116例不合理用药相关医疗损害案例分析  

Analysis of 116 Cases of Medical Damage Related to Irrational Drug Use

作　　者：李为 郭敏[1] 刘秀兰 杜金凤 刘东[1] 李娟[1] Li Wei;Guo Min;Liu Xiulan;Du Jinfeng;Liu Dong;Li Juan(Department of Pharmacy,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030;Beijing Yingke Law Firm)

机构地区：[1]华中科技大学同济医学院附属同济医院药学部,武汉430030 [2]北京盈科律师事务所

出　　处：《中国药师》2022年第3期490-493,共4页China Pharmacist

基　　金：国家重点研发计划项目(编号:2020YFC2009000、2020YFC2009001)。

摘　　要：目的:分析不合理用药导致的相关医疗损害案例,以期降低医疗机构(医方)诊疗活动的潜在法律风险。方法:收集2010年8月1日~2020年12月1日北京盈科律师事务所法律文书数据库中公布的不合理用药相关医疗损害案例,汇总分析相关案例的类型、判决原因和结果等。结果:共检索到1142例裁判文书,经法院最终判决医疗机构不合理用药存在过错的案例为116例(10.16%),其中因药物性肝损、药物相互作用、儿童用药和超说明书用药相关医疗损害案例占比较大,分别为29.31%、18.10%、14.65%和12.93%,判决结果中医疗机构方最高需承担100%的赔偿责任;判罚原因分别为:未告知风险或告知不充分、忽视了不合理用药可能导致的风险、处理不合理用药导致结果不及时、药物应用不规范。结论:当前我国医疗责任纠纷相关法律对医方与患方的责任和义务界定还不够清晰,医方对不合理用药所带来的风险认识不足,未能充分履行告知义务以及关注责任,药师应严格履行处方审核第一责任人的职责,监督、促进合理用药,降低药物治疗中的风险,保障医患双方的合法权益。Objective:To analyze the cases of medical damage caused by irrational drug use in order to reduce the potential legal risks of medical treatment activities.Methods:The cases of medical damage related to irrational drug use published in the legal document database of Beijing Yingke Law Firm from August 1,2010 to December 1,2020 were collected to analyze the types,reasons and results of the relevant cases.Results:A total of 1142 judgment documents were retrieved,of which adverse reactions(49.91%)and route of administration(15.76%)were the most common;the court finally judged that medical institutions were at fault in irrational drug use in 116 cases(10.16%).Among them,drug-induced liver damage,drug interactions,children*s medications and off-label medications accounted for a relatively large number of 29.31%,18.10%,14.65%and 12.93%,respectively.The maximum liability for compensation was 100%;the main reasons for the judgment were as the follows:failure to inform or inadequate notification of risks,ignoring the risks that may result from irrational drug use,untimely treatment of unreasonable drug use and irregular drug application.Conclusion:The current laws related to medical liability disputes in our country are not clear enough to define the responsibili-ties and obligations of doctors and patients.Doctors have insufficient understanding of the risks caused by unreasonable drug use,and fail to fully fulfill the obligation of notification and attention.Pharmacists should strictly fulfill the responsibilities of the first responsible person for prescription review,supervise and promote rational drug use,reduce the risks in drug treatment,and protect the legitimate rights and interests of both doctors and patients.

关 键 词：不合理用药 医疗纠纷 处方审核 药品风险管理 

分 类 号：R969.3[医药卫生—药理学]