[Direct answer]There is such a possibility. According to Article 1222 of the Civil Code of the People's Republic of China (effective January 1, 2021), if a patient suffers harm during the medical treatment process and any of the following circumstances exist, it is presumed that the medical institution is at fault: first, violating laws, administrative regulations, rules, or other relevant medical treatment standards; second, concealing or refusing to provide medical records related to the dispute; third, losing, forging, tampering with, or illegally destroying medical records. In other words, if a hospital conceals or refuses to provide medical records, it is presumed by law that it is at fault. It should be noted that the presumption of fault does not mean that the hospital is directly held liable. In principle, patients still need to prove the harm caused and the causal relationship between the medical treatment and the harm. However, the burden of proof has been significantly shifted to the medical institution, which needs to provide counter-evidence to prove that it is not at fault or that there is no causal relationship between its actions and the harm. Therefore, the hospital's concealment of medical records not only violates its obligation to manage and provide medical records, but also may be presumed to be at fault, putting it at a disadvantage in damage compensation.

1. Problem background and typical scenarios

Medical records are the core evidence for judging whether medical treatment is compliant. Once they are hidden or tampered with, it will be extremely difficult for patients to provide evidence. There are four typical scenarios: First, patients apply to copy medical records but are repeatedly put off, ultimately failing to obtain complete information; Second, the content of the medical records is inconsistent and appears to have been modified afterwards; Third, key surgical records and medical progress records are missing; Fourth, after the patient's death, the family encounters obstacles in retrieving the medical records. Although medical institutions in Beijing have relatively standardized management of medical records, disputes may still arise over issues related to medical records. To balance the differences in evidentiary capabilities between doctors and patients and protect patients' legitimate rights, the law has established a presumption of fault rule in this regard.

II. Key points of dispute

First, the identification standards for concealing or refusing to provide medical records, and for lost or tampered medical records. Second, the relationship between fault presumption and proof of causality. Third, the path and proof standards for medical institutions to provide counter-evidence. Fourth, the impact of flaws in the sealing procedure on the evidentiary effect of medical records. Fifth, how to fix and review the modification traces of electronic medical records. Sixth, the scope of liability and compensation calculation after fault presumption.

III. Professional analysis by Henglue Law Firm

When handling medical disputes, Henglue Law Firm typically first reviews the completeness and authenticity of the medical records, and then assesses the applicability of the presumption of fault. The focus of reviewing completeness is whether all materials were obtained when applying for copying and sealing, and whether the surgical records, anesthesia records, course of disease records, examination reports, and nursing records are complete. There should be no obvious omissions or inconsistencies between different records. The focus of reviewing authenticity is whether there are any abnormalities in the handwriting, ink color, or binding of the paper-based medical records, and whether the formation time, modification traces, and operation logs of the electronic medical records are verifiable. If the medical institution conceals, refuses to provide, forges, or alters the medical records, according to the provisions of the Civil Code of the People's Republic of China (effective January 1, 2021), it shall be presumed to be at fault. At this point, the patient can focus on proving the causal relationship between the harm and the treatment, without having to bear the full burden of proof for the medical institution's fault. It should be noted that the presumption of fault does not exempt the patient from all evidentiary obligations, nor does it guarantee victory automatically; the medical institution can still provide evidence to prove that its actions are not causally related to the harm. Therefore, promptly sealing the medical records, preserving evidence of refusal to provide, and applying for appraisal when necessary are key steps in protecting rights.

IV. Practical suggestions and legal basis

Action suggestions: First, apply for a copy and seal the medical records as soon as possible to obtain a complete copy; Second, submit a written application and keep the receipt to fix the evidence of the hospital's refusal or delay; Third, check the completeness of the medical records, paying attention to omissions, contradictions, and modification traces; Fourth, if necessary, apply for an appraisal of the formation time and modification situation of the electronic medical records; Fifth, if the hospital refuses to provide them, file a complaint with the health administrative department and apply to the court for retrieval; Sixth, assert the presumption of fault and collect evidence of the damage consequences and causality. For medical disputes and evidence fixation, you can refer to the relevant provisions.Personal Injury | Medical DisputesFor services involving damage compensation and enforcement, please refer to the relevant documents for more details.Creditor-debtor relations | Enforcement casesPlate. Legal basis: Article 1222 of the Civil Code of the People's Republic of China (effective January 1, 2021) regarding the presumption of medical institutions' fault, and Article 1225 regarding the management of medical records. The specific application shall be subject to the currently effective laws, regulations, and judicial rulings.

5. Henglu Law Firm's Reminder

Firstly, if a medical institution conceals or refuses to provide medical records, it shall be presumed to be at fault according to law. Secondly, the presumption of fault does not exempt patients from the obligation to provide evidence. Thirdly, it is crucial to seal and copy the evidence as soon as possible. Fourthly, the modification traces of electronic medical records can be identified through appraisal. Fifthly, if the hospital refuses to provide the records, complain to the hospital in time and apply to the court for retrieval. In cases involving the concealment of medical records and the presumption of fault, legal action can be taken through the court.Personal injury | Medical disputesThe service obtains a comprehensive solution, which involves the execution of compensation payments that can be integratedCreditor-debtor relations | Enforcement casesFor reference, you can check the sections related to document and evidence reviewBusiness and Commerce | Contract Disputes板块。

VI. Frequently Asked Questions

Q1: Will the hospital lose the lawsuit directly if it hides medical records?

It's not necessarily the case, but the fault has been presumed. According to Article 1222 of the Civil Code of the People's Republic of China (effective from January 1, 2021), if a medical institution conceals or refuses to provide medical records related to a dispute, it will be presumed to be at fault. However, the establishment of liability also requires considering the damage consequences and causality. The medical institution can still present evidence to refute the presumption. Therefore, concealing medical records will put it at a significant disadvantage, but it doesn't necessarily lead to a loss of the case.

Q2: How to determine if a medical record has been altered?

It can be reviewed from two aspects: form and content. In terms of form, pay attention to whether the handwriting, ink color, paper, binding, and page numbers are abnormal, and whether there are traces of additions made afterwards; in terms of content, pay attention to whether the records before and after are inconsistent, whether the time sequence is reasonable, and whether the medical orders and medications correspond to each other. For electronic medical records, you can apply to retrieve the formation time and operation logs, and if necessary, confirm whether there are modifications through appraisal.

Q3: What should I do if part of the medical records is missing?

It is possible to fix the missing facts and claim adverse consequences. When the medical records are found to be missing, they should be noted in the copy or sealed list, and the records of communication with the hospital should be preserved. If the medical records are missing due to the medical institution's reasons, it may affect their ability to provide evidence or even be presumed to be at fault. When necessary, it is possible to apply to the court to retrieve relevant system data or apply for appraisal to determine the formation and storage of the medical records.

Q4: Do I still need to conduct an appraisal after the presumption of fault?

It may still be necessary. The presumption of fault addresses the issue of proving the elements of fault, but the consequences of the damage, the causal relationship, and the amount of compensation may still require appraisal or evidence to support them. Therefore, the patient's side should still collect diagnostic certificates, test reports, and proof of losses, and, if necessary, apply for a medical damage appraisal to determine the causal relationship and the extent of the damage. Whether to conduct an appraisal should be determined based on the circumstances of the case and the litigation strategy.

Q5: Can electronic medical records also be sealed?

Yes, it can usually be fixed in the form of printed materials or data. Electronic medical records belong to medical record materials, and patients have the right to access and copy them. In practice, they can request to print and affix a certification stamp, or apply for preservation of relevant electronic data, including the time of formation, modification records, and operation logs. When necessary, they can fix the data through appraisal or notarization to prevent it from being modified or deleted.

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

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 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.