The law enforcement officers of the Huadu District Health Bureau found that the outpatient department had the illegal act of using gynecological practitioners to receive medical and surgical patients and issue prescriptions during the inspection of a comprehensive outpatient department, which violated the provisions of Article 27 of the Regulations on the Administration of Medical Institutions, and according to Article 47 of the Regulations on the Administration of Medical Institutions, the Huadu District Health Bureau imposed an administrative penalty of 10,000 yuan on the outpatient department.
Warning significance: The second paragraph of Article 81 of the "Detailed Rules for the Implementation of the Regulations on the Administration of Medical Institutions" stipulates that if a medical institution uses health technicians to engage in diagnosis and treatment activities other than its own specialty, it shall be treated as using non-health technicians. Paragraph 1 of Article 14 of the Physicians Law stipulates that after registration, a physician may practice in a medical and health institution in accordance with the registered practice location, practice category and scope of practice, and engage in corresponding medical and health services. Internal medicine, surgery, obstetrics and gynecology are all within the scope of clinical practice, medical institutions should arrange their practice according to the scope of practice of physicians, and shall not exceed the scope of practice.
Case 2: Liu's failure to practice in accordance with the registered scope of practice
When the law enforcement officers of the Huadu District Health Bureau inspected a comprehensive outpatient department, they found that Liu had violated the law of treating elderly patients beyond the scope of his pediatric practice, violating the provisions of Article 14, Paragraph 1 of the "Physician Law", and according to the provisions of Article 57 of the "Physician Law", the Huadu District Health Bureau issued a warning to Liu and imposed an administrative penalty of a fine of 10,000 yuan.
Cautionary significance: The first paragraph of Article 14 of the Physicians Law stipulates that after registration, physicians may practice in medical and health institutions in accordance with the registered practice location, practice category and scope of practice, and engage in corresponding medical and health services. In order to save costs, or for reasons such as insufficient staffing, or a large number of patients, individual medical institutions arrange for doctors to receive patients beyond the scope of practice, which not only brings hidden health risks to patients, but also brings "stains" to physicians' practice in accordance with the law.
Case 3: A hospital failed to implement a medical quality and safety management system in accordance with regulations
The Huadu District Health Bureau received complaints and reports from the public: a hospital tampered with the medical records of patient Zhou. Law enforcement officers went to a hospital to verify the complaints and reports, and after investigation, a hospital formulated a medical quality and safety management system (including a medical record management system), but a hospital did not truthfully fill in the two informed consent forms for surgery of patient Zhou, which constituted an illegal act of failing to implement the medical record management system in the medical quality and safety management system in accordance with the regulations, and violated the provisions of Article 10, Paragraph 1 of the Regulations on the Prevention and Handling of Medical Disputes, in accordance with the Regulations on the Prevention and Handling of Medical Disputes According to the provisions of Paragraph 1 of Article 47, the Huadu District Health Bureau issued a warning to a hospital and imposed an administrative penalty of a fine of 26,000 yuan.
Warning significance: "Basic Medical Care and Health Promotion Law", "Regulations on the Prevention and Handling of Medical Disputes" and "Medical Quality Management Measures" have made specific provisions on the formulation and implementation of medical quality and safety management systems for medical institutions, and the medical record management system is one of the 18 core systems of medical quality and safety, including medical record writing, storage, A series of requirements for quality control and other links are the systems that must be implemented by all types of medical institutions at all levels, and all types of medical institutions at all levels should formulate a medical quality and safety management system in line with the actual situation of medical institutions in the process of practice, and implement relevant systems in the practice process.
Case 4: A case of imperfect medical quality and safety management system of a medical beauty clinic
When the law enforcement officers of the Huadu District Health Bureau inspected a medical cosmetology clinic, they found that the medical cosmetology clinic had formulated a management system for botulinum toxin type A for injection, stipulating that the use of botulinum toxin type A for injection must establish and improve the procurement, storage, acceptance, issuance, and verification mechanisms and strictly implement them;
However, the above-mentioned system is not implemented in actual management, and there are problems such as the use of nurses to review the prescription of botulinum toxin type A for injection, and the inconsistency of the registration of botulinum toxin type A for injection in and out of the warehouse. After investigation, the above-mentioned behaviors have hidden dangers in medical quality and safety, which constitute an illegal fact of failing to comply with laws, regulations and rules, establishing and improving the internal quality management and control system, and being responsible for the quality of medical and health services, violating Article 9 of the Measures for the Administration of Toxic Drugs for Medical Use, Articles 17 and 18 of the Measures for the Administration of Medical Quality, Article 43 of the Basic Medical Care and Health Promotion Law, and in accordance with the Basic Medical Care and Health Promotion Law According to Article 101, the Huadu District Health Bureau issued a warning to a medical beauty clinic and fined 34,000 yuan for administrative punishment.
Warning significance: The use of botulinum toxin type A for injection to carry out medical cosmetology projects is very common in medical cosmetology institutions, but individual medical cosmetology institutions do not use botulinum toxin type A for injection in accordance with the requirements of toxic drugs for medical use, do not establish warehousing records, and do not keep them in double locks. Problems such as the review of prescriptions by personnel who do not use the technical title of pharmacist or above are widespread, and there are hidden dangers in medical quality and safety, which constitute an illegal act of imperfect medical quality and safety management system, which not only brings health risks to beauty seekers, but also brings the risk of administrative punishment to medical institutions themselves.
Case 5: Case of Wu failing to fill in medical records as required
When the law enforcement officers of the Huadu District Health Bureau inspected a dental outpatient department, they found that the outpatient department used the dental housekeeper system to register the patient's medical information, and randomly checked the diagnosis and treatment information of patients Zhang and Fan in the dental housekeeper system. According to the provisions of Article 47, Paragraph 4 of the Regulations on the Prevention and Handling of Medical Disputes, the Huadu District Health Bureau issued a warning to Wu and fined him an administrative penalty of 10,000 yuan.
Warning significance: The "Basic Standards for Medical Record Writing" stipulates that medical record writing should be objective, true, accurate, timely, complete and standardized. Whether it is an outpatient, an inpatient, a clinic, an outpatient department, or a hospital, as a doctor, writing medical records is a basic skill, and medical records are also important materials for patients to protect their rights.
Case 6: A medical cosmetology clinic carried out cosmetic dermatology diagnosis and treatment activities beyond the scope of registration
The Huadu District Health Bureau received complaints and reports from the public: a medical cosmetology clinic was suspected of exceeding the scope of the laser freckle removal project implemented for it. When law enforcement officers went to a medical cosmetology clinic for verification, they found that the clinic had approved cosmetic surgery but not cosmetic dermatology, and had carried out cosmetic dermatology projects such as laser spot removal and mole removal for beauty seekers from November 2020 to February 2023, which constituted an illegal act of carrying out cosmetic dermatology diagnosis and treatment activities beyond the scope of registration, in violation of Article 26 of the Regulations on the Administration of Medical Institutions, in accordance with the Regulations on the Administration of Medical Institutions Article 46 stipulates that the Huadu District Health Bureau issued a warning to a medical cosmetology clinic, confiscated 3,980 yuan of illegal gains, and fined 64,000 yuan as an administrative punishment.
Warning significance: Procedures such as spot removal and mole removal belong to the invasive treatment projects of cosmetic dermatology in the "Catalogue of Hierarchical Management of Medical Cosmetology Projects", and medical institutions should approve the cosmetic dermatology department before they can be carried out. Medical institutions must carry out diagnosis and treatment activities in accordance with the diagnosis and treatment subjects approved for registration or filing. If the scope of diagnosis and treatment needs to be expanded according to business development, the medical institution shall submit an application for the addition of diagnosis and treatment subjects, and the corresponding diagnosis and treatment subjects can only be carried out after the license review or filing. Individual medical institutions are limited by site and qualifications or in order to save costs, and only report part of the licensed subjects at the time of declaration, but carry out diagnosis and treatment activities beyond the diagnosis and treatment subjects in the actual business process, and this illegal behavior will be punished by law.
Case 7: A clinic prescribes a restricted-use antimicrobial treatment program to a person who has not obtained the right to prescribe antimicrobial drugs
When the law enforcement officers of the Huadu District Health Bureau inspected a clinic, they saw that the prescription of patient Gao in the clinic pharmacy had "cefixime granules" on it, and the signature of the physician on the prescription was Liu. According to the Administrative Measures for the Clinical Application of Antimicrobial Drugs and the Catalogue of Hierarchical Management of Clinical Application of Antimicrobial Drugs in Medical Institutions in Guangdong Province (2022 Edition), cefixime is a restricted-use antimicrobial drug, and physicians with intermediate or above professional and technical qualifications can be granted the right to prescribe restricted-use antimicrobial drugs only after passing the examination. After investigation, a clinic had the illegal act of using Liu, a person who had not obtained the right to prescribe restricted-use antimicrobial drugs, to carry out the prescription of restricted-use antimicrobial drugs, in violation of the provisions of Article 24, Paragraph 1 of the Administrative Measures for the Clinical Application of Antimicrobial Drugs, and in accordance with the provisions of Paragraph 1 of Article 50 of the Administrative Measures for the Clinical Application of Antimicrobial Drugs, the Huadu District Health Bureau issued an administrative penalty of warning to a clinic.
Warning significance: "Administrative Measures for the Clinical Application of Antimicrobial Drugs", the antimicrobial drugs are divided into three categories: non-restricted use, restricted use and special use, and at the same time, it also stipulates the prescribing authority of doctors at different levels. However, in individual medical institutions, it is very common for antimicrobial drugs to be prescribed by doctors with qualifications for primary professional and technical positions, or even practicing assistant physicians, which will not only harm the lives and health of the medical public, but also be a waste of medical resources. Therefore, medical institutions should strengthen the training on the clinical application of antimicrobial drugs, and physicians must strictly grasp the indications for the use of antimicrobial drugs, and at the same time prescribe antimicrobial drugs according to their own prescription authority, and should not use antimicrobial drugs beyond the level.
Case 8: Case of Yu's forgery of medical documents
When the Huadu District Health Bureau inspected a general outpatient department, it saw that the patient Luo was undergoing infusion therapy, and saw the prescription of the patient Luo in the pharmacy, and the doctor's signature on the prescription was Liu. After questioning and investigating the patient Luo, he said that he was treated by a physician from the internal medicine clinic. After the law enforcement officers checked the practice information of the physician in the internal medicine clinic, it was Yu, a practicing assistant physician, and after investigation, Yu admitted that he received the patient Luo alone and signed Liu's name on the prescription. After investigation, Yu's act of falsely signing the name of practicing physician Liu on the prescription of the patient Luo was an illegal act of forging medical documents. In violation of the provisions of Article 24, Paragraph 1 of the "Physician Law", in accordance with the provisions of Article 56, Paragraph 3 of the "Physician Law", the Huadu District Health Bureau issued a warning to Yu and imposed an administrative penalty of a fine of 10,000 yuan.
Warning significance: Article 24 of the "Physicians Law" stipulates that doctors who implement medical, preventive and health care measures and sign relevant medical certificates must personally examine and investigate, and fill in medical records and other medical documents in a timely manner in accordance with regulations, and shall not conceal, forge, tamper with or destroy medical records and other medical documents and related materials without authorization. Falsely signing someone else's name on a prescription is a forgery of medical documents. Physicians shall practice in accordance with laws and regulations, and the writing of medical records and other medical documents shall be objective, truthful, accurate, timely, complete, and standardized, and must not tamper with medical records and other medical documents.
Case 9: Case of Fu's non-physician practicing medicine
When the law enforcement officers of the Huadu District Health Bureau inspected a medical cosmetology outpatient department, they saw that the outpatient department carried out cosmetic dermatology projects such as laser spot removal and mole removal, and the operator Fu failed to show the "Physician Qualification Certificate" and "Physician Practice Certificate". After investigation, Fu's behavior of providing cosmetic dermatology treatment services to patients without obtaining a physician's qualification certificate and physician practice certificate constituted a non-physician practicing medicine, violating the provisions of Article 8, Paragraph 1, Article 12, Article 13, Paragraph 1 and Paragraph 4 of the "Physician Law", and in accordance with Article 59 of the "Physician Law", the Huadu District Health Bureau imposed an administrative penalty of a fine of 68,000 yuan on Fu.
Warning significance: The "Physician Law" has greatly increased the punishment for non-physicians practicing medicine, and if a non-physician practices medicine, the competent health department of the people's government at or above the county level shall order him to stop illegal practice activities, confiscate illegal income, drugs and medical devices, and impose a fine of not less than two times but not more than ten times the illegal income, and if the illegal income is less than 10,000 yuan, it shall be calculated as 10,000 yuan. Individual medical institutions appoint personnel without professional qualifications to carry out diagnosis and treatment activities for patients, and personnel without professional qualifications often have no medical knowledge and clinical experience, and are prone to accidents in the process of diagnosis and treatment, and it is difficult to maintain patients' right to health.
Case 10: Hong did not obtain a medical institution practice license
The Huadu District Health Bureau received a report from the masses that a place in Huadu District was suspected of practicing medicine without a license. Law enforcement officers went to the site and accompanied by the person in charge of the site, Hong, to conduct an inspection, and saw foam test tube holders with blood specimens, portable digital ECG machines, printed and unsigned ECG reports, electric centrifuges, medical ultrasonic couplants, disposable venous blood collection needles, disposable human venous blood collection containers,
Cell preservation solution and other items. At the same time, two bags of medical waste were discarded, including medical rubber examination gloves, disposable blood collection needles, medical cotton swabs, and test tubes containing blood samples. Later, after the law enforcement officers questioned and investigated Hong, it was found that Hong's conduct of processing blood and body fluid samples at the above address and charging fees and providing others with places for blood collection and electrocardiogram collection constituted an act of practicing without obtaining a medical institution's practice license, violating the provisions of Article 38 of the "Basic Medical Care and Health Promotion Law", in accordance with the "Basic Medical Care and Health Promotion Law" According to the provisions of the first paragraph of Article 99, the Huadu District Health Bureau imposed an administrative penalty of confiscation of 10,619 yuan of illegal gains and items registered and stored in advance of evidence, and imposed a fine of 159285 yuan.
Warning significance: To carry out diagnosis and treatment activities, it is necessary to obtain the "Medical Institution Practice License" or "Clinic Record Certificate". Illegal practitioners often have no medical knowledge and clinical experience, and the premises, personnel, equipment and technical level of their diagnosis and treatment activities do not meet the requirements, and the quality of medical care cannot be guaranteed. In order to make improper profits, they use informal channels to purchase unregistered medicines, even expired, ineffective or harmful medicines. Due to the lack of professional knowledge and experience, it is easy to delay the disease, misdiagnosis and mistreatment. At the same time, illegal medical practice facilities often lack the necessary rescue facilities, which can lead to disability or even death in the event of an accident. In addition, there is a high risk of infectious disease infection in the illegal practice of medicine, and devices that do not meet the disinfection requirements may lead to patients being infected with infectious diseases such as hepatitis B, hepatitis C, and AIDS.