Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, China.
Center for Medicolegal Expertise of Sun Yat-Sen University, Guangzhou 510080, China.
Fa Yi Xue Za Zhi. 2021 Feb;37(1):49-53. doi: 10.12116/j.issn.1004-5619.2019.491105.
Objective To explore the causes and characteristics of medical disputes caused by death after cardiac surgery and to analyze the pathological changes after cardiac surgery and the key points of forensic anatomy, thus to provide pathological evidence for clinical diagnosis and treatment of cardiac surgery and judicial appraisal as well as reference for the prevention of medical disputes in such cases. Methods Forensic pathological cases of medical disputes caused by death after cardiac surgery which were accepted by the Center for Medicolegal Expertise of Sun Yat-Sen University from 2013 to 2018 were analyzed retrospectively from aspects such as causes of death, pathological diagnosis, surgery condition, medical misconduct, and so on. Results The causes of death after cardiac surgery of 43 patients were abnormal operation, low cardiac output syndrome, postoperative infection, postoperative thrombosis, and other diseases. Among the 43 cases, there were 18 cases without medical fault while 25 cases had medical fault. Conclusion The medical disputes caused by death after cardiac surgery are closely related to the operative technique and postoperative complications. The causes of medical faults include defects in diagnosis and treatment technique, as well as unfulfillment of duty of care.
目的 探讨心脏手术后死亡引发医疗纠纷的原因及特点，分析心脏手术后的病理变化及法医解剖要点，为心脏手术后临床诊治提供病理依据，为司法鉴定及此类纠纷的防范提供参考。方法 对中山大学法医鉴定中心 2013 年至 2018 年受理的心脏手术后死亡引发医疗纠纷的法医病理学案例进行回顾性分析，从死亡原因、病理诊断、手术情况、医疗过错等方面进行分析。结果 43 例心脏手术后死亡患者的死亡原因为手术操作异常、低心排综合征、术后感染、术后血栓形成等其他疾病。43 例患者中，无医疗过错 18 例，有医疗过错 25 例。结论 心脏手术后死亡引发的医疗纠纷与手术操作及术后并发症密切相关，医疗过错的原因包括诊疗技术缺陷及未尽到注意义务。
