An analysis on the current situation and compensation in the obstetrics and gynecology-related medical malpractice second-instance cases in Henan Province
Objective To analyze the characteristics,causes,judicial expertise,and compensation of the medical malpractice second-instance cases related to obstetrics and gynecology in Henan Province to prevent medical malpractice and reduce social burden.Methods This empirical research was conducted by collecting second-instance medical malpractice cases related to obstetrics and gynecology,which were trialed in intermediate people's courts from January 2017 to December 2021.A total of 1,897 documents were examined,including 1,024 medical malpractice cases and 164 second-instance medical malpractice cases of obstetrics and gynecology.Results The results showed a downward trend in the second-instance medical malpractice cases since 2019.In 46.34%of the secondinstance cases(76/164 cases),it was unilaterally appealed by the medical institutions.Among the second-instance verdicts,75.00%(123/164 cases)upheld the original judgment by rejecting the appeal.The main points of the contention were violations of diagnosis and treatment standards,improper operations,insufficient disclosure obligations,and non-standard medical records.The quantity of forensic appraisal for obstetric and gynecological medical malpractice was significantly greater than the quantity of technical appraisal performed by medical associations.However,there was no statistically significant difference in the acceptance rates by the second-instance court between the two groups(P≥0.05).Among various hospital grades,second-grade hospitals accounted for 54.40%(22.42/41.21 million RMB)of the total compensation paid by hospitals(H = 6.146,P≤0.05).Forensic appraisal fees were shared by both parties according to the degree of responsibility in 80.17%cases(97/121 cases).The compensation rate for mental impairment reached 72.60%(119/164 cases),and the mental impairment compensation accounted for 60.00%(3.00/5.00 million RMB)of the total claims.Conclusion Improving the regulations for preventing and handling medical damages,strengthening the management of medical records and treatment protocols in the obstetrics and gynecology departments of second-grade hospitals,and fulfilling the duty to provide comprehensive information can contribute to reducing the occurrence of medical malpractice.The medical institutions should attach importance to the presentation of evidence and defense during the first instance,particularly focusing on the causality and the degree of responsibility.Both doctor and patient sides should avoid the need of retrial,reduce the wastage of judicial resources,maintain the social stability,and alleviate the burden on society.The dual-track system for medical malpractice appraisal still has certain rationality.
Obstetrics and gynecologyMedical malpracticeForensic appraisalCompensationSecond-instance casesHenan Province