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Retrospective Analysis: The Medical Dispute Appraisal of 78 Cases of Sudden Cardiac Death
ZHANG Ping, XU Hui, GAO Jue, JIANG Shihao, ZHANG Zhixiang, SHI Xiaoling
2023(5):
57-63.
DOI: 10.3969/j.issn.1671-2072.2023.05.008
Objective To explore the characteristics, causes and appraisal approach of sudden cardiac death induced medial disputes. Methods 78 cases of sudden cardiac death were analyzed retrospectively. Results The incidence of sudden cardiac death in male was higher than that in female, and mainly happened in the rang of 40-59 years old. 37 cases had acute coronary syndrome, 24 cases had aortic dissection, 10 cases had myocarditis, 1 case had heart conduction system disease, 2 cases had valvular disease, 2 cases had congenital heart defect, and 2 had other situations. The departments primarily responsible for medical errors were counted as follows: cardiovascular department （48 cases）, emergency department （15 cases）, general surgery department （7 cases）, orthopedics department （3 cases）, respiratory department （3 cases） and endocrinology department （2 cases）. In the cases mentioned above, 6 cases had no fault in diagnosis and treatment, 15 cases had faults in diagnosis and treatment, but had no cause-and-effect relationship with the patient’s death. 32 cases had weak cause-and-effect relationship between the faults in diagnosis and treatment and the patient's death. In 18 cases, the faults in diagnosis and treatment were of secondary responsibility for the death of patients. In 3 cases, the faults in diagnosis and treatment were of primary responsibility for the death of patients. No case was completely responsible for the death of patients. Conclusion The occurrence of medical disputes about sudden cardiac death is affected by many factors. Consequently, the high risk of disease, the degree of diagnosis and treatment fault, and the compliance of patients should be considered in the forensic appraisal of medical malpractice. Sudden cardiac death is characterized by acute onset, rapid change of condition, atypical clinical manifestations and low rescue success rate, which are the main reasons for the low proportion of the causal force between medical errors and patients’ death.
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