If a patient commits suicide in a hospital, will the hospital have to lose money?
Written by | Wang Hang
Source | "Medical Community" public account
A medical case involving 2.37 million in damages was pronounced.
Recently, the Shanghai No. 1 Intermediate People's Court ruled on a case of "suicide during hospitalization", rejecting the family's claim for compensation of 2.37 million yuan from the hospital.
It is worth mentioning that this is a second-instance judgment, in which the court has ruled that the hospital should bear more than 356,000 yuan in compensation. After the results of the second-instance trial were announced, some netizens left a message saying: "If the sentence is good, the atmosphere of where to die must be killed!" But some netizens wondered: "How to consider the responsibility of the hospital when the patient commits suicide during hospitalization?" ”
The scene of the trial
The pictures in this article are from "Shanghai First Intermediate Court"
The first instance determined that the hospital was at fault, and the second instance changed the judgment
According to the official information of the "Shanghai First Intermediate Court", the court of first instance held that the hospital "has a certain fault for the death of the patient".
"Managers of public places such as hotels, shopping malls, banks, or organizers of mass activities who fail to fulfill their obligations to ensure safety and cause harm to others shall bear tort liability." If the infringed party is also at fault for the occurrence of the damage, the liability of the infringer may be reduced. ”
In this case, the court of first instance stated that the patient came to the hospital for treatment due to a wrist cutting injury, and for such a special patient, the hospital, as a medical institution, should fulfill a more prudent duty of care, and be more rigorous and meticulous in nursing care than ordinary patients.
Therefore, the first instance found that after transferring the patient to the ordinary ward, the hospital did not give special treatment in nursing care, and did not find the abnormal situation in time during the period from the time he left the ward to the time he fell to his death, so it was determined that the hospital had certain faults.
However, considering that the patient's falling from the building is a subjective act and he has the vast majority of faults, the court of first instance decided that the hospital should bear 15% of the compensation liability, that is, more than 356,000 yuan, for the losses of the family.
The hospital was not satisfied, and then appealed to the Shanghai First Intermediate Court. During the second-instance trial, the collegial panel judge and a group of others went to the hospital to conduct on-site investigation, and both the plaintiff and the defendant were present.
Collegial panel judges conduct on-site investigations
The investigation found that there was a nurse desk in the orthopedic ward where the patient was located, and two nurses were on duty every night. There are two glass windows on the wall of the accident site, and a limiter is installed on each window, and the maximum opening stroke of the window, the height of the window edge from the ground, whether to install a stainless steel guardrail, and the height of the guardrail from the ground are also examined one by one.
In addition, the "Shanghai First Intermediate Hospital" found that after the patient was transferred from the ICU ward to the general ward, the hospital implemented first-level nursing care for him, and the medical staff made hourly rounds of the room, and instructed the family to accompany them 24 hours. This means that the hospital has done its part.
In the second instance, the Shanghai First Intermediate People's Court made a revised judgment: the hospital has fulfilled reasonable security obligations and does not need to be responsible. The hospital said it would voluntarily compensate the family for 30,000 yuan.
Why is the hospital at no fault?
Around this case, the "Shanghai First Intermediate People's Court" held that the focus of the dispute mainly lies in two aspects:
Has the hospital fulfilled its reasonable duty of safety and security?
Is there a causal relationship between the death of a patient falling from a building and the caregiving behavior of the hospital?
For the first dispute, the court held that the hospital was a general hospital, and it was only possible to save its life, but could not carry out psychiatric treatment, that is, in terms of hardware, the hospital did not have the isolation measures of the mental health specialist hospital, and could not demand that it should be protected according to the standards of the specialist hospital.
From the perspective of supporting facilities, the facilities at the site of the incident meet the industry standards for the safety requirements of medical places, there is no safety hazard, and ordinary people cannot accidentally slide through the narrow window gaps, which shows that the patient's intention to pursue death independently is obvious.
From the perspective of nursing measures, the hospital and the family have done their best to criticize the guardianship, and it is normal for patients to move freely in the ward, and it is difficult for strong people to expect unexpected results from the normal behavior of patients wandering in the corridors.
In summary, a Shanghai Intermediate People's Court has determined that the hospital has fulfilled reasonable safety and security obligations.
For the second controversy, the court held that the patient's subjective motivation and the magnitude of the causal force between the act of caregiving and the outcome of death should be examined. On the night of the accident, the police station made a record of the patient's family questioning, and the family admitted that he fell from the building due to suicide.
Therefore, the Shanghai First Intermediate People's Court believes that the patient' suicidal behavior as an adult with full legal capacity is the root cause of death, and at the same time, his family has a supervisory negligence, and the hospital does not neglect to round the room, there is no negligence in supervision, so the hospital does not have a causal impact on the patient's death outcome.
If a patient commits suicide while in the hospital, the hospital will have to lose money?
There is an unwritten tacit agreement in the medical community that if a patient commits suicide in the hospital, the hospital will lose some money.
The "medical community" combed and found that there are many lawsuits in which patients commit suicide during hospitalization and family members claim compensation from the hospital accordingly, but the hospital does not necessarily have to lose money.
In 2020, the Shanghai No. 1 Intermediate People's Court tried a similar case. The patient was hospitalized in a psychiatric hospital in Shanghai due to anxiety disorders, and then jumped to his death, and the family sued the hospital and claimed more than 1.9 million yuan.
After verifying the medical history records, hospital nursing system and other contents, the Shanghai First Intermediate People's Court made a judgment, holding that the patient's suicide was not necessarily related to the hospital's diagnosis and treatment and nursing work, rejected all the patient's litigation claims, and the hospital compensated the family for 50,000 yuan as appropriate.
In response to such cases, Daniel Zhang lawyer, founder of the medical legal team of Medical Law Hui, told the "medical community" that the types of hospitals are different, and the requirements for their security obligations are also different.
"Patients are treated in a general hospital, and in fact, a medical service contract relationship is formed with the hospital, and they need to fulfill their safety and security obligations. It is examined whether the medical institution has fulfilled its obligations in accordance with the 18 core systems of medical treatment and nursing care, and whether it has fulfilled the relevant notification obligations. ”
Daniel Zhang lawyer explained that suicide is the subjective will of patients, and general hospitals cannot restrict their free movements or predict such extreme events.
For psychiatric hospitals, Daniel Zhang lawyer said that such hospitals not only have the obligation of diagnosis and treatment, but also be responsible for nursing, and their functions are more concerned about the mental state of patients. Different types of patients are subject to different levels of constraints, and the hospital needs to make necessary restrictions on patient movements and make predictions for extreme events.
"This also warns relevant medical personnel to strictly abide by the core medical system in the process of diagnosis and treatment, fully perform the obligation to inform, and actually protect patients and medical staff themselves."
Source: Medical community
Editor-in-charge: Zheng Huaju
Proofreader: Zang Hengjia
Plate making: Xue Jiao