On the eve of the wedding, she was killed by a first-class medical accident at the age of 31, leaving her relatives with endless grief.
After graduating with a master's degree, she went to work overseas and returned to China to work as an English teacher in a university in Beijing
The woman's name was Mao Xingxing (pseudonym), died at the age of 31, lived in Huairou District, Beijing, and was an English teacher at a university in Beijing before her death.
Her mother, Ms. Yin, said that their hometown is in Li County, Changde City, Hunan Province, and that her daughter was admitted to a well-known university in Nanjing after graduating from high school, and later sent her to the school to study for a master's degree.
She said that after graduating from university, her daughter went to work as an executive in an overseas company, returned to Beijing two years later, and was admitted to a university as an English teacher after working for a while.
Mao Xingxing was an English teacher at a university in Beijing before his death. Courtesy of the family
Lung nodules were found in the physical examination of relatives in his hometown in Hunan, and the doctor recommended follow-up after returning to Beijing for reexamination
On August 5, 2022, when Mao Xingxing returned to his hometown in Hunan to visit relatives, he went to Xiangya Hospital of Central South University in Changsha for a physical examination.
One of her CT diagnostic reports showed a pure ground-glass nodule in the anterior segment of the upper lobe of the left lung, about 7×8mm in size, which showed a "burr sign". Examination suggests that the nodule is LU-RADS class 4B and has a high probability of early lung cancer.
"After reading the report, the doctor suspected that it was inflammation, so he prescribed anti-inflammatory drugs and asked for a re-examination one month after taking the medicine." Ms. Yin said that her daughter later returned to Beijing in an emergency, "On September 5 of the same year, she went to Peking University People's Hospital for a CT review after taking medicine for a month. ”
The reporter saw that a CT examination report of the hospital said that the bronchial vascular bundles of both lungs were clear, and multiple small nodules were seen in both lungs, and the larger one was located in the upper lobe of the left lung, with clear borders, ground-glassed, and short burrs around it, with a diameter of about 4mm.
At the same time, the report also stated, "Nodules in the upper lobe of the left lung do not exclude lung cancer, please combine it with clinical practice." Multiple nodules in both lungs, consider the possibility of benign lesions, please combine clinical and follow-up observation. ”
In response to this examination report, a doctor at the hospital recommended a follow-up after reading it.
It was suspected to be early-stage lung cancer, and the family discussed whether to remove it through surgery
Ms. Yin said that from the results of the two examinations before and after, the nodule became 4mm after taking anti-inflammatory drugs, and the feeling was significantly reduced, but her daughter was still not at ease, so on October 9, 2022, she hung up the number of a doctor in the Department of Thoracic Surgery of Peking University People's Hospital through a scalper to consult on the previous two imaging reports, "The doctor suspected that it was early lung cancer, and said that there was an indication for surgery, and it could be removed by wedge resection, which was less traumatic, recovered quickly, and had no impact on the body. He also suggested that he go to Beijing Haidian Hospital, where he practiced a lot, to have surgery, and he would personally perform the surgery at that time. ”
"My husband and I have never believed that our daughter's lung nodule is cancer, and our family has discussed whether to remove it through surgery, but my husband does not agree with my daughter to have surgery now, let alone go to Haidian Hospital for surgery." Ms. Yin said that her husband thought that he should follow the doctor's advice and "have regular check-ups", but later for unknown reasons, her daughter was admitted to Haidian Hospital on October 10.
A photo of scissor hands was taken outside the ward, and he died 53 days after an accident occurred in preoperative puncture positioning
Ms. Yin clearly remembers that at around 7 a.m. on October 12, 2022, a medical staff came to the ward to pick up her daughter for preoperative puncture positioning, and when she walked out of the ward, she asked the patient to take a photo of her scissor hands.
Ms. Yin recalled that she was sitting on a chair outside the door of the CT room, and the doctor was doing preoperative puncture positioning after giving her daughter local anesthesia inside, "Later, I suddenly heard a quarrel inside, and after a few minutes, my daughter's crying came, and someone rushed out after the door of the CT room opened, and I walked in and saw my daughter lying on the table of the CT room, with blood at the corner of her mouth. ”
She said that she once knelt and begged the doctor to save her daughter, who was transferred to Peking University Third Hospital for further rescue by 120, and was also transferred to Beijing Tiantan Hospital affiliated to Capital Medical University and Beijing Electric Power Hospital for treatment.
What is extremely sad is that at around 4 pm on December 4, 2022, Mao Xingxing passed away at the age of 31 in Beijing Electric Power Hospital after the medical staff tried their best to rescue him.
After being cremated in Beijing, he was sent back to his hometown for burial, and he originally planned to hold a wedding on the eve of the Spring Festival
Ms. Yin choked up and said that after her daughter's death, her body was cremated in Beijing, and then sent back to her hometown in Hunan for burial, "We arrived in the early morning, and at about 3 o'clock in the middle of the night, relatives and friends drove more than 100 cars to the highway intersection, and they waited in the cold wind for more than two hours to welcome my daughter home." ”
Subsequently, Mao Xingxing was buried in a cemetery.
Ms. Yin said sadly that her daughter had only received her marriage certificate for more than 20 days before the operation, and she wanted to take advantage of the winter vacation to go back to her hometown to hold a wedding.
She said that the grandparents in their 80s still do not know that their granddaughter has died, and they hide from them that they have gone abroad, but they look forward to her coming home every day. ”
Cardiac arrest due to pleural reaction was identified, and no tumor cells were found in the surrounding lung tissue
In a hospital record of Mao Xingxing, Beijing Haidian Hospital recorded the incident and rescue process of that day, saying, "At 7 o'clock this morning, local anesthesia was performed in the CT room under CT guidance...... After the local anesthesia was satisfied, the puncture positioning was performed at the predetermined puncture positioning point, the process was smooth, she did not complain of discomfort, after the puncture positioning was completed at 7:30, she planned to perform a routine CT scan to determine the puncture position, at 7:31 she suddenly had angular arch reflexion, loss of consciousness, inhalation, trismus, intraoral bleeding, carotid pulse disappearance, thoracic respiratory activity disappeared, and the cardiorespiratory arrest was judged, and the rescue was immediately started. At 7:41, the endotracheal intubation was completed, the simple respirator was connected to the oxygen cylinder to assist ventilation, and the manual cardiopulmonary resuscitation was continued, and at 7:54, the patient was transferred to the emergency room in the state of cardiopulmonary resuscitation to continue the rescue, and the spontaneous heart rhythm was restored at 8:16. Later, he was transferred to another hospital for further treatment.
On December 7, 2022, Beijing Haidian Hospital and Mao Xingxing's family jointly commissioned the Institute of Scientific and Technical Appraisal of the Law University to conduct an appraisal of the cause of his death.
According to the expert identification, a needle-like object (metal filament) can be seen piercing into the upper lobe of Mao Xing's left lung, and the pleura of the visceral layer is tightly adhered to the pleura of the third to fourth ribs on the left side, "The puncture site of the upper lobe of the left lung and the surrounding lung tissue showed inflammatory changes, and no tumor cells were found." ”
At the same time, it was said that, combined with the existing clinical records, these were consistent with the nodules in the upper lobe of the left lung (inflammatory) and the left side after thoracoscopic puncture. In addition, the available clinical records show that the symptoms and manifestations of Mao Xingxing when performing puncture positioning are consistent with the pleural reaction. Pleural reaction is one of the complications of thoracoscopic puncture positioning, and in severe cases, shock and death from respiratory and cardiac arrest may occur.
On March 8, 2023, the appraisal agency issued an appraisal opinion, saying, "Mao Xingxing was consistent with the pleural reaction after left thoracoscopic puncture, and secondary ischemic-hypoxic encephalopathy, confluent lobular pneumonia and pulmonary hemorrhage, right lung abscess, and finally died of multiple organ failure." ”
Later, the Beijing Haidian District Health Commission commissioned the Beijing Haidian District Medical Association to conduct a technical appraisal of Mao Xingxing's medical malpractice, and planned to further clarify their respective responsibilities.
The family of the deceased raised 9 major suspicions, saying that the hospital should bear full responsibility and was identified as a first-class medical accident
Mao Xingxing's family once raised 9 major suspicions, saying that according to relevant regulations, her lung nodules did not have the indications for immediate surgery, and the doctor violated the diagnosis and treatment norms and over-treated, and there was a major fault in directly operating on her and causing her death; The doctor did not study the imaging data before she was admitted to the hospital, did not evaluate and diagnose the inflammatory nature of the pulmonary nodules that had significantly shrunk after one month of anti-inflammatory treatment, did not explain to her the obvious benign tendency of the lesions, did not conduct imaging re-examination of her lung nodules before the operation, and blindly decided to die due to surgery, and the medical behavior was at fault.
At the same time, she claimed that before the operation, the doctor should have explained to her the method, medical risks and alternative medical options for implanting the positioning needle, and obtained her written consent, but there was no surgical record of the placement of the positioning needle in the medical record, and the details of the puncture operation could not be confirmed, resulting in the cause of the cardiac arrest caused by the pleural reaction being concealed.
The family of the deceased also claimed that the doctor asked Mao Xingxing to buy high-risk Class III medical device positioning needles in individual pharmacies outside the hospital, which was a serious violation, and the medical records did not paste the unique identification barcode and other information of the positioning needle, which was an important factor leading to the patient's pleural shock death, and also concealed the patient's true condition, and did not inform the patient that the patient with a significant benign tendency to lung nodules can be treated by conservative observation, and surgery is not the only option for patients.
In this regard, Haidian Hospital said that Mao Xingxing's indications for surgery were clear, and she voluntarily chose surgery after being fully informed, and the relevant preoperative examinations provided a sufficient basis for surgery; She was clearly aware of the conservative treatment plan for regular re-examinations and actively requested surgery as soon as possible. After the accident, the doctor actively rescued on the spot, the rescue standard was effective, and the patient's vital signs were restored after rescue.
The hospital also said that Mao Xingxing's respiratory and cardiac arrest was caused by a pleural reaction, which was rarely reported, but it was also repeatedly reported in clinical practice, and it was difficult to completely avoid prevention during treatment, and it was routinely informed in writing before surgery. Although doctors have adequate rescue plans and active rescue, they are still powerless in the face of the limitations of modern medicine and the different reactions of individuals to diagnosis and treatment operations.
In view of the different views of the two sides, the expert group responsible for the identification analyzed that after reading and comparing the chest CT films and reports of Xiangya Hospital and the chest CT films and reports of Peking University People's Hospital, it was believed that "the left upper lobe nodule was saved by 7mm×8mm, and the size did not change significantly, and the remaining small nodule foci were absorbed, and the anti-infection treatment was effective." According to the Chinese Expert Consensus on the Diagnosis and Treatment of Pulmonary Nodules (2018 Edition), the follow-up process of pulmonary nodules can be followed, and it is recommended that patients have follow-up and diagnosis and treatment. The patient Mao Xingxing had fertility considerations, and after several visits, surgical resection was selected to confirm the diagnosis, which met the relative surgical indications. Haidian Hospital chose to combine preoperative follow-up CT and preoperative positioning CT, and there was no fault in it. ”
The expert group said that the doctor did not fully inform the auxiliary positioning operation and surgery before the operation, the alternative was not specific, and the medical behavior was at fault. The surgical consent form is formatted and does not elaborate on alternative treatment options, such as the injection of positioning dyes such as Meilan or the injection of positioning glue, the surgical method of lung segmentectomy, which may not require preoperative positioning, and the use of radiofrequency ablation therapy for lung cancer. Some deletions and additions have been made to the rescue records of medical records, which have an impact on the determination of facts and the evaluation of medical behaviors.
In particular, the expert group pointed out that the puncture positioning needle is an implantable high-value consumable medical device, and this kind of medical device should be provided by the doctor, and the consumables should be purchased in a unified manner, and the source and quality of medical devices should be strictly controlled to reduce the risks that may exist in clinical application. The doctor asked the patient to purchase high-value consumables and medical devices, and did not provide the quality qualification test certificate of the purchased implantable consumables in the case, the puncture positioning needle has obvious safety risks, which can clearly locate the needle in the upper lobe of the left lung, and in the medical records and all imaging data, there is no data showing the rationality of the operation of the positioning hook release, the placement of the positioning needle and the relationship between the position of the positioning needle and the position of the pleura and other organs, "Therefore, it cannot be ruled out that the quality of the positioning needle, the operation of the implantation positioning needle, and the placement of the positioning needle have nothing to do with the occurrence of pleural reaction." There is negligence in these medical practices. ”
On June 11, 2024, the Beijing Haidian District Medical Association issued an appraisal conclusion, stating that according to relevant regulations, after discussion and collegial discussion by the expert group, it was believed that there was medical fault and negligence in Haidian Hospital's medical behavior, in which there was a causal relationship between the negligence of the medical behavior and the patient's death, which constituted a first-class medical accident. During the "CT-guided percutaneous puncture of pulmonary nodule assisted positioning surgery", the patient had a sudden severe pleural reaction leading to cardiorespiratory arrest, which is a rare complication and difficult to rescue. The rescue process after the completion of endotracheal intubation is in accordance with the routine of medical practice. Secondary responsibility is recommended for the doctor.
The appraisal conclusion issued by the Beijing Haidian District Medical Association.
Ms. Yin said that they were not satisfied with the conclusion of the appraisal, believed that the doctor should bear full responsibility, and planned to reapply for the appraisal.
The hospital responded positively and took responsibility, and the Health Commission said it was studying the treatment of relevant personnel
On July 2, a staff member of the medical department of Haidian Hospital responded to a reporter from Huashang Daily Gale News that the follow-up should wait for the family of the deceased to go to the court (sue) according to the appraisal results, and then the court will decide how much economic compensation the hospital should bear. ”
"Our hospital will actively assume whatever responsibility it should bear, and will never evade it, and no matter what way the deceased's family seeks to solve it in the future, we will actively cooperate with it." The staff member said sadly that they also regretted the consequences.
She said that the doctor responsible for the medical accident did not know who was finally decided, because this is a team working, not a specific person, "At present, some of the team has been transferred, and some are still in our hospital." ”
A female staff member of the Health Commission of Haidian District, Beijing, told reporters that as far as this medical accident is concerned, they are organizing research and discussion on the treatment of relevant personnel, and a follow-up treatment result will be given, "At present, Ms. Yin is not satisfied with the appraisal conclusion and has questions, and after she has a clear consideration, we will study the next step according to the final medical malpractice appraisal conclusion." ”
Source: Huashang Daily Gale News reporter Shen Xiaodu
Original title: A 31-year-old female university teacher was found to have a pulmonary nodule suspected of being cancerous, and she died of cardiac arrest caused by a pleural reaction caused by preoperative puncture positioning, and was identified as a first-class medical accident