240例用药错误引发医疗损害责任纠纷的案件分析

Analysis of 240 Cases of Medical Damage Liability Disputes Caused by Medication Error

目的:研究因用药错误引发医疗损害责任纠纷案件的基本特征及用药情况,为相关部门及医务工作者预防或减少用药错误所致医疗纠纷提供参考。方法:纳入2001年1月至2020年2月北大法宝法律数据库中因用药错误引发的医疗损害责任纠纷案件240例,对案件的一般情况、损害结局、涉事医院级别、责任判决及赔偿、用药错误类型及药品种类等进行分析。结果:因用药错误引发的医疗损害责任纠纷占总体医疗损害纠纷案例的25.3%;损害结局以患者死亡比例最高(占68.3%);主要鉴定方式为医疗过失司法鉴定(占57.9%);例均赔偿金额为20.30万元;涉事医院以三级医院为主(占48.8%);涉案的主要用药错误类型为处方错误;涉案的主要药品类别为化学药,其中例数排前3位的分类依次是全身用抗菌类药物、全身用糖皮质激素类药物和精神安定类药物。结论:用药错误引发不良后果是常见的医疗纠纷原因。医疗机构应着力于完善相关制度、流程,加强药学信息化、自动化系统建设,降低用药错误的发生概率;同时,应重视医院药学人才队伍培养,充分发挥药师的作用,加强对用药错误事件的监测和干预;最后,国家司法相关部门应不断完善医疗损害责任纠纷案件的解决机制,为医患双方提供合理保障。

OBJECTIVE:To study general characteristics and medication of medical damage liability disputes cases caused by medication error,and to provide references for related departments and medical staff for preventing and reducing medication-induced medical disputes.METHODS:A total of 240 cases of medical damage liability disputes cases caused by medication error were collected from Peking University’s Fabao Law Database during Jan.2001 to Feb.2020,and analyzed in terms of general situation,damage outcome,level of the hospital involved,liability judgment and compensation,types of medication error and drug types.RESULTS:medication-related medical damage liability disputes accounted for 25.3%of overall medical damage disputes;the most damage result of patients was death(68.3%);medical negligence forensic appraisal was conducted as the main appraisal pattern with a proportion of 57.9%;the average case compensation was 203,000 yuan;the hospitals involved were mainly tertiary hospitals(48.8%);the main type of medication error involved was prescription error;chemical medicine was mainly involved,of which the top three categories were systemic antibacterial,systemic corticosteroids and antipsychotics.CONCLUSIONS:ADR caused by medication errors are the common causes of medical disputes.Medical institutions should focus on improving the relevant systems and processes,strengthen the construction of pharmaceutical information and automation system,and reduce the probability of medication errors;at the same time,great importance should be paid to the cultivation of pharmaceutical talents in hospital,give full play to the role of pharmacists,and strengthen the monitoring and intervention of medication errors.Finally,the relevant national judicial departments should constantly improve the settlement mechanism of medical damage liability disputes to provide reasonable protection for both doctors and patients.