Lu J, Zhang Y L, Luo L
Xiaoshan Branch Office, Hangzhou Minghao Forensic Judical Appraisal Institute, Hangzhou 311200, China.
Fa Yi Xue Za Zhi. 2018 Aug;34(4):389-391. doi: 10.12116/j.issn.1004-5619.2018.04.009. Epub 2018 Aug 25.
To synthetically analyse the medical malpractice cases of cardiac death in forensic identification, and to explore the generality and characteristic of cause of death, medical malpractice and assessment of participation degree.
Totally 52 medical malpractice cases of cardiac death examined in the Xiaoshan Branch Office, Hangzhou Minghao Forensic Judical Appraisal Institute, from January 2015 to April 2018 were collected. The general information of cases, medical institutions and situations of hospital stay, cause of death, medical malpractice and assessment of participation degree were retrospectively analysed.
In 52 cases, the male to female ratio was 2.25:1, and most subjects aged >50-60. Cardiac death caused by hypertensive heart disease or coronary heart disease was most common （67.3%）, followed by viral myocarditis and cardiomyopathy （13.5%）. There were 24 cases involved surgery, and the survival time after surgery was from 1 h to 118 d with a 7 d medium value. There were 63 medical institutes involved in these medical malpractices. Medical malpractice presented in most hospitals more or less, and the participation degree was >20%-30%.
Forensic appraisal contributes to determine causes of death, which not only provides scientific evidence for medical malpractice identification, but also improves diagnosis and treatment levels of medical institutions.
综合分析法医鉴定中心源性死亡的医疗纠纷案例，探讨其死亡原因、医疗过错及参与度评定的特点和规律。
收集杭州明皓司法鉴定所萧山分所2015年1月至2018年4月间受理的52例心源性死亡医疗纠纷案例，对案例的一般资料、医疗机构、住院情况、死亡原因、医疗过错及参与度评定情况进行回顾性分析。
52例中，男女比例为2.25∶1，年龄多在50～60岁。以高血压性心脏病或冠心病致心源性死亡最为常见（67.3%），其次为病毒性心肌炎和心肌病（13.5%）。涉及手术24例，术后生存时间1小时至118天，中位数为7天。涉及医疗机构63家。多数医院均或多或少存在医疗过错，参与度多在20%～30%。
法医鉴定有助于明确死亡原因，不仅为医疗纠纷鉴定提供科学依据，也有助于提高医疗机构的诊疗水平。
