刘宜林、储博刚律师亲办案例：孕妇分娩大出血致次全子宫切除，伤残七级赔偿20余万元

<h3 style="text-indent: 0;white-space: normal;padding: 0;text-align: justify;vertical-align: baseline"><strong><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px"><span style="font-family:仿宋"></span></span></strong></h3><p style="font-size: medium;white-space: normal"><span style="font-family: 黑体;letter-spacing: 0;font-size: 19px"><span style="font-family:黑体">承办律师：</span></span></p><p style="font-size: medium;white-space: normal"><span style="font-family: 黑体; font-size: 19px; letter-spacing: 0px;">刘宜林，法学硕士、安徽金亚太律师事务所合伙人、医药大健康部副主任</span></p><p style="font-size: medium;white-space: normal"><span style="font-family: 黑体; font-size: 19px; letter-spacing: 0px;">储博刚，安徽金亚太律师事务所专职律师、医药大健康部秘书长</span></p><p style="font-size: medium;white-space: normal"><span style="font-family: 黑体; letter-spacing: 0px; font-size: 19px;">关键词：子宫大部分切除 同等过错 七级伤残</span><strong style="font-size: 16px; text-align: justify;"><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px">&nbsp;</span></strong></p><p style="font-size: medium;white-space: normal"><strong style="text-align: justify; font-size: 16px;"><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px">一、案情简介</span></strong></p><p style="font-size: medium;white-space: normal"><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; font-size: 19px;">2022年1月6日，原告S某</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">因“第四胎孕足月阴道流水7小时”</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; font-size: 19px;">入住</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">被告H医院</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">，</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">入院诊断为</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">1、胎膜早破；2、G4P1孕39+1WLOA待产；3、单脐动脉；4、脐带绕颈</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">。</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">原告平素体健，月经规律，孕期产检5次，胎心及胎动正常。专科检查：宫高35cm，腹围98cm，胎方位LOA，胎心140次/分，原告分娩前其身体及胎儿的各项指标均正常。</span></p><p style="font-size: medium;white-space: normal"><span style="font-family: 仿宋; font-size: 19px; letter-spacing: 0px; text-align: justify; text-indent: 37px;">原告入院当日</span><span style="font-family: 仿宋; font-size: 19px; letter-spacing: 0px; text-align: justify; text-indent: 37px;">17：00出现胎心减慢，17:42分娩出一男活婴，产后原告子宫收缩欠佳，出血量多，约300毫升，19:18原告阴道流血多，值班医生给予按压宫底，压出宫腔积血约400毫升，有少量血块，10分钟后再次按压宫底，出血约100毫升左右，仍有阴道继续出血，后主治医生前来检查，再次出血200毫升左右，遂对原告进行抢救。经抢救无效，原告再次出现阴道流血不止，病情迅速恶化，出现休克症状并伴随血压下降、凝血功能障碍等症状。</span></p><p style="font-size: medium;white-space: normal"><span style="font-family: 仿宋; font-size: 19px; letter-spacing: 0px; text-align: justify; text-indent: 37px;">因阴道不断出血且治疗无效，被告于当日</span><span style="font-family: 仿宋; font-size: 19px; letter-spacing: 0px; text-align: justify; text-indent: 37px;">22:20对原告行“次全子宫切除术”，手术指征为产后子宫收缩乏力，失血性休克，凝血功能障碍。经开腹探查，术中见原告子宫收缩欠佳，软袋状，苍白，双侧输卵管及双侧卵巢外观无异常。术后检查盆腔创面仍有渗血，于2022年1月7日1:00将原告转入ICU（脑外）进行进一步抢救治疗，入科诊断为：1、胎膜早破；2、失血性休克；3、重度贫血；4、凝血功能障碍；5、代谢性酸中毒；6、呼吸性碱中毒；7、低钙血症；8、子宫次全切术后。</span></p><p style="font-size: medium;white-space: normal"><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">原告</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">S某</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">认为，</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">被告对</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">其</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">住院期间的诊疗措施存在过错，</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">分娩前</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">未能正确诊断、评估不足，</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">分娩及手术过程中未尽合理诊疗义务，导致患者子宫被切除，</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">给原告造成了巨大的</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">身体伤害</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">和精神伤害。</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">为维护原告的合法权益</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px; background: rgb(255, 255, 255);">，</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">为了保护自己的权益，</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">S某</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">遂将</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">H</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">医院诉至法院</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">。</span></p><p style="font-size: medium;white-space: normal"><strong style="text-indent: 32px;"><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px">二、办案经过</span></strong></p><p style="font-size: medium;white-space: normal"><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">安徽金亚太律师</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">刘宜林、储博刚</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">接受当事人</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">S某</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">的委托为其</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">诉讼</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">代理人，接受委托后，</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">代理</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">律师通过反复查阅病历材料，认为被告</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">H</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">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，遂向法院</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">及鉴定机构</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">申请医疗损害过错鉴定</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">及伤残等级、“三期”鉴定</span><span style="text-align: justify; text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">。</span></p><p style="font-size: medium;white-space: normal"><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">经鉴定，</span><span style="text-align: justify; text-indent: 37px; font-family: 仿宋; font-size: 19px;">认定被告的诊疗行为与原告的损害后果之间存在因果关系，医疗过错的参与度建议为45%-55%，子宫大部分切除术后，构成七级伤残，误工期90日，护理期45日，营养期45日。</span></p><p style="font-size: medium;white-space: normal;margin: 20px 0 0;text-indent: 32px;padding: 0;text-align: center;vertical-align: baseline;line-height: 21px"><img src="http://d02.wanglv.vip/images/upload/site/27016/default/2022/11/20221128183809.png" alt="1"/><img src="http://d03.wanglv.vip/images/upload/site/27016/default/2022/11/20221128183950.png" alt="2"/><span style="font-family: 仿宋;font-size: 19px">&nbsp;</span></p><p style="font-size: medium;white-space: normal;margin-top: 20px;margin-right: 0;margin-bottom: 0;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><strong><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px">&nbsp;</span></strong></p><p style="font-size: medium;white-space: normal;margin-top: 20px;margin-right: 0;margin-bottom: 0;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><strong><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px"><span style="font-family:仿宋">三、代理思路</span></span></strong></p><p style="font-size: medium;white-space: normal;margin-top: 20px;margin-right: 0;margin-bottom: 0;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">接受委托后，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">刘宜林、储博刚</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">律师通过</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">对</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">病历</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">的审查</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">，及时与原告</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">S某</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">沟通，经过分析案情和研究证据后，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">两位律师</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">律师发现被告</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">H</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">医院在诊疗过程中存在严重</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">的医疗过错。</span></p><p style="font-size: medium;white-space: normal;margin-top: 20px;margin-right: 0;margin-bottom: 0;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">第一，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">被告在患者分娩前未能正确诊断</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">、</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">评估不足</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">没有做好应急预案</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">耽误后续诊疗</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">；</span></p><p style="font-size: medium;white-space: normal;margin-top: 20px;margin-right: 0;margin-bottom: 0;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">第二，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">被告在患者分娩后存在漏诊</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">未能及时判断</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">明确是否为</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">羊水栓塞的情况</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">导致患者出现了产后大出血</span></p><p style="font-size: medium;white-space: normal;margin-top: 20px;margin-right: 0;margin-bottom: 0;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">第</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">三，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">被告医院没有及时告知患者家属病情变化</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">侵犯了家属的知情权</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">延误了病情</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">造成出血加重</span></p><p style="font-size: medium;white-space: normal;margin-top: 20px;margin-right: 0;margin-bottom: 0;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><strong><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px"><span style="font-family:仿宋">四、裁判结果</span></span></strong></p><p style="font-size: medium;white-space: normal;margin-top: 20px;margin-right: 0;margin-bottom: 0;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">经鉴定，</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">S某</span><span style="text-indent: 32px; font-family: 仿宋; font-size: 19px;">子宫大部分切除术后，构成七级伤残</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">。法院最终判决被告</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">H</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">医院应当赔偿原告</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">S某</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">因医疗损害造成的各项损失共计</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">200220.93</span><span style="text-indent: 32px; font-family: 仿宋; letter-spacing: 0px; font-size: 19px;">元。</span></p><p style="font-size: medium;white-space: normal;margin: 20px 0 0;text-indent: 32px;padding: 0;text-align: center;vertical-align: baseline;line-height: 21px"><img src="http://d03.wanglv.vip/images/upload/site/27016/default/2022/11/20221128184000.png" alt="3"/><img src="http://d03.wanglv.vip/images/upload/site/27016/default/2022/11/20221130172933.jpg" alt="3ed486af43dbcd6527a697ddc6bf92d"/></p><p style="font-size: medium;white-space: normal;margin: 20px 0 0;text-indent: 32px;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px">&nbsp;</span></p><p style="font-size: medium; white-space: normal; margin: 20px 0px 0px; padding: 0px; text-align: justify; vertical-align: baseline; line-height: 21px; text-indent: 0em;"><strong><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px">五、办案心得</span></strong></p><p style="font-size: medium; white-space: normal; margin: 20px 0px 0px; padding: 0px; text-align: justify; vertical-align: baseline; line-height: 21px; text-indent: 0em;"><span style="font-family: 仿宋; font-size: 19px;">由于医疗纠纷案件的专业性很强，此类案件通常要通过鉴定确认医方的过错及程度，而鉴定需要的最主要材料则是来自医方的病历。因此，为了保证在案证据客观、完整，律师代理这类案件第一步要做的便是复印、封存病历及固定其他治疗过程中形成的材料和证据；当医院拒绝给患者复印、封存病历时，律师应当据法力争，有效沟通并在必要的时候向卫生行政部门求助、投诉直至达成目标。此外，某些案件如果不能通过病历找到医方在治疗过程中存在的问题，还要通过分析对比、查阅文献、参加尸检、听证等方式发现医方的过错。因此，律师办理医疗损害案件一定要有耐心和足够的专业知识。</span></p><p style="font-size: medium;white-space: normal;margin: 20px 0 0;text-indent: 32px;padding: 0;text-align: justify;vertical-align: baseline;line-height: 21px"><br/><span style="font-family: 仿宋;letter-spacing: 0;font-size: 19px"></span></p>