During the flood fighting and rescue, he fell into a coma due to overwork
Later, he died after treatment failed
The determination of work-related injuries leads to litigation
After losing the case, the family applied to the procuratorate for supervision
The prosecutor investigated and verified and found new evidence
Things took a turn for the better
……
On July 8, at a press conference held by the Supreme People's Procuratorate with the theme of "Administrative Procurators Walk with the People to Help the Construction of the Rule of Law in China", the Supreme People's Procuratorate released the 14th and 15th batches of "Procurators Do Practical Things for the People - Administrative Procurators and the People Walk Together" series of typical cases. The case of Zhang v. the Municipal Human Resources and Social Security Bureau of Henan Province, which was handled by the Procuratorate of Xinxiang City, Henan Province, was selected as the 14th batch of typical cases of "inspecting people's livelihood".
"Thanks to the supervision of the procuratorate, our family can see the hope of life!" Not long ago, Zhang, who finally received her husband's compensation for work-related death, sent a pennant to the Xinxiang City Procuratorate. Holding the hand of Xu Weijie, the prosecutor who undertook the case, Zhang's grievances and sufferings in the past three years were finally let go.
Death in the line of duty
No work-related injuries have been recognized
On July 20, 2021, heavy rains hit Zhengzhou City and Xinxiang City in Henan Province. In many places in Xinxiang City, rivers burst their banks, floods poured in, and houses collapsed, and the danger was urgent.
On July 23, Yang, a staff member of the Xinxiang Municipal Market Supervision Bureau, who had been fighting on the front line of the embankment rescue for 5 consecutive days, rushed back to the unit to carry out the task of emergency rescue and risk pumping.
On the morning of July 25, Yang, who had just finished the night shift and had not closed his eyes all night, rushed to the Pingyuan Sports Center in Xinxiang City with his colleagues to carry out the task of docking and coordinating with the city's Red Cross disaster relief material receiving point. In the afternoon of the same day, Yang drove back to the unit. At this time, he was already in a state of physical exhaustion, and soon developed symptoms of coma and vomiting, and finally collapsed on the floor of the office.
When he was sent to the hospital for rescue, Yang was diagnosed with acute brainstem hemorrhage, and the hospital took a series of treatment measures for him-
At 18:45 on July 25, the first craniotomy was performed;
At 9:15 on July 26, Yang suffered a massive brain hemorrhage and underwent a second craniotomy, during which Yang was in a deep coma;
At 9:30 on July 27, Yang's spontaneous breathing disappeared and his light reflex disappeared;
At 11:20 on July 30, the doctor announced that Yang had died of heart and lungs.
Upon learning of Yang's death, his wife Zhang felt that the sky had fallen, and she washed her face with tears all day long.
"Yang was assigned by the unit to perform tasks and died on the front line of disaster relief, and meets the conditions for work-related injury recognition." The Xinxiang Municipal Market Supervision Bureau applied to the Municipal Human Resources and Social Security Bureau for a work-related injury determination.
After receiving the application, the Municipal Human Resources and Social Security Bureau believed that Yang had been declaring his death for more than 48 hours from rescue to death, which did not meet the provisions of Article 15, Paragraph 1 (1) of the "Regulations on Work-related Injury Insurance", which stipulates that "death from sudden illness during working hours and at work or death within 48 hours after rescue is ineffective" is regarded as a work-related injury, and decided not to recognize work-related injuries on August 20, 2021.
On January 19, 2022, Zhang filed an administrative lawsuit with the court. According to Zhang's testimony, the Hongqi District Court of Xinxiang City held that although Yang was declared clinically dead for more than 48 hours, he was brain dead within 48 hours, which should be regarded as a work-related injury, and the judgment revoked the decision of the Municipal Human Resources and Social Security Bureau not to recognize the work-related injury.
The Municipal Human Resources and Social Security Bureau was dissatisfied and appealed. On May 24, 2022, the Xinxiang Intermediate People's Court held that the medical records lacked the opinion on the clinical judgment criteria for Yang's brain death within 48 hours of being admitted to the hospital, and the evidence in the case could not prove that Yang was brain dead within 48 hours of being admitted to the hospital, and the judgment revoked the first-instance judgment and rejected Zhang's litigation claim.
Zhang was unwilling and applied to the Henan Provincial High Court for a retrial, which was also rejected.
Apply for supervision
Find new evidence
"My lover is a party member, and he always rushes to the front when he works, and this flood rescue is the same, and this is a task arranged by the unit, why can't it be recognized as a work injury? I can't figure it out...... "I have to take care of the elderly and children, and I have to go back and forth for my husband's work-related injury identification, in just one year, Zhang has aged a lot."
When he learned that his case could apply to the procuratorate for supervision, Zhang came to the Xinxiang City Procuratorate with the last shred of hope. Prosecutor Xu Weijie received her and patiently listened to the ins and outs of the case.
After careful reading of the case file, Xu Weijie preliminarily believed that neither the Municipal Human Resources and Social Security Bureau nor the courts of first and second instance had any objections to the determination of work-related injury elements such as "working hours, work location, and direct delivery to the hospital", and the focus of the dispute in the case was whether Yang's brain death had occurred within 48 hours of being admitted to the hospital for rescue. On the basis of the available evidence alone, there was nothing manifestly improper in the Court's decision. However, during a visit, Zhang reported to him that she had heard that patients who were treated in the hospital had subjective medical records in addition to objective medical records, which she did not obtain in the previous lawsuit, and only went to the hospital to make copies of 32 pages after the lawsuit was over.
This new clue allowed Xu Weijie to find the focus of supervision. He immediately checked the contents of the medical records. The subjective medical record recorded in detail the nursing medication, vital signs, and the doctor's consultation and discussion on death during Yang's admission to the hospital. But whether Yang's brain death time can be determined through this subjective medical record, Xu Weijie has no idea in his heart.
Therefore, Xu Weijie first consulted Zhang Yanmin, director of the procuratorial technical information department of the procuratorate, and then took all the evidence materials to visit senior experts in the respiratory department and neurology department of many hospitals in Xinxiang City. Through consultation with professionals, Xu Weijie judged that Yang may have been brain dead within 48 hours of being admitted to the hospital.
"The typical cases issued by the Supreme People's Procuratorate and the previous administrative judgments of the Henan Provincial High Court all state that when laws, regulations, and technical specifications do not stipulate relevant standards or the provisions are not clear, in order to protect the legitimate rights and interests of workers, an interpretation favorable to workers should be made." Xu Weijie pointed out that the current death standard is divided into two types: cardiopulmonary death and brain death, in the previous litigation process, the evidence provided by Zhang is not complete, if the heart and lung death is used as the standard, the time for the doctor to declare the death is of course more than 48 hours, if it can be determined that Yang has been brain dead within 48 hours, adopting the standard of brain death will be more conducive to protecting the legitimate rights and interests of Yang and his family.
Specialist consultation
Recognized as "brain dead"
However, based on the photocopies of the medical records provided by Zhang, it could not meet the standard of proving that Yang was brain dead within 48 hours. In order to establish an effective chain of evidence, Xu Weijie obtained a total of 322 pages of medical records formed during Yang's hospitalization in accordance with the law, of which 99 pages were about all the subjective medical records of Yang after he was admitted to the hospital.
"This medical record clearly records that at 9:30 on July 27, 2021, Yang had clinical symptoms of spontaneous breathing loss and dilated pupils, which are the main characteristics of brain death." After verifying and confirming the authenticity of the medical records, Xu Weijie found a key breakthrough point in handling the case.
At the same time, during the visit, Yang's attending physician also mentioned to Xu Weijie: "After the second operation, the patient was still in a deep coma, the brainstem reflex disappeared, and there was no spontaneous breathing, which was determined to be a symptom of brain death, and there was no possibility of saving life, but the family has been asking for the best to rescue, so we did not carry out the medical identification of brain death in time." During this period, we also recommend that family members donate organs. ”
With the supplement of this 99-page subjective medical record, can it be proved that Yang's brain death did occur within 48 hours?
Considering that the identification of brain death is relatively professional, the Xinxiang Municipal Procuratorate gave full play to the advantages of integrated and comprehensive performance of duties, and the Administrative Procuratorate Department and the Procuratorial Technical Information Department discussed and researched together, and actively sought help from the "external brain".
On April 27, 2023, the hospital hired five clinical medical experts, including Fan Aiying, professor of forensic clinical science at the School of Forensic Medicine of Xinxiang Medical College and director of the Forensic Center of Xinxiang Medical College, to consult the medical history data.
The Xinxiang Municipal Procuratorate invited clinical medical experts to collectively consult and judge.
"Judging from the hospitalization medical records and head CT scan, Yang is a brainstem hemorrhage, with deep coma, no spontaneous breathing, bilateral pupil dilation, and loss of light reflex, which meets the clinical criteria for brain death."
"Although the hospital did not conduct a death confirmation experiment, Yang still had irreversible coma after two craniotomys, and the subjective medical record not only specifically stated the time when Yang had clinical symptoms of brain death, but also the doctors' consultation and discussion records on Yang's death, and comprehensive analysis can determine that Yang has been brain dead within 48 hours of being admitted to the hospital."
After discussion, the consultation opinions reached by relevant experts are consistent with the technical evidence review opinions issued by the Procuratorial Technical Information Department of the Xinxiang Municipal Procuratorate: Yang's brain death has occurred within 48 hours of his admission.
Submit a procuratorial suggestion for retrial
The family received $990,000 in compensation
With the consultation opinion of the professional "external brain", Xu Weijie further confirmed his judgment and submitted the review report to the inspection committee in accordance with the process. After discussion and analysis at the meeting of the procuratorial committee, the members of the procuratorial committee unanimously agreed: "The subjective and objective evidence collected by Yang with a total of 322 pages of medical records, written expert consultation opinions, and testimony of the treating doctor can fully confirm that Yang has met the clinical judgment criteria for brain death within 48 hours of admission." Yang meets the conditions for deemed work-related injuries and shall be found to be work-related injuries. ”
On June 5, 2023, the Xinxiang Municipal Procuratorate issued a procuratorial recommendation for retrial to the Xinxiang Intermediate Court in accordance with the law. On March 5 this year, the Xinxiang Intermediate People's Court made a judgment: Yang met the conditions for deemed work-related injury as stipulated in the "Regulations on Work-related Injury Insurance", and the judgment revoked the second-instance judgment and upheld the first-instance judgment.
In order to allow Yang's family to get the work-related injury certificate as soon as possible, the Xinxiang Municipal Procuratorate communicated with the Municipal Human Resources and Social Security Bureau many times to urge it to implement the court judgment.
As of press time, the Xinxiang Municipal Human Resources and Social Security Bureau has issued a decision on the determination of work-related injuries to Yang's family, and Yang's work-related injury compensation of more than 990,000 yuan has also been put in place.
"The identification of work-related injuries is an important way to safeguard the legitimate rights and interests of employees, ensuring that they can receive timely and effective treatment and compensation when they are injured at work. However, work-related injury determination and work-related injury insurance cases are prone to disputes in administrative determination and judicial handling. In the process of handling this case, on the basis of accurately grasping the relevant provisions of the "Regulations on Work-related Injury Insurance", the procuratorial organs conducted in-depth investigation and verification, gave full play to their functional advantages, and effectively safeguarded the legitimate rights and interests of the parties by putting forward procuratorial suggestions for retrial in accordance with the law, which not only comforted the deceased and comforted their families, but also made the broad masses of the people truly feel the warmth of the party and the temperature of the judiciary. Deputy to the National People's Congress, Secretary of the Party Committee and Chairman of Xinxiang Sugar Tobacco and Liquor Co., Ltd. Mai Shirui commented on the case.
According to the prosecutor
Work-related injury benefits should not be frustrated by active treatment
The Regulations on Work-related Injury Insurance stipulate that "a person who dies of sudden illness or dies within 48 hours after rescue is ineffective during working hours and at work" shall be regarded as work-related injuries. In reality, in order to meet the conditions for determining work-related injuries, when the injured person is in critical condition and the rescue effect is not obvious, the family gives up treatment before the "48-hour time limit" arrives. However, in this case, Yang suddenly fell ill due to hot weather and overwork during the flood fighting and rescue work, and his relatives insisted on treating him, which is not only human nature, but also in line with the core values of socialism, and the employee cannot be deprived of the work-related injury benefits that he should have enjoyed because of the active rescue of his family and the hospital.
The Criteria and Operational Standards for the Determination of Brain Death in Adults in China (Second Edition) clearly stipulates the criteria and operational norms for the determination of brain death, but due to factors such as the passage of time and the lack of evidence, it is difficult to accurately determine brain death in judicial practice, which in turn affects the handling of work-related injury determination cases.
For work-related injury determination cases involving professional issues such as brain death, procuratorial organs should persist in performing their duties in an integrated and comprehensive manner, emphasizing giving play to the role of procuratorial technology in safeguarding and supporting the supervision and handling of cases, entrusting people with specialized knowledge to guide procurators to improve the chain of evidence, and using the knowledge advantages of professionals to solve specialized issues such as brain death determinations, and at the same time, attend the retrial court to explain the review of technical evidence, so as to lay a solid foundation for accurate and effective supervision.
(Procuratorate Daily, Liu Lixin, Li Rui, Sun Fang)
![【Heartwarming stories around you】Citizens suddenly fell ill, and the urban management team members warmly rescued[fig]](data:image/gif;base64,R0lGODlhAQABAIAAAP///wAAACwAAAAAAQABAAACAkQBADs=)