Liu ZhiQin About details of the case It initiates the dispute that the intestines mirror checks and punches The 72 -year-old uncle Wang's reason " The rare half congealed companion of stool obviously becomes thin for half a year " Go to one hospital to go to a doctor. Because doubt and examine it that suffers from colon, doctors have implemented mirror inspection of electronic intestines for him. After checking, uncle Wang feels belly there is a bloated pain slightly, suffer from abdominal pain and disappear after staying in bed for 20 minutes, uncle Wang leaves the institute and goes home. About 4 hours later, uncle Wang presents the indistinct bloated pain of belly again, later aggravated gradually, and symptom of nausea appears, vomiting etc.. After about 10 hour, the king uncle aggravates visit of this town of hospitals because of symptom, diagnosed as " Form intestinal perforation, filling the air peritonitis " ,Carried on the emergency call and mended the operation smoothly immediately. But 4 hours after the operation, uncle Wang breathed rapid, blood pressure to drop, have the fidgets suddenly, town hospital please make the intersection of electron and enteric the intersection of mirror and hospital that check, hold a consultation for uncle Wang originally while being urgent, plan to diagnose as " Sucking pneumonia, ARDS are early " ,Then change over to this courtyard of treatments. Diagnose as in hospital " Form postoperative intestinal perforation, filling the air peritonitis, sucking pneumonia, infective shock, ARDS, electrolyte disorderly, severe malnutritive, low albumen blood disease " . Through the complex treatment of the hospital, uncle Wang's condition obviously takes a favorable turn one week later, the physical sign of the life is steady. But 3 weeks later, uncle Wang is taken place, infected in serious institute, use breathing machine,etc. to support to treat once again, because its family give up treating 6 months later, uncle Wang's death. At time when uncle Wang is in hospital, the medical dispute take place to doctors and patients both sides, the hospital considers treating for the previous principle, have not applied for the technical appraisement of the malpractice. After uncle Wang's death, its family apply for the technical appraisement of the malpractice. The expert's conclusion that the local medical association provides is " Form the first class first rate malpractice " . The accident grade of statement of the citing case asserts it is the key " medical crash handling regulations " fourth provision that a dispute is dealt with, the medical behavior causes patient's death, severe deformity to damage the consequence, it is a first class malpractice. As everyone knows, in the malpractice dispute is dealt with, the grading of the malpractice is the just, fair key links of dealing with the medical dispute. First, the direct relation compensation question of grading of the malpractice. In article 49 of " regulations ", confirm one of the three factors that concrete compensation number should be considered, the malpractice grade is asserted. Second, the malpractice grade involves health authority's dealing with and supervising to the administration of the malpractice, also involve the duties and responsibilities between the health authorities at all levels to divide. According to the provision of article 38 of " regulations ", and may deal with the administration of the above- second -class malpractice to the malpractice dispute caused by patient's death, should be dealt with by the health authorities at a higher level of the health authorities at county level. Third, malpractice grade direct relation medical organization and the medical worker administrative penalty. The 55th provision of " regulations ", medical organization and medical worker " of a serious nature " to the malpractice happening ,can revoke responsible institution their operation licence or practising certificate. So, the malpractice determines that asserts the malpractice grade, deal with the medical organization related to malpractice dispute and an important basis of the medical worker correctly, every relevant respect should have no a bit despising. Act now so the grade is asserted and worthed discussing in this case, asserting whether it is appropriate or not to malpractice grade, become the focus that doctors and patients both sides dispute. First of all, " regulations " provision divides the malpractice grade according to the extent of damage that the medical behavior causes to patient's life, its related file " hierarchical standard of the malpractice " has just stipulated too that damages the intensity of the consequence, have enumerated and corresponded to " The wounded or disabled grade " Damage consequences of different situations, define the grade of the malpractice, depend on the extent of damage that the medical fault behavior causes to patient's life. But it's a pity, the two do not have this clear kind of damage to damage directly, include, damage derivatized to continue, take place, damage directly, and because patient's physique factor initiates the others to continue and send damaging. In addition, the current laws and regulations have not stipulated clearly that carry on the opportunity of the technical appraisement of the malpractice, practise the activity and bring some realistic questions for malpractice technical appraisement and administration of justice virtually. Because have the life caused by medical fault behavior to damage clinically, not merely the consequence is complicated, its course is multifactor too. Take this case as an example, the hospital thinks the hospital determines that asserts that it only should to suffer from the square damage consequence be intestinal perforation, filling the air peritonitis, infective shock,etc. complication caused by intestinal perforation, having taken a favorable turn and very steady through positive rescue, and it is that its itself is malnutritive to cause patient death finally seriously, the resistance of the organism is extremely low due to. Because of this, what the hospital proposed to malpractice grade asserts it should not be first class first grade. I think to state one's views reasonable involved in the case medical organization. The malpractice determines that asserts this case patient damages the grade of the consequence, should only mean intestinal perforation and complication initiated by intestinal perforation, should not include breath machine reliance, pneumonia of relevance of breathing machine initiated by patient's physique factor later, so that the damage consequence of patient's death. Assert the accident grade if includes the latter, it is that one kind is unfair to medical organization and medical worker to a certain extent. The necessary complete accident grade asserts the qualification regulation that the life that the standard our country causes to many kinds of reasons damages is sounder, I think, the malpractice appraises the hierarchical standard that it is necessary to give completely according to the following laws and regulations. 3.2 regulations of national standard GB18667-2002 " the injured personnel's disability of traffic accident of the road is evaluated ": The wounded or disabled evaluation opportunity should end for being accurate with the accident damage or really due to damaging complication treatment directly due to; End opinion to be inconsistent treating, can handle a case organ organize relevant professional personnel go on, determine, confirm whether it treats and ends. " labour capacity determines worker's industrial injury and occupational disease disable the grade GB/T16180-2006 " to the regulation appraising the opportunity for the national standard, adopt the standard of article 21 of " insurance regulations of the industrial injury ", the industrial injury takes place to the worker, the deformity exists, influence labour capacity after treating the condition of the injury relatively stably, should appraise labour capacity. Worker's industrial injury stops work and leaves the firewood one to terminate a regulation according to medical treatment, is confirmed by evaluation committee of labour capacity, do not exceed 24 months longest. <
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