[Direct answer]In the Beijing area, in principle, the patient is responsible for the compensation, but in certain circumstances, the medical institution is presumed to be at fault. According to Article 121 of the Civil Code of the People's Republic of China (effective from January 1, 2021), if a patient suffers harm during the medical treatment, and the medical institution or its medical staff are at fault, the medical institution shall bear the liability for compensation. In terms of evidence, the patient generally needs to prove that there is a fault in the medical treatment and a causal relationship between the fault and the harm. However, according to Article 122, if the medical institution conceals, forges, alters, or destroys medical records, it is presumed that the medical institution is at fault. The action aims to emphasize the integrity and authenticity of medical records, and when necessary, apply for appraisal to safeguard rights and interests using the rules of burden of proof.

1. Problem background and typical scenarios

"In medical litigation, patients have to prove that doctors are at fault," is the intuitive impression many people have of medical litigation. In fact, the burden of proof does not entirely fall on the patient's side. The law also imposes corresponding requirements on medical institutions, especially in the issue of medical records. Understanding the distribution of the burden of proof is the key to formulating litigation strategies.

II. Key points of contention

First, how is the burden of proof divided between patients and medical institutions? Second, what are the specific circumstances in which the medical institution is presumed to be at fault? Third, what is the role of medical damage appraisal and how to apply for it? Fourth, what are the consequences of refusing to provide or tampering with medical records? Fifth, what are the criteria for judging medical treatment standards and duties of care?

III. Professional analysis by Henglue Law Firm

The allocation of the burden of proof in medical liability follows the basic principle of "who claims, who proves", with exceptions for presumed fault. According to Article 121 of the Civil Code of the People's Republic of China, the medical institution's liability for compensation is conditional on its fault. Patients usually bear the burden of proof for the medical institution's fault, the damage consequences, and the causal relationship between the two. In cases of overlapping personal injury compensation and contractual liability, the choice of the basis of the claim will also affect the focus of the burden of proof. On the other hand, Article 122 stipulates that if a patient suffers damage during the medical treatment, the medical institution shall be presumed to be at fault in any of the following circumstances: violating laws, administrative regulations, rules, and other relevant medical treatment norms; concealing or refusing to provide medical records related to the dispute; losing, forging, tampering with, or illegally destroying medical records. This provides an important basis for patients. When handling medical disputes, Henglue Lawyers usually first assist clients in sealing medical records and fixing evidence, then assess whether there are circumstances of presumed fault; and subsequently apply for a medical injury appraisal based on the case, using the appraisal opinion to clarify the degree of fault and causality. It should be noted that the appraisal opinion often has a significant impact on the judgment result, so sufficient preparation of medical records, sealed transcripts, and expert consultation opinions should be made before the appraisal. Overall, patients do not necessarily need to "prove the medical party's fault themselves", but rather assert their rights through a comprehensive process of evidence fixation, burden of proof allocation, and appraisal. Neglecting the medical record stage often leads to unfavorable outcomes.

IV. Practical suggestions and legal basis

Action List: 1. Seal the medical records immediately to prevent loss or tampering; 2. Secure evidence such as medical treatment records, examination reports, and informed consent documents; 3. Investigate potential negligence, such as violations of medical treatment standards or refusal to provide medical records; 4. Apply for a medical malpractice appraisal to determine liability and causality; 5. Claim compensation based on the appraisal findings and, if necessary, consult a professional lawyer. Legal Basis: Articles 121 and 122 of the Civil Code of the People's Republic of China (effective January 1, 2021); Regulations on the Prevention and Handling of Medical Disputes (State Council Decree No. 701, effective October 1, 2018); Specific applications shall be governed by currently valid laws, regulations, and judicial rulings.

5. Henglue Law Firm's Reminder

There are three key points in medical litigation: in principle, patients should provide evidence of the doctor's fault and causality; if the doctor conceals or alters the medical records, it is presumed that the doctor is at fault; and sealing the medical records and applying for appraisal are two important approaches. For cases involving personal injury and medical disputes, the parties concerned can proceed through legal channels to protect their legitimate rights and interests.Personal injury and medical disputesYou will get a comprehensive solution for the service, and the specialized services can be combined as needed.Special servicesFor matters related to criminal cross-border issues, please feel free to consult us.Criminal defenseThe team can be referred to for matters related to evidence and contractsBusiness and contract disputes in enterprisesFor more information on the column related to the enforcement of compensation, please refer to itCreditor's rights and debts, and enforcementFor any questions regarding corporate compliance, please feel free to consult us through this columnIntellectual property and corporate lawTeam.

VI. Frequently Asked Questions

Q1: Do patients have to prove that the hospital is at fault in medical disputes?

In principle, patients need to prove the fault and causality, but when there are situations such as violating medical treatment norms and concealing or tampering with medical records, it is presumed that the medical institution is at fault, and the burden of proof is not borne by one party alone.

Q2: What evidence is required to prove medical negligence?

The key points are the sealed complete medical records, examination and imaging materials, informed consent documents, and clues indicating violations of medical treatment standards; when necessary, the medical malpractice appraisal can be used to determine the fault and degree of involvement.

Q3: How much does a medical lawsuit cost?

The litigation fees shall be paid in accordance with the standards for property cases and are related to the amount of the claim. The appraisal fees are usually paid in advance by the applicant, and the final fees will be shared according to the proportion of responsibility. The specific amount will be determined by the court.

Q4: How long does it usually take to adjudicate such cases?

The first-instance trial under the ordinary procedure usually lasts for several months, and the period of appraisal will be extended accordingly. The appraisal period is often the main factor affecting the overall timeframe.

Q5: The hospital has altered the medical records. How can I prove it?

Compare the sealed original with the current medical records to fix the evidence of discrepancies; one can claim that the medical institution is at fault and report it to the health department, demanding verification of the authenticity of the medical records.

The above Q&A is mainly based on the judicial practice in Beijing. There may be differences in the interpretation of the law in different regions. It is recommended to consult a professional lawyer based on the specific circumstances of the case.

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 Henglue Law Firm

Disclaimer: This article is compiled based on the current effective laws and regulations and open 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. In case of disputes, please consult a practicing lawyer in time.