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    誤診

    誤診,即錯誤的診斷。診斷的目的在于確定疾病的本質,并隨之選擇有針對性的治療,使病情向好的方面轉化。因此把不正確的診斷看作是錯誤的,把不及時、不全面的診斷也同樣看作是錯誤的。華律網誤診專題為您提供全面的誤診相關的法律知識,以及提供全國各地的誤診律師,如果您有誤診相關的法律問題可以在線咨詢專業律師。

    目錄

    • 1判斷誤診的相對標準

      判斷某個疾病是否被誤診,也應該象診斷一個疾病一樣,有個相對的標準。但是,由于誤診的原因復雜,不僅涉及到醫務人員和醫療設備,還有病員及疾病本身的特殊性等諸多因素,所以難以制訂一個準確的判定是否誤診的標準。參閱目前各種雜志對誤診病例的報道及對誤診所作的理論研究,我們提出如下幾個相對的標準供臨床參考:誤診發生在診斷過程之后、誤診的時間性、誤診導致誤治、誤診未誤治。

      誤診率的計算

      某一種疾病誤診率的高低,在一定程度上反映著該病本身的復雜性和診斷的難度。因此,在研究誤診時,首先應對每種疾病的誤診率有一個基本的了解,這樣才能作到胸中有數。下面分三方面介紹誤診率的計算:評價診斷試驗的誤診率和漏診率、臨床回顧性研究中的誤診率和漏診率、本書中誤診率的計算。

      誤診造成的不良后果

      誤診造成的不良后果是多方面的,對被誤診的患者是個不幸,對社會、家庭、醫院及醫生也都將帶來不良的影響。概括起來,有以下幾個方面:對病人的影響、對社會的影響、對醫療質量的影響。

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    • 2誤診分類

      錯誤的診斷在教科書中或臨床上尚缺乏嚴格的分類。我們結合現行臨床上比較通用的分類,并根據誤診性質和程度的不同,試將誤診分為下述五個類型:診斷錯誤、延誤診斷、漏誤診斷、病因判斷錯誤、疾病性質判斷錯誤。

      診斷的目的在于確定疾病的本質,并隨之選擇有針對性的治療,使病情向好的方面轉化。因此把不正確的診斷看作是錯誤的,把不及時、不全面的診斷也同樣看作是錯誤的。關于錯誤診斷的分類,除了目前已被臨床普遍接受的“錯誤診斷”、“延誤診斷”、“漏誤診斷”3種之外,上述病因判斷錯誤、疾病性質判斷錯誤及對新發生疾病和并發癥的漏診誤診,雖然與前3種誤診有程度的區別,但是都能給病人帶來不良的后果,所以也應當包括在誤診研究之列,否則就不利于臨床醫療質量的提高。

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    • 3誤診的法律責任如何承擔

      臨床誤診的性質不同,涉及到法律責任也不同,從過錯原則上看,無過錯的誤診不承擔法律責任,有過錯的誤診有以下幾種法律責任。

      一、醫療事故責任,按照《醫療事故處理條例》規定,醫療活動中存在過失,即違反了醫療衛生管理法律、行政法規、部門規章和診療護理規范、常規,造成患者人身損害的不良后果,損害程度必須達到《醫療事故處理條件》規定的醫療事故等級,以及衛生部《醫療事故分級標準(試行)》的規定要求,且過失行為不良后果之間存在因果關系時,即構成醫療事故,應當承擔醫療事故責任。

      二、民事法律責任,人民法院在審理醫療糾紛案件時,對不構成醫療事故,但經審理能夠認定醫療機構存在過錯的誤診行為,符合民事侵權構成要件的,應當依照《中華人民共和國民法通則》確定醫療機構承擔責任。

      對技術性誤診,無論給患者造成何種程序的損害,都要由醫療機構承擔民事責任。根據誤診給病人帶來的損害,醫院應賠償患者因誤診誤治增加的不必要醫療費、交通費,根據不同情況賠償病人因營養支持從而支出的營養費,因

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    • 4誤診中過錯的認定及賠償范圍的確定

      案例一:

      1995年10月初,原告張某因病在被告某三級甲等醫院進行檢查,同月19日,被告診斷原告患有“低度惡性血管免疫母細胞性T細胞淋巴瘤”(以下簡稱為淋巴瘤),預計中期存活期為30個月,隨后即進行了第一次化療。從1995年10月24日至1997年7月14日,原告先后9次在被告處進行了時間不等的化療。1999年10月9日,原告因左頸淋巴結腫大再次住院治療,被告主治醫生經全面輔助檢查及活檢,結論是不支持診斷,建議轉上海會診。出院診斷是“左頸部淋巴結顯著反映性增生”,對淋巴瘤表示懷疑。同年10月29日,經上海醫科大學腫瘤醫院會診考慮為“淋巴組織不典型增生,建議密切隨訪,如臨床不能除外腫病,必要時重取活檢,以最后除淋巴病之可能”。

      審理中,因雙方對責任爭執不一,經原告申請,法院委托北京腫瘤醫院病理室對某醫院的病理片進行了病理診斷,診斷結論為“淋巴結反映性增生,部分細胞增生較活躍,建議密切隨訪”。

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    最近更新:2019-07-03
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