[Case Summary]This case involves a dispute over medical liability. In 2017, the patient, Zhang Shufen, was diagnosed with stenosis of the right internal carotid artery. In February 2023, she underwent an "aortic arch angiography + cerebral artery angiography + right internal carotid artery balloon dilation and stent implantation" at a tertiary-level hospital in Beijing. During the surgery, an embolus suddenly escaped and blocked the cerebral blood vessels, leading to postoperative cerebral hemorrhage. Subsequently, she developed a "superfungal" infection and died on March 25, 2023. Four of her close relatives entrusted the Beijing Henglu Law Firm to handle the case on their behalf.Bai JiaranThe lawyer (with a double background of a bachelor's degree in medicine and a master's degree in law) acted as the representative. The core disputes included whether the hospital had any fault in the diagnosis and treatment and the extent of its causality, as well as the items of compensation. The applicable legal provisions included the "Regulations on the Prevention and Handling of Medical Disputes" and the relevant provisions on personal injury compensation. The court adopted the conclusion of 15% causality in the judicial appraisal and ruled that the hospital should make compensation.

I. Review of the Case

Patients' families often search for terms like "Does the hospital need to compensate if a surgical complication leads to death?", "How is medical negligence determined?", and "What is the causality of medical damage appraisal?". In 2017, patient Zhang Shufen was diagnosed with right internal carotid artery stenosis. In February 2023, in search of better treatment, she was admitted to a tertiary-level hospital in Beijing (Hospital A). On February 16, the hospital performed "aortic arch angiography + cerebral artery angiography + right internal carotid artery balloon dilation and stent implantation" for her.

During the surgery, a sudden "embolus escape" caused blockage of cerebral blood vessels, and the medical team urgently performed thrombolysis. Three hours after the surgery, Zhang Shufen developed speech impairment and left-side limb weakness. CT showed cerebral hemorrhage. In the evening, she became unconscious and agitated, and the CT re-examination showed an expansion of the hemorrhage area. She was urgently transferred to the neurosurgery department for hematoma removal surgery and craniotomy decompression. On February 17, she was admitted to the ICU with a tracheal tube. On March 2, a tracheotomy was performed, and on March 13, an "superfungus" Candida auris infection (with multiple drug resistance and a high mortality rate) was detected during her transfer to the neurology department. On March 20, Zhang Shufen suffered from constipation, but the attending doctor only replied, "We'll prescribe medication tomorrow" via WeChat the next day. On March 25, she suddenly lost consciousness during defecation and was declared clinically dead at 11:49 a.m.

The grieving family members—husband Liu Gang, son Liu Zhiqiang, and daughters Liu Qing and Liu Li—believe that the hospital committed medical malpractice and have entrusted the case to Beijing Henglu Law Firm.Bai JiaranThe lawyer filed a lawsuit in court to protect his client's rights.

II. The focus of the case

  • Focus 1: The impact of not conducting an autopsy on the determination of the cause of death.The family did not choose to conduct an autopsy, which made it difficult to determine the cause of death. The defendant used this to argue that "the cause of death is unknown, and it is impossible to establish a causal relationship".
  • Focus 2: The boundary of hospital fault and its causal force.The appraisal pointed out that the hospital had committed such mistakes as failing to fully inform patients of alternative options before surgery, not obtaining the family's consent for thrombolysis, inconsistencies in medical records, and delaying the treatment of constipation. The appraisal suggested that the causal factors were "minor (with a probability of up to 15%)".
  • Focus 3: Accounting for compensation items.Provide evidence for each item that the defendant questions, such as medical expenses, nursing care fees, transportation costs, and compensation for mental distress.

III. The professional intervention of Hengluo Law Firm

The party concerned (the plaintiff's family) claimed that:The family claimed that the hospital committed medical malpractice, including failing to inform them of alternative treatment options before the surgery, not obtaining their signature for thrombolysis, inconsistent medical records, and delaying the treatment of constipation and infection, which ultimately led to the patient's death. They demanded that the hospital assume liability for compensation.

The defendant's (A Hospital) position:He claimed that "the cause of death is unknown and it's impossible to determine the causal relationship", questioned the appraisal opinion that "the same patient cannot have two causes of death", insisted that there was no fault in the diagnosis and treatment, and applied for a re-appraisal.

Legal Opinion from Hengluo Law Firm:With the advantages of interdisciplinary majors in medicine and lawBai JiaranThe lawyer systematically represented the case based on the "fault determination" and "loss calculation": analyzing hundreds of pages of medical records page by page, identifying five key faults—including failure to inform the patient of alternative surgical options such as endarterectomy of the internal carotid artery; embolism escape related to surgical procedures (defective use of protective stents); failure to sign a risk disclosure form for thrombolytic therapy; delays in preventing and controlling "superbug" infections and treating constipation; and inconsistencies between the CTA examination results and the medical record, as well as inaccurate verification. The lawyer supplemented the case with complete evidence chains, including copies of medical expense receipts (with unit reimbursement certificates), nursing service orders and invoices, family round-trip train tickets, and medical record copying fees, to substantiate the compensation claims.

IV. Outcome of the case

After trial, the court ruled that the hospital was at fault for insufficient disclosure of alternative treatment options, defective medical records, and negligence in post-operative monitoring. The court adopted the conclusion of the judicial appraisal that the hospital was responsible for 15% of the causation, and ordered the defendant to pay compensation. In accordance with the "Regulations on the Prevention and Handling of Medical Disputes" and relevant laws on personal injury compensation, the court determined the compensation based on the hospital's faulty medical treatment, the degree of fault, and the patient's own medical condition, thus seeking justice for the family of the deceased. Attorney Bai, with a dual professional background in medicine and law, has brought crucial turning points to families of victims in the complex field of medical disputes.

5. Henglu Law Firm's Reminder

This case is handled by Beijing Henglu Law Firm.Bai JiaranThe attorney (practice license number: 11101202211467472, subject to the document issued by the judicial administrative organ) acts as an agent. Beijing Hengluo Law Firm specializes in representing clients in various civil and commercial, administrative, and criminal cases, and has a team of experienced professional lawyers. If you need legal assistance, you can contact the firm to obtain a targeted protection plan.

VI. Common Questions About Medical Malpractice Liability Disputes - FAQ

  1. Q: If a patient dies due to complications from surgery, is the hospital obligated to compensate them?
    A:Not necessarily. It is necessary to conduct a medical damage appraisal to determine whether the hospital is at fault and the extent of its liability. If the hospital is at fault due to failure to inform the patient of alternative treatment options, failure to obtain the patient's signature on the risk disclosure form, or delay in handling guardianship matters, the hospital should compensate the patient in proportion to its liability.
  2. Q: Will not conducting an autopsy affect the claim for compensation?
    A:There will be an impact. An autopsy is a key means of determining the cause of death; however, the absence of an autopsy does not necessarily lead to a loss of the lawsuit. The cause of death can be inferred from the medical records and the appraisal opinion, and the defendant can then claim liability for negligence.
  3. Q: How should we understand the term "minor/secondary causation" in the context of medical malpractice?
    A:The causality refers to the proportion of medical malpractice contributing to the harm caused. Different compensation ratios correspond to different degrees of causality, such as minor (15%), secondary (16%-44%), etc., which are determined by the court based on a comprehensive assessment.
  4. Q: Can a miswritten hospital medical record be used as evidence of negligence?
    A:Yes. Medical records with inconsistencies, gender errors, and time discrepancies reflect non-standard medical treatment, and can be used as evidence to determine the hospital's fault and the degree of its negligence.
  5. Q: What items are included in the compensation for medical disputes?
    A:It includes medical expenses, hospitalization subsidies, nursing fees, death compensation, funeral expenses, appraisal fees, transportation fees, accommodation fees, and compensation for mental distress, etc. These expenses need to be accounted for in accordance with the corresponding receipts and legal provisions.