[Direct answer]They should be held accountable. According to Article 105 of the Civil Code of the People's Republic of China (adopted on May 28, 2020 and implemented on January 1, 2021), where a natural person's right to life is infringed or they are in other dangerous situations, organizations or individuals with statutory rescue obligations shall provide timely rescue; Article 27 of the Physician Law of the People's Republic of China stipulates that physicians shall take emergency measures to diagnose and treat patients in need of urgent treatment and shall not refuse to provide emergency treatment; Article 31 of the Regulations on the Management of Medical Institutions requires medical institutions to immediately rescue critically ill patients, and where they are unable to diagnose and treat due to limited equipment or technical conditions, they shall promptly refer the patients to other hospitals. Even if the appraisal concludes that the refusal to accept treatment is not causally related to the death, those who violate the obligation to provide treatment may still bear corresponding responsibilities.

I. Problem Background and Typical Scenarios

Patients from lower-level hospitals are often turned away by higher-level hospitals on the grounds of a lack of beds or specialized departments. After emergency triage, they are not admitted for treatment for a long time. Emergency centers refuse to dispatch ambulances on the grounds that the patients do not meet the criteria for emergency treatment. They also hint to patients to seek treatment elsewhere due to cost concerns. All of these are types of disputes. The window of opportunity for treating critically ill patients is extremely short, and a single refusal could potentially change the outcome.\nDisputes over the responsibility for refusing to provide medical treatmentThe family members of the Chinese victims are also the most vocal in demanding justice.

II. Key points of dispute

First, the nature of the obligation to provide treatment. Public medical institutions have an obligation to provide treatment to emergency patients and a statutory obligation to provide treatment. Refusing to treat patients may itself constitute a breach of this obligation. Second, a two-tier assessment of causality and liability. Forensic appraisals may determine that there is no causal relationship between the refusal to treat and the patient's death, but the court can still determine liability from the perspective of breach of contractual obligations, and the two are not conflicting. Third, the obligation to refer patients for treatment. When a medical institution lacks the necessary equipment or technical capabilities to provide treatment, it must refer patients for treatment in a timely and standardized manner and ensure that the receiving institution can continue the treatment. Fourth, the pre-hospital emergency care process. Whether the emergency center's response time to calls for help and its on-site treatment comply with emergency care protocols. Fifth, the apportionment of liability and the scope of compensation, which includes medical expenses, funeral expenses, death compensation, and compensation for mental distress.

III. Professional analysis by Henglue Lawyers

When handling disputes involving refusal of treatment, Henglue Law Firm typically collects evidence from three aspects: 1. **Admission Records**: Retrieve emergency triage forms, first-visit medical records, consultation and referral records to verify whether the hospital failed to admit the patient or simply provided intravenous fluids and examinations before discharging the patient to another hospital. 2. **Emergency Response**: Verify call response times, vehicle dispatch times, arrival times, and transfer records to compare them with the time limits specified in pre-hospital emergency protocols. 3. **Qualifications and Informed Consent**: Confirm whether the hospital possesses the necessary treatment qualifications and has fulfilled its obligation to provide timely and clear referral notifications. In such disputes, the most overlooked issue is the "violation of obligations without causality": Even if the appraisal concludes that no medical harm occurred, it does not exempt the hospital from liability entirely. The violation of treatment obligations itself constitutes an independent basis for breach of contract or infringement, and the court may award compensation accordingly. If another institution involved in the treatment process is found to have acted negligently, that institution will bear liability in proportion to its fault. In similar cases in the Beijing region, courts generally emphasize the independent review of hospitals' obligations to treat emergency patients.

IV. Practical suggestions and legal basis

In accordance with Article 105, Article 122, and Article 122-1 of the Civil Code of the People's Republic of China (effective January 1, 2021), Article 27 of the Physician Law of the People's Republic of China (effective March 1, 2022), Article 31 of the Regulations on the Administration of Medical Institutions, and the Basic Medical and Health Promotion Law of the People's Republic of China (adopted on December 28, 2019 and effective June 1, 2020), which stipulate that medical and health institutions shall not refuse to provide emergency treatment, the following actions are proposed: 1. Immediately seal the emergency and inpatient medical records, as well as the referral and consultation records; 2. Retrieve the emergency center's call-for-help and dispatch records, and the call recordings; 3. If necessary, apply for an autopsy to determine the cause of death; 4. Apply for a medical malpractice appraisal and pay attention to the independent evaluation of the breach of obligations; 5. File a lawsuit within the three-year statute of limitations stipulated in Article 188 of the Civil Code of the People's Republic of China.

5. Henglu Law Firm's Reminder

The difficulty of refusal of treatment cases often lies not in "whether there is an obligation", but in "how to account for the violation of obligations and the resulting deaths". Emergency records and dispatch logs have a limited storage period, and it is more advantageous to request their retrieval as early as possible. Hospitals should also establish a closed-loop process for the admission and referral of emergency patients and keep records of it. Where multiple institutions share responsibilities, it is advisable to clarify the responsible parties and compensation ratios simultaneously.\n Protecting rights in medical disputesAndSpecialised legal servicesWe can jointly facilitate the collection of evidence and the application for appraisal. You can also consult us about the arrangement of evidence collection and statute of limitationsBeijing Henglu Law Firm.

VI. Frequently Asked Questions

Q1: If a hospital refuses to admit a patient, resulting in their death, can the hospital be held liable for the death?

If it can be proven that there was a refusal or delay in accepting and treating patients, or that there were deficiencies in the performance of the obligation to provide treatment, the claimant has a stronger case for liability. Even if the appraisal concludes that there is no causal relationship, the court may still award compensation based on the breach of obligation at its discretion.

Q2: What evidence do I need to prepare?

The emergency triage form, the first consultation medical record, the referral and consultation records, the emergency call and dispatch records and call recordings, the death certificate and autopsy report, and the expense bills.

Q3: How much does it cost to handle cases like this?

The appraisal fee usually ranges from several thousand yuan to ten thousand yuan. The litigation fee is calculated in stages according to the amount of the claim and is prepaid by the plaintiff. The attorney's fee is determined in accordance with the provisions of the agency contract.

Q4: How long does the entire process take?

The identification and first-instance trial usually take half a year to a year. If there are multiple institutions sharing responsibilities or criminal procedures involved, it will take even longer. It is advisable to complete the evidence fixation as soon as possible.

Q5: What should I do first?

First, seal the emergency and referral medical records, retrieve the emergency and dispatch records, and, if necessary, apply for an autopsy to determine the cause of death. Then, apply for an appraisal and decide whether to negotiate or sue based on the conclusion of the appraisal.

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

VII. Relevant public cases (for reference only, not handled by our firm)

The following cases are all sourced from the official websites of courts at all levels, judicial authorities, and authoritative media, and are not related to the cases handled by our firm. They are provided solely for reference in understanding relevant adjudication rules and do not constitute opinions on specific cases.

[Case No.]The case number has not been made public.
[Trial Court]The People's Court of Yangpu District, Shanghai City (the case analysis was awarded the Second Prize of Excellent Case Analysis in the National Court System in 2023)
[Judicial Summary]The patient was referred to D Hospital for rescue by a lower-level hospital, but D Hospital refused to admit him and only provided intravenous fluids and examinations. The patient's family then transferred him to another hospital, where he eventually died. The judicial appraisal concluded that D Hospital did not constitute medical harm or have a causal relationship with the patient's death, but the court held that public medical institutions have an obligation to provide emergency treatment to critically ill patients. D Hospital handled the case improperly and breached its contractual obligations, so the court ordered it to pay compensation of 5,000 yuan as appropriate; another hospital with treatment non-standard faults was held liable for compensation at a rate of 20%.
[Source]The official website of the People's Government of Yangpu District, Shanghai City (Shanghai Yangpu Court's "Research and Reflection Moment" column: Liability of medical institutions when they refuse to treat patients who are not causally related to the final harm suffered by the patients) (2024-01)

[Case Number]The case number has not been made public.
[Trial Court]The People's Court of Qijiang District, Chongqing City (case settled through mediation)
[Judicial Summary]After the 120 ambulance arrived at the scene, it determined that the intoxicated man, Zhang *, was not an emergency patient and refused to take him back to the hospital for treatment. The next morning, the ambulance was again refused to respond. When the medical staff arrived, Zhang * had already died. According to the autopsy, he died from acute respiratory and circulatory failure caused by coronary heart disease and ethanol poisoning. The appraisal found that the hospital had the following faults: insufficient evaluation of the condition of acute alcohol poisoning, failure to dispatch the ambulance within the time stipulated by the pre-hospital emergency protocol, and failure to perform cardiopulmonary resuscitation according to the rescue protocol for cardiac and respiratory arrest, which were the main causes of the death. Medical institutions have the obligation to treat emergency patients and cannot refuse emergency treatment. After the court's mediation, the hospital compensated the victim's family for various losses amounting to more than 620,000 yuan.
[Source]Legal News (Drunk man calls 120 for emergency but is refused service, leading to his death) (2022-03)

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 Henglu Law Firm

Disclaimer: This article is compiled based on the current 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.