitalization and the hospital has been formed, and the patient enjoys many rights, but of course he has to bear the necessary obligations. Patients' obligations are mainly to pay medical expenses and file hospital instructions. The rights of patients should be said to be multifaceted, and the opposite of patients' rights is the obligation of hospitals. No matter which party violates its obligations, there will be disputes.
(1) Patients have the right to know. Patients have the right to know their own diseases, drugs they need to use, drug prices and the consequences after treatment, and hospitals have the obligation to inform them. If the hospital ignores or ignores this and violates the obligation to inform, it should bear the corresponding responsibility.
(2) Patients have the right to choose. When patients have a correct understanding of what they should know, they have the right to treat their own diseases or not. Of course, if it is a minor, this right should be subject to certain restrictions, that is, it should be exercised by its legal representative. Medical institutions should fully respect patients' right to choose. If they ignore or ignore this right and go their own way, they should bear the responsibility.
(3) Patients have the right to appropriate treatment. When a patient visits a hospital or other medical institution, the hospital shall undertake the obligation of special care. The patient should be carefully examined, and the disease should not be examined as no disease, and the minor illness should be examined as a serious illness or even a terminal illness; Treatment should be serious, and careless and irresponsible situations are not allowed, such as leaving scalpels, scissors or gauze in the abdominal cavity during the operation and mistakenly removing ovaries as tumors.
(4) Patients have the right to life and health in the hospital. In addition to the normal requirements of treating and curing diseases and improving physical condition, patients also enjoy the right to normal life and good health. In the hospital, patients should not suffer accidental injuries because of the defects of medical facilities. If oxygen transmission is needed, the oxygen transmission facilities are not in place and the rescue is not timely, resulting in the death of the patient; The patient fell down because the toilet was out of power at night and no one repaired it.
(5) Patients have the right to fair service. What disease does the patient spend money on, what medicine to use and how much medicine to use. At the same level of hospitals, the charging standards should be roughly the same. If they spend money to treat onychomycosis (high fees), spend money on drug A (high prices), and also spend money on useless drugs (overcharge, various excuses to charge), arbitrary charges (hitchhiking), and excessive fees (excessive fees).
3. Disputes caused by cosmetic surgery. Everyone loves beauty, and in recent years, there have been more and more disputes caused by beauty. There are scars and dysentery caused by cutting double eyelids; Some are inflamed and ulcerated because of breast augmentation; , skin pigmentation caused by long-term use of beauty products; Some people have plastic surgery to disfigure their faces.
Second, some basic principles for handling medical dispute cases.
Because in the past, when dealing with disputes between doctors and patients, the identification of medical accidents was often used as the pre-procedure. First of all, the case will not be accepted without identification. Second, cases that have not been identified as medical accidents by the medical accident appraisal Committee will not be accepted. If the patient insists on prosecution, the prosecution will be rejected at the filing stage. After the Supreme Court made a new stipulation that medical malpractice appraisal is not a necessary pre-procedure, most judges are still used to the old practice. Therefore, several principles should be mastered in trying medical dispute cases well.
1, adhere to the principle that medical accident identification is not the first. The Supreme Court stipulates that the trial of medical dispute cases is no longer based on medical malpractice identification, which is not only a buffer for the procedural comfort and dissatisfaction of the parties, but also a denial of past practices. Because giving priority to medical malpractice identification is undoubtedly equal to the identification of medical malpractice and the judgment of the court, because without or without medical malpractice identification, not only can we not win the case, but we are not even qualified to sue. The previous medical malpractice appraisal protected the legitimate rights and interests of the parties to a certain extent. However, because the appraisal committee is often composed of local medical experts, letting them make their own appraisal is tantamount to taking a drastic measure, and its fairness is greatly reduced, which is hard for patients to believe.
2, adhere to the principle of equal status between doctors and patients. The doctor is the owner of the hospital and the god of the patients. It can be said that the fate of patients is in their hands. Some doctors don't think they are treating patients and serving them, but what patients want from themselves. China has already provided medical care at public expense.
3, adhere to the principle of fault. The fault principle here is not only the fault in the process of treating patients, but also the fault in the whole process of fulfilling medical contracts. That is, in the performance of medical contract, the general principle of contract law is violated, that is, there is fault. Essentially, it is the principle of good faith stipulated in the contract. If one party to a contract violates the principles of the contract, it will be liable for breach of contract.
Third, the handling of some specific medical dispute cases.
1. Handling of cases of infringement of the right to know
As a kind of contract, a medical service contract is also a kind of service. Article 8 of the Consumer Protection Law stipulates that "consumers have the right to know the real situation of the goods they buy or use or the services they receive" and Article 9 stipulates that "consumers have the right to choose their own goods or services". In other words, as a patient, he has the right to know the treatment process of his disease, the treatment measures to be taken, the purpose of treatment, the cost of treatment and the possible adverse consequences, and have a clear understanding. Then, the patient can make a choice independently and freely, that is, whether to treat, whether to agree to undergo surgery that is considered necessary by medical treatment or to use drugs recommended by the hospital. On this issue, the medical behavior of the hospital is divided into two parts: behavior and treatment behavior, and no matter which part is at fault, it must bear legal responsibility. For example, patient Chen Mou went to the hospital for lipoma resection of the left eye. Postoperative ptosis of the left eye occurred. Chen Mou believes that medical accidents in hospitals need to be identified. The appraisal results show that there is no problem in the hospital's diagnosis and treatment, and the patient's ptosis is a surgical complication, not a medical accident. Chen Mou filed a lawsuit on the grounds that the hospital was at fault in treatment and had not informed of the consequences of the operation before, demanding that the hospital compensate for the loss of 250,000 yuan. The court of first instance found that there was no fault in the hospital's diagnosis, but based on the fact that the hospital voluntarily paid part of Chen Mou's economic compensation, it allowed the hospital to pay compensation of 30,000 yuan while rejecting Chen Mou's claim. Chen Mou refused to accept the appeal. After trial, the court of second instance held that although the hospital was not at fault in the process of diagnosis and treatment, it did not inform Chen of the consequences of the operation, which led to the inability to choose whether to operate or not, which violated the right to know. Therefore, the hospital should bear legal responsibility. The hospital compensated Chen Mou for more than 60,000 yuan at one time. This shows that in order to treat some diseases, during the operation, some inevitable adverse consequences may occur while treating some diseases. For these adverse consequences, as a medical unit, it has the ability to know and the obligation to inform patients. Then, the patient can decide whether to perform this operation or not. If the patient still chooses surgery while knowing the consequences, the adverse consequences after surgery should naturally be borne by the patient himself. For example, if a patient has a malignant tumor in his leg, it must be amputated, otherwise it will be life-threatening. Then the patient has the right to choose whether to amputate. If the hospital does not inform, it will violate the obligation to inform and bear legal responsibility. 200 1 1 1 "Zhejiang Province
2, medical equipment, medical products unqualified damage disputes.
In some medical processes, the treatment of certain diseases requires the use of certain medical equipment or new medical products. As a hospital, one is to ensure the quality of medical equipment and new medical products, and the other is to ensure the correct guidance and service for the use of medical equipment and new medical products. If disputes arise from this, we should bear corresponding responsibilities according to the principle of fault. Medical devices and new medical products are unqualified, which may be the responsibility of manufacturers, but as a medical treatment, we should bear the responsibility first. For example, Zhao, a student in Mudanjiang City, saw in a hospital that the use of the newly introduced "OK" lens can quickly reduce myopia patients below 500 degrees to below 75 degrees, with a success rate of over 95%. With this method of treatment, natural vision can be restored in a week or so. After a month of consolidation and stability propaganda, he went to the hospital for treatment. The hospital handed over the relevant inspection materials to Zhao's "OK" lens manufacturing company and put on "OK" lenses for him. Zhao got the "ok" mirror back in August, 1999. The mirror has no place of production marked in Chinese and no warning instructions. The hospital only gave Zhao Yi a copy of the "Instructions for Patients" formulated by the hospital. There are no explanations and warnings about the possible consequences of using this mirror in the instructions for use. Because the mirror accessories were not mailed to the hospital in time, the hospital handed over half a bottle of nursing liquid, artificial sputum suction stick and other accessories used by other patients to Zhao. 1August 2, 999, Zhao started to use lenses, only to find that the lenses were eccentric. He went to the hospital several times to report the situation, and the hospital replied, "Just wear it for a while and make sure it doesn't hurt your eyes." By June 5438+ 10 of the same year, Zhao found that his eyes were red and swollen and went to several hospitals for treatment. Because of wearing "OK" glasses, he was diagnosed with Pseudomonas aeruginosa corneal ulcer in the right eye. After treatment, his right cornea left a white spot, which should be treated with corneal transplantation. Zhao took the hospital to court. The court of first instance rejected the claim on the grounds that Zhao did not agree to make a medical accident appraisal. The court of second instance supported the appellant's claim and awarded the hospital compensation for medical expenses and disability compensation 9853 1. 10 yuan according to the Product Quality Law and the Consumer Protection Law. The first instance of this case, including the first instance and the second instance, is correct for the court to conclude that it is not a medical malpractice dispute. Because in this case, Zhao's corneal injury was caused by wearing "OK" glasses, not by the diagnosis and care of the hospital medical staff, which is correct, especially because the "OK" glasses recommended by the hospital did not have the product quality inspection certificate, and the packaging did not indicate the place of origin, address and warning label. The product has serious indication defects and does not meet the product quality requirements. However, on the one hand, it is considered that the damage result has nothing to do with the diagnosis and nursing behavior of the hospital medical staff, on the other hand, it is considered that the hospital should implement the inspection and acceptance system for "OK" mirrors to verify the product certificate; After receiving the "OK" lens, they are obliged not to inform the eyes of the possible dangers caused by incorrect wearing of the "OK" lens on the cornea; In particular, Zhao put forward that wearing glasses was inappropriate, which not only failed to deal with it, but also irresponsibly guaranteed that there would be no problem that caused Zhao's right eye to be disabled at grade 9. The hospital was at fault, so the product quality law was applied. In our opinion, "OK" mirror as a product, there is no quality problem. But this product was not purchased by Zhao himself from this store. Instead, I listened to the propaganda of the hospital and was recognized by the hospital. It is also used under the guidance of the hospital. When there was a problem, it was precisely because of the guarantee of the hospital staff that Zhao Cai continued to wear it. The injury caused here is caused by the inaction of the hospital. So the dispute between the two sides is still a medical dispute between doctors and patients. Imagine that if the hospital immediately examined Zhao when he suggested that he was inappropriate, he might no longer wear "OK" glasses, and the final damage result might not appear. The relationship between Zhao and the hospital is not just a business relationship like buying goods or medical devices in a store, so it is by no means a general product quality liability dispute. In this case, there are both the problem that the hospital failed to fulfill its obligation to inform and the problem of irresponsibility in the treatment process. Because in this case, Zhao went to the hospital for treatment, went to the hospital for examination and customized an "OK" mirror for Zhao, until Zhao's eyes returned to normal, and the two sides had formed a medical contract relationship. The fault of the hospital is precisely because of breach of contract, which has developed into infringement from breach of contract to making Zhao's eyes disabled. Therefore, it is no problem to sentence the hospital to bear the liability for compensation. It can also be seen from this case that in the case of medical damage, you can't hang yourself from a medical appraisal tree as in the past.
3. Disputes arising from damage caused by imperfect hospital service facilities and conditions.
As a medical institution, mainly a hospital, it is necessary not only to have an appropriate number of medical personnel and medical facilities with a certain professional level, but also to have conditions suitable for patients to treat and seek medical treatment during hospitalization. The word "waiting for medical treatment" quoted here means that patients need to eat and live in the hospital because of their own conditions (such as serious injury, serious illness, and inability to travel between home and hospital). In this way, in addition to providing medical conditions, hospitals should also provide patients with the same normal living conditions as at home, including eating, living, traveling and going to the toilet. If these conditions are not available or perfect, and there are defects, which cause damage to patients, they should bear the responsibility. For example, patient Liu underwent "total hysterectomy" in the hospital on June 9, 2000, went to the toilet with her husband Zhang on the evening of June 2, 2000, and waited outside after arriving at the toilet. At that time, the light in the toilet was broken and there was no electric light. As a result, Liu fell down because there was no light in the toilet. After examination, Liu skull fracture suffered from subdural hemorrhage in the right temporal region and died after being rescued. Liu's relatives sued the court for compensation. The court of first instance held that Liu and the hospital had formed a medical service relationship, and the hospital should provide corresponding medical services. Toilets in inpatient departments are necessary ancillary facilities for medical units to provide medical services. There is no electric light in the women's toilet at night, which fully shows that the medical facilities it should provide are flawed. On the grounds of hospital infringement, the hospital was sentenced to compensate the economic loss of 46,660.50 yuan. The hospital refused to accept the appeal on the grounds that Liu's husband was not properly accompanied and there was no clear standard in the Second Hospital, arguing that he should not bear the responsibility. After examination, the court of second instance held that the doctor-patient relationship belongs to the medical service contract relationship. Hospitals should not only provide treatment services, but also provide complete service facilities. However, the fact that there was no light in the toilet made Liu fall down and die while going to the toilet. If the hospital breaches the contract, it should bear Liu's liability for compensation. If the cause of action is found to be inaccurate in the first instance, it shall be corrected, the appeal shall be rejected and the original judgment shall be upheld. Looking at this case, it is correct that the judgments of the first and second instance should be compensated, but the court of second instance changed the lawsuit of infringement from the court of first instance to the lawsuit of breach of contract, and it was correct to identify the nature of the case. Whether the hospital violates the contract or not, the hospital thinks there is no clear stipulation, which is incorrect. Don't say hospital. Many of them are sick and injured, and some of them are disabled. They go to the toilet at night, not to mention there is no lighting, or the lights are dim, which may cause them injuries. So the fault of the hospital should be obvious. This kind of fault is not directly caused by the hospital itself, but a breach of contract when performing the medical contract, so it should bear the responsibility for breach of contract. As for Liu's husband, that's another problem, and it's a minor one.
4. Disputes arising from the damage consequences caused by hospital safety measures.
As a hospital, it is a place for patients to seek medical treatment, and a medical service relationship has been formed since hospitalization. In addition to proper treatment of patients' diseases, it is also necessary to ensure their personal and all aspects of safety. If the patient suffers personal injury or other personal-related damage because of loopholes in the public security of the hospital, the hospital should also bear the necessary compensation. For example, patient Wang had a caesarean section in the hospital, and one person lived in a room. The hospital put the baby in the room to live with his mother at night. Wang's husband is a nurse and lives in the same room. Because both of them were too tired to sleep, they woke up to find that the child was gone. Wang took the hospital to court. The hospital refused to pay compensation on the grounds that Wang and her husband should not fall asleep at the same time. After investigation by the court, the hospital has unwritten rules that all rooms are not allowed to pull doors from the inside at night, and there is no facility to pull doors from the inside. As a court, this case is also based on the rights and obligations of both parties to the service contract to distinguish responsibilities. Patients who give birth in hospitals have the right to personal safety of themselves and their children, and hospitals should also bear corresponding obligations. If the hospital is not allowed to draw doors, it should be able to ensure the safety of the hospital at night. In other words, when the patient and the nursing staff are asleep, there will be no personal safety accidents. The escort is not a security guard, and has neither the obligation to care for patients without sleeping nor the obligation to protect hospital safety. When considering certain rules, hospitals should not only consider factors that are beneficial to their own work and protect their own interests, such as preventing patients from committing suicide, but also consider factors such as theft, beating and robbery when others invade the ward. Therefore, if the hospital neglects to consider safety facilities and eventually causes personal injury to patients, it should bear the corresponding liability for compensation. . Of course, this kind of liability is also the liability for breach of contract.
5. Disputes caused by medical error damage.
Now we have made a distinction between medical malpractice damages and medical service contract disputes. In fact, these two cases have been strictly regarded as two cases in the division of civil causes of action in China. Compensation for medical malpractice damages is a case of infringement of personal rights, while medical service disputes are service contract disputes. Damages for medical accidents refer to damages for death, disability and dysfunction caused by the negligence of medical staff in the process of diagnosis and treatment. Compensation for medical errors is the damage caused by medical staff's mistakes in diagnosis and treatment, which does not constitute a medical accident after identification, or the parties do not require medical accident identification. In this kind of compensation cases, it is often that both sides hold their own words and are consistent. In view of this, such disputes should be handled according to the situation.
(1) If the medical party admits that there is a fault, and the content and degree of the fault have been mastered and confirmed, the patient agrees. The court can compensate according to the size of the fault and the degree of damage.
(2) If the two sides have a big dispute and cannot reach an agreement, the medical fault shall be identified. What is particularly emphasized and paid attention to here is the identification of medical errors or medical errors, not the identification of medical accidents. What is medical fault identification? The Supreme People's Court Institute of Judicial Science and Technology clearly pointed out in the article "Classification and Appraisal of Medical Disputes" published in People's Court Newspaper that "medical fault appraisal refers to that the people's court entrusts people with specialized knowledge to analyze, evaluate and judge whether there are medical faults and the degree of damage caused by them in the process of providing medical services, and its essence is that the people's court exercises the right to decide, entrust and supervise the appraisal." At the same time, the article also emphasizes that "medical malpractice appraisal should be organized by the judicial appraisal institution of the people's court and carried out by combining medicine with forensic medicine, instead of entrusting the medical malpractice technical appraisal Committee of the health administrative department." Because: a, the medical accident appraisal must be signed and sealed by the appraiser to have legal effect. Litigation evidence must be objective, relevant and legal, and at the same time, it should conform to the legal characteristics of appraisal, that is, the people's court decides and entrusts the appraisal, and the appraisal conclusion is made in the litigation stage, and the expert responsibility system and court appearance system are implemented. Medical malpractice appraisal does not have the above characteristics, and it should not and cannot be the pre-procedure and premise for the people's court to accept litigation cases, let alone effective evidence in litigation. Moreover, the medical malpractice in the field of medical administration that is not recognized by the medical malpractice appraisal Committee does not mean that there is no medical fault in civil tort. B, the identification of medical fault is not only a simple clinical medical identification process, but also must use forensic theory and practical experience to analyze and judge. For example, the technical appraisal of medical record modification and alteration, the appraisal of the injury time and injury mode of the patient's original injury, etc. C. Medical fault identification organized by the judicial authentication institutions of the people's courts according to law, with the third party as the center. The appraiser and the appraisal institution sign and seal, bear corresponding legal responsibilities, and have strict supervision and management, misjudged case investigation and the system of appraiser appearing in court, which can effectively ensure the fairness and scientificity of appraisal and the seriousness and authority of judicial trial. Medical fault identification, medical accident identification and medical accident crime identification constitute a unified and complete medical dispute identification system. If it is identified that the medical department is at fault, it shall bear the corresponding liability for compensation.
(3) The content of medical error identification. At present, medical malpractice identification is common in medical disputes in China, that is, to identify whether a medical incident constitutes a medical accident. China's "General Principles of Civil Law" does not stipulate that compensation can only be made if it constitutes a medical accident, but if it is at fault, it should be compensated. Medical error identification and medical accident identification have different contents and requirements. The contents of its appraisal should include: first, whether there are any damage consequences. What I'm talking about here is the consequences of damage, which should not happen in the medical process. It is not a treatment act taken by a medical unit with the consent of the patient or his legal representative in order to treat the patient. Such as: thigh amputation, removal of patients' organs; Nor is it the result of the side effects and damage caused by medical measures themselves in the medical process; It is not an irreversible result of the patient's own disease development, such as the patient's death a few months after cancer surgery. That is, people often say that curing a disease can't cure a life. Second, the cause of the damage. That is, the diagnosis is wrong, or the surgical plan is improper or the surgical technique is not high, or the surgical object is wrong. Third, the proportion of responsibility of medical units for the consequences of violating contractual obligations. Fourth, whether there is any problem with the medical records of medical units, whether there is any tampering or forgery, etc. For example, in a medical damage compensation case, the patient was first appraised by the medical accident appraisal committee, and it was considered that according to the appraisal principle of medical accident, it did not constitute a medical accident. The plaintiff refused to accept, and the court entrusted Beijing Institute of Judicial Appraisal Science and Technology to conduct forensic identification of the patient. The identification results are as follows: 1. The hospital mistook the patient's right testis for hernia during the operation, which may lead to the displacement of the right testis. Second, the hospital mainly has the following defects in the process of patient diagnosis and treatment: (1) The preoperative examination is not perfect and the diagnosis is not clear. (2) The operator is inexperienced and does not pay attention to the position of the posterior testis. (3) There are defects in the writing of medical records, which are mainly manifested in the inconsistency and contradiction between the surgical records of hernia repair and the postoperative medical records. The position of the patient's testis is still good, no substantial injury is found, and the right testis still has symptoms such as swelling and pain. According to relevant regulations, this situation does not constitute a disability. From then on, forensic identification can clearly understand whether there is a fault in medical treatment, the size of the fault, whether it causes damage and whether it should be compensated. Compared with general medical malpractice identification, it is more convincing. Whether it is compensation or not, both doctors and patients are more acceptable.
(4) Pay attention to the defects in medical behavior, but compensation is not suitable for the damage caused by different medical levels or different understanding of diseases. In practice, in the diagnosis or treatment of diseases, we can't judge the nature of diseases very accurately at once, or we can start to judge diseases and perform operations according to this judgment. However, after further analysis and testing, we have a different understanding of the disease. In this case, it is inappropriate to award compensation. For example, in the compensation, the patient is a young woman, and when she was admitted to the hospital, she found that "the right breast mass is to be investigated; Lobular hyperplasia of the right breast? " Before operation, the hospital carried out puncture cytological examination and various routine examinations. The surgical plan was carefully discussed. Because the possibility of malignant tumor could not be ruled out, it was decided to perform "right breast tumor resection+quick frozen section examination" on the patient. If the pathological report of quick-frozen section diagnosed the lump as malignant, it is planned to carry out "improved radical operation" and inform the relatives, who will sign it. Later, when the part was considered malignant, it was completely removed. But later, after different medical units tested the sections, some thought they were not malignant. Because this kind of tumor is rare, it is not easy to define at the initial stage. However, as a patient, it is really painful. In this case, if it really belongs to the medical level, it is difficult to accurately identify the fault of the medical department and cannot rashly judge that the medical department should bear the responsibility. However, in this case, some medical departments should be allowed to give appropriate compensation voluntarily out of sympathy for patients.
(5) If a medical unit is injured and dies for other reasons, it shall not bear civil liability. For example, in some medical disputes, the victims were injured for other reasons (such as traffic accidents, being killed, being robbed, fighting, accidents, etc.). ), but in the process of rescue due to serious injuries or poor medical conditions failed to rescue success. If the medical unit is not at fault, it should not bear the responsibility. For example, on August 10, 2000, Chen Mou was sent to the hospital for emergency treatment due to a car accident. The hospital immediately carried out rescue measures such as B-ultrasound without charging a deposit, and pressurized the wound, and established anti-shock treatment for venous access. Due to the serious injury, the hospital transferred Chen to the Municipal People's Hospital for treatment. However, Chen Jing died after being rescued. Appraised by the two-level medical accident appraisal committee, it not only does not constitute a medical accident, but also has no medical fault. After Chen Mou's family sued, the court of first instance held that although the hospital was not at fault and should not be held responsible for his death, it sentenced the hospital to pay 2,000 yuan to stabilize social order and resolve disputes. The hospital refused to accept the appeal. Chen Mou, the main partner of the court of second instance, was crushed in the chest and abdomen due to a traffic accident, resulting in acute hemorrhagic shock and death. The two-level medical accident appraisal committee believes that the hospital did not violate the medical routine in the rescue, and the rescue measures taken include the implementation of transfer to meet the requirements of medical operation, and the possibility of Chen's death caused by improper rescue by hospital staff was ruled out. The direct cause of Chen's death was a traffic accident, and the medical staff had neither intention nor negligence. Therefore, hospitals should not be liable for compensation, nor should they be liable for compensation.
Several problems to be paid attention to in the trial of medical dispute cases
First, the identification of the causes of medical disputes
The medical service contract is a contract that clearly defines the mutual rights and obligations between medical institutions and patients, and it is also the basis for disputes between medical institutions and patients. When patients are damaged due to the fault of medical institutions or medical personnel, there is a phenomenon of concurrence of liability for breach of contract and liability for tort. The contract law gives the parties the right to choose. The Regulations on Handling Medical Accidents is to investigate the tort liability. Article 1 of the Notice of the Supreme People's Court on Trial of Civil Cases of Medical Disputes with Reference to Regulations on Handling Medical Accidents stipulates that other medical compensation disputes caused by reasons other than medical accidents shall be governed by the provisions of the General Principles of Civil Law. One is to affirm the remedy of tort law, and the other is "for reasons other than medical malpractice", which means that in addition to investigating tort liability, liability for breach of contract can also be investigated. The parties may choose to sue for infringement or breach of contract. In the Provisions on the Cause of Action of Civil Cases implemented on April 1 2008, there are two causes of action for medical disputes. First, a medical damage compensation dispute was established under the dispute over the right to life, health and body in the first part of the personality right dispute. Refers to the medical and nursing work of medical institutions, which directly causes patients' death, disability, tissue and organ damage, resulting in dysfunction accidents and injuries. Second, the medical service contract dispute is established under the fourth part of the creditor's rights dispute, which mainly refers to the dispute between medical institutions and patients in the process of exercising their contractual rights and fulfilling their contractual obligations. Therefore, in the trial practice, the cause of action should be determined according to the different causes of action chosen by the parties. If the parties choose to sue for breach of contract, the cause of action shall be determined as a medical service contract dispute; If the parties choose to sue for infringement, the cause of action shall be determined as a medical damage compensation dispute.