[Direct answer]In the Beijing area, the sealing list shall specify the sealing time, sealing location, the medical staff and patients present, the name and number of pages or copies of the medical records, the form of the carrier (original or copy), and the conditions for unsealing, and shall be signed or stamped by both parties and each party shall keep a copy. According to Article 24 of the "Regulations on the Prevention and Handling of Medical Disputes" (State Council Decree No. 701, implemented on October 1, 2018), the sealing and unsealing of medical records shall be carried out in the presence of both parties. Medical institutions shall prepare a sealing list for the sealed medical records; if the medical records have not been completed, the completed part shall be sealed first, and the unsealed part shall be supplemented and sealed after completion; if the medical institution seals the medical records for more than three years without raising any request for dispute resolution, the medical institution may unseal them on its own. The sealing list is different from the copy list: the former fixes the status of the medical records to prevent tampering, while the latter is only used for reference and copying. In the event of a dispute, it is necessary to apply for sealing and check the list on the spot as soon as possible. For more details, please refer to the relevant provisions.Legal services for personal injury and medical disputes.

1. Problem background and typical scenarios

When patients doubt the diagnosis and treatment, encounter adverse outcomes, or die, family members often go to the hospital to request copies of medical records. The hospital will often ask if they want to seal the records. Many people just take a copy and leave, while others fail to check the contents of the list when sealing the records, and later have different opinions on the scope of sealing and the number of pages. Some hospitals also have irregular sealing procedures, with missing list elements. Medical records are the core evidence in medical malpractice cases. The purpose of sealing the records is to fix the state of the medical records and prevent alterations or additions. The list is a written document of the sealing process, directly related to the unsealing verification and the determination of the authenticity of the evidence. In similar cases in Beijing, the completeness of the sealing list often becomes the focus of cross-examination in court. The relevant process can be referred to here.Legal services for personal injury and medical disputes.

II. Key points of dispute

First, the scope of sealing: whether all medical records or only some of them should be sealed, and whether subjective and objective medical records should be sealed together. There are often disagreements in practice. Second, the form of sealing: the regulations allow sealing the originals or copies, but the probative force of the copies relies on the standardization of the copying process. Third, whether the elements of the inventory are complete: time, place, personnel present, name and page number or number of copies, form of the carrier, conditions for unsealing, and signature confirmation. Missing items may weaken the probative force of the sealing records. Fourth, conditions and deadlines for unsealing: the records can be unsealed after the dispute is resolved or after three years of sealing. When unsealing, it is necessary to count and check again and sign the confirmation. Fifth, remedies for missing inventory: it is possible to require correction, retrieve the surveillance footage of the sealing scene, and corroborate with the testimonies of the personnel present.

III. Professional analysis by Henglue Lawyers

The medical malpractice liability dispute case handled by Attorney Yu Dawei demonstrates the fundamental role of preserving medical records in determining the outcome of the case. On May 16, 2024, Zhao Dashan, an elderly patient with esophageal cancer, underwent a gastroscopic biopsy at A City Tumor Hospital after a follow-up examination. However, he suddenly suffered from vomiting blood and was rushed to B County People's Hospital for emergency treatment. Due to his critical condition, he was transferred to C Medical University First Affiliated Hospital, where he died on the afternoon of May 18th from hemorrhagic shock and gastrointestinal bleeding. The three hospitals provided continuous medical care for less than 48 hours. 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". The defendant, B County People's Hospital, raised multiple objections to the appraisal, including the lack of autopsy to determine the cause of death, the appraisal institution's lack of pathological qualifications, and the unlawful determination of "loss of survival opportunity". The appraisal institution responded to each objection, and the court ultimately accepted the appraisal opinion, concluding that B County People's Hospital failed to conduct comprehensive assessments of the critical patient, failed to promptly improve resuscitation treatment, lacked sufficient dynamic monitoring, and failed to use gastroscopy to identify the bleeding site. The court determined that the hospital's negligence was causally related to the "loss of survival opportunity", attributing 50% of the responsibility, and ordered it to bear compensation accordingly. This case highlights that complete and standardized medical records are the foundation of appraisal. Timely sealing medical records and carefully checking the sealing list after disputes arise are the first steps for patients to preserve evidence. This case was handled by Beijing Henglu Law Firm.Yu DayiThe lawyer (practice certificate number: 11101201010292290, subject to the certificate issued by the judicial administrative organ) acts as the agent.

IV. Practical suggestions and legal basis

Legal basis: Article 24 (Procedures for Sealing and Unsealing and Sealing List) and Article 16 (Access to and Copying of Medical Records) of the "Regulations on Prevention and Handling of Medical Disputes" (Decree No. 701 of the State Council, effective October 1, 2018); Article 1222 (Presumption of Fault in Cases Involving Medical Records) and Article 1225 (Fill-in and Storage of Medical Record Information) of the "Civil Code of the People's Republic of China" (effective January 1, 2021); Articles 16 and 17 (Sealing of Medical Records and Physical Evidence at the Scene) of the "Regulations on Handling Medical Accidents" (effective September 1, 2002). Action list: First, immediately submit a written request for sealing after a dispute arises, requiring both parties to be present; Second, check the list elements on the spot, including the sealing time, location, personnel present on both sides, name and page number or number of copies of the medical records, and the form of the carrier; Third, the list shall be signed or stamped by both parties, with each party keeping a copy, and photos shall be taken for preservation; Fourth, if the medical records are not completed, the completed parts shall be sealed first, and the right to seal the supplementary parts shall be reserved; Fifth, both parties shall be present when unsealing, check and confirm the items again, and the specific rules shall be subject to the currently effective laws, regulations and judicial rulings. For details, please refer to the following link:Legal services for personal injury and medical disputes.

5. Henglu Law Firm's Reminder

The details of the sealed list are often overlooked, but they may become the trigger for future disputes: if the list does not specify the number of pages, it will be impossible to prove the scope of the sealing afterwards; if the list is unsigned, it may be questioned that the procedure is not standard. It should also be noted that the sealed medical records are kept by the medical institutions, and sealing does not mean obtaining the original medical records. If it is necessary to analyze the case, the applicant should also apply for a copy in accordance with the law. When handling similar cases in the Beijing area, it is recommended to keep a full record of the sealing process, invite third-party witnesses when necessary, and consult as soon as possibleBeijing Henglu Law FirmA professional lawyer.

VI. Frequently Asked Questions

Q1: If the list of sealed medical records is incomplete, can I still win the lawsuit?

The incompleteness of the list does not necessarily lead to a loss of the lawsuit, but it will weaken the evidentiary advantage. The sealed list is a written proof of the medical record status. If there are missing items or it is unsigned, the patient can request rectification, or retrieve the on-site monitoring of the sealed list and obtain testimony from the on-site personnel to remedy the situation; if the hospital conceals, forges, alters, or illegally destroys medical records, the patient can also claim its fault according to Article 1222 of the Civil Code of the People's Republic of China. Whether the patient can obtain compensation depends on the overall evidence and the appraisal conclusion. No lawyer can unilaterally guarantee victory or defeat. Fixing the evidence as soon as possible is the fundamental solution.

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

The patient's side needs to prepare the patient's identity certificate, the certificate of kinship or the authorization and entrustment procedures; the written sealing application shall specify the scope and reasons for sealing; when sealing, check the name of the medical record, the number of pages or copies, and the form of the carrier item by item, form a list and have it signed or stamped by both parties, each keeping a copy; at the same time, they can apply for copying the medical records in accordance with Article 16 of the "Regulations on the Prevention and Handling of Medical Disputes", and the copies shall be stamped with the certification mark of the medical institution. If the patient dies, a death certificate is also required; if there are objections to the cause of death, an autopsy shall be conducted within the statutory time limit.

Q3: How much does it cost to seal medical records?

The act of sealing the medical records does not incur any additional fees, and the medical institution shall keep the sealed medical records. According to Article 16 of the "Regulations on the Prevention and Handling of Medical Disputes" (effective October 1, 2018), the medical institution may charge a copying fee for the medical records at the request of the patient, and the charging standards shall be made public. The subsequent expenses mainly include litigation fees, appraisal fees, and attorney fees: litigation fees shall be calculated in stages according to the amount of the claim in accordance with the "Measures for the Payment of Litigation Costs" (State Council Decree No. 481, effective April 1, 2007), and shall be borne by the losing party; medical damage appraisal fees shall be charged by the appraisal institutions according to the specific items, and shall generally be prepaid by the applicant and ultimately shared according to the proportion of responsibility; attorney fees shall be determined by the client and the law firm through consultation.

Q4: How long after sealing can the seal be broken, and how long will it take to resolve the dispute?

According to Article 24 of the Regulations on the Prevention and Handling of Medical Disputes, if the medical dispute has been resolved after the medical records are sealed, or if the patient has not raised any request for resolving the medical dispute within three years after the medical records are sealed, the medical institution may unseal them on its own; when unsealing them, the medical records shall be checked and verified again, and the two parties shall sign and confirm them. The dispute resolution period varies depending on the approach: through consultation and people's mediation, it may take a few weeks; through litigation, the first-instance ordinary procedure takes six months and the summary procedure takes three months. For cases involving medical damage appraisal, the appraisal period is not included in the time limit for trial, and most cases will have results within half a year to one and a half years.

Q5: If I suspect there are problems with the hospital, what's the first step to seal the medical records?

Four steps to proceed: First, submit a written request for seal-up to the hospital's medical or complaint management department as soon as possible, and require both the doctor and the patient to be present during the process; Second, when sealing the medical records, check the name of the medical records, the number of pages or copies, and the form of the carrier on the spot. The checklist shall be signed or stamped by both parties, with each party keeping a copy, and taking photos for reference; Third, simultaneously apply for a copy of the full set of medical records for analysis; Fourth, if the hospital refuses to cooperate or violates the procedures, record the time and the person in charge, and if necessary, report the matter to the health supervision department. If you are unsure about the procedures, consult a professional lawyer for guidance as soon as possible.

This article is written based on the common judicial interpretation in the Beijing area. If the case occurs in other regions, it is recommended to consult local lawyers to verify the regional differences.

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

Disclaimer: This article is compiled based on current laws and regulations and publicly available 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 the event of a dispute, please consult a practicing lawyer promptly.