65例新生儿脑损害医疗赔偿案件分析及对策建议  

Analysis of 65 cases of medical compensation for neonatal brain damage and countermeasures

作　　者：王惠琼[1] 邱小英 Wang Huiqiong;Qiu Xiaoying(Department of Medical safety office,Hunan Provincial People's Hospital(The First Affiliated Hospital of Human Normal University),Changsha 410005,China;Department of oncology II,Hunan Provincial People's Hospital(The First Affiliated Hospital of Human Normal University),Changsha 410005,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)医疗安全办,湖南长沙410005 [2]湖南省人民医院(湖南师范大学附属第一医院)肿瘤二科,湖南长沙410005

出　　处：《中国法医学杂志》2024年第5期610-615,共6页Chinese Journal of Forensic Medicine

摘　　要：目的分析65例新生儿脑损害医疗赔偿案件的特点及规律,并提出对策建议,为改善产科诊疗工作提供参考。方法以新生儿脑损害为关键词,检索2021年6月—2023年6月期间中国裁判文书网上发布的判决文书,用Excel表建立资料数据库,对案件基本情况、伤残等级、鉴定意见等进行统计分析。结果共检索到相关裁判文书79例,纳入裁判文书65例,其中,90.77%发生于近10年(2011—2020年);发生于星期六—星期日、星期五、星期一—星期四的比例分别为38.46%、15.38%、46.16%;法院判决医方责任为50%及以上占49.23%,50%以下占50.77%;赔偿金额100万元及以上、50~99万元、10~49万元、9万元及以下的比例分别为18.46%、12.31%、49.23%、20.00%;主要责任原因为医疗、护理技术不当、医护人员疏忽、超范围诊疗、病历记录缺陷、未充分告知风险和其它因素的比例分别为29.23%、20%、7.69%、9.23%、13.85%和20%;发生于三级医院、二级医院、一级医院及乡镇、社区医院的比例分别为52.31%、41.54%、6.15%;新生儿一级伤残、二级伤残、三级及以上伤残和不明级别的比例分别为18.46%、18.46%、21.54%、41.54%。结论新生儿脑损害赔偿案件伤残等级均较严重,突出反映了产科医疗资源配置不合理、“产科周末效应”、产科诊疗规范执行不足、医护人员法律意识淡薄等问题,因此,要针对上述问题加强对新生儿脑损害的预防及处理,减少事件的发生,助力和谐的医患关系的建立。Objective To analyze the characteristics and rules of 65 cases of medical compensation for neonatal brain damage,and put forward countermeasures and suggestions to provide reference for improving obstetric diagnosis and treatment.Methods Using neonatal brain damage as the key word,the judgment documents published on China Judgments Online from June 2021 to June 2023 were retrieved.the data database was established with Excel,and the basic situation of the case,disability grade and appraisal opinions were statistically analyzed.Results A total of 79 cases of relevant judgment documents were retrieved,and 65 cases were included in the judgment documents,of which 90.77%occurred in the last 10 years(2011-2020).38.46%,15.38%and 46.16%occurred on Saturday to Sunday,Friday and Monday to Thursday,respectively.The proportion of medical institutions being judged by the court to bear 50%or more of the responsibility was 49.23%,and the proportion of less than 50%was 50.77%;The proportions of compensation amount of 1 million yuan and above,500,000-990,000 yuan,100,000-490,000 yuan and less than 90,000 yuan were 18.46%,12.31%,49.23%and 20.00%respectively.The main causes of responsibility were improper medical and,nursing techniques,negligence of medical staff,outof-range diagnosis and treatment,defects in meidcal record keeping,insufficient risk notification,and other factors,which were 29.23%,20%,7.69%,9.23%,13.85%and 20%,respectively.The incidence rates in tertiary hospitals,secondary hospitals,primary hospitals or township hospitals and community hospitals were 52.31%,41.54%and 6.15%,respectively.The proportion of first degree disability,second degree disability,third degree and above disability and unknown grade of newborn were 18.46%,18.46%,21.54%and 41.54%,respectively.Conclusion The disability level of newborn brain damage compensation cases is relatively serious,which highlights the problems such as unreasonable allocation of obstetric medical resources,"obstetric weekend effect",insufficient implementation of obstetri

关 键 词：新生儿 医疗损害 产科 医疗纠纷 

分 类 号：D919.5[医药卫生—法医学]