Complicated disputes

Complicated disputes

Zhang Kun
Shanghai_Star
page02  2006-12-7

A newborn baby girl to a German businessman and his Chinese wife can no longer lift her leftarm.

An appraisal found that the problem was caused by obstetrics forceps during labour.

The hospital tried to give her physical treatments in an attempt to correct the damage,but only succeeded in further injuringthe arm, causing permanent deformity.

But the fi rst medical appraisal showed that the hospital had taken the proper procedures in treatment, and the case was not recognized as a medical accident.

Lawyer Tang Jianli of Haida Law Office then took up the case. When Tang asked the court to acquire the medical record of the baby, he found a number of changes,
falsifi cations and added information in the fi le. New writings were made, on the record,about the use of obstetrics forceps.

Yet this is only one of some 40 medical accidents announced by Shanghai Municipal Health Bureau that happened during the fi rst half of this year. Of these accidents,
14 occurred in maternity departments and 13 in surgery departments.

"Patients make easier judgments as to the treatment result in these two departments," explained lawyer Lu Yiguang."Besides, parents tend to have very high expectations for their newborns, so that even the slightest injury can easily escalate into a medical dispute."

The health bureau received 90 reports of medical accidents in the fi rst six months of this year. In the above mentioned 40 cases, the hospitals were deemed to have taken "full" or "major" responsibility.

Medical record falsifaction also seems to happen very often in medicine-related legal cases.

"Hospital staff don't realize the seriousness of medical record falsifi cation,"said Lu. "Stricter punishments should be metered out for such conduct."

Lawyers suggest patients who doubt their hospital's treatment should make copies of their medical records and have the original ones sealed in the presence of both themselves and the hospital.

"The hospital is in an advantageous position in disputes with the patient, with all the information it has," Lu said.

An authorative agency is required to offer appraisals for medical accidents, but the process brings more problems and questions on the part of the patient.

"I used to go for appraisal conferences for surgeons," said Lu. "It's not rare to see the appraiser greet the appraised in a very friendly manner, almost like an old acquaintance."

These appraisers are picked from professional medical practitioners. "It's like criticizing a colleague. When a group of appraisers sit together, it takes lots of courage for the fi rst one to speak up, pointing out the mistake of the appraised surgeon.

"Besides, the appraisers do not have to face the court," said Lu, explaining why appraisals to medical accidents are sometimes inaccurate. "Whatever their conclusion is,the appraisers face no legal obligation."

"I would recommend the appraising procedure in Xuhui District," Lu said. "Patients can sit face to face with the hospital and in front of the appraisers, who can hear the opinions from both parties. At least the legal process is fair in this way."

More ambiguous is the level of standards in these appraisals.

"There is no clear defi nition to the amount of responsibility a hospital should take in an accident," Lu said. "Say, for instance,the hospital is judged to have taken a 'minor' responsibility in a case. Who,then, should take the main responsibility,the patient?" he challenged.

Lu believed the actual number of medical accidents was larger than the announced 40 cases.

The Health Bureau tracks the record ofhospitals. If several medical accidents happen in a hospital, of which the hospital itself is deemed "main" or "total" in responsibility,the hospital will lose some funding from the government, and its president will lose opportunities for promotion.

But compared with a lost life, or a permanent deformity, this punishment does not seem much. China's hospitals are mostly owned by the State. "Some would say it is unfair to pay State assets to patients in cases of medical accidents," Lu said.

The past few years witnessed the exacerbation of confl icts between hospitals and their patients. Infuriated people have hung mourning fl owers and white paper in hospital halls, blaming the medical staff for killing their family loved ones instead of curing them. Violent scenes have also occasionally been witnessed, when patients,
or their families, vent their anger to the doctor about a failed medical treatment. There was even a bombing at a hospital in Chongqing, and the murder of one doctor in Hubei Province.

Dr Wang Shuo was consulting a patient when a woman approached him and asked:"Are you Wang Shuo?" When the doctorsaid yes, the woman produced a bottle ofdangerous liquid and sprayed it on his face,seriously injuring his cornea.

This scene happened because Wang had carried out a surgery on the woman's mother.

Doctor Wang's surgery was actually successful, but the patient later died of organfailure.

Medical staff often describe the relationship with their patients as "intense", "complicated" or "abnormal."

Relatives of patients sometimes make trouble inside hospitals, by insulting doctors or demolishing hospital property, simplybecause they believe the patient had not received the proper medical treatment.

Since no objective standard has been established on the appraisal of a medical accident, sometimes these trouble-making people are heard in the appraisals tothe
accidents, winning higher compensation in the fi nal trial.

"This becomes a vicious circle, further deteriorating the complicated relationship between hospitals and their patients," Lu said.

According to the Municipal Health Bureau, the quality of management and the technique of medical workers in hospitals still lags behind what the public demand. "Misdiagnosis, improper operation within surgeries, and improper doses of medicine are the main reasons for medical accidents,"said a report by the Bureau.