[Facts ascertained]
On March 8, 2021, the plaintiff Wang Mouqun was hospitalized in the rehabilitation physiotherapy department of the defendant's hospital for lumbar intervertebral disc herniation, and was diagnosed with lumbar intervertebral disc herniation, and underwent "L5-S1 intervertebral disc radiofrequency ablation + collagenase lysis" on the day of admission. The surgical records showed that the preoperative diagnosis was "L5-S1 intervertebral disc herniation", and the postoperative diagnosis was the same as the preoperative diagnosis.
After the operation, the patient was given drugs to prevent infection, dehydration, and nutrition of nerves, and told the patient to stay in bed absolutely in the prone position for 8 hours, bed rest for 1 week, and wear waist circumference protection for 2 months when getting out of bed. On March 8, 2021, the MRI examination report of an imaging institution in a hospital showed that the L5/S1 intervertebral disc was herniated backward and the anterior edge of the dural sac was slightly compressed.
On March 15, 2021, the MR imaging examination report of a hospital showed: 1. Mild bone hyperplasia of the lumbar spine and straightening of physiological curvature; 2. L5-S1 intervertebral disc degeneration and posterior bulge; 3. The L5-S1 intervertebral space is narrowed, and there is a little endplate inflammation at the adjacent edge of the vertebral body.
On March 17, 2021, the plaintiff went to a Hongren No. 1 Hospital for examination, and the MRI imaging report showed that the diagnosis was: lumbar 5-sacral 1 intervertebral disc herniation. On March 19, 2021, the plaintiff was discharged from the hospital, and the hospitalization situation in the discharge record stated that the day after the operation, because the patient did not wear a waist circumference and the neuraxial pressure increased due to the patient's cold and cough, the intervertebral disc herniated again was highly likely, and the patient was recommended to be transferred to a higher-level hospital for further examination and surgical treatment;
The patient did not accept the opinion due to financial reasons. Nutritional nerve prevention of infection, dehydration and swelling treatment is given. The discharge situation stated: the patient's pain symptoms were slightly relieved, the muscle strength of the right lower limb was grade IV., the plantar flexion dorsal extension was poor, the big toe was numb, and the feeling was poor. The patient and his family agree to the recommendation of transferring to a higher level hospital for examination and treatment, and after asking the senior physician for approval, the patient will be discharged and transferred to a higher level hospital for examination and treatment.
The discharge diagnosis states: 1. Lumbar intervertebral disc herniation, 2. Upper respiratory tract infection, 3. Insomnia. The discharge order states: transfer to a higher-level hospital for examination and treatment. On the day of discharge, the plaintiff was admitted to the Second Department of Orthopedics of the People's Hospital of a district in a certain city, and was diagnosed with lumbar intervertebral herniation, and after being admitted to the hospital, he was discharged from the hospital on March 25, 2021 after bed rest, swelling, pain relief, nerve nutrition, symptomatic supportive treatment to improve microcirculation, local physiotherapy, and improvement of relevant examinations and examinations.
[Plaintiff's opinion]
During the plaintiff's treatment with the defendant, the plaintiff did not fully understand the pathogenesis of the disease, did not pay enough attention to the relevant conditions of the disease, and improperly handled the situation, resulting in the plaintiff not receiving timely and effective medical treatment, resulting in further aggravation of the condition and inducing other physical diseases. Therefore, the plaintiff filed a lawsuit with the court, seeking that the defendant be ordered to compensate the plaintiff for disability compensation, lost work expenses, and nursing expenses of 374881 yuan.
[The defendant hospital believes]
1. In 2021, the plaintiff has claimed to the court for lost work, nursing and other expenses and has been adjudicated, and the plaintiff can no longer claim it.
2. The plaintiff's injury has been assessed by the appraisal agency as a grade 10 disability, and our hospital will only be liable for compensation within the scope of liability.
【Judicial Appraisal Results】
1. Plaintiff Wang Mouqun, female, born on November 13, 1978, after reviewing the medical records and imaging data provided by Wang Mouqun, Wang Mouqun was surgically treated for lumbar disc herniation this time, and the postoperative examination combined with the current situation showed that Wang Mouqun's damage consequence was moderate damage to the right nerve root of L5 and S1, and he currently has grade IV of right ankle dorsiflexion and right foot toe dorsiflexor muscle, so Wang Mouqun is currently a grade 10 disability.
2. There is a certain causal relationship between the fault of a hospital in a certain district of a certain city in the process of dealing with Wang Mouqun's lumbar intervertebral disc herniation and the consequences of Wang Mouqun's current right nerve root injury in lumbar 5, which is in line with the "slight cause".
【Medical Error】
1. Lack of treatment plan and remedial measures for accidents occurring during/after minimally invasive surgery before surgery.
2. The content of the notification in the "Doctor-Patient Communication Record" and the "Preoperative Informed Instructions" is not perfect.
3. Violating the industry norms involved in the "Surgical Grading Management System" and the "Medical Record Quality Management System" in the core medical system.
【Verdict】
On December 28, 2023, it was decided that the defendant should bear 15% of the liability and pay compensation of 18,787.09 yuan to the plaintiff Wang Mouqun.
[Excerpt from judicial adjudication cases]