医疗纠纷中死亡争议案件尸检价值的评估

目的探讨尸体检验对死亡争议事件的医疗鉴定、赔偿处理上的价值,以妥善处理医疗纠纷中医患双方的矛盾。方法对温州市4个市、区、县2002—2004年的182例死亡争议事件进行回顾性分析,就尸检率,临床、尸检诊断,尸检对医疗鉴定及争议事件处理上的作用,及其在不同级别医院的具体情况等进行了统计处理。结果182例其中尸检46例,尸检率25.27%。二级以上医疗机构死亡争议事件112例,尸检率19.64%。临床死因诊断与尸检死因诊断不符合率37%,以循环系统、呼吸系统为多。46例尸检中,医疗鉴定32例(69.5%),经济赔偿29例(63%)。未尸检136例,医疗鉴定20例(14.7%),经济赔偿121例(88.9%),两者差异显著,有统计学意义(P<0.05)。结论尸体检验对死亡争议案件的医疗鉴定与处理具有重要意义,尤其在死因鉴定方面具有不可替代性。

The value of autopsy in medical dispute over cause of death

Objective Discuss the value of forensic autopsy to death dispute identification, compensation and disposal, so as to appropriately handle the contradiction between patients and hospital in medical tangles. Methods 182 death dispute cases from four cities and counties in Wenzhou from the year 2002 to 2004 were retrospectively analyzed. The rate of forensic autopsy, clinical and forensic pathological diagnose, way of handle were statistically treated. Results The rate of autopsy was 25.27%. 34.78% of the clinical diagnosis was inconsistent with forensic pathological findings. The highest death rate is in circulation system and breathing system. For the112 death dispute cases taken place in hospitals above grade two, the rate of forensic autopsy is only 19.64%. Among the 46 autopsy cases, 29 (63%) were for economical compensation; for the 136 cases without autopsy, 121 (88.9%)is for identification, the differences was significant. Conclusion Autopsy is indispensable for identifying cause of death, compensation and disposal.