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《广州医药》编辑部
目的 对医疗损害责任纠纷案的法庭审理进行分析,探究医疗损害责任纠纷案件的处理现状,对此过程中医疗机构应当关注的问题进行分析总结,以期为医院应对医疗损害鉴定工作和法官审理医疗损害责任纠纷案提供参考。方法 对广州市三所综合医院2015—2021年共93例医疗损害责任纠纷案的判决书进行描述性分析。结果 93例案例中79例进行了医疗损害鉴定。79例进行医疗损害鉴定的案例中,71例鉴定结论被法院采信,采信率达90%。有29例案件鉴定人出庭(占比36.7%),其中有25例鉴定意见被法院采信,采信率为86.2%,仅有7例案例当事人申请了专家辅助证人出庭。医方大多数最终承担次要及以下责任占比为73.4%。鉴定结论为责任范围的,法院最后判决偏向于取最高值和中间值(43例出具责任范围的案例中,14例为最高值,13例为中间值)。结论 医疗机构要充分加强对医疗事故技术鉴定和医疗损害鉴定的认识,高度重视医疗损害鉴定工作,尤其加强尸体解剖告知及病历书写管理,充分利用好鉴定人和专家辅助证人出庭两种手段。
Objective To analyze the court trial of medical damage liability disputes,to explore the current situation of medical damage liability disputes,to analyze and summarize the problems encountered in dealing with medical damage disputes,so as to provide some references for hospitals to deal with medical damage disputes.Methods Descriptive statistical analysis performed on the written judgment of 93 cases of medical damage liability disputes in three large comprehensive hospitals in Yuexiu District,Guangzhou from 2015 to 2021.Results In 93 cases,79 cases had expertise of medical malpractice.In 79 expertise,71 of them were adopted,and the acceptance rate was 90%.Among the 29 cases in which the appraisers appeared in court,25 expert opinions were accepted by the court,the acceptance rate was 86.2%.In only 7 cases,the parties applied for expert witnesses to appear in court.In most cases,hospitals ultimately took secondary and lower responsibilities,accounting for 73.4%.If the appraisal conclusion falls within the scope of responsibility,the court’s final judgment tends to take the highest and middle values.Conclusions Medical institutions should fully strengthen their understanding of technical identification of medical accidents and medical malpractice identification.Attach great importance to the identification of medical malpractice,especially strengthen the management of autopsy notification and medical record writing,make full use of two methods:appraisers and experts witnesses appearing in court.