Case
Case 1: Death of sudden cerebral hemorrhage goes out during patient be in hospital, the hospital compensates for 240 thousand yuan
On June 8, 2016, the patient lives into some courtyard internal medicine because of cerebral block.
On June 13 18 when, the patient is outer and abrupt occurrence shiver, kubla khah unwell.
Urgent remand hospital, check coronal CT to show a head to do haemorrhage, continue hospitalization, the illness happens to change repeatedly during in all rescue 15, classics rescue is invalid on June 25 die.
After the patient dies, family member courtyard just sticks to his argument: It is dangerous to the illness of cerebral block that the family member thinks cure protects personnel the gender knows inadequacy, agree with a patient to come home, make the patient did not receive reasonable treatment, with come after the head does haemorrhage to have direct causal.
The courtyard just says, cure protects personnel to ever dissuaded a patient not to go out repeatedly, and after patient do sth without authorization goes out, did not return via be being persuaded for many times.
Then, the family member entrusts a lawyer for you thought fors the time being.
The lawyer reads carefully the discovery after anamnesis and cure of inquiry family member pass:
One, behavior of the accused diagnosis and treatment has fault
1, dangerous to the illness of cerebral block sex knows inadequacy: The accused agrees with a patient to come home, make the patient did not receive reasonable treatment, with come after the head does haemorrhage to have direct causal.
2, filling Potassium is undeserved bring about elephant of danger of tall blood Potassium: From June 13 21 when to on June 14 8 when, because of shock condition, uric quantity is few, 4 grams of ＞ of vein filling Potassium, "Luo Saike " group a bit is useful ultimate Potassium chroma, " amino acid " tall Potassium chroma is used in group a bit, did not make clear a bit speed, cause a patient to will appear on June 14 hematic Potassium 8.82mmol/L, have with the patient's death direct causal.
3, did not go as early as possible tracheotomy, cause a patient pneumonic incontrollable, with the patient death has causal.
2, the accused undertakes bogus to anamnesis, distort and make false record
1, distort the 1st page " temperature is odd " .
Accuser ever filmed with the mobile phone primitive the 1st page " temperature is odd " , the patient is in originally on June 9 ～ 12 days 14 when go out, but still temperature surveys a record, and new " temperature is odd " the 1st page already deleted above temperature to record.
2, the accused is in " leave hospital record, nurse record " the place such as the 1st page makes false record.
Nurse Huang Mou will nurse some on June 8 in the record " patient do sth without authorization goes out, did not return via be being persuaded for many times " , but the accused offers " the nurse discharges a watch " in will mix on June 8 9 days of Huang Mou fill cease Pure Brightness is false.
Maintain the accused to was not used up thereby during telling patient be in hospital, go out He Feng is reached nearly tell the obligation that must not go out.
3, accuser one relative is the nurse with old job of Ceng Zailin bed, appeal to nightly on June 13 to bag of morning patient catheterization is medium on June 14 almost anuresis.
Appear after danger of tall blood Potassium is resembled, this relative ever oppugned the fault of filling Potassium of the accused anuresis, discover this period of time nurses later have in the record " uric 300ml " false notes.
4, come after rescue is successful in the evening on June 13 on June 14 in the morning, degree of saturation of patient blood oxygen is in for many times 70% much, nurse overall record is in the record 80% much.
5, " leave hospital record " indication patient is admitted to hospital to was diagnosed namely that day for " cerebral dry haemorrhage, object indigestion the gender is pneumonic " , the fact is the patient when be admitted to hospital does not have cerebral hemorrhage, also do not have pneumonic.
Finally, accuser just obtains damages of more than yuan of 240 thousand person.
Case 2: Do sth without authorization of patient of be in hospital dies from the courtyard, hospital compensate 170 thousand
Patient Huang Mou fastens retired medical worker, on July 15, 2016, because the bosom is painful,enter cure of internal medicine of some courtyard heart.
Be the same as a month 19 days, carried out radiography of heart coronal arteries and veins and bracket of coronal arteries and veins embedded art.
Be the same as a month 22 days afternoon, patient privately goes out from the courtyard.
Morrow before dawn 6 when, because the illness produces serious change by family member call 120 emergency treatment, death defines via the examination after sending toward the hospital.
After the court is tried, think, the accused should observe after art patient patient's condition changes closely, after patient privately goes out, did not grant to inquire and be prevented, all did not notice obligation to height.
Patient of as a result cannot get seasonable cure and die unfortunately, compensatory duty 170 thousand.
Analysis
From above in two case see not hard, lawsuit basically is defeated to go up in anamnesis:
Case 1, disobeyed vein filling Potassium " 4 unfavorable " principle
Uric quantity is few, give vein filling Potassium more than 4 grams.
And " amino acid " tall Potassium chroma is used in group a bit, important had not made clear a bit speed.
Although the nurse is in,drip fast appropriate, also be 100 difficult argue right now, prop up without evidence;
Undertake bogus to anamnesis, distort and make false record: This is the biggest contraindication in writ.
Also be one side of square to the courtyard worst, no matter this record and patient have,do not have direct causal, all can be surely lose lawsuit.
Case 2, did not fulfill should do one's duty.
If be not had in anamnesis,sign " the patient goes out inform a book " , probably cure protects personnel to already was in when be admitted to hospital, impart the risk that its do sth without authorization exists possibly from courtyard behavior.
Think the patient ever was him medical worker probably witting its risk, but why to no matter be,plant circumstance, sign personally without the patient or household sign one's name, be in jural it is invalid.
Once law is involved, be all-pervasive
Anything wants withstand to relapse deliberate, so, answer to be a basis with the fact, it is criterion with law, write your place to do, do your place to write.
Answer
1, the accident produces during the patient goes out, have after all without legal responsibility? The patient asks for leave go out means, whether ought to be withheld?
The lawyer expresses: The patient once be in hospital, both sides of doctors and patients built medical treatment to serve contract concern, those visit abides by a contract to agree to answer.
Medical establishment agrees with a patient to ask for leave from the courtyard, leave courtyard occurrence consequence with patient do sth without authorization, respective law responsibility all differs.
Alleged ask for leave, be suffer from square request and furlough, it is the response that the hospital requests to the patient.
Medical establishment agrees with a patient to go out, all had arrived necessary risk is evaluated and tell obligation, thinking the patient goes out is safe.
If produce an accident, medical establishment hard to avoid its duty.
Accordingly, 2011 edition " hospital job system and staff post duty " in " the patient is admitted to hospital notice " regulation: "After formalities of conduction be in hospital, obedient ward bed is arranged, the patient does not get do sth without authorization to go out.
The person that do sth without authorization goes out, by leave hospital automatically processing, have the person that main reason must leave a courtyard truly, need to sign affirmatory from courtyard know the inside story book, from this and all undesirable consequence of generation, responsibility conceit.
2, can affirmatory from courtyard know the inside story book keep out all risks?
The answer is negative.
Medical establishment has: ① evaluates patient patient's condition to may produce the obligation of the risk during leaving a courtyard;
② tells obligation;
③ dissuades a patient to go out as far as possible compulsory.
Accordingly, chinese hospital association releases " patient of be in hospital goes out inform a book " , assess the risk of medical establishment obligation, inform the compulsory, be clear at a glance that dissuades obligation to write, patient (or relative) acceptance and sign to be united in wedlock effectively, it is efficient way.
3, patient do sth without authorization goes out, should the hospital manage like where again?
"Be admitted to hospital notice " it is an effective writ, but the signature that cannot ignore him patient.
Below any case, abide by system ability utmost strictly to avoid only duty, nurse post classification manages by different levels system, nurse shift changing rule is spent, protect manage lash-up to manage beforehand the case also weigh particularly should.
Once discover patient do sth without authorization goes out, be in as far as possible start inquiry program for a short while.
Include a phone to contact patient or family member, search in time call the police in time even wait for means, do one's best falls patient risk and hospital responsibility to the nadir.
4, there should be relevant evidence ability to avoid in lash-up program duty
If the detail in lash-up program was not accomplished, same likelihood is faced with compensation.
The lawyer is mentioned should relevant evidence ability is avoided duty, namely produce the expected result of opinion of testimony of data of data of card of the allegation of party, book, material evidence, seeing and hearing, electron, witness, appraisal, survey notes.
That is to say, cure protects personnel to discover the patient is absent ward, in phone connection process.
Only communicate the record is no good, have even communicate recording, namely data of seeing and hearing.
Like the phone not if send a short message to give opposite party,get through leaves a mark even, namely electronic data.
Proposal
Notable is, some hospitals still are being used original the sort of " inpatient asks application for leave " , this kind " ask application for leave " mode, very adverse to the hospital, be equal to is the hospital allows inpatient to go out, patient occurrence accident, more say not clear.
The hospital can be adopted sign " the patient goes out inform a book " form, make unified pattern plate and form, perfect give a complete inpatient to go out announcement relevant procedures, ensure patient safety manages, effective avoid risk.
How to avoid a risk:
1, safety informs: Be admitted to hospital moment, be about to undertake safety informs a book. The program that produces written agreement to inform a patient to ought to be abided by from the courtyard when the patient is admitted to hospital and do sth without authorization need to assume responsibility by oneself from the courtyard.
2, serious and perambulatory: The patient that 2 class nurse, the nurse wants 2 hours perambulatory ward, ensure patient safety.
3, had done join a class: When cure protects personnel to join a class, want to examine a patient.
4, dissuade obligation: Have go out the patient of the tendency, want to undertake in time dissuasion.
5, had done evaluate: Evaluate the person that give safety administration to need to pay close attention to mainly, if have the patient of psychological problem.
6, the key superintends: Try to distinguish on management to average patient and special patient, give a key the patient with certain and special, all the more safe safeguard. Undertake communication more, especially senile action inconvenience and special situation patient should take a heart more, contact relevant personnel more.
