Medical dispute: The hospital was ordered to pay 200,000 yuan in compensation for the hysterectomy after insisting on massive bleeding after vaginal birth

2022-06-14 0 By

On October 3, 2020, the plaintiff checked into the defendant’s office for full term pregnancy.After being admitted to the hospital, the defendant carried out various relevant examinations on the plaintiff and found it suitable for a vaginal delivery (the plaintiff requested a cesarean section, but the hospital did not accept the plaintiff’s opinion). The plaintiff delivered a baby boy naturally at 16:45 on 4 October.Postpartum, the plaintiff’s vagina continued to bleed.Later, the defendant was diagnosed with postpartum hemorrhage, uterine weakness, hemorrhagic shock, disseminated intravascular coagulation, acidosis and other diseases. In order to save the plaintiff’s life, the defendant finally performed total hysterectomy for the plaintiff.On October 6, 2020, the plaintiff was transferred to the First Affiliated Hospital of China Medical University for further treatment.After his condition stabilized, the plaintiff was transferred back to Liaoyang Central Hospital for further treatment on October 11, but thrombosis had formed in the course of treatment.On November 9, 2020, the plaintiff was discharged from the hospital and went home to recuperate.The plaintiff (Wang Mou) thinks that the defendant hospital is at fault and should assume the liability for compensation. After the two parties negotiate fruitlessly, the plaintiff complains to the local people’s court and sees the details of the trial.The plaintiff argues that on October 3, 2020, the plaintiff was admitted to the defendant’s office because she was pregnant and expecting to give birth.After being admitted to the hospital, the defendant conducted various examinations on the plaintiff and the plaintiff gave birth to a baby boy at 1645 hours on October 4.Postpartum, the plaintiff’s vagina continued to bleed.Later, the defendant was diagnosed with postpartum hemorrhage, uterine weakness, hemorrhagic shock, diffuse intravascular coagulation and other diseases. In order to save the plaintiff’s life, the defendant finally performed total hysterectomy for the plaintiff.On October 6, 2020, the plaintiff was transferred to the First Affiliated Hospital of China Medical University for further treatment.After his condition stabilized, the plaintiff was transferred back to Liaoyang Central Hospital for further treatment on October 11, but thrombosis had formed in the course of treatment.On November 9, 2020, the plaintiff was discharged from the hospital and went home to recuperate.In the process of motherhood and the treatment of postpartum hemorrhage, whether the defendant to the plaintiff is suitable for the natural production were not told, don’t accept the plaintiff asked to cesarean section, postpartum vaginal bleeding, found that the plaintiff did not timely and effective treatment, the loss of the best treatment opportunity, causes the plaintiff in extreme danger of life, and just keep life, at the price of the loss of the uterusThese brought great harm and hidden danger to plaintiff’s health.Therefore, the plaintiff holds that there is a causal relationship between the defendant’s medical misconduct in the treatment of the plaintiff’s pregnancy, childbirth and postpartum hemorrhage.Therefore, the defendant shall bear the corresponding compensation liability for the medical expenses and other economic losses incurred by the plaintiff due to the physical injury.To sum up, the plaintiff makes the above request based on the above facts and reasons, and requests your court to make a fair ruling in accordance with the law to safeguard the legitimate rights and interests of the plaintiff.The defendant holds that: for the compensation in this case, our hospital agrees to pay compensation according to the appraisal conclusion and relevant standards. Since the causal relationship is between 31% and 50% according to the appraisal conclusion, our hospital agrees to pay compensation according to the compromise standard, that is, 40% responsibility proportion.The mental compensation claimed by the plaintiff is too high, and the cost of living of the dependents is wrongly calculated. The nursing fee after discharge should be calculated according to the resident service standard multiplied by the nursing period of 60 days in the appraisal conclusion.A judicial appraisal court entrusts a judicial appraisal institute to issue a written opinion on judicial appraisal.In the third People’s Hospital of a certain city, there was a causal relationship between inaccurate uterine packing, incomplete arterial ligation, delayed surgical treatment, and too long operation time in the treatment of the identified person Wang, and the delayed control of postpartum hemorrhage, the occurrence of DIC and inevitable hysterectomy.There was a causal relationship between the medical injury factors and the patient’s own factors (uterine weakness), and the participation rate of medical injury was between secondary responsibility and equivalent responsibility (31%-50%).2. After total hysterectomy, wang Mou, the identified person, constituted seven levels of disability.3. After hysterectomy, the nursing period and nutrition period of the identified person Wang were 60 days and 60 days respectively.4. The follow-up treatment fee of the identified person Wang mou thrombosis shall be subject to the actual occurrence.The court believes that the medical institution and its medical staff are at fault if the patient suffers damage in the diagnosis and treatment activities, the medical institution shall bear the liability for compensation.In this case, it has been identified that there is a causal relationship between the medical injury factors and the patient’s own factors in the occurrence of the injury consequences, and the participation of medical injury is between secondary liability and equivalent liability (31%-50%), so it is appropriate for the third People’s Hospital of the defendant to bear 40% of the liability.Judgment Result On December 29, 2021, the court made a judgment: the defendant of the third People’s Hospital of a city to compensate the plaintiff Wang Mou 209,333.61 yuan.The author reminds 1. Why are hospitals unwilling to give pregnant women cesarean section?(1) The state has established assessment standards.According to statistics, the cesarean section rate in China was 5% in the 1980s, no more than 10% in the 1990s, and as high as 36% ~ 58% in 2010.The world Health Organization has set a safe limit of 15 percent for cesarean section, which China has exceeded by a large margin.Therefore, the National Health Commission in the “2011 ~ 2020 Chinese women and children to carry out the outline implementation plan” will “improve the rate of natural childbirth, reduce the rate of cesarean section”, into the assessment of modern hospitals within the scope.If a hospital doctor casually allows a pregnant woman to perform cesarean section, it will be difficult to achieve the goal, affecting the assessment standard of the hospital, this risk is actually many doctors do not dare to disclose.(2) Cesarean section without indication is not supported medically.According to the Expert Consensus on Cesarean Section (2014), the indication of cesarean section refers to the pathological or physiological state in which vaginal delivery is impossible or unsuitable.There are indications for cesarean section only when the following conditions exist: fetal distress, missize cephalic pelvis, scar uterus, abnormal fetal position, placenta previa and prevascular, twin or multiple pregnancy, umbilical cord prolapse, placental abruption, pregnant women with serious complications and complications:Such as heart disease can not bear vaginal delivery, pregnancy huge children, birth malformation, genital diseases, reproductive tract serious infectious diseases, pregnancy combined with tumors.Cesarean section required by pregnant women must also meet certain conditions: the American College of Obstetricians and Gynecologists (cesarean section required by pregnant women) defined as a single term, no medical indication for the implementation of cesarean section required by pregnant women.A. The pregnant woman’s personal request shall not be regarded as an indication for cesarean operation. If there are other special reasons, it shall be discussed and recorded in detail.B. When a pregnant woman requests a cesarean section without knowing her condition, she should be informed in detail about the overall advantages and disadvantages and risks of cesarean delivery compared with vaginal delivery and record them.C. When a pregnant woman requests a cesarean section because of her fear of the pain of vaginal delivery, psychological counseling should be provided to help alleviate her fear;Labor analgesia is used to relieve labor pain and shorten labor.D. The clinician has the right to refuse a request for cesarean section where there is no clear indication, but the pregnant woman’s request should be respected and the alternative recommended.Because this case although the patient points out the hospital does not give cesarean section to have the fault, but the appraisal organization did not adopt this opinion.2. The hospital should fully explain whether cesarean section can be delivered to obtain understanding.Lawyer Lin come into contact with most of the medical dispute is related to labor, with all the hospital adherence to natural labor disputes childbirth way, and is the cause of the dispute, they think that if the cesarean delivery, or adopting cesarean delivery in time, birth trauma, such as neonatal brachial plexus injury will happen cerebral hemorrhage, neonatal asphyxia, and so on and so forth.Therefore, to fully explain the choice of natural birth mode, obtain understanding, is conducive to ease the contradiction between doctors and patients, reduce the occurrence of medical disputes.3. What are the hazards of cesarean section?Due to the delivery mode of cesarean section, it is easy to cause harm to the puerpera, as follows :(1) the injury of anesthesia.Cesarean section surgery will mostly use semi-anesthesia (spinal anesthesia and epidural anesthesia), unless in the case of emergency will be used general anesthesia, and anesthesia may cause some side effects, such as dizziness, headache, nausea and vomiting, but also may affect the blood circulation, resulting in insufficient blood oxygen and other conditions.(2) Injuries during surgery.Due to cesarean section is cut open belly into the uterus to fetal maternal straight out, it’s very test doctor medical skill and operation environment, if in the whole process, appear one by one small error, are likely to become infected, endanger the life safety of the maternal and fetal, blood loss and operation in the accident situation is much better than the natural birth.(3) Postoperative injuries.Because cesarean section does not belong to the way of natural delivery, the recovery rate will be much slower than natural birth, such as natural birth in the first day can be free to get out of bed, to feed the child, and cesarean section in the second day need to be supported by the family, it is possible to get out of bed.In addition, Cesarean section will leave wounds and scars on the abdomen and uterus, if the incision is not completely healed, it is easy to form scar uterus, and when pregnancy again, there is the risk of uterine rupture, the probability of premature delivery and abortion will increase accordingly.(4) for the baby, because the fetus in the Caesarean section, without the strength of contractions, extruded from the mother’s birth canal, but directly from the womb by the doctor out, therefore, will have a certain impact on the baby, as follows.A. Damage body sensitivity.Since no part of the baby’s body is squeezed by the curved and narrow birth canal, his body’s touch and sensitivity may be lower than a natural birth.B. Respiratory system affected.Because the baby’s head, lungs and so on are not squeezed by the mother’s birth canal, there is no breathing under atmospheric pressure, it is easy to cause amniotic fluid inhalation, and respiratory problems in the lungs.According to statistics caesarean section of the baby with aspiration pneumonia probability than vaginal delivery of the baby to be much greater.C. Immune system.Because the baby is not ripe and squeezed by the birth canal, the tissues and organs of the body are not fully exercised, leading to the strong immune ability of the baby is not as strong as that of the natural birth. Moreover, studies have shown that there are 27 kinds of microorganisms in the birth canal of Chinese women of the right age, which will promote the systematic development of the baby.Pictures from the network, the case from The Chinese judgment documents network, if there is infringement please notice to delete