Abstract:

Objective To analyze the high risk factors of obstetric brachial plexus palsy （OBPP）, and to explore how to evaluate the relationship between fault medical behavior and OBPP in the process of medical damage forensic identification. Methods A retrospective analysis was carried out on 25 cases of medical damage liability disputes related to OBPP from 2017 to 2021 in Beijing Fayuan Judicial Science Evidence Appraisal Center. The shortcomings of hospitals in birth weight assessment, delivery mode selection, labor process observation and shoulder dystocia management, and the causal relationship between them and the damage consequences of the children were summarized. Results Fault medical behavior was assessed as the primary cause in 2 cases, equal cause in 10 cases， secondary cause in 8 cases, minor cause in 1 case, no causal relationship in 1 case, and unclear causal force in 3 cases. Conclusion In the process of forensic identification of OBPP, whether medical behaviors fulfill diagnosis and treatment obligations should be objectively analyzed from the aspects of prenatal evaluation, delivery mode notification, standardized use of oxytocin, standard operation of shoulder dystocia, etc. Meanwhile, it is necessary to fully consider the objective risk of different risk factors and the difficulty of injury prevention, and comprehensively evaluate the causal force of fault medical behavior in the damage consequences.

Key words: forensic medicine, obstetric brachial plexus palsy, medical damage, cases analysis