法医学杂志

法医学杂志 ›› 2019, Vol. 35 ›› Issue (4): 428-432.DOI: 10.12116/j.issn.1004-5619.2019.04.009

• 案例分析 • 上一篇    下一篇

1900例医疗损害鉴定的回顾性分析

杨立1， 蔡继峰1，2， 高东3， 邓振华4， 郭亚东1，2， 常云峰1，2   

  1. 1. 湖南省湘雅司法鉴定中心，湖南 长沙 410013； 2. 中南大学基础医学院法医学系，湖南 长沙 410013； 3. 司法鉴定科学研究院 上海市法医学重点实验室 上海市司法鉴定专业技术服务平台，上海 200063； 4. 四川大学华西基础医学与法医学院，四川 成都 610041
  • 发布日期:2019-08-25 出版日期:2019-08-28
  • 通讯作者: 常云峰，男，博士，主要从事法医临床学和法医病理学研究；E-mail：changyunfeng880@163.com
  • 作者简介:杨立（1974—），女，硕士，主要从事法医临床学和法医物证学研究；E-mail：yangli741221@126.com
  • 基金资助:
    湖南省自然基金面上资助项目（2018JJ2558）

Retrospective Analysis on 1 900 Cases of Medical Malpractices

YANG Li1, CAI Ji-feng1,2, GAO Dong3, DENG Zhen-hua4, GUO Ya-dong1,2, CHANG Yun-feng1,2   

  1. 1. Hunan Xiangya Judical Identification Center, Changsha 410013, China; 2. Department of Forensic Science, School of Basic Medical Science, Central South University, Changsha 410013, China; 3. Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China; 4. West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
  • Online:2019-08-25 Published:2019-08-28
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摘要： 目的 通过对1 900例医疗损害案件进行回顾性分析，研究18年间医疗损害案件的变化趋势、分布特点和发生原因，为医疗损害的预防和处理提供指导。 方法 选择湖南省湘雅司法鉴定中心2000—2017年受理的1 900例医疗损害鉴定案件，对每年的案件量、委托方、科室分布、医院等级、发生原因等数据进行统计。 结果 委托第三方鉴定机构进行医疗过错鉴定的案件数量呈上升趋势，医疗损害鉴定的委托单位在18年间发生了显著变化。医疗损害以二级和三级医院发生较多，在外科和妇产科明显偏多。医疗损害的发生与医方对病情严重性及可能出现的并发症预见不足、未尽到充分告知相关注意义务等有关。 结论 我国医疗损害案件的解决途径和医疗过错鉴定程序在逐步完善，加强外科、妇产科医护人员医疗损害防范意识有利于医疗损害的解决。

 

关键词: 法医学, 回顾性研究, 医疗损害, 案例分析

Abstract: Objective To study the change trend, distribution characteristics and causes of medical malpractices in 18 years, through retrospective analysis of 1 900 cases of medical malpractices, in order to provide guidance for the precaution and the treatment of medical malpractices. Methods A thousand and nine hundred medical malpractice cases that were accepted by Hunan Xiangya Judical Identification Center from 2000 to 2017 were collected. Statistical analysis on the caseloads, the clients, the department distributions, the levels of the hospital and the causes of medical malpractices, etc were conducted. Results The number of cases commissioned by third-party accreditation agencies for medical fault identification was on the rise; The clients of medical malpractices changed significantly in 18 years. Most of the medical malpractice cases occurred in secondary and tertiary hospitals, significantly more in surgery, obstetrics and gynecology. The occurrence of medical malpractices was related to the doctor’s insufficient prediction of the severity of the disease and the possible complications, and failure to fully inform the relevant duty of care, etc. Conclusion China’s medical malpractice solutions and medical fault identification procedures are gradually improving. Strengthening the medical malpractice precaution awareness of medical workers in surgery, obstetrics and gynecology will be conducive to resolution of medical malpractices.

Key words: forensic medicine, retrospective studies, medical malpractice, cases analysis

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