摘要
目的 分析眼外伤医疗纠纷鉴定中的医院过错,指导眼外伤临床。方法 通过中国裁判文书网搜索关键词为“眼外伤”“医疗损害责任纠纷”“鉴定”的裁判文书作为分析样本,分析基本案情、鉴定结果、医疗过错及其原因力大小和法庭的采信情况。结果 53例眼外伤相关医疗纠纷共实施了63次鉴定,其中司法鉴定36例42次,占67.92%;医学会鉴定8例10次,占15.09%;未选择鉴定7例,占13.21%。法庭判定医院承担完全责任3家、主要责任8家、同等责任7家、次要责任16家、轻微责任13家、无责任6家;与鉴定意见参与度高度一致。不同级别医院表现的过错不完全相同;医疗过错行为主要表现在未尽诊疗责任、病历书写与记录不规范、告知未落实到位。结论 眼外伤相关医疗纠纷法律途径处理中87%(46/53)选择医疗鉴定,95%(44/46)的鉴定意见医院存在过错;医疗过错行为主要表现在未尽诊疗责任、病历书写与记录不规范、告知未落实到位;且鉴定意见基本都被法院直接采用。
Objective To analyze medical institutional responsibilities in the medical disputes related to ocular trauma and to guide the clinical management of ocular trauma.Methods Through the China Judgments Online,searched for judgment documents with the keywords of "eye injury","medical damage liability disputes" and "appraisal" as analysis samples,and analyzed the basic case,appraisal results,medical fault and its causative force,and the court's acceptance.Result 53 cases of medical disputes related to ocular trauma were carried out identification 63 times totally,including 36 cases were forensic identified 42 times(67.92 %),8cases were identified by the Medical Association 10 times(15.09 %),and 7 cases(13.21 %) were not identified.The court ruled that 3 hospitals had complete responsibility,8 hospitals had primary responsibility,7 hospitals had equal responsibility,16 hospitals had secondary responsibility,13 hospitals had minor responsibility,fand 6 hospitals had no responsibility,which were highly consist with the identification results.The faults of hospitals at different levels were not exactly the same.The medical malpractice mainly manifested in the failure to fulfill the responsibility for diagnosis and treatment,the nonstandard writing and recording of medical records,and the failure of notification.Conclusions Medical identification was selected in 87 %(46/53) of the ocular traumarelated medical disputes.95 %(44/46) of the identified hospitals had responsibility.The medical malpractice mainly manifested in the failure to do all the responsibility,the nonstandardmedical records,and the ineffective notification,and almost identification opinions were directly adopted by the court.Regulating medical instrument writing,effective informed consent,meeting hospital responsibilities,and improving medical services can circumvent the responsibilities borne by hospitals with medical disputes.
作者
何继武
袁文保
段鹏
何东全
刘爽
He Jiwu;Yuan Wenbao;Duan Peng;He Dongquan;Liu Shuang(Department of Medical,Xiangyang No.1 People's Hospital,Hubei University of Medicine,Xiangyang 441000,China;Xiangyang Fazheng Forensic Identification Institute,Xiangyang 441000,China)
出处
《中国法医学杂志》
CSCD
2023年第2期187-190,共4页
Chinese Journal of Forensic Medicine
基金
湖北省教育厅高等学校省级教学研究项目(2020559)
湖北省“323”攻坚行动襄阳市第一人民医院重点专项(XYY2022-323)。
关键词
眼外伤
医疗损害鉴定
知情同意
法律伦理
医生认知
I Ocular trauma
Medical damage identification
Informed consent
Legal ethics
Physician perception
