药源性交叉过敏医疗纠纷分析及其处方审核策略研究  

Analysis of medical disputes related to drug-induced cross-allergy and study on prescripition review strategy

作　　者：李为 张程亮 薛娉娉 杜金凤 刘东[1] LI Wei;ZHANG Chengliang;XUE Pinpin;DU Jinfeng;LIU Dong(Department of Pharmacy,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Beijing Yingke(Wuhan)Law Firm,Wuhan 430000,China)

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(武汉)律师事务所,武汉430000

出　　处：《药物流行病学杂志》2024年第1期2-8,共7页Chinese Journal of Pharmacoepidemiology

基　　金：国家重点研发计划项目“主动健康和老龄化科技应对”重点专项(2020YFC2009000、2020YFC2009001)。

摘　　要：目的 分析药源性医疗纠纷交叉过敏相关案例的规律与特点,为交叉过敏处方审核策略的制定提供参考。方法 对2010年8月—2023年6月录入北京盈科律师事务所法律文书数据库或中国裁判文书网数据库中交叉过敏相关医疗损害责任纠纷案例的判决书进行分析,汇总分析相关纠纷的原因并制定较为全面的应对措施。结果 共检索到符合标准的判决书7份。导致交叉过敏的药物主要为抗菌药物(青霉素类、头孢菌素类及磺胺类)。7例医疗纠纷法院均判决医方因交叉过敏存在医疗过错,需承担30%~80%的赔偿责任;判罚理由主要为医方对患者的既往过敏史关注不足、选择药物不合理。结论医疗机构可利用信息化的手段降低交叉过敏发生风险,并发挥药师在处方审核与药学服务中的作用。医师应重视患者既往过敏史,切实询问,加强用药教育及监护,减少不良反应对患者造成的生命安全威胁及相关用药纠纷,保障医患双方合法权益。Objective To analyze the rules and characteristics of cross-allergy cases related to drug-related medical disputes,and to provide reference for the formulation of cross-allergy prescription review strategy.Methods The judgments of cross-allergy related medical damage liability disputes recorded in the legal document database of Beijing Yingke Law Firm and the Chinese Judgment Document Network database from August 2010 to June 2023 were analyzed,the causes of relevant disputes were summarized and analyzed,and more comprehensive response measures were formulated.Results A total of 65 judgments were retrieved,and seven judgments were included.The main drugs causing cross allergy were antibiotics(penicillins,cephalosporins and sulfonamides).Seven cases of medical disputes,all of which were ruled by the court that the medical party had medical errors due to cross-allergies,and had to bear 30%to 80%of the compensation liability.The main reasons for the punishment were that the doctor did not pay enough attention to the patient's past history of allergy and chose unreasonable drugs.Conclusion Medical institutions can reduce the risk of cross-allergy by means of information technology,and play the role of pharmacists in prescription review and pharmaceutical care.Physicians should pay attention to the patient's past history,earnly inquire,strengthen medication education and monitoring,reduce the threat of adverse reactions to the patient's life safety and related drug disputes,and protect the legitimate rights and interests of both doctors and patients.

关 键 词：交叉过敏 医疗纠纷 侵权责任 处方审核 药品不良反应 

分 类 号：R197.3[医药卫生—卫生事业管理]