甲状腺手术医疗损害鉴定10例分析  

Analysis of 10 Forensic Clinical Cases Involving Medical Damage Caused by Thyroid Surgery

作　　者：李丽增 徐静涛[1,2] 陈莉坚 王爱枫[1,2] LI Lizeng;XU Jingtao;CHEN Lijian;WANG Aifeng(School of Forensic Medicine,Guangzhou 510515,China;Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学法医学院,广东广州510515 [2]南方医科大学司法鉴定中心,广东广州510515

出　　处：《中国司法鉴定》2019年第3期27-34,共8页Chinese Journal of Forensic Sciences

摘　　要：目的总结和探讨甲状腺外科手术后出现不良后果的医疗损害司法鉴定案例。方法对南方医科大学司法鉴定中心2011—2016年受理并完成的10例甲状腺外科手术相关医疗损害鉴定案件,从案件概况、医疗过错评定、过错行为与损害后果之间因果关系及原因力大小进行回顾分析。结果10例案件经鉴定均存在医疗过错行为,且与患者损害后果存在因果关系,按照原因力大小分级,主要因素7例,同等因素2例,次要因素1例。结论甲状腺外科手术治疗各环节均可发生医疗过错行为,因并发症的发生而导致医疗纠纷。在实际鉴定中,应从术前诊断、手术指征、术前准备、手术操作、术后并发症的处理、知情告知等各方面评估诊疗行为,结合患者损害后果客观评定过错参与度。Objective To summarize and discuss the forensic expertise cases involving medical damages related to thyroid surgeries.Method 10 cases of medical damages related to thyroid surgery in Southern Medical University from 2011 to 2016 were collected.The reviewed date included general profiles,medical negligence analysis,casual relationship between negligence and medical damage consequences,and analysis of the degree of medical negligence.Results Medical negligence existed in all 10 cases according to the forensic expertise,and there were casual relationships between negligence and damage consequences.Medical negligence was the main factor that caused damages in 7 cases,the same factor in 2 cases and the secondary factor in one case.Conclusion Thyroid surgery can produce medical disputes in every step of the disease diagnosis and treatment.In the practice of forensic expertise,we should assess medical behaviors from the aspects including pre-operative diagnosis,surgical indication,surgical preparation,surgical technique,complication treatment and medical informed notification,and evaluate the degree of medical negligence objectively combining with the patients' medical consequences.

关 键 词：医疗损害鉴定 甲状腺外科手术 并发症 医疗纠纷 

分 类 号：DF795.4[医药卫生—法医学]