医疗事故技术鉴定中对并发症定性的探讨

Investigation on identification of complications in technical identification of malpractice

“并发症”可定义为在某种原发疾病发展进程中发生的，由原发疾病或其他独立原因所导致的继发疾病。在临床上不外乎两种基本类型：一是疾病并发症；二是医疗并发症。并发症具有可预见性、不确定性、相对可避免性等风险特征，是否发生受多种因素的影响。在医疗事故技术鉴定中对并发症的定性应从并发症的发生和发展的整个诊疗护理过程中，医务人员是否遵守了诊疗护理操作规范及常规；是否履行了应尽的风险注意义务、风险回避义务、风险救治义务，其医疗行为是否存在过失；患者的并发症及其相关人身损害后果与医疗过失行为是否存在因果关系等方面进行判定。

The term complication is defined as a secondary disease, an accident, or a negative reaction occurring during the course of an illness and usually aggravating the illness. It usually takes two forms： a secondary illness of a disease; or a complication resulting from medical treatments. Characteristic of being risky, predictable, uncertain, and relatively avoidable, complications are affected by a variety of factors. In the course of identifying medical malpractice, identification of complications should be achieved according to how complications occur and evolve in the entire course of treatment and care, whether staffs have followed standards and regulations for treatment and care, whether staff are well aware of their obligations to take precautions to avoid risks, and provide medical care once complications take place, whether malpractice exists in the practice of medical staff, whether a cause - effect relationship exists between complications in patients and harms caused to families and medical malpractice.