45例手术并发症致死医疗损害责任纠纷司法鉴定回顾性分析

Retrospective analysis of judicial expertise on 45 cases of medical liability disputes of death caused by surgical complications

目的:探讨手术并发症致死医疗损害鉴定的特点、过错表现及分类意义。方法:对45例手术并发症致死医疗损害责任纠纷鉴定案例进行回顾,划分医院级别和科室,分类并发症,归纳过错表现形式。结果:医疗纠纷案例大多发生在三级医院,占比86.7%,最常见为普外科;认定医疗过错108处,其中术前30处,术中23处,术后55处;判定医方存过错并担责43例,占比95.6%,起根本因素作用14例;Ⅰ类并发症19例,Ⅱ类并发症为23例,Ⅲ类并发症3例。结论:在鉴定实践中,要按当时医学水平,针对围手术期各环节审查注意义务;并发症分类用于医疗纠纷鉴定有积极意义。

Objective:To explore the characteristics,fault manifestations and classification significance of the identification of medical damage caused by operative complications.Methods:45 cases of medical malpractice liability disputes of death caused by surgical complications were reviewed,and the levels and departments of hospitals were divided,the complications were classified,and the forms of fault were summarized.Results:Most cases of medical disputes occurred in tertiary hospitals,accounting for 86.7%.General surgery is the most common.108 medical faults were identified,including 30 before operation,23 during operation and 55 after operation;43 cases of fault and responsibility were identified,accounting for 95.6%,14 of which played a fundamental role;19 cases of classⅠcomplications,23 of classⅡcomplications and 3 of classⅢcomplications.Conclusion:In practice,according to the medical level at that time,it is necessary to analyze the duty of care in all aspects of the perioperative period.In addition,the classification of complications is of positive significance in the appraisal of medical disputes.