医院判赔166万!延误抢救致病人成植物人……

2017-07-23 Alice 朱丽华的医与法

法院认为医院的责任比例为90%,赔偿患者各项损失共计1662537元人民币。


患者注射CT造影剂后严重过敏,因医院抢救迟了10分钟,致使患者成植物人状态,最终,医院赔偿了166万余元!

2005年9月29日下午,患者张某来到某三甲医院进行体检,医生建议患者进行CT(冠状动脉造影)检查,该项检查需要事先注射血管造影剂碘普罗胺注射液(优维显),但是医生在为其完成CT检查后,却发现患者已经没有知觉。CT医生紧急联系了急诊科医生,急诊科医生对患者进行紧急抢救,但仍没有让患者醒过来,患者一直处于植物人状态。患者家属遂起诉医院至法院。

法院为何判决医院90%的责任?

法院认为,本案中,患者在被告处进行CT检查时出现过敏反应。就患者从发生严重过敏反应到被送至急诊室抢救的时间,原、被告产生争议。被告作为医疗机构,应当就此争议承担举证责任。由于医院不能提供患者原始的扫描图像资料,致使鉴定机构无法确定患者在2005年9月29日行CTA检查结束时的具体时间,也即无法确定患者发生严重过敏反应到进入急诊科之间的准确时间。

而患者提供了CT室技师所写的事发经过:

患者于14时40分检查完毕,在发现患者发生过敏反应后,CT室的大夫立即对病人进行吸氧,并通知急诊科医生。

14时42分患者出现抽搐,吐白沫,血压测不到的情况;

14时45分急诊室医生到场,一边处理一边听取CT室人员介绍相关情况;

14时50分,急诊室医生把病人接走(上述时间为当时在场的医生手机时间)。

该经过显示从患者检查完毕到急诊室医生将患者接走间隔10分钟。

法院采纳患者的主张,认定患者从发生严重过敏反应到被送至急诊室抢救的时间为10分钟以上。根据相关的鉴定意见,医院存在明显的过错,且该过错与患者损害后果之间存在因果关系,应承担相应的赔偿责任。最终法院确认医院的责任比例为90%,赔偿患者各项损失共计1662537元人民币。

鉴定机构怎么看?

鉴定机构认为:

1、患者为严重过敏反应,CT室医生抢救存在过失

患者在做CTA过程中,应用“优维显”检查结束后出现“不舒服、恶心、心慌”后,又出现颈面部及肩部皮肤发红,继而出现抽搐、吐白沫、血压测不到等临床表现,医方应考虑到患者出现严重过敏反应,CT室除给予立即通知急诊室准备抢救、吸氧外,应立即给予抗过敏药治疗,控制病情进一步发展。

2、患者抢救延误时间成鉴定关键

患者在急诊室抢救过程中,医方治疗恰当,患者经抢救成功复苏,此过程医方无过错。严重过敏反应发生在CT检查完成后,出现意识障碍到进入急诊室之前的准确时间无法作出准确判定。

若患者从发生严重过敏反应到到达急诊室抢救的时间为10分钟以上,则医方存在明显的过错,且该过错与患者损害后果之间存在因果关系,建议过失参与度为E级(参与度系数值为60%-90%)。

就患者目前伤残等级及护理状况,该鉴定机构亦出具了鉴定意见,结论为患者目前属一级伤残,护理依赖程度为完全护理依赖。

专业律师怎么看?

北京市邦道律师事务所主任、高级律师武绍智认为,对于医疗事故医院应负完全的举证责任,医生及医疗档案不能举证急诊医生开始抢救的时间,所以采信了患者方的举证时间,即医院的抢救迟延了十分钟(将患者接走的时间),法院的判决合法合理。

有网友质疑,CT室医生发现患者异样,已经采取了吸氧,并通知急诊科医生的抢救措施,但法院认为还应该加上马上给予抗过敏药治疗,这样要求CT室医生是不是有点强人所难?

对此,武绍智律师表示,法院不会采信医学是个庞大复杂的学科,迁就CT医生对过敏病的判断和治疗。就如中文老师是教中文的,教了学生一些错字,教了学生一些数学题目而出现错误,进了医院,患者是来享有健康、救治等权利的,反而因为主、客观原因又发生了疾病,还疏于防范,未能得到及时救治。在医院从发病到救治用了十分钟时间,错过了救治的最佳时间,说明医院的治疗环节,服务态度不积极,应予以改进。

针对这个案件,武绍智律师也给出了医护一些建议:

医疗界确实存在很多人类目前不能攻克的疾病,所有不能求全责备医院和医生。但医院和医生的治疗服务:

1、必须规范化,这样可以获得患者的信任,避免风险,减少人为失误。

2、协同协调机制,若某一个环节出现了问题,有一个协调机构及时调动相关部门医生救治,无缝隙链接,形成一个整体。

3、建立健全适时档案记录制度,使医院发生法律风险时能详尽举证。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1745252, encodeId=1c781e45252a4, content=<a href='/topic/show?id=bdc262694bb' target=_blank style='color:#2F92EE;'>#植物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62694, encryptionId=bdc262694bb, topicName=植物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a5e35527958, createdName=xuyong535, createdTime=Sun Oct 22 12:25:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008953, encodeId=b1822008953ff, content=<a href='/topic/show?id=4875626990e' target=_blank style='color:#2F92EE;'>#植物人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62699, encryptionId=4875626990e, topicName=植物人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Mar 19 16:25:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471277, encodeId=ca7014e127763, content=<a href='/topic/show?id=ac13558e9cb' target=_blank style='color:#2F92EE;'>#抢救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55879, encryptionId=ac13558e9cb, topicName=抢救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be1a7117101, createdName=lfyang, createdTime=Tue Jul 25 01:25:00 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225427, encodeId=748622542e2e, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Sun Jul 23 13:40:04 CST 2017, time=2017-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225395, encodeId=bcf8225395db, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Sun Jul 23 12:46:50 CST 2017, time=2017-07-23, status=1, ipAttribution=)]
    2017-10-22 xuyong535
  2. [GetPortalCommentsPageByObjectIdResponse(id=1745252, encodeId=1c781e45252a4, content=<a href='/topic/show?id=bdc262694bb' target=_blank style='color:#2F92EE;'>#植物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62694, encryptionId=bdc262694bb, topicName=植物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a5e35527958, createdName=xuyong535, createdTime=Sun Oct 22 12:25:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008953, encodeId=b1822008953ff, content=<a href='/topic/show?id=4875626990e' target=_blank style='color:#2F92EE;'>#植物人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62699, encryptionId=4875626990e, topicName=植物人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Mar 19 16:25:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471277, encodeId=ca7014e127763, content=<a href='/topic/show?id=ac13558e9cb' target=_blank style='color:#2F92EE;'>#抢救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55879, encryptionId=ac13558e9cb, topicName=抢救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be1a7117101, createdName=lfyang, createdTime=Tue Jul 25 01:25:00 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225427, encodeId=748622542e2e, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Sun Jul 23 13:40:04 CST 2017, time=2017-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225395, encodeId=bcf8225395db, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Sun Jul 23 12:46:50 CST 2017, time=2017-07-23, status=1, ipAttribution=)]
    2018-03-19 xjy02
  3. [GetPortalCommentsPageByObjectIdResponse(id=1745252, encodeId=1c781e45252a4, content=<a href='/topic/show?id=bdc262694bb' target=_blank style='color:#2F92EE;'>#植物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62694, encryptionId=bdc262694bb, topicName=植物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a5e35527958, createdName=xuyong535, createdTime=Sun Oct 22 12:25:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008953, encodeId=b1822008953ff, content=<a href='/topic/show?id=4875626990e' target=_blank style='color:#2F92EE;'>#植物人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62699, encryptionId=4875626990e, topicName=植物人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Mar 19 16:25:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471277, encodeId=ca7014e127763, content=<a href='/topic/show?id=ac13558e9cb' target=_blank style='color:#2F92EE;'>#抢救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55879, encryptionId=ac13558e9cb, topicName=抢救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be1a7117101, createdName=lfyang, createdTime=Tue Jul 25 01:25:00 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225427, encodeId=748622542e2e, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Sun Jul 23 13:40:04 CST 2017, time=2017-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225395, encodeId=bcf8225395db, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Sun Jul 23 12:46:50 CST 2017, time=2017-07-23, status=1, ipAttribution=)]
    2017-07-25 lfyang
  4. [GetPortalCommentsPageByObjectIdResponse(id=1745252, encodeId=1c781e45252a4, content=<a href='/topic/show?id=bdc262694bb' target=_blank style='color:#2F92EE;'>#植物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62694, encryptionId=bdc262694bb, topicName=植物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a5e35527958, createdName=xuyong535, createdTime=Sun Oct 22 12:25:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008953, encodeId=b1822008953ff, content=<a href='/topic/show?id=4875626990e' target=_blank style='color:#2F92EE;'>#植物人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62699, encryptionId=4875626990e, topicName=植物人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Mar 19 16:25:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471277, encodeId=ca7014e127763, content=<a href='/topic/show?id=ac13558e9cb' target=_blank style='color:#2F92EE;'>#抢救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55879, encryptionId=ac13558e9cb, topicName=抢救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be1a7117101, createdName=lfyang, createdTime=Tue Jul 25 01:25:00 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225427, encodeId=748622542e2e, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Sun Jul 23 13:40:04 CST 2017, time=2017-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225395, encodeId=bcf8225395db, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Sun Jul 23 12:46:50 CST 2017, time=2017-07-23, status=1, ipAttribution=)]
    2017-07-23 137****9095

    henhao

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1745252, encodeId=1c781e45252a4, content=<a href='/topic/show?id=bdc262694bb' target=_blank style='color:#2F92EE;'>#植物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62694, encryptionId=bdc262694bb, topicName=植物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6a5e35527958, createdName=xuyong535, createdTime=Sun Oct 22 12:25:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008953, encodeId=b1822008953ff, content=<a href='/topic/show?id=4875626990e' target=_blank style='color:#2F92EE;'>#植物人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62699, encryptionId=4875626990e, topicName=植物人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Mon Mar 19 16:25:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471277, encodeId=ca7014e127763, content=<a href='/topic/show?id=ac13558e9cb' target=_blank style='color:#2F92EE;'>#抢救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55879, encryptionId=ac13558e9cb, topicName=抢救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be1a7117101, createdName=lfyang, createdTime=Tue Jul 25 01:25:00 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225427, encodeId=748622542e2e, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=353a2047758, createdName=137****9095, createdTime=Sun Jul 23 13:40:04 CST 2017, time=2017-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=225395, encodeId=bcf8225395db, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzR8ylhYfiaoAUx2BsaYHVia1IKhG3Cg8CT84rBrn6iaVRkyAibJxBcLEXabOQ5p19vWgDe34ib5ErxNgx/0, createdBy=8a701629084, createdName=jihuaijun1112, createdTime=Sun Jul 23 12:46:50 CST 2017, time=2017-07-23, status=1, ipAttribution=)]
    2017-07-23 jihuaijun1112

    学习学习学习

    0

相关资讯

植物人有感情吗?

  今天聊天又被问及,植物人是否有感情的话题。  不同于以往的是,今天的话题是从岛叶,脑干,杏仁核和断续的连接开始的。       所以很难启用猫猫从前常用的经典答案——“你猜”——来作结论。       科学家话题里的“感情”,是那些从杏仁核发出来的长短通路,是与额叶内侧、眶额回、隔区、无名质、视前区、海马体、下丘

植物人也有意志,25%的植物人有能力进行沟通

“为什么我们不给他们一个机会,听听他们想说什么?”“处于植物状态的病人看上去没有反应,其实许多想法被困在他们的身体里,必须要寻找一种不同的方法表达出来。”如果医生告诉处于植物状态的病人动一动手指,病人很可能没有任何回应,这说明也许病人已经完全丧失意识,无法听到提问并做出反应,也可能是病人听到并完全理解这句话,只是无法通过语言和行为来反馈。     

Neurology:植物人也会痛?

     一位无反应性清醒综合征患者对精神图像刺激均有正常反应   近期的文章显示使用意向指令、脑激活模式发现10%的无反应性清醒综合征(UWS,之前称为植物状态)患者存在意识。但是也有可能,无法依从指令的患者(如由于记忆、注意能力受限)能够感知疼痛和愉悦,并留有情绪能力。德国海德堡大学医学心理学与行为性神经生物研究所的Boris Kotchoubey博士等人进行了一项研究,在一个特

NMR Biomed:植物人可以通过fMRI与外界意识交流

功能性磁共振成像(fMRI)是通过追踪富氧血液的流动,实时呈现大脑的活动情况,评估大脑活动的一种工具。功能核磁问世20年,为人类认知功能探 索做出了巨大的贡献。近几年,《新英格兰医学》、《nature》、《Science》及《Lancet》连续发表报告证实:①部分植物人大脑中存在接近 正常的意识活动,通过fMRI甚至可与外界形成交流;②意识状态水平和fMRI的大脑网络活动显著相关;③保存良好神