[Direct answer]In the Beijing area, sealed medical records cannot be opened without authorization. The opening of sealed medical records must comply with statutory or contractual conditions and follow established procedures. According to Article 27 of the "Regulations on the Management of Medical Records in Medical Institutions (2013 Edition)" (issued by the National Health Commission on January 1, 2014), the opening of sealed medical records shall be carried out in the presence of all parties who signed the seal; according to Article 24 of the "Regulations on the Prevention and Handling of Medical Disputes" (issued by the State Council on October 1, 2018), if the medical dispute has been resolved after the medical records are sealed, or if the patient does not request to resolve the medical dispute within three years after the medical records are sealed, the medical institution may open the sealed medical records on its own. In litigation, if the sealed medical records are needed for trial, they are generally retrieved by the people's court in accordance with legal procedures; if they are needed for appraisal, they shall be obtained through mutual entrustment by both parties or legal procedures. If the sealed medical records are opened without authorization, resulting in the inability to verify the authenticity and integrity of the medical records, the party who opened the sealed medical records may bear the unfavorable consequences of failing to provide evidence.

1. Problem background and typical scenarios

When the medical records are sealed, both parties sign to confirm it, and it is also written on the sealing bag that it is not allowed to open it without authorization. However, not long after that, the family members want to take a look at the content, the hospital says it needs to be sent for appraisal, the mediation organization wants to retrieve it, and one party wants to make a copy for retention — can the sealed documents be moved? Who can move them? How to move them? Some parties open the sealing bag on their own when they are angry, and some hospitals open and copy the documents without notifying the patients, which triggers new disputes: since they have already opened it, does this medical record still have probative force? The rules for opening the sealing bag may seem like a minor matter, but they actually affect the effectiveness of the entire core evidence. If it is not handled properly, it may make all the previous efforts to seal the documents in vain. The relevant procedural rules can be referred to here.Legal services for personal injury and medical disputes.

II. Key points of dispute

The controversy focuses on four points. First, the procedural conditions for opening the sealed documents: the presence of all parties involved in the sealing process is a basic requirement. If only one party requests to open the sealed documents without notifying the other parties, the procedure will be difficult to justify. Second, the legitimate reasons for opening the sealed documents: dispute resolution, sealing for more than three years, the court's legal request to use the documents in litigation, and the need for both parties to jointly commission an appraisal. Except for these cases, the opening of the sealed documents should be subject to the consensus of all parties and be fully documented throughout the process. Third, the use of the sealed documents in litigation and mediation: after the case enters litigation, the submission of the sealed medical records as evidence, cross-examination, and transfer for appraisal should all be conducted within the litigation process, organized by the court or retrieved upon request. If the sealed documents are used in the mediation process, they should be handled in accordance with the procedures prescribed by the mediation institution. If there are disputes between the parties regarding whether to open the sealed documents or how to open them, they can be resolved through consultation, mediation, or litigation procedures, and the court shall determine the responsibility according to law. Fourth, the consequences of unauthorized opening of the sealed documents: if the opening of the sealed documents results in the inability to verify the authenticity and integrity of the medical records, the party who opened them may bear the unfavorable consequences of failing to provide evidence; if the medical institution alters, falsifies, or illegally destroys the medical record information, it may be presumed to be at fault according to Article 1222 of the Civil Code of the People's Republic of China (effective January 1, 2021) and may be subject to administrative liability in accordance with Article 45 of the Regulations on the Prevention and Handling of Medical Disputes. In the judicial practice of Beijing, the court's review of the transfer of the sealed documents focuses on who opened them, when they were opened, and who was present. Incomplete records often lead to a series of doubts.

III. Professional analysis by Henglue Lawyers

The significance of sealing medical records only fully manifests itself when they are subject to review. In a medical malpractice liability dispute handled by Attorney Yu Dawei, the elderly patient, Zhao Dashan, underwent a gastroscopic biopsy at A City Tumor Hospital on May 16, 2024, for a follow-up examination of esophageal cancer. He returned home that day but suddenly suffered from vomiting blood and was rushed to B County People's Hospital for emergency treatment. He was later transferred to the First Affiliated Hospital of C Medical University, where he died on the afternoon of May 18 due to hemorrhagic shock and gastrointestinal bleeding. His wife, Liu Shufen, and three children entrusted Attorney Yu Dawei to file a lawsuit against the three hospitals, alleging that their negligent treatment caused his death. The attorney comprehensively retrieved the medical records, emergency records, and payment receipts from the three hospitals to reconstruct the timeline and applied for a judicial appraisal of medical negligence and causality. During the trial, the defendant, B County People's Hospital, raised multiple challenges to the appraisal opinion: claiming that the appraisal institution lacked pathological qualifications, violated regulations in determining loss of survival opportunities, failed to provide expert information, and relied on unverified autopsy results. After the appraisal institution responded to each point, the court determined that the grounds for reappraisal did not meet legal requirements and ultimately accepted the appraisal opinion, concluding that the hospital's negligence contributed to the loss of survival opportunities with a 50% causality rate and ordering it to bear compensation liability according to this proportion. Considering another scenario: if the sealed medical records had been tampered with before the appraisal, the authenticity would have been impossible to verify, and the defendant's objections would likely have been successful, creating significant obstacles to the acceptance of the appraisal opinion. Thus, the intact preservation of sealed documents throughout the litigation and appraisal process itself constitutes a critical piece of evidence. This case was handled by Beijing Henglu Law Firm.Yu DayiAttorney (Practice Certificate No.: 11101201010292290, subject to the certificate issued by the judicial administrative organ) acting as the agent.

IV. Practical suggestions and legal basis

The legal basis includes Article 24 of the "Regulations on the Prevention and Handling of Medical Disputes" (Decree No. 701 of the State Council, implemented on October 1, 2018) (sealing and unsealing in the presence of both parties, storage by medical institutions, sealed lists, dispute resolution, or unsealing upon expiration of three years); Article 45 (administrative responsibility for altering, forging, concealing, or destroying medical records); Article 27 of the "Regulations on the Management of Medical Records in Medical Institutions (2013 Edition)" (implemented on January 1, 2014) (opening only in the presence of all parties involved in the sealing); Articles 23 to 25 of the "Regulations on the Application and Management of Electronic Medical Records (Trial)" (implemented on April 1, 2017) (rules for sealing and unsealing electronic medical records); Article 1222 of the "Civil Code of the People's Republic of China" (implemented on January 1, 2021) (presumption of fault for loss, forgery, alteration, or illegal destruction of medical records); and the provisions on evidence transfer and review in the "Several Provisions of the Supreme People's Court on Evidence in Civil Proceedings" (amended on December 25, 2019 and implemented on May 1, 2020). Action list: First, after sealing, neither party may unseal unilaterally. If there is a need to retrieve the records, consultation and written record must be conducted in advance; Second, when unsealing, notify all parties involved in the sealing to be present and jointly verify the sealing status before opening; Third, if the medical records need to be sealed in litigation, they shall be retrieved, cross-examined, and transferred through the court in accordance with the law; Fourth, if appraisal is needed, the parties shall jointly commission an appraisal institution or retrieve the records through legal procedures; Fifth, if the medical records are found to have been unsealed without authorization, immediately take photos, record the time and attendees, and clearly state this in the litigation. For details, please refer to the following link:Legal services for personal injury and medical disputes.

5. Henglu Law Firm's Advice

Unsealing medical records is often not a trivial matter, but a crucial issue involving evidentiary value. Once the records are unsealed, their status changes, and previous efforts to seal them may be greatly undermined. Families should resist the urge to open them first, and hospitals should adhere to the principle of not unsealing them without prior notice. If there are legitimate needs, follow the procedures of consultation, mediation, or litigation, and record the presence of witnesses, the time and scope of the unsealing. When handling similar cases in the Beijing area, it is recommended to reach a written agreement with the other party on the rules for accessing and unsealing the records at the outset, eliminating potential risks at the source. For specific arrangements, please consult relevant authorities.Beijing Henglu Law FirmA professional lawyer.

VI. Frequently Asked Questions

Q1: If the sealed medical records are opened without authorization, do patients still have a chance of winning in legal disputes to protect their rights?

There are, but the evidence base will be affected. If unauthorized opening of the sealed materials results in the inability to verify the authenticity and completeness of the medical records, the party who opened them may bear the unfavorable consequences of failing to provide evidence; if the medical institution conceals, forges, alters, or illegally destroys the medical record materials, the patient may claim that the medical institution is presumed to be at fault according to Article 1222 of the Civil Code of the People's Republic of China, and the relevant responsible persons may also face administrative penalties. If it can be proven that the medical records were not altered after being opened and there are synchronized images or third-party witnesses, the medical records can still be used. The outcome of the case depends on the overall evidence. No lawyer can guarantee victory or defeat on their own, but the party with complete procedural records is usually more proactive.

Q2: What materials are needed to unseal and retrieve the sealed medical records?

The core materials include: the original inventory list, used to verify the scope and status of the sealed items; the application for unsealing or the negotiation records, stating the reasons for unsealing, the time and the personnel present; the identity certificates and authorization procedures of all parties; in litigation, preparing the procedures for the court to retrieve evidence or the outline of evidence; if appraisal is needed, preparing the jointly entrusted appraisal agreement or the court's entrustment procedures. The unsealing process should also be recorded on site: taking photos and videos, counting the number of pages, checking the status of the sealed items, and forming a written record signed by the persons present.

Q3: How much does it cost to seal, unseal, and appraise a document, respectively?

The sealing and unsealing of evidence are procedural measures and do not incur additional fees; only the cost of copying may be charged. Appraisal fees are charged by appraisal institutions based on the complexity of the case, typically ranging from several thousand yuan to tens of thousands of yuan, with no unified government pricing. In litigation, the fees are generally prepaid by the applicant and ultimately shared according to the proportion of liability; in mediation procedures, where appraisal is commissioned, the fees are collected from both parties in advance and borne according to the proportion of liability (Article 34 of the Regulations on the Prevention and Handling of Medical Disputes). Litigation fees are paid in stages in accordance with the "Measures for the Payment of Litigation Costs" (State Council Decree No. 481, implemented on April 1, 2007). The overall cost should be comprehensively considered in light of the expected compensation amount.

Q4: How long can medical records be stored after being sealed, and what is the average duration of a case?

There is no expiration date for the sealed state itself, but there are clear rules for unsealing: if the dispute is resolved or the patient has not raised any further resolution requests after three years of sealing, the medical institution may unseal the records on its own. Regarding the statutory retention period of medical records, outpatient (emergency) medical records kept by medical institutions shall be preserved for no less than 15 years from the last visit, and inpatient medical records shall be preserved for no less than 30 years from the last discharge (Article 29 of the "Regulations on the Management of Medical Records in Medical Institutions (2013 Edition)"). Case cycle: mediation shall be completed within 30 working days from the date of acceptance; first-instance litigation in ordinary procedures takes six months, and in summary procedures, it takes three months. The overall period for appraisal usually ranges from half a year to one and a half years.

Q5: If you find that the medical records have been unsealed, what should you do first?

Four steps to proceed: First, immediately take photos and videos of the current status of the sealed documents, record the traces of opening the seal, the time and the people present; Second, require the party opening the seal to explain in writing the reasons, basis and process of opening the seal, and keep the communication records; Third, check whether the content of the medical records is complete, and list any missing pages or alterations and raise objections in writing; Fourth, formally raise the claim in consultation, mediation or litigation that the party opening the seal should bear the adverse consequences of the inability to verify the authenticity of the medical records, and apply for an appraisal of the process of forming the medical records when necessary. It is recommended to involve professional lawyers in the process as soon as possible.

The above content is based on the compilation of judicial practices in the Beijing area. The facts of individual cases and the jurisdiction of the court may affect the conclusions. Welcome to consult Henglue Lawyers about specific situations.

If you are facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the relevant evidence to avoid missing the statutory time limit. →Personal injury legal services·Attorney Yuan Hang·Beijing Henglu 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. If you encounter disputes, please consult a practicing lawyer in time.