[Direct answer]In the Beijing area, altering medical records may directly lead to the court presuming that the hospital is at fault. According to Article 1222 of the Civil Code of the People's Republic of China (adopted in 2020 and implemented on January 1, 2021), if a patient suffers harm during the medical treatment process, the medical institution shall be presumed to be at fault under any of the following circumstances: violating laws, administrative regulations, rules, and other relevant medical treatment norms; concealing or refusing to provide medical records related to the dispute; losing, forging, altering, or illegally destroying medical records. It can be seen that altering medical records belongs to a statutory presumption of fault. Once it is identified, the medical institution needs to bear the burden of proof that it is "not at fault", and in practice, it is often at a disadvantage. Correspondingly, when patients find that there are inconsistencies in the medical records, uneven handwriting, content substitution, or discrepancies between electronic medical records and paper medical records, they should promptly apply for the sealing of the medical records and verify their authenticity through medical injury appraisal or document appraisal. It should be noted that to claim alteration, specific clues and comparison materials are required. Subjective suspicion alone is usually difficult to gain support.

1. Problem background and typical scenarios

"What's written in the medical records doesn't match what I remember" is a common complaint in medical disputes. Typical scenarios include: the admission time recorded in the hospitalization notes not matching the one known to the family; the content of the surgical records not corresponding to the actual scope of the surgery; contradictions in the timing of nursing records; multiple revisions to electronic medical records with abnormal modification traces; and hospitals delaying or providing only partial copies of medical records when patients request them. At this point, the authenticity of the medical records often becomes the key to determining the outcome of the entire case—if it can be proven that the medical records were tampered with, the rule of presumption of fault may be triggered; conversely, if there are only minor discrepancies without any substantial impact, the court will still make a comprehensive judgment based on other evidence.

II. Key points of contention

First, the standard for determining tampering requires that it be of sufficient significance to affect the determination of the facts of diagnosis and treatment, rather than insignificant clerical errors. Second, the mode of evidence collection. Patients can fix the evidence by applying for the sealing of medical records, retrieving the modification logs of electronic medical records, and applying for document appraisal. Third, the effect of presumption of fault. This is a legal fiction, and medical institutions need to provide evidence to prove that they are not at fault. Fourth, independent judgment of causality. Even if it is presumed that there is fault, it is still necessary to prove the connection between the damage and the fault. Fifth, the procedure for sealing medical records. This is usually carried out in the presence of both the doctor and the patient, and records are made at the same time.

III. Professional analysis by Henglue Lawyers

The core of the medical record dispute is "timely fixation and professional comparison". In practice, we usually advise patients to do three things immediately after discovering abnormalities: first, submit a written application to the hospital, requesting to copy or reproduce all medical record materials and affix a certification stamp; second, apply for the sealing of medical records, especially the objective part of the medical records that is the focus of the dispute; third, request to retrieve the records of the electronic medical record system, including the modification time, the modifier, and the versions before and after the modification. With these materials, we can then verify the authenticity through professional appraisal. It should be noted that in medical damage cases, fault, damage consequences, and causality are three independent elements. Even if the fault is presumed to exist due to medical record issues, it is necessary to prove that the damage actually occurred due to this fault. Conversely, if the medical records are true and complete, the patient's side needs to prove the existence of fault in the medical actions through appraisal and other means.

IV. Practical suggestions and legal basis

According to Article 121 of the Civil Code of the People's Republic of China (effective January 1, 2021), Article 122 on the presumption of fault, Article 123 on the obligation to provide explanations, and Article 124 on the preservation of medical records, as well as the Regulations on the Prevention and Handling of Medical Disputes (effective in 2018) on the writing, storage, and preservation of medical records, and the Regulations on the Management of Medical Records in Medical Institutions (revised in 2013) on the procedures for copying, duplicating, and preserving medical records, it is recommended to follow four steps: First, apply in writing for a copy of all medical records and affix a certification stamp as soon as possible; Second, apply for the joint sealing of medical records by both parties, make a sealing record and specify the scope of sealing; Third, request to retrieve the modification logs and version records of electronic medical records to fix possible traces of tampering; Fourth, entrust a lawyer to sort out the contradictions in the medical records and apply for a medical damage appraisal, claiming the presumption of fault. Those involved in medical damage disputes may refer to the above-mentioned provisions for reference.Personal injury and medical disputes; The aspects related to evidence fixation and document authentication can be combined togetherSpecialised legal servicesAndBusiness and contract disputes in enterprisesMy experience.

5. Henglu Law Firm's Reminder

Suspect tampering? Act quickly. Three reminders: First, don't just negotiate with the department verbally. It's essential to initiate the copying and sealing procedures through a written application. Second, don't overlook electronic medical records. Modified logs and version records are often crucial evidence. Third, don't focus all your attention on the medical records. Proving fault and causality is equally important.Beijing Henglue Law FirmIt is recommended that patients apply for the sealing of medical records on the same day they raise questions, to prevent the materials from being further altered.

VI. Frequently Asked Questions

Q1: If a hospital alters medical records, how will the court handle it?

According to Article 1222 of the Civil Code, if medical records are lost, forged, tampered with, or illegally destroyed, it is presumed that the medical institution is at fault. After being identified, the medical institution needs to provide evidence to prove that it is not at fault, and is usually at a disadvantageous position.

Q2: If I suspect that my medical records have been tampered with, what evidence do I need to prepare?

All medical records that have been copied and stamped, sealed records, electronic medical record modification logs and version records, nursing and medication records, payment and examination documents, as well as family statements and imaging materials that can reflect the actual situation.

Q3: How much does it cost to protect one's rights?

The litigation fees shall be paid in accordance with the standard based on the amount of the claim; the appraisal of medical damages and the appraisal of documents shall be charged in accordance with the standard of the appraisal institutions. If a lawyer is engaged, the fees shall be calculated based on the proportion of the amount of the claim or charged on a stage-by-stage basis, subject to the provisions of the written entrustment contract.

Q4: How long does it take from protecting one's rights to obtaining the desired outcome?

Medical malpractice cases usually require an appraisal process, which typically takes several months. Lawsuits applying the simplified procedure are generally concluded within three months, and those applying the ordinary procedure are generally concluded within six months. The appraisal period is not included in the trial period.

Q5: What should I do first?

Immediately apply to the hospital in writing for a copy of all medical records with a stamped certificate, and simultaneously apply for the hospital and the patient to seal the medical records; then request to retrieve the electronic medical record modification logs, and entrust a lawyer to compare the contradictions and assess the necessity of applying for an appraisal.

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.

VII. Related 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 that have been publicly released. They are unrelated to the cases handled by our firm and are provided solely for reference in understanding relevant adjudication rules. They do not constitute opinions on specific cases.

[Case No.]The case number has not been made public.
[Trial Court]The People's Court (the case was published on the China Court Online website)
[Judicial Summary]The patient's family and the hospital both applied for a medical malpractice appraisal, but due to the hospital's multiple editing and saving actions on the hospitalization records, discharge records, doctor-patient communication records, disease assessments, and accompanying personnel, three appraisal agencies successively withdrew their appraisal applications, resulting in the inability to conduct a medical malpractice appraisal. The court held that if a medical institution loses, falsifies, alters, or illegally destroys medical record materials, it shall be presumed to be at fault. The hospital failed to provide a reasonable explanation for the obvious contradictions in the medical records, and was therefore presumed to bear the liability for fault. Combined with the patient's own disease factors, the court ruled that the hospital should bear corresponding compensation responsibilities and compensate for various expenses totaling 600,000 yuan.
[Source]China Court Online (Hospital Modifies Medical Records, Causing Controversy; Appraisal Institutions Return Them Multiple Times—How Will the Court Rule?) (2025-12)

[Case No.]The case number has not been made public.
[Trial Court]The People's Court of Haishu District, Ningbo City, Zhejiang Province
[Judicial Summary]The patient sued the dental clinic for severe dental damage caused by the clinic's negligence in dental correction. During the two pre-trial exchanges of evidence, the court found multiple discrepancies in the medical records submitted by the clinic, and the clinic admitted on the spot that it had modified the electronic medical records after the first exchange of evidence. The court held that the clinic had modified the medical records without authorization after responding to the lawsuit, engaged in forgery and tampering with medical records, and seriously disrupted the litigation order. The court fined the clinic 100,000 yuan. Due to the tampering of medical records, the judicial appraisal of medical damage could not be carried out, and the clinic failed to prove that its medical treatment complied with norms. According to the law, it was presumed that there was negligence in the clinic's medical treatment. Taking into account the patient's own negligence, the court ruled that the clinic should bear 80% of the compensation liability.
[Source]China Court Online (Ningbo Dental Clinic was fined for altering medical records and obstructing litigation) (2023-02)

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·Beijing Henglue Law Firm

Disclaimer: This article is compiled based on the current laws and regulations and publicly available adjudication rules. It is for general reference only and does not constitute formal legal advice for 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 a timely manner.