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告知不到位和检查上疏漏 孕妇生下畸形儿医院赔14万
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告知不到位和检查上疏漏 孕妇生下畸形儿医院赔14万
April 19, 2015, 06:19:31 PM
#1
孕妇李女士到医院建档并产检时,因医院告知不到位和检查上的疏漏,始终没有进行唐氏筛查,最终产下了畸形婴儿。近日,市二中院终审判决医院承担25%的责任,赔偿李女士夫妇14万余元。
是否有过错双方有争议
李女士和丈夫起诉称,李女士于2011年6月怀孕,同年9月到中国航天科工集团七三一医院(下称七三一医院)建档并进行产前检查。B超提示NT值偏高,提示胎儿发育异常,建议进一步检查,但主治医生认为不需进行进一步检查,她遵医嘱,未行其他检查。此后,她按时就诊,但七三一医院未依照法律规定对她进行产前筛查,导致她于2012年2月产下一唐氏综合征(即21-三体综合征)患儿,属于畸形儿。
李女士认为,唐氏筛查为产前诊断中最重要的检查之一,七三一医院未进行此项筛查导致她产下一唐氏综合征患儿,严重侵犯了他们的优生优育权,造成巨大损失。他们起诉要求医院赔偿医疗费、特殊抚养费、精神损害抚慰金等共计50余万元。
七三一医院辩称,该院的诊疗行为没有过错,符合诊疗常规。该院不具备进行唐氏综合征筛查的资格,李女士于孕13周首次产检时,医院已向其告知应于孕15-18周到外院进行唐氏综合征筛查,并向其发放了孕期产前检查告知单,贴于门诊病历手册上,上面有详细的孕期检查项目。李女士在孕18周产检时,医院再次向其告知应当进行唐氏综合征筛查,但李女士未按医嘱到外院进行检查。患儿所患“21-三体综合征”是一种由遗传因素所导致的出生缺陷类疾病,即受父母本身遗传基因的影响,属于目前医学尚无法改变的因素,与医院的诊疗行为没有因果关系,不同意赔偿。
司法鉴定医院有过失
经李女士申请,一审法院委托的鉴定机构对医院产前检查是否存在过错等进行了司法鉴定。鉴定意见书认为,七三一医院粘贴在病历上的产前检查单,虽有唐氏筛查的内容和时间,但告知方式不够严谨、内容不够具体,应认为医方告知义务不到位,存在一定缺陷。
李女士于2011年9月8日的超声检查报告单已提示“胎儿NT略厚,建议进一步检查”,但七三一医院未行进一步检查,追踪NT值增厚情况,不排除错过补救时机,不利于21-三体征者的早期检测,应认为医方注意义务不到位,存在不足。
在2012年2月21日及26日的超声检查已提示羊水量偏少,在孕妇未进行唐筛和曾有胎儿NT略厚的情况下,医方应对胎儿进一步的产前B超等详细检查、诊断,以明确羊水量偏少的原因及可能出现的不良后果等相关风险,向孕妇及家属充分告知,医方存在不足。
鉴定结论认为,七三一医院在对李女士的医疗行为中存在医疗过失,其医疗过失与患儿出生的后果之间存在部分因果关系,参与度建议为25%。
医院被判赔14万余元
一审法院根据司法鉴定意见书认为,医院在对李女士的诊疗行为中存在过错,该过错侵害了李女士夫妇的知情权、选择权,影响了其是否选择终止妊娠,并最终导致了孩子的畸形出生。
孩子的畸形出生,使李女士夫妇用于孩子抚养的相关费用有所增加,而且孩子的畸形出生势必造成其严重的精神损害,医院应承担相应的侵权责任。2014年8月,一审法院判决七三一医院按25%的比例赔偿李女士夫妇医疗费、抚养费等共计14万余元。七三一医院上诉被市二中院驳回。
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