论无过错输血感染的法律责任

目前,无过错输血感染在世界范围内引发了诸多的法律问题,其中,该感染的法律责任的承担更是当下研究的热点。上世纪80年代以来,西方国家对输血安全和输血感染的相关理论和实践经验,于我国有较高的借鉴价值。因此,从我国国情出发,对无过错输血感染应当适用无过错责任原则,同时建立健全相应保险和输血风险基金等制度,切实保护无过错输血感染受害者的合法权益。     

浅析《侵权责任法》中医疗物品致人损害责任归责原则

关于医疗产品责任的归责原则,我国在理论上经历了一个由过错责任原则到无过错责任原则的演化。自1986年的《民法通则》开始,到后来随着《产品质量法》的颁布实施,产品责任的无过错原则成为通说,关于医疗产品责任也是如此。而输血感染致人损害归责原则到目前还都是众说纷纭,但依我们《侵权责任法》的规定,显然目前认为应采用无过错责任原则。     

论无过错输血感染的法律责任

目前，无过错输血感染在世界范围内引发了诸多的法律问题，其中，该感染的法律责任的承担更是当下研究的热点。上世纪80年代以来，西方国家对输血安全和输血感染的相关理论和实践经验，于我国有较高的借鉴价值。因此，从我国国情出发，对无过错输血感染应当适用无过错责任原则，同时建立健全相应保险和输血风险基金等制度．切实保护无过错输血感染受害者的合法权益。     

无过错输血感染的法律问题

无过错输血感染是指采用血机构在无过失的情况下，为患者输血而感、染疾病造成的损害。根据现行的法律规定，无过错输血感染适用过错责任原则及公平责任原则，这使得患者的损害无法救济或者救济不充分，这种规定无法体现法的公正性。笔者认为，无过错输血感染适用无过错责任原则有利于建立降低输血感染的激励机制，而且能够对患者的损害充分进行补偿。     

医疗物品致人损害责任的举证制度研究

医疗物品致人损害责任是医疗损害责任的一种特殊形式,同时又具有产品责任的某些特点。对外,药品、消毒药剂和医疗器械致损的归责原则是无过错原则;而血液致损的归责原则是过错原则。对内,医疗机构承担的是无过错责任,因此在无过错时有权向最终的责任主体追偿。医疗物品责任实行的是谁主张,谁举证的归责原则,因此受损害方承担了证明医疗损害责任三个构成要件的证明责任;而医疗产品生产商和医疗机构都可以通过举证《产品质量法》规定的法定情况的存在而免责,但医疗机构不得对未投入流通这一情况而免责,血液提供机构承担了证明自己不存在过错的举证责任。为了更好的平衡举证责任和举证能力,我国应该对与证据价值密切相关的两个制度证据保全和医疗鉴定予以完善。     

医疗机构连带承担药品缺陷责任之质疑

我国《侵权责任法》第59条规定了医疗机构同药品生产者连带承担药品缺陷引起的责任,而不论医疗机构有无过错。医疗机构不是单纯的药品销售者,其主要职责在于提供专业化的诊疗服务;医疗机构连带承担无过错责任与无过错责任立法目的相悖,医疗机构不能成为受害患者的保险人。我国应将医疗机构对药品瑕疵责任限定于医疗过错责任范畴,医疗机构可能因违反诊疗和组织义务而承担基于药品缺陷的过错责任。     

医疗物品致人损害责任的举证制度研究

医疗物品致人损害责任是医疗损害责任的一种特殊形式，同时又具有产品责任的某些特点。对外．药品、消毒药剂和医疗器械致损的归责原则是无过错原则；而血液致损的归责原则是过错原则。对内。医疗机构承担的是无过错责任．因此在无过错时有权向最终的责任主体追偿。医疗物品责任实行的是“谁主张。谁举证”的归责原则，因此受损害方承担了证明医疗损害责任三个构成要件的证明责任；而医疗产品生产商和医疗机构都可以通过举证《产品质量法》规定的法定情况的存在而免责，但医疗机构不得对“未投入流通”这一情况而免责．血液提供机构承担了证明自己不存在过错的举证责任。为了更好的平衡举证责任和举证能力．我国应该对与证据价值密切相关的两个制度证据保全和医疗鉴定予以完善。     

医疗纠纷与赔偿责任体系建立——法国医疗赔偿制度最新发展及其启示

20世纪90年代以来,法国最高行政法院从维护公民权益的角度出发,通过一系列判例降低了公立医疗机构承担赔偿责任的门槛,不仅在医疗行为领域用一般过错归责原则代替了以往的重过错归责原则,还承认在特殊情况下医疗机构可以基于风险承担无过错赔偿责任。2002年的《患者权利及医疗质量保障法》对上述判例原则加以确认,形成了统一的适用于公私立医疗机构的、以一般过错原则为主、无过错原则为辅的医疗赔偿责任体系。     

刍议输血感染案件的法律责任

有关输血感染损害赔偿等医疗纠纷是近来医学界、法律界所经常涉及的话题 ,对此的研究存在着诸多的观点。本文对输血感染赔偿纠纷是否适用产品责任、是否存在侵权与违约的竞合以及无过错输血感染案件是否采用公平责任发表作者自己的观点。     

医疗机构因医院感染应承担的法律责任探讨

医院感染是影响病人安全、医疗质量和增加医疗费用的重要原因。当患者因医院感染受到损害时,医疗机构是否应当承担赔偿责任,医患双方可能各执一词。本文根据《侵权责任法》与《医院感染管理办法》分析、讨论医疗机构因医院感染而应承担的法律责任。     

新冠疾病对法医精神病鉴定的挑战与思考

新冠疾病(COVID-19)传染性强,潜伏期长,已在全球快速蔓延,给司法鉴定带来新的挑战.本文对COVID-19疫情下法医精神病鉴定的日常工作相关环节如何避免感染,COVID-19导致的器质性与功能性精神损伤特点及其损伤/伤残评定,COVID-19与精神卫生医疗机构医疗纠纷的防范及法医学鉴定思路等方面进行了探讨,并提出...     

Antibodies in threshold dilutions of group-specific immune sera and their forensic medical significance

Antibodies of nonadsorbed antisera are specific and under certain conditions can react with nonhomologous antigens. This assumption is scientifically based and experimentally confirmed. This property of antibodies opens new vistas for solving theoretical and practical tasks in medicine and biology with regard to the antigen-antibody tests. A technology of making highly effective group specific immunoreagents for forensic medical institutions and blood transfusion service has been created. The technology of immunoreagent making is patented.     

因输血感染所致损害的法律救济探析

在因输血使患者感染疾病的场合,如果血液提供者存在过错,由于过错责任原则的存在,患者可获得的法律救济较为简单。如果血液提供方没有过错,患者会求助于货物销售、默示担保、产品责任法律制度,诉讼前景不容乐观。货物与服务的二分法排除了在医疗输血领域货物销售法律制度的适用。血液提供的必要性、不可替代性和风险的不可避免性否定了默示担保和严格责任的适用余地。要获得产品责任制度的益处,患者要跨过"产品"、"缺陷"、"发展抗辩"三道关口,结果可想而知。     

Medicare and Medicaid programs; hospital conditions of participation: laboratory services. Final rule

This final rule finalizes the hospital conditions of participation requirements for hospitals that transfuse blood and blood components. It requires hospitals to: Prepare and follow written procedures for appropriate action when it is determined that blood and blood components the hospitals received and transfused are at increased risk for transmitting hepatitis C virus (HCV); quarantine prior collections from a donor who is at increased risk for transmitting HCV infection; notify transfusion recipients, as appropriate, of the need for HCV testing and counseling; and extend the records retention period for transfusion-related data to 10 years. The intent is to aid in the prevention of HCV infection and to create opportunities for disease prevention that, in most cases, can occur many years after recipient exposure to a donor.     

Medicare and Medicaid programs; hospital standard for potentially HIV infectious blood and blood products--HCFA. Final rule

This final rule requires hospitals participating in the Medicare and Medicaid programs to take appropriate action when the hospitals learn that they have received whole blood, blood components (including recovered plasma), source plasma, and source leukocytes (hereafter referred to as blood or blood products) that are at increased risk of transmitting Human Immunodeficiency Virus (HIV) infection. If the hospital learns that it has received blood or blood products collected from a donor recently exposed to HIV, before the donor has a sufficient level of antibody to be detected by the screening test for antibody to HIV, the hospital must quarantine any blood or blood products remaining in inventory pending confirmation testing. If the presence of HIV is confirmed by more specific testing, the hospital must notify patients who received the blood or blood product. This final rule is intended to ensure that proper health and safety steps are taken to minimize further spread of HIV infection. A final rule published elsewhere in this Federal Register by the Food and Drug Administration applies the same requirements to entities furnishing transfusion services that do not participate in the Medicare and Medicaid programs and clarifies the responsibilities of blood establishments to identify and notify the transfusion service that received affected blood and blood products.     

Medicare and Medicaid programs; hospital conditions of participation: laboratory services. Interim final rule with comment period

This interim final rule with comment period requires hospitals that transfuse blood and blood components to: Prepare and follow written procedures for appropriate action when it is determined that blood and blood components the hospitals received and transfused are at increased risk for transmitting hepatitis C virus (HCV); quarantine prior collections from a donor who is at increased risk for transmitting HCV infection; notify transfusion recipients, as appropriate, of the need for HCV testing and counseling; and extend the records retention period for transfusion-related data to 10 years. These changes are based on recommendations by the Secretary's Advisory Committee on Blood Safety and Availability and are being published in conjunction with the Food and Drug Administration's (FDA) Final Rule, "Current Good Manufacturing Practice for Blood and Blood Components; Notification of Consignees and Transfusion Recipients Receiving Blood and Blood Components at Increased Risk of Transmitting HCV Infection" ("lookback") found elsewhere in this issue of the Federal Register. The intent is to aid in the prevention of HCV infection and to create opportunities for disease prevention that, in most cases, can occur many years after recipient exposure to a donor.     

输血与丙型肝炎因果关系鉴定及相关法律问题探讨

丙型肝炎病毒（ＨＣＶ）已成为输血后非甲非乙型肝炎的主要致病因子，但是要确定患者所感染的丙型肝炎与某次输血有必然的因果关系仍很困难。本文通过对一个案例进行研究，提出鉴定方法，即收集病人的所有住院病历，查阅病人输血前、输血后或者以后一段时间转氨酶的变化情况，尤其是伤后近期查出的转氨酶水平，基本上可代表伤前的水平。结合抗－ＨＣＶ抗体的变化，确定输血与肝炎间的因果关系。作者还结合我国法律，提出输血后感染丙型肝炎的患者可以“严格责任原则”起诉医院或者血库，医院或者血库承担举证责任，举证的内容包括其所提供血液的献血员来源合法，已作了法定的筛选检测，同时提供所有法定的记录档案，否则血库或者医院将承担败诉的民事责任。     

医疗纠纷病历资料保全存在问题与对策

《侵权责任法》第六十一条第二款规定，患者要求查阅、复制病历资料的，医疗机构应当提供。第五十八条规定，医疗机构隐匿或者拒绝提供与纠纷有关的病历资料的，人民法院推定医疗机构有过错。病历资料作为医疗损害案件诉讼的核心证据，对病历资料保全自然就成为医患双方诉前关注的焦点问题。由于现行法律法规对病历资料规定的不一致，导致医患双方对病历资料的范围、保全的方式方法、封存病历资料期限、保全病历资料主体等诸多问题认识极不一致，争议颇多。造成医患双方在发生医疗纠纷的基础上进而引发次生纠纷，导致医患矛盾进一步加深，不利于纠纷的及时解决。笔者不揣简陋，试对病历资料保全环节中存在的问题及对相关问题提出规制建议，希望同仁不吝赐教。