[Direct answer]In the Beijing area, the liability for compensation is usually borne by medical institutions, and doctors may also face administrative or even criminal prosecution. Physicians should practice within the registered practice location, practice category, and practice scope, which is required by Article 14 of the "Physician Law of the People's Republic of China". If a doctor performs medical treatment beyond the scope of practice, it constitutes a violation of medical treatment norms. If this causes harm to the patient, the medical institution shall bear the liability for compensation in accordance with Article 121-8 of the "Civil Code of the People's Republic of China"; if there are circumstances such as concealing or altering medical records or violating medical treatment norms, the medical institution shall be presumed to be at fault in accordance with Article 122-2. It is recommended to first fix the evidence of practice qualifications and practice scope, and then claim rights within the three-year statute of limitations.

I. Problem Background and Typical Scenarios

It's not uncommon for medical practitioners to exceed their scope of practice in clinical settings. Common scenarios include surgeons independently performing complex operations that should have been carried out by corresponding specialists, primary healthcare institutions conducting surgical or diagnostic procedures beyond their approved scope, practicing assistants independently prescribing medications without obtaining prescription rights, and physicians providing consultations at unregistered institutions outside their authorized practice locations. Patients often only realize the issue after retrieving qualification materials following an accident, only to discover that the practitioners conducting the treatments lacked the appropriate scope of practice. The complexity of such cases lies in the fact that they involve three levels: civil compensation, administrative penalties, and professional liability. Patients need to clarify who to sue and what to claim against.

II. Key points of contention

First, the determination of practicing beyond the scope of authorization. It is necessary to compare the practice location, practice category, and practice scope registered on the physician's practice certificate with the specific implementation of medical treatment activities to make a judgment. Second, the causal relationship with the damage results. Practicing beyond the scope of authorization itself indicates a flaw in the duty of care, but it is still necessary to prove the causal relationship between this flaw and the damage consequences. The appraisal opinion is crucial in this regard. Third, the subject of liability. If a medical worker causes damage to a patient while performing their work duties, the medical institution shall bear the liability for compensation, and the patient generally does not need to sue the doctor directly. Fourth, the parallel imposition of administrative responsibilities. The health and health competent departments may impose on the medical institutions and physicians respectively the treatment of ordering correction, giving warnings, imposing fines, or even suspending practice activities and revoking practice certificates. Fifth, the criminal boundaries. The subject of the crime of illegal medical practice is someone who does not have a medical practice qualification. Practicing beyond the scope of authorization generally does not constitute this crime, but in serious circumstances, it may involve the crime of medical accident, which needs to be judged based on the specific circumstances and judicial determination and cannot be generalized. The relevant liability determination can be referred toMedical disputesIt's a general rule.

III. Professional analysis by Henglue Lawyers

When handling such consultations, Henglue Lawyers always take the first step to verify the qualifications rather than argue about the injury situation. The specific approach is to require medical institutions to provide information on the practitioners' practice certificates, check the practice location, practice category, and practice scope, and compare the specific medical treatment items implemented with the registered scope item by item; for surgical cases, we also verify the surgical grading management and authorization records, preoperative discussions, and informed consent materials. The second step is to substantiate the fault and causality. Proving that the practice exceeds the scope demonstrates a flaw in the duty of care, and the final liability ratio still depends on the evaluation of the causality by the appraisal opinion. In the judicial practice of Beijing courts, the defense argument of medical institutions claiming exemption from liability on the grounds that patients signed informed consent forms is usually difficult to establish, because informed consent cannot replace the requirement of a doctor's practice qualifications. The third step is to advance on both administrative and civil fronts. Complaining and reporting to the competent health department can not only promote administrative handling of institutions and individuals, but also objectively facilitate the negotiation of civil compensation. It should be reminded that patients should not give up claiming just because they are worried about "sueing doctors personally". The external subject of compensation liability is the medical institution, and the administrative responsibility of individual doctors will be investigated by the competent department, which is not conflicting. For surgical cases, attention should also be paid to whether the surgery exceeds the scope of the institution's own medical treatment approval, which is often an overlooked second-level violation.

IV. Practical suggestions and legal basis

In terms of legal basis, Article 14 of the "Physician Law of the People's Republic of China" (adopted on August 20, 2021 and implemented on March 1, 2022) stipulates that physicians shall practice in accordance with the registered practice location, practice category, and practice scope after registration. The law also provides for administrative penalties such as ordering rectification, issuing warnings, confiscating illegal income, and imposing fines on acts exceeding the registered practice scope. Where the circumstances are serious, the physician's practice activities shall be suspended until the physician's practice certificate is revoked. Article 1228 of the "Civil Code of the People's Republic of China" (implemented on January 1, 2021) stipulates that where a medical institution and its medical staff cause damage to patients due to their faults, the medical institution shall bear the liability for compensation; Article 1221 establishes the standard of medical treatment obligations corresponding to the then-current medical level; Article 1222 stipulates the presumption of fault in violating treatment norms, concealing or refusing to provide medical records, and losing, forging, or destroying medical records; and Article 1225 stipulates the obligation to preserve medical records. The "Regulations on the Prevention and Handling of Medical Disputes" (State Council Decree No. 701, implemented on October 1, 2018) stipulates the sealing of medical records and the resolution path for medical disputes. Action list: First, request the medical institution in writing to provide the qualification materials of the medical staff and keep a copy; Second, copy and seal the medical records, surgical records, informed consent forms, and preoperative discussion materials; Third, file a complaint or report to the health authority against acts of practicing beyond the scope; Fourth, apply for a medical damage appraisal to clarify the fault, causality, and degree of participation; Fifth, determine the litigation claims and compensation items with the assistance of professional lawyers. Administrative complaints and appraisals can be coordinated with each other.Specialised legal servicesWhen the implementation of the compensation payment is obstructed, it can be resolved throughExecute the programAdvance.

5. Henglue Law Firm's Reminder

Three tips. First, the statute of limitations. The statute of limitations for litigation is three years, calculated from the date when the plaintiff knows or should have known that his rights have been infringed and the defendant's obligations have been breached. Although qualification verification often takes time, it should not be used as an excuse for delaying litigation. Second, evidence awareness. The integrity of qualification information, surgical records, anesthesia records, and nursing records is crucial to the outcome of this case. Sealing these records as soon as possible can help avoid subsequent additions or alterations. Third, rational expectations. Exercising medical practice beyond the scope of one's qualifications is an important clue to identifying negligence, but the amount of compensation ultimately depends on the assessment of the damage consequences, the disability rating, and the conclusion of the causality analysis. It is not appropriate to presume the amount of compensation solely based on the fact of unlawful practice. Henglue Law Firm advises you to pay attention to these issues during the litigation process.Practice scope: compliance and damage compensationThe two processes proceed simultaneously. Handling administrative complaints and civil litigation in parallel can often significantly improve the efficiency of negotiations.Beijing Henglu Law FirmTip: When faced with an institution's claim that "the surgical results are excellent", you should focus your attention on the institution's qualifications and its obligation to exercise due diligence.

VI. Frequently Asked Questions

Q1: If a doctor practices beyond his scope of practice and causes an accident, do patients have a good chance of winning the lawsuit?

The act of practicing beyond the scope of one's qualifications is itself a clue to fault. If it can be further proven through appraisal that there is a causal relationship between this behavior and the resulting damages, it will be easier to gain support for the claim. If there is no causal relationship between the damages and the medical treatment, it will only lead to administrative action, and it will be difficult to establish a claim for compensation.

Q2: What evidence do I need to prepare?

The practicing certificates and practice scope information of medical staff, the approval materials of the medical institutions' clinical departments, medical records and surgical records, anesthesia and nursing records, informed consent forms, preoperative discussion records, postoperative follow-up materials, and the diagnostic and appraisal materials of the damage consequences.

Q3: Approximately how much will it cost to claim compensation?

The cost of medical damage appraisal is charged on a per-item basis, usually ranging from thousands of yuan to tens of thousands of yuan, and is prepaid by the applicant in advance; the litigation fees are calculated in stages based on the amount of the dispute, and the losing party will bear the fees proportionally after the plaintiff wins the case; and the attorney's fees are subject to the provisions of the entrustment contract and can be arranged in stages.

Q4: How long does the entire process take?

It usually takes several weeks to several months to receive feedback from qualification verification and complaint reporting; the first-instance civil litigation generally takes about six months, and it will take longer if appraisal is involved; after the judgment comes into effect, if the other party fails to perform its obligations, it is necessary to apply for compulsory execution. The overall process should be scheduled to take more than half a year.

Q5: What should I do first?

First, request the medical institution in writing to provide the practicing qualification materials of the medical staff and check their scope of practice. At the same time, seal and copy the medical records, then file a complaint and report to the competent health department. Finally, based on the appraisal conclusion, decide on the specific plan for civil compensation.

This article is written based on the common judicial interpretations 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 currently facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the relevant 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 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 case of disputes, please consult a practicing lawyer in time.