On October 27, Korea’s iconic rock star Hae Chul Shin passed away due to blood poisoning caused by peritonitis. His death was made an issue medically and socially, because the suspicion that medical malpractice had occurred during his healthcare service has aroused nationwide. The investigation is being conducted to reveal the truth, and the social concern for medical accidents has surfaced after this huge incident. However, medical accidents are not the case that targets some unlucky people. Rather, medical accidents are common occurrences. In other words, people around you might also be one of the victims. The Sungkyun Times (SKT) looks into the definition and causes of medical accidents, and introduces some judicial precedents in medical disputes to Kingos.
What Exactly Is a Medical Accident?
A medical accident, or a medical error, happens by the malpractice of healthcare providers, such as misdiagnoses, mistakes in injections, blood transfusions, and administrations of medicines. A medical accident has an adverse effect to patients, from injury even to death. However, the definition of medical accident is controversial, since a lot of taxonomies exist for classifying medical accidents.
Why Does a Medical Accident Occur?
There are innumerable factors that are responsible for medical accidents to happen, for slight mistakes of healthcare providers may be directly related to the health of the patients. The potential errors are eventually man-made, and thus preventable. The three mainstream reasons that cause medical accidents are as follows.
Unskilled Healthcare Providers and Their Mistakes
The lack of experience of healthcare providers and their lack of understanding about potential risks and severity of medical accidents are some of the factors that increase the possibility of medical accidents. In addition, there are minor mistakes that results in major medical accidents. For instance, an absurd accident in 2005 at a university hospital occurred because the medical charts of two cancer patients were switched. As a result, the medical staffs of the hospital removed the thyroid gland of a gastric cancer patient, and vice versa, which led to huge financial and physical waste of both the patients. Especially, the thyroid cancer patient, whose healthy stomach was removed, was known to have serious inconvenience because of an eating disorder gained from the mistake.
Problems in Medical System
In Korea, avoidance of certain majors in medical colleges, specifically in internal medicine department, surgery department, and in obstetrics and gynecology department, is a serious social issue. This problem is partly due to economic situation, in which opening a private hospital is becoming harder and harder, and the number of occupations in these departments is reducing. Besides the economic aspects, the particularly hard resident training period is another cause of the evasion of these departments. The shortage of professional manpower in these departments results in an overburdening of a small number of medical staffs. For example, according to a university hospital physician, a medical oncologist has over 50 assigned inpatients a day on average. These poor conditions lead to sleep deprivation and fatigue of medical residents, which can be a major cause of medical accident.
The Excessive Familiarization of Medical Science
People in these days are much more familiar with medical science than in the past. A lot of small-scale medical procedures have developed, and these are exposed to the public by various kinds of media. Especially, some doctors are appearing on television very often, promoting medicines and surgeries that are not medically verified. A new term doctortainers (doctors entertainers) is made for some doctors who appear frequently on TV shows or home shopping channels for the sake of earning money. From their broadcasting activities, people are not only getting too familiarized to underestimate the danger and severity of medicine and surgery, but also getting exposed to false medical information. Hence, a lot of people are risking their lives to unproven medical procedures with inappropriate information, and being targets of medical accidents themselves.
Disputes on Medical Treatment
According to the statistics of Korea Medical Dispute Mediation and Arbitration Agency, 1391 incidents of medical accidents have gone through mediation. On the other hand, an essay written by a university hospital professor insists that there were estimated 17,000 preventable deaths in 2010. The statistics from a physician indicate that patients over ten times as many as government’s statistics are victims of medical accidents. As shown in this difference, the cause and responsibility for medical accidents are relatively obscure, which leads to even more preventable deaths being neglected. In medical maltreatment litigation, it is crucial for a patient, or the legal representative of the patient, to find evidence that prove the patent mistake of the healthcare providers. However, the patient’s side is placed at a rather disadvantageous position for the following three reasons. First, since human body is a harmonious complex in which organs and tissues are constantly interacting, there may be innumerable causes of bad outcomes, for which the medical staffs are not responsible. Second, the level of medical knowledge between the patient’s side and the healthcare providers is substantially different. Third, it is difficult to prove the malpractice of healthcare providers because medical practices are privately executed, and evidence that may be the clue to prove the errors are mainly in the hospital. These are some of the judicial precedents about claims of medical malpractice. The plaintiff is the patient, and the defendant is the medical staff, or the hospital.
The Case in Which the Plaintiff Won the Lawsuit
Case 1. Supreme Court Decision 2007Da76290
In 2008, the ureter of a patient was damaged during hysterectomy, the operation of removing ovaries. The Supreme Court delivered the judgment that since ureteral injury is one of the general complications of hysterectomy, the plaintiff failed to prove that the damage of ureter is beyond the bounds of typical complications. The defendant was pleaded not guilty.
Case 2. Supreme Court Decision 2001Da20127
In 2003, a patient died of a cryptogenic intraventricular hemorrhage while recovering after an operation for meningitis which occurred due to intraoperative infection. The Supreme Court judged that the defendant had done all the necessary measures to prevent infection from surgery, hence it is inappropriate to assume the defendant had neglected the duties of infection prevention. According to the Supreme Court, since the cryptogenic intraventricular hemorrhage is unrelated to the mengitis, it is not approvable that the defendant is on the charge of neglecting the duties of infection prevention, with the fact alone that the intraoperative infection had occurred to the deceased
The Case in Which the Defendant was Pleaded Innocent
Case 1. Supreme Court Decision 99Da66328
In 2000, a patient died during a heart operation because of an aortic dissection. The plaintiff claimed that the aortic dissection occurred right after the arterial cannulation, an intubation of a tube into the artery. In conclusion, it is apparent that no other possible reason exists for the aortic dissection but the clinical error. The Supreme Court judged that the cannulation might have caused damage to aortic intima, and pleaded the defendant guilty. In this case, the plaintiff proved that the medical error is the sole cause of the side effect regarding the extraordinary nature of medical behavior, and made it possible for the Supreme Court to presume that the side effect is due to the malpractice of the defendant.
Case 2. Supreme Court Decision 2005Do8980
In 2009, a patient lapsed into unconsciousness after an injection. The patient was on the process of postoperative recovery. It transpired that the doctor in charge had prescribed the inappropriate injection by mistake, which could not be injected without proper preparation of artificial respiration. The Supreme Court judged that the doctor in charge had neglected the duty of care and thus is criminally liable for the result. Additionally, the nurse in charge was also pleaded guilty, for applying the wrongly prescribed injection and making the patient to be in a coma. As an assistant of a physician in general hospital, the nurse should have noticed the mistake if she was well informed of the remedial effect of prescribed chemicals, and of the precaution about the injection.
Medical accidents happen unexpectedly, regardless of time and people. Since healthcare providers are also human, the medical service we receive can not always be perfect. Despite the number of alleged medical accidents is increasing year by year, it could be said that we are risking our lives every time we get healthcare service at some point. There is a saying that goes “Dead men tell no tales.” Even after the victim’s death, some families keep on with the solitary and disadvantageous fight against the hospital, only to reveal the wrongful death of their beloved ones, which could have been prevented by decent care of the medical staffs. The SKT hopes for the improvement of various medical and social conditions for both the patients and healthcare providers.