Case 1

On April 16th, 27, Hu Hailong, a villager in Damao Banner, Inner Mongolia, sent his wife Li Lintao to the Maternal and Child Health Center in the banner to give birth. At the time of admission, the pregnant woman and the fetus were in normal condition. But after more than two hours of hard work, the child was not born. The doctor decided to have a caesarean section. At about 2 pm, when Hu Hailong went to pay the blood fee, he realized that neither the hospital nor the Damaoqi blood bank had the same blood type as his wife, and he had to be transported from the blood station in Baotou city center. Because the blood station in the center of Baotou is a certain distance from Damaoqi (it takes about 3 hours at the earliest on the way to the speed limit section), the situation is critical, and the family members asked to take their own blood, but the hospital refused to agree on the grounds that "blood collection is not allowed without permission according to regulations". However, when the parturient was under anesthesia and needed blood transfusion, there was no blood source. When the blood station in Baotou city center sent 1 ml of blood into the parturient, it was already 3 hours later, that is, more than 5 pm that day. After blood transfusion, the maternal had blood pressure, and when the second blood was delivered around 18: , the maternal breathing and heartbeat had stopped. Hu Hailong was told that neither the children nor the adults could be saved ... < P > After comprehensive analysis, it can be concluded that the death of Li Lintao's mother and baby was mainly caused by the failure of timely blood transfusion. This case has constituted a first-class medical accident, and the hospital bears the main responsibility. In other words, if there was enough blood matching the maternal blood type at that time, Li Lintao's mother and baby would not have died. The direct reason is that the blood bank of Damaoqi, which is responsible for the blood supply of Damaoqi, has no blood that matches the maternal blood type. Because the blood bank in Damaoqi only has the functions of blood storage and blood supply, the blood stored in the blood bank needs to be submitted to the blood storage plan, which will be collected and distributed by the blood station in Baotou city center. The day before Li Lintao's operation, an operation in Damaoqi Hospital used up the reserve blood in the blood bank, and the reserve blood was not replenished in time. According to the relevant laws, blood banks are not allowed to collect blood, and maternal and child health centers are not qualified to collect blood. They can only watch the maternal step by step to death and hope that life-saving blood will come as soon as possible.

Case 2

At midnight on March 25th, 27, pregnant woman Cheng Guiyun suddenly felt abdominal pain and gave birth symptoms. Because her husband Wu Zhongshan was not at home, her neighbor took Cheng to Hequ People's Hospital in Shandong Province by motorcycle. After getting off the bus, Cheng Guiyun walked into obstetrics and gynecology. The doctor on duty immediately conducted a routine prenatal examination. At 1: 3, Cheng Guiyun developed dystocia and bleeding symptoms. After more than an hour of preoperative preparation, he began to give anesthesia to Cheng Guiyun at 3: 1. At 3: 4, Wu Zhongshan's brother Wu Zhongxiong signed on behalf of his family, and Cheng Guiyun began caesarean section. During the two-hour operation, the lying-in woman was bleeding, with a bleeding amount as high as 4, ml. After using up two bags of B-type plasma prepared in advance, she went to the laboratory of the technical building of the hospital to take blood, and there was no plasma left. The doctor asked Cheng Guiyun's sister-in-law to run to the laboratory to get blood. The operation is in progress, because there is no plasma in the clinic, and the bleeding from the surgical wound is not limited, the doctor can only use the plasma substitute to temporarily maintain blood pressure, and immediately report to the dean on duty. Near 6 o'clock in the morning, Ma Qingyun, the vice president on duty, heard the doctor's report before calling Li Meiqin, the deputy section chief of hospital inspection, and contacted Wuzhai blood supply point of Xinzhou blood station to deliver plasma to Hequ County People's Hospital quickly. Life-saving plasma arrived at Hequ County People's Hospital more than two hours after receiving the transfer order, but it was useless.

The main cause of maternal death is hemorrhagic shock, which is caused by not timely blood transfusion. In the more than two hours of rescuing the parturient. Family members, including maternal mothers, cried outside the operating room and repeatedly begged the hospital to take their own blood to save their loved ones. All of them were rejected by the hospital on the grounds that blood collection must be carried out according to law, and the county hospital has no right to take blood for clinical use.

The same tragedy happened again. On June 5th, Zhang Jianfang, a 36-year-old villager from Beiyijing Village, Xinfu District, Xinzhou City, Shandong Province, gave birth to a baby in Xinzhou Central Hospital at around 8: 3 pm. After delivery, the medical staff could not take out the placenta for a while, resulting in postpartum hemorrhage. The doctor immediately arranged for the staff and their families to go to the blood bank in the city center to take plasma. When the plasma was taken at around 11 o'clock that night, the mother could not be treated and died at around 11: 3 that night.

Case 3

On June 8, 25, Ruan Huailian, a pregnant woman, suffered from massive uterine bleeding after caesarean section in Dongchuan District People's Hospital, Kunming City, Yunnan Province, and needed emergency blood transfusion. At that time, the hospital did not store AB blood, and it was unsuccessful to find a voluntary blood donor. Dean Tan Zhongneng of Dongchuan District People's Hospital agreed to donate 2 ml of blood to the attending doctor Lu Xinhua on the phone with the consent of the leaders of the District Health Bureau, so that Ruan Huailian turned the corner. The patient and his family were grateful for Dr. Lu's kindness. The hospital was ready to commend her, but Dr. Lu declined politely.

However, on August 15th, the hospital received the "Decision on Administrative Punishment" issued by the Provincial Health Department, and found that the hospital had no blood collection and supply license, and the blood collection and supply behavior was illegal, and ordered the hospital to immediately rectify and impose a fine of 6, yuan. According to the provincial health department, from December 17, 24 to June 16, 25, this hospital carried out temporary emergency blood collection for seven patients with massive hemorrhage, of which two cases were not reported to the health administrative department of Dongchuan District for the record. From September 24 to June 25, the hospital collected 62 ml of blood for clinical use. Article 18 of the Blood Donation Law of the People's Republic of China stipulates that illegal blood collection shall be banned by the health administrative department of the local people's government at or above the county level, the illegal income shall be confiscated and a fine of less than 1, yuan may be imposed.

In this regard, Tan Zhongneng, president of Dongchuan District People's Hospital, explained that it was a last resort for the hospital to take emergency blood samples repeatedly. In September, 24, after the blood collection station in Dongchuan District was cancelled according to law, the first clinical bloodline of medical institutions in this district was supplied by Kunming Blood Center. Dongchuan District is 16 kilometers away from Kunming, and it takes 5-6 hours to get blood back and forth, which may delay the emergency rescue of some critically ill patients. The blood source of the blood station in Kunming city center is insufficient, and it is impossible to supply the plasma requested by the hospital for many times. Moreover, it is difficult to estimate the blood use plan, and ischemia often occurs.

from the above three cases, we can see that because the blood crisis directly threatens the lives of pregnant women and babies, the former takes the national laws as a shield, watches pregnant women and babies sit still with peace of mind, and lets their lives disappear while obeying the law. The latter, who was punished for violating the law, saved the maternal life. If the Dongchuan District People's Hospital of Kunming follows the rules, we may see the same result as the previous case.

We often say that the law is heartless. Indeed, the law is emotionless. From a legal point of view, it is not wrong for these hospitals to refuse patients' family members' requests for blood transfusion for their loved ones, which can be regarded as the right given to them by the hospital and above in implementing the law. But seriously think about it, things are far from legal or illegal. China's "Blood Donation Law" stipulates that in order to ensure emergency use of blood, medical institutions can temporarily collect blood, but it should be in accordance with the provisions of this law to ensure the safety of blood collection. The Ministry of Health has three unified principles: medical institutions can collect blood when they meet the following conditions: 1. There is no blood bank (or central blood bank) in medical institutions in remote areas and where they are located; 2. The life of critical patients is in urgent need of blood transfusion, which cannot be replaced by other medical measures; 3. Have the conditions for cross matching and rapid diagnosis to test hepatitis B virus surface antigen, hepatitis C virus antibody and HIV antibody. That is to say, for the safety of citizens' lives, the law has made provisions on dealing with emergencies that may occur in the process of saving lives. It is not impossible to collect blood temporarily, but it is entirely possible under the condition of having three unified principles.

when I say this, I will definitely be opposed by some people. They will think: If hospitals have three unified conditions, how can they not take temporary blood collection to save patients? In fact, this is precisely the contradiction. For hospitals, it is difficult to meet the three unified conditions by rapid diagnostic methods to test hepatitis B virus surface antigen, hepatitis C virus antibody and HIV antibody. If we rashly take temporary blood collection to rescue patients, because blood safety problems will leave too many uncertain hidden dangers and troubles in the future. We can understand this problem, but why not consider all the problems before operating on the patient? If the preoperative preparation is sufficient, and the possible problems are predicted more, it will be impossible to think of the problem of insufficient blood use after cutting open the pregnant woman's stomach.

According to statistics, more than 5, pregnant women die every year in the world, 99% of them are in developing countries, and 25% of them die of massive bleeding during childbirth, which shows that it is not uncommon for pregnant women to have massive bleeding during childbirth. For hospitals, first of all, we should think about whether you have the ability to control and deal with sudden massive bleeding of pregnant women, and don't be reckless just to make money. For example, in case one, doctors should know about the blood preparation before deciding to carry out caesarean section. Even if hospitals and blood banks don't have plasma that matches the parturient, it will be too late to ask Baotou Central Blood Station for emergency allocation first. I have already had a knife on the parturient here, and I didn't think of plasma until the blood stopped. It didn't help to cram for it temporarily. Obviously, it is the hospital's own responsibility. When faced with the choice of life and death, it does not try to take remedial measures. At this time, it reminds me of the qualification of blood collection and uses national laws to cover up the doctor's mistakes. Do you think this is caused by the contradiction of blood transfusion?

angels in white, which used to be proud of saving lives, is now stinking with copper. For them, patients are the foundation and guarantee for creating economic benefits. Needless to say, the cost of having children in the past is very different from today's consumption. Driven by economic interests, they put the patient's life in the first place, don't take having children seriously, and everything goes smoothly, and they are at a loss when they encounter unexpected situations. This has technical reasons, but it is more of an ideological problem. Therefore, when discussing this issue, we can't talk about the ruthlessness of the law without seeing the apparent contradiction of blood transfusion. In fact, we blame too many human mistakes on the ruthlessness of the law, which is obviously inaccurate.