徐权峰亲办案例：孕妇分娩侧切致直肠阴道瘘，伤残五级赔偿近50万元

e-space: normal;text-indent: 32px;line-height: 21px"><strong><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">一</span></span></strong><strong><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">、</span></span></strong><strong><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">案情简介</span></span></strong></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="font-family: 宋体;line-height: 24px;font-size: 16px">2016<span style="font-family:宋体">年</span><span style="font-family:Calibri">7</span><span style="font-family:宋体">月</span><span style="font-family:Calibri">31</span><span style="font-family:宋体">日</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">原告钟某某因</span>“停经<span style="font-family:Calibri">37+6</span><span style="font-family:宋体">周，阴道流液半小时”入住被告</span></span><span style="line-height: 24px;font-size: 16px">**</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">医院。当晚</span>6<span style="font-family:宋体">时</span><span style="font-family:Calibri">40</span><span style="font-family:宋体">分在会阴侧切下以</span><span style="font-family:Calibri">LOA</span><span style="font-family:宋体">顺娩一活男婴，新生儿体重</span><span style="font-family:Calibri">3.25kg</span><span style="font-family:宋体">。</span></span><span style="line-height: 24px;font-size: 16px">8</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">月</span>3<span style="font-family:宋体">日，原告钟某某经检查，子宫复旧良好，宫底脐下四指，会阴伤口愈合可，无红肿渗出，阴道少量流血，予以出院。被告</span></span><span style="line-height: 24px;font-size: 16px">**</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">医院于</span>2016<span style="font-family:宋体">年</span><span style="font-family:Calibri">8</span><span style="font-family:宋体">月</span><span style="font-family:Calibri">4</span><span style="font-family:宋体">日的出院医嘱示</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">：</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">注意休息及会阴部卫生，加强营养</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">；</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">忌盆浴，禁欲两月，避孕</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">；</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">出院医嘱并未提及无渣流质饮食。</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">出院一周后</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">原告钟某某主诉</span>“会阴部切口自产后一直都痛”再次入住被告潜山县中医院。专科检查</span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">：</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">外阴部红肿，触痛明显，内见大量异味恶臭脓性分泌物</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">。</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">入院后诊断为</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">：</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px">“</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">产后会阴切口感染</span>”</span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">。</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px">8<span style="font-family:宋体">月</span><span style="font-family:Calibri">16</span><span style="font-family:宋体">日，被告</span></span><span style="line-height: 24px;font-size: 16px">**</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">医院邀请某医院肛肠科主任医师会诊，诊断为</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">：</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px">“</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">会阴侧切口感染、直肠阴道瘘</span>”</span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">。</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">原告钟某某认为</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">被告</span></span><span style="line-height: 24px;font-size: 16px">**</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">医院存在误诊</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">、</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">漏诊</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">隐瞒</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">、</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">遗漏病情等一系列过错</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">：</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">术前未充分告知取得患者同意就进行手术</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">；</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">术中操作不当</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">造成瘘口及侧切口内部感染</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">；</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">术后未对病情予以重视</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">未及时发现瘘口</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">未对患者饮食进行规范指导</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">最终导致钟某某被诊断为会阴侧切口严重感染</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">直肠阴道瘘</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">影响生活质量</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">身心均受到了极大的折磨</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">。</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">为了保护自己的权益</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">钟某某遂将</span></span><span style="line-height: 24px;font-size: 16px">**</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">医院诉至法院</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">。</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><strong><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">二</span></span></strong><strong><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">、</span></span></strong><strong><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">办案经过</span></span></strong></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">安徽金亚太律师徐权峰接受当事人夏某某的委托为其代理人，接受委托后，徐权峰律师通过反复查阅病历材料，认为被告</span></span><span style="line-height: 24px;font-size: 16px">**</span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">医院在诊疗过程中存在重大过错，与损害结果的发生存在直接因果关系</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">遂向法院申请医疗损害过错鉴定</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">。</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="line-height: 24px; font-size: 16px; font-family: 宋体;">经鉴定，综合上述分析，被告</span><span style="line-height: 24px;font-size: 16px">**<span style="font-family:宋体">医院在</span></span><span style="line-height: 24px; font-size: 16px; font-family: 宋体;">原告钟某某分娩过程中为其行会阴侧切术违反了诊疗规范的相关要求，所实施诊疗行为存在一定的过错，原告直肠阴道瘘的发生主要与会阴侧切术后会阴部切口感染有关，被告</span><span style="line-height: 24px;font-size: 16px">**<span style="font-family:宋体">医院的诊疗行为与</span></span><span style="line-height: 24px; font-size: 16px; font-family: 宋体;">原告直肠阴道瘘的发生存在一定的因果关系，因果关系程度可为</span><span style="font-family: 宋体; line-height: 24px; font-size: 16px; text-decoration: underline; color: rgb(255, 0, 0);"><strong>主要因果关系</strong></span><span style="line-height: 24px; font-size: 16px; font-family: 宋体;">程度范围。<strong>（笔者注：主要因果关系程度范围建议为60%～90%）</strong></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="line-height: 24px; font-size: 16px; font-family: 宋体;"><strong><img src="http://d02.wanglv.vip/images/upload/site/27016/default/2022/01/20220125172457.jpeg" alt="WechatIMG697"/></strong></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><strong><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体"></span></span></strong></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><strong><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">三</span></span></strong><strong><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">、</span></span></strong><strong><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">代理思路</span></span></strong></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">接受委托后，徐权峰律师通过翻看病历资料，及时与原告</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">钟</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">某某沟通，经过分析案情和研究证据后，徐权峰律师发现</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">被告</span></span><span style="line-height: 24px;font-size: 16px">**<span style="font-family:宋体">医院在诊疗过程中存在严重的医疗过错</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">。</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">第一</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，原告面对的产伤和手术创伤，本足以避免，但因被告过错没有避免。</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">原告在产检时母体和胎儿身体状况良好</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，没有其他不良症状，完全没有必要进行会阴侧手术分娩，被告却进行该手术。且被告术前未进行充分告知取得患者知情同意的情况下，为原告进行会阴侧切手术；</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">第二</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">术中</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">操作失误，手术器械伤及直肠阴道黏膜，造成瘘口；切口缝合未按规范操作，缝合过程冲洗不彻底，造成侧切口内部感染，出现大量异味恶臭脓性分泌物；</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">第三</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，术后在原告主诉切口一直疼痛未予重视，被告未密切观察，未达出院标准通知原告出院；在原告一直主诉疼痛</span>,<span style="font-family:宋体">未及时进行肛査、指诊；未及时发现瘘口；诊断直肠阴道瘘，延误治疗，加重病情；术后未对</span></span><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">患者</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">饮食进行规范指导，加重病情；延误诊疗，造成患者出现严重的损害后果，毫无生活质量；隐瞒原告病情或遗漏病情。</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">第四</span></span><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">，被告明知原告仍未完全恢复的情况下准予出院，且出院医嘱并未提及无渣流质饮食，明显违反医疗常识。</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">由于被告的严重过失，未能查出原告病症，无法及时医治延误治疗，导致病情加重，给被告带来了严重创伤，应当承担全部责任。</span></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><strong><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">四</span></span></strong><strong><span style="line-height: 24px;font-size: 16px"><span style="font-family:宋体">、</span></span></strong><strong><span style="font-family: 宋体;line-height: 24px;font-size: 16px"><span style="font-family:宋体">裁判结果</span></span></strong></p><p style="text-align: justify; font-family: Calibri; font-size: 14px; white-space: normal; text-indent: 2em;"><strong><span style="font-size: 16px; font-family: 宋体;">经鉴定</span></strong><strong><span style="font-size: 16px; font-family: 宋体;">，</span></strong><span style="text-decoration: underline; color: rgb(255, 0, 0);"><strong><span style="font-size: 16px; text-decoration: underline; font-family: 宋体;">钟某某构后遗直肠阴道瘘难以修复</span></strong><strong><span style="font-size: 16px; text-decoration: underline; font-family: 宋体;">，</span></strong><strong><span style="font-size: 16px; text-decoration: underline; font-family: 宋体;">构成五级伤残</span></strong></span><strong><span style="font-size: 16px; font-family: 宋体;">。</span></strong><span style="font-size: 16px; font-family: 宋体;">法院最终判决被告</span><span style="font-size: 16px">**</span><span style="font-size: 16px; font-family: 宋体;">医院应当赔偿原告钟某某因医疗损害造成的各项损失</span><span style="color: rgb(255, 0, 0); text-decoration: underline;"><strong><span style="color: rgb(255, 0, 0); text-decoration: underline; font-size: 16px; font-family: 宋体;">共计</span><span style="color: rgb(255, 0, 0); text-decoration: underline; font-size: 16px;">415406</span><span style="color: rgb(255, 0, 0); text-decoration: underline; font-family: 宋体; font-size: 16px;">.</span><span style="color: rgb(255, 0, 0); text-decoration: underline; font-size: 16px;">5</span><span style="color: rgb(255, 0, 0); text-decoration: underline; font-size: 16px; font-family: 宋体;">元，精神损害抚慰金</span><span style="color: rgb(255, 0, 0); text-decoration: underline; font-size: 16px;">48000</span><span style="color: rgb(255, 0, 0); text-decoration: underline; font-size: 16px; font-family: 宋体;">元。</span></strong></span></p><p style="text-align: justify; font-family: Calibri; font-size: 14px; white-space: normal; text-indent: 2em;"><span style="color: rgb(255, 0, 0); text-decoration: underline;"><strong><span style="color: rgb(255, 0, 0); text-decoration: underline; font-size: 16px; font-family: 宋体;"><img src="http://d02.wanglv.vip/images/upload/site/27016/default/2022/01/20220125172511.jpeg" alt="WechatIMG696"/></span></strong></span></p><p style=";text-align: justify;font-family: Calibri;font-size: 14px;white-space: normal;text-indent: 32px;line-height: 21px"><br/></p><p><br/></p>