119例医疗事故死亡伤病员司法鉴定报告的回顾性分析

A retrospective analysis of 119 wounded forensic reports on the medical accident death

目的分析医疗事故死亡事件中死亡伤(病)员的主要致死原因,探讨降低死亡事件司法鉴定百分比的方法。方法回顾性分析德阳市司法鉴定机构2009年1月至2012年12月119例医疗事故死亡伤(病)员的司法鉴定资料,分析医患沟通情况对司法鉴定的事件的影响。结果有医疗过失者12例,占尸检的11.11%;无医疗过失者96例,占尸检的88.89%。医患沟通不良99例,均司法鉴定;医患沟通良好20例,9例司法鉴定,11例未进行司法鉴定。医患沟通良好与不良者尸检率比较差异有统计学意义(χ2=59.99,P<0.01)。结论伤情或病情危重的不可逆性发展是伤(病)员死亡的主要致死原因,医疗过失是伤(病)员死亡的次要原因。医患双方沟通良好,能降低医疗事故死亡事件司法鉴定的百分比。

Objective To analyze the main causes of medical accident death,and explore the methods to reduce the percentage of judicial identification in the death events. Methods The judicial authentication information of 119 medical accident deaths from January 2009 to December 2012 in the Deyang City were retrospectively. The effects of doctor-patient communication situation on judicial identification causes were analyzed. Results There were 12 deaths with medical negligence, accounting for 11.11% of autopsies while 96 deaths without medical negligence, accounting for 88.89% of autopsies. There were 99 cases with poor communication in which all had forensic identification while 20 cases with good doctor-patients communication in which only 9 cases had judicial identification. The difference in rate of autopsy between the poor and good communication was statistically significant （X2 = 59.99, P 〈 0. 01 ）. Conclusion The irreversible development of the injury or the severity of the illness is the main cause of death of the injury（ disease）, and the medical negligence is the minor cause of death of the injured（ the disease）. Good communication between doctors and patients can reduce the percentage of judicial identification of medical accident death incidents.