173例医疗纠纷司法鉴定分析

Forensic Analysis of 173 Cases of Medical Disputes

目的分析本地区医疗纠纷的规律及医疗过失的特点,为医疗纠纷防范提供参考,探讨医疗纠纷司法鉴定中应注意的问题。方法对河南科技大学司法鉴定中心2010年至2014年173例医疗纠纷鉴定案例资料进行回顾性分析。结果二级、三级医疗机构的医疗纠纷所占比例相对较高,大部分医疗机构的过错参与度在50%以下;妇产科、骨科和普通外科医疗纠纷所占比例较高;手术科室的过错率高于非手术科室(χ2=5.65,P=0.017);交通事故、工作意外入院的骨科患者由于病情危急、复杂,易引发医疗纠纷。结论医疗损害司法鉴定应参照临床诊疗规范,考察医务人员履行诊疗义务的情况,重点关注手术操作、术后处理及医患沟通等环节。

Objective To analyze the rules of medical disputes and the characteristics of medical faults and provide references for preventing medical disputes.The related problems were also discussed in forensic practice.Methods The data of 173 medical dispute cases were analyzed retrospectively in Forensic Science Center of Henan University of Science and Technology from 2010 to 2014.Results The secondary hospitals and tertiary hospitals accounted for a higher proportion of medical disputes.Most medical institutions have less than 50 percent of the fault participation degree in medical disputes.The majority of medical disputes were distributed in the departments of gynecology,orthopedics and general surgery.The fault rate of surgical department was higher than that of non-surgical department(χ^2=5.65,P=0.017).The patients who injury in traffic accidents and work accidents were likely to involved in medical disputes due to serious and complex injury.Conclusion The forensic identification of medical damage should refer to clinical regulations and check whether the doctor fulfill their obligations.Meanwhile,significant attention should be paid to the surgical operations,postoperative management and communication between doctors and patients.