Forensic Pathological Study On 586 Cases Of Medical Tangle

【Background】With the rapid development of society and the constant improvement of living standard in our country, people pay more and more attention to self-health. Hence the higher standards and requirements are put forward for the medical work and condition. Although medical and health work have greatly improved since reform in China, the medical and health conditions, especially in the medical environment, don't meet the people's expectation for a variety of reasons. Therefore the medical tangle has increased unceasingly and become one of focus to which was closely paid attention by people.Medical tangle is referred to the dispute caused by the disagreement on the medical consequences between patients and doctors. The patient and his relatives often think that it was hospital's responsibility and should pay for it. As people do not understand well the medical consequences, even misunderstand it, they thought their lives would be assured as long as they went to the hospital, and the doctor has not done their work well enough and should be responsible for it once some problems happened in hospital. With the improvement of people's law and rights awareness, it is easy to happen to medical tangle, In addition, the new"Regulations of the medical malpractise"promulgated on September 1, 2002 performed a new method of"inverted evidence"which is a new challenge to medical workers. Whereby we selected autopsied materials of medical tangle in our department and retrospectively analyzed some characteristics about them in order to offer some references for reasonable medicating medical tangle for relative departments and clinical workers and for constructing harmonious relationship between doctor and patient and maintaining social stability. 【Objects】This dissertation is to retrospectively study and analyze some characteristics of autopsied cases of medical tangle in order to offer some references for reasonable medicating medical tangle for relative departments and clinical workers. The main contents included as follows: the incidence of medical tangle, departments of these cases of medical tangle, the gender and age of these subjects, distribution of cause of death, coincidence between the pathological and clinical diagnoses, and the importance of autopsy in dealing with medical tangle and so on.【Materials and Methods】586 cases have been collected in file of Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology from January 1999 to December 2008. Firstly we selected and read all materials of each case and designed some tables and forms, and then filled them one by one. Lastly all statistical information was analyzed.【Results】①Of 2465 autopsied cases during 10 years, there were 586 cases of medical tangle, accounting for 23.77%, with ages ranging from 1 days to 82 years old and male was a little more than female, but boy was much more than girl within 10 years old children.②There were 2 predominant age groups, 31~40 years old (112cases, 19.11%) and baby within1 year old (97cases,16.55%).③The cases of medical tangle happened in obstetrics and gynecology were more than other departments of hospital, but it deserves to pat attention to the cases both in private clinic and illegal practice medicine.④The interval time between death and autopsy were mainly with 48 hours (47.40%).⑤The most causes of death were due to natural disease and original injury, true malpractice was only minority(6.66%). The commonest disease was cardiovascular disease. Therefore medical tangle is never the same thing as medical malpractice.【Conclusions】The case of medical tangles is increasing, of which, the predominant age group are 31~40 years old and baby within1 year old, with the cases happened in obstetrics and gynecology being more than other departments of hospital, but it deserve to pat attention to the cases both in private clinic and illegal practice medicine. The most cause of death is caused by natural disease and original injury and true malpractice is only minority, of which the commonest disease is cardiovascular disease. Therefore medical tangle is never the same thing as medical malpractices. Forensic pathological autopsy and identification can provide important scientific basis for identifying the cause of death, dividing responsibility and mediating medical tangle fairly and reasonably, and it should be done as earlier as possible.