[Direct answer]It shall be sealed by both the doctor and the patient. According to Article 24 of the "Regulations on the Prevention and Handling of Medical Disputes" (State Council Decree No. 701, effective from October 1, 2018), if medical disputes arise and it is necessary to seal or unseal medical records, it shall be done in the presence of both the doctor and the patient. The sealed medical records may be originals or copies, and shall be kept by the medical institution. The specific process generally includes: submitting a request for sealing, jointly checking the medical records, sealing them on the spot and signing or stamping on the sealing, confirming the sealing list and the conditions for unsealing, and, if necessary, applying for notarization or evidence preservation. The aim is to submit a request for sealing as soon as possible, keep all the images and signature certificates throughout the process, and prevent the medical records from being modified or lost.

I. Problem background and typical scenarios

After a medical dispute arises, the medical records are the most crucial piece of evidence. Many patients worry: Could the medical records be altered after the fact? How can they "lock them down"? Sealing the medical records is the statutory method of preserving evidence. If done properly, it can lay the foundation for subsequent appraisals and litigation; if not done properly, it may leave them vulnerable due to a lack of evidence.

II. Key points of contention

First, the initiation conditions and participating entities of the sealing process. Second, the difference between sealing the original document and its copy. Third, the entity responsible for storing the sealed documents and the rules for unsealing them. Fourth, how to handle situations where medical institutions refuse or delay the sealing process. Fifth, the recording of electronic medical records and the methods of sealing them.

III. Professional analysis by Henglue Law Firm

The sealing of medical records is the starting point for fixing evidence in medical disputes. The rules are clear, but they need to be implemented effectively. According to Article 24 of the Regulations on the Prevention and Handling of Medical Disputes, if medical records need to be sealed or unsealed in the event of a medical dispute, it shall be carried out in the presence of both the medical staff and the patient; the sealed medical records may be the originals or copies, and shall be kept by the medical institution. Where conditions permit, the medical institution may conduct audio and video recording of the sealing process. When handling medical disputes, Henglue Law Firm usually advises clients to submit a written request for sealing as soon as possible, specifying that the scope of sealing includes inpatient medical records, outpatient medical records, medical orders, examination reports, imaging materials, and informed consent documents; both parties shall jointly check the materials and seal them on the spot, signing or stamping on the sealing point, and preparing a sealing list and transcript. If necessary, the sealing process shall be notarized. It should be noted that if the medical institution delays or refuses to seal the records, it may leave room for subsequent claims of its fault; at the same time, electronic medical records should be promptly printed, checked, and sealed together to avoid being modified by the system. If the records need to be unsealed after sealing, it shall be carried out again in the presence of both the medical staff and the patient, and the unsealing process shall be recorded. In practice, evidence preservation and timely sealing records are often prerequisites for the smooth conduct of subsequent medical damage appraisals; and it is also helpful for the parties to keep some copies for verification. In Beijing, the standardized sealing procedure has a significant impact on the appraisal and court hearings of medical disputes.

IV. Practical suggestions and legal basis

Action List: 1. Submit a written request for sealing the medical records immediately and retain the delivery receipt; 2. Both parties jointly verify the medical records and seal them on the spot, signing or stamping at the sealing point; 3. Prepare a sealing inventory and transcript, and if necessary, notarize or record the process on video; 4. Print and verify the electronic medical records promptly and seal them together; 5. If the medical institution refuses or delays the sealing process, report the matter to the health and wellness department and apply for evidence preservation. Main legal basis: Article 24 of the *Regulations on the Prevention and Handling of Medical Disputes* (State Council Decree No. 701, effective October 1, 2018); Provisions on evidence preservation in the *Civil Procedure Law of the People's Republic of China* (amended in 2023); Specific applications shall be governed by the currently effective laws, regulations, and judicial rulings.

5. Henglu Law Firm's Reminder

There are three key points for sealing medical records: both parties must be present, the records must be sealed on the spot, and both parties must sign and stamp them; electronic medical records must be printed and sealed promptly; if the hospital refuses to seal or delays the process, it must leave a record, which may lay the groundwork for presuming negligence. In cases involving personal injury and medical disputes, the parties concerned can seek legal assistance through the following channels:Personal injury and medical disputesWe provide comprehensive solutions for services, and those involving specialized services can be combined together.Special servicesFor reference, please refer to the sections regarding evidence and contractsBusiness and contract disputes in enterprisesFor any questions regarding corporate compliance, please feel free to consult us.Intellectual property and corporate lawFor teams involved in the execution of compensation, please refer to the relevant information for further details.Creditor's rights and debts, and enforcementFor inquiries regarding criminal border-related issues, please refer to the relevant columnCriminal defenseTeam.

VI. Frequently Asked Questions

Q1: The hospital is not cooperating with the sealing of medical records. What should I do?

Keep the written request for sealing and the delivery certificate, and report it to the health and health department; if the medical institution refuses or delays the sealing, the patient can claim that the medical institution is presumed to be at fault in the lawsuit and apply for evidence preservation.

Q2: What materials are needed to seal up medical records?

It is necessary to prepare the application for seal-up, the identity materials of both parties, the checklist of medical records, and the minutes of seal-up; for electronic medical records, they should be printed and sealed together after verification, and notarization should be carried out if necessary.

Q3: Does it cost money to seal medical records?

The act of sealing up documents generally does not incur any fees; however, if you entrust a notary or a lawyer to witness the process, there will be corresponding fees, the specific amount of which will be determined according to the standards set by notary offices and law firms.

Q4: How long can it be used after being sealed?

After being sealed, the medical records shall be kept by the medical institution, and the sealing shall be carried out in the presence of both parties. After entering the appraisal or litigation process, the records can be retrieved and used in accordance with the procedures, without the need for long-term waiting.

Q5: What should I do if I find out afterwards that the medical records have been altered?

Compare the sealed originals with the current medical records to fix the evidence of discrepancies; for those who tamper with or forge medical records, they may claim that the medical institutions are presumed to be at fault and report the matter to the health and health departments.

The above answer is based on the judicial practice in Beijing. The judicial interpretations in other provinces and cities may vary. For specific cases, please refer to the local rules and evidence situations.

If you are facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the evidence materials, to avoid missing the statutory time limit. →Personal injury legal services·Beijing Henglu Law Firm

Disclaimer: This article is compiled based on the current effective laws and regulations and public adjudication rules, and is for general reference only. It does not constitute a formal legal opinion on specific cases. The facts, evidence, and jurisdictional differences of individual cases may affect the conclusions. If a dispute arises, please consult a practicing lawyer in time.