Analysis of the Medical Lawsuit Based on Events of the Supreme Court By Fu-Yao Wang Advisor: Prof. Chung-Yu Pan A Thesis Submitted to Tunghai University in Partial Fulfillment of the Requirements for the Degree of Master of Business Administration July 2008 Taichung, Taiwan
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Analysis of the Medical LawsuitBased on Events of the Supreme Court Student: Fu-Yao Wang Advisor: Prof. Chung-Yu Pan Department of Industrial Engineering and Enterprise Information Tunghai University ABSTRACT The entanglements of medical lawsuits came always from various medical malpractices. If the two sides could not reach an agreement, except irrational combat, medical lawsuits would be deemed the only path to solve this controversy, which costs a lot of social resources. It`s frequent that they both disputed solely standing on each place until the court declared a final sentence. However, in this view, we could just obtain the reference books which focused on medical laws and never mentioned the defense skills of lawsuits. Meanwhile, any article about this issue could not be reviewed among the academic journals. Therefore, in this research we had taken the civil court verdicts of Supreme Judicial Court as the database. It s highly expected that the results of this study could be recommended as an essential reference before legal actions from the rivaling identities such as hospital managers, physicians and patients, in order to cut the meaningless filing of lawsuits, to promote the medical quality and then to improve patient safety. Keyword: Medical malpractice,medical negligence,damage compensation II
III 2008
IV
V
VI
VII
1 1.1 informational asymmetry
2 1.2 1997
3 2.1 1984 1993 1994 Medical Dispute Medical Malpractice Claim 1994 2001 (1998) 2002
4 2.2 2001 2002 2.3 (1998) 1. 2. 3. 2000 15 10 5
5 2.4 2002 2003 2003 2.5 2004
6 2004 2007 Doctor Company 2.6 2005 2.7 1998 2000 2002 2002 2003 2005 2003 2004
7 2003 2003 2000 2006 1983 2003 2000 2002 2000 2003 24 182 75 2,409 200 406 416 85 96 85 1 96 13 184185188 192~195227 7
3.1 85 1 1 96 12 31 http://jirs.judicial.gov.tw/fjud/ 3.2 85 1 1 96 12 31 508 58 48 28 8
4.1 85 96 85 1 86 2 89 3 90 1 91 2 92 2 93 2 94 4 95 4 96 7 28 2.33 94 4.1 90 85 94 5 29 94 96 5 3390 96 22 9 41 90 1 91 2 92 1 95 1 96 4 4.2 4.1 85-96 9
4.2 85-96 4.2 85 96 9 9 2 1 1 28 32% 2001 3-4 2-3 4.3 4.3 10
4.3 12 4 6 1 5 64% 4.4 2007 2007 4.4 4.4 4.4.1 11
15 54% 6 4 2 2 1 13 46% 50 4.5 4.5 8 47% 5 2 1 9 53% 5 1 1 1 1 5 45% 2 2 1 6 55% 1 2 1 1 1 4.6 4 27 33 3 20 2 13 1 7 46% 4.7 4.8 12
1. 2. 3. 4. 5. 6. 7. 4.6 4.7 13
4.8 6 40% 4 27% 2 13% 2 13% 1 7% 67% 4.9 4.9 14
19 68% 9 32% 16 84% 4 2 2 1 7 3 16% 1 1 1 8 42% 11 58% 4.10 4.1 4.10 15
16 4.1 91..222 92..2695
17 95..2950 400cc 600cc ()
18 ()
4.4.2 1,978,825 329,804 2,530 2,530 2,372,847 338,978 11,256,569 5,628,285 5,442,613 2,721,307 3,108,764 1,036,255 2,972,917 990,972 10,345,046 3,448,349 4,207,890 2,103,945 26,949,998 2,073,077 4,921,880 4.11 4.12 6,179,926 4,440,122 3,367,564 26,949,99 11,256,569 5,628,285 3,448,349 193 194 192 192 192 19
20 4.11 4.12
1,978,825 2,530 2,372,847 11,256,569 5,442,613 3,108,764 2,972,917 10,345,046 4,207,890 41688001 61 26949998 39 4.13 4.13 391,684 2,372,847 5,442,813 101,448 230,000 8,538,792 36 15,349,998 64 4.2 4.14 $1,219,827 $2,192,857 $3,412,684 $1,219,827 $451,471 $1,671,298 85 94 504,150 2,150,000 94 96 1,810,595 21
2,612,500 4.15 1,306,445 ( 259) 462,500 22 4.2 391,684 2,372,847 5,442,813 101,448 230,000 15,349,998 4.14 22
4.15 10 3 1,587,141 2,530 11,256,569 3,007,316 2,742,917 10,345,046 4,207,890 33,149,409 74 11,600,000 26 4.3 4.16 $4,735,630 $1,933,333 $6,668,963 $4,735,630 $1,657,143 $6,387,373 85 94 5,127,749 1,720,000 94 96 10,691,887 4,300,000 4.17 5,564,138 ( 109) 2,580,000 150 23
4.3 1,587,141 2,530 11,256,569 3,007,316 2,742,917 10,345,046 4,207,890 11,600,000 4.16 24
4.17 10 3 4.5 85 1 86 2 89 3 90 1 91 2 92 2 93 2 94 4 95 4 96 7 4.4 4.4 1 85,,1131 2 86,,56 3 86,,1731 ( ) 4 89,,276 87..154 5 86..2562 89,,1286 85..2845 6 89,,1834 7 90,,709 ( ) 8 91,,222 25
9 91,,1941 ( ) 10 92,,1057 90..468 11 92,,2695 89..722 12 93,,69 13 93,,852 ( ) 14 94,,1605 15 94,,1859 ( ) 16 94,,2128 17 94,,2303 18 95,,519 92..2680 19 95,,1226 ( ) 92..1453 94..936 20 95,,2178 21 95,,2950 ( ) 94..1499 22 96,,258 23 96,,323 24 96,,450 25 96,,2032 26 96,,2476 ( ) 27 96,,2738 28 96,,2885 26
27 19961-200712 5.1 4,921,880 6,179,926 4,440,122 3,367,564 $1,671,298 $6,387,373 $3,412,684 $6,668,963 67%
28 5.2 192 193 10 5 8 7
29 2002 2001 2003 11(3): 31-61 1994 2000 43 649 2003 36(5): 69-77 2007 9341-81 2000 2000 2003 2000 2007 11 19 2002 2005 2007 2004 551-4 2003 1994 37 6102 1997 1998 2005 2002 39121 1993 2004
2003 2001 2004 http://jirs.judicial.gov.tw/fjud/ http://www.thrf.org.tw/page_show.asp?page_id=340 30
31 86..1731 89..276
32 90..709
33 91..222 91..1941
34 93..852
35
36 94..1605
37 94..1859
38 94..2303
39 95..1226
40 95..2950 400cc 600cc
41 96..258 0000000 0000000
42 96..2032
43 96..2476
44 () ( )( ) 96..2885
45
46 -- 85,,1131 850523
47
48
49 -- 86,,56 860110
50
? 51
52 -- 86,,1731 860530?
? 00000000? 53
54 -- 89,,276 890127 ()
55
56 -- 89,,1286 890602 ()
57 Cimedin Decadron Dermovate 87 87 Decadron Dermovate Cream Oint
58
59 -- 89,,1834 890811.. () Ketoprofenid Aspirin Buscopan
60 Ketoprofenid? Aspirin Buscopan
61 Aspirin Ketoprofenid
62
63 Aspirin
64
65 -- 90,,709 900426 Mc-Robert Mc-Robert
66 Johnson Spellacy Mc-Robert
67 Mc-Robert? Johnson Spellacy
-- 91,,222 68
69 910201?
70
71
72 -- 91,,1941 910926
73 ()
() 74
75 -- 92,,1057 920522 () () ()
76 ()
77 00000000 00000000
78
79 0000000000 ()
80 () ()
81
82 -- 92,,2695 921218 ()
83 4 2 15 20 5
84
-- 93,,69 930115.. () () 85
86 propofol () () ()
87 () () () ()
88
89
90 -- 93,,852 930429 <span style="color:#e8e8e8">.</span>
91 () ()
() () () () 92
93 -- 94,,1605 940831
94 106/64mmHg 35 16 110-118 () Q ST T GOT 22 GOT capoten
95
96 -- 94,,1859 941013 22.
97
98
99 -- 94,,2128 941118
100
101
102 () 0000000 () 0000000 ()
103 () 3,215,2392,130,7583,944,500893,676599,2324,000,000 14,783,405 () ()
104
105 -- 94,,2303 941215 20. 11. 1. ( ) ()
106 000000000
107
108 -- 95,,519 950323
109 () ()
110 () ()
111
112 -- 95,,1226 950614. 19..... ()
113
114
115 -- 95,,2178 950928
116 williams 1~0 PRO
Cx.O s APGAR E4V2M3 E V M Problem OrientedSheet PROM and large hematoma on head R/O vaccumcaputcephalohematoma Problem Oriented Sheet R/O Subgaleal hemorrhage Special conditions of Baby HGB APTT APTT>100 APTT69 HGB 145 71/61 117
118 hypovolemicshock 29% Ahuja Christmas IX APTT K VIIIXX prothrombin 221 WC:Subgalealhematoma.JAMA244:1597-8,1980 0000000000
119
120 -- 95,,2950 951228 83 8 22 84 12 22 () () () ()
121 Sabiston's Chest of Surgery ray
122 Chest PA Chestpa in
123 () () ()
124 400cc 600cc () () () 400cc 600cc () ()
125
126 -- 96,,258 960201
127
128 () 0000000 () 0000000 () ()
() () 129
130 -- 96,,323 960208
131
132 ROV size normal
Myoma=1.62x1.49cm atfundus 133
134 -- 96,,450 960308 () () () ()
135
136 GCSVital signpupil sign GCS M GCS EMV 12MN-8AM ICU 0
137 ICU
138
139 -- 96,,2032 960906
140
141 OPDF/U pt pt 0000000
142 AJCC B2 AJCC
143
144 -- 96,,2476 961101 56 () () () () () () ()
145 NaKClCaGlu CC
146 () ( )( )
147 ()
148
149 -- 96,,2738 961206
150
151
152
153 -- 96,,2885 961226 1073 31 145 75 493 9 12
154
155
156
157
158