Measures for the prevention and treatment of medical disputes in Zhejiang Province

Article 1 In order to effectively prevent and handle medical disputes, protect the legitimate rights and interests of both doctors and patients, and maintain medical order, these Measures are formulated in accordance with the Regulations on the Handling of Medical Accidents and other relevant laws and regulations, combined with the actual situation of this province.

Article 2 The term "medical disputes" as mentioned in these Measures refers to disputes caused by medical behaviors between doctors and patients.

Article 3 These Measures shall apply to the prevention and treatment of medical disputes within the administrative area of this province.

Responsibility identification and compensation for medical accidents shall be implemented in accordance with the Regulations on Handling Medical Accidents.

Article 4 The prevention and handling of medical disputes shall adhere to the principles of putting prevention first, fairness and reasonableness, timely convenience for the people and handling according to law.

Article 5 People's governments at or above the county level shall strengthen their leadership in the prevention and handling of medical disputes, urge relevant departments to perform their duties according to law, and coordinate and solve major problems in the prevention and handling of medical disputes.

Article 6 The health administrative department of the people's government at or above the county level shall strengthen the supervision and management of medical institutions and their medical personnel according to law, urge medical institutions to improve the quality of medical services, ensure medical safety, and do a good job in the prevention and handling of medical disputes.

The public security organs of the people's governments at or above the county level shall maintain the public order of medical institutions in accordance with the law, strengthen supervision and guidance on the internal public security work of medical institutions, and promptly investigate and deal with violations of public security management.

The judicial administrative department of the people's government at or above the county level shall strengthen the guidance on the people's mediation of medical disputes.

Insurance supervision and management institutions shall strengthen the supervision and management of medical liability insurance according to law.

Article 7 The township people's government, sub-district offices and village (neighborhood) committees where patients are located shall cooperate in handling medical disputes.

Article 8 The people's mediation committees for medical disputes shall be established in cities and counties (cities), and the people's mediation committees for medical disputes shall be established in municipal districts according to actual needs, and shall be responsible for the people's mediation of medical disputes within their respective administrative areas.

The staffing and management of the people's mediators of medical associations shall be stipulated by the people's governments of cities and counties (cities, districts).

Medical mediation and mediation of medical disputes do not charge fees, and their working expenses and compensation subsidies for people's mediators are solved by the people's government at the same level.

Article 9 The people's governments of cities and counties (cities, districts) may establish a medical liability insurance system or a medical liability risk premium system according to the actual needs of the prevention and treatment of medical disputes in their respective administrative areas.

Tenth newspapers, radio, television, websites and other news media should abide by professional ethics, in accordance with the provisions of relevant laws and regulations, objectively and fairly report medical disputes, and correctly guide public opinion. Eleventh medical institutions and their medical staff should strictly abide by the laws, regulations and rules of medical and health management in medical activities, standardize the behavior of diagnosis and treatment, and abide by the professional ethics of medical services.

Twelfth medical institutions and their medical staff shall truthfully inform patients of their illness, medical measures, medical risks and other conditions, and promptly answer patients' consultations; But may have adverse consequences for patients, you can notify their close relatives.

If surgery, special examination, special treatment and experimental clinical treatment are needed, medical institutions and their medical staff shall obtain the written consent of patients; If it is impossible or inappropriate to explain it to the patient, it shall explain it to the patient's close relatives and obtain their written consent. If the opinions of patients or their close relatives cannot be obtained due to emergency situations such as rescuing dying patients, it shall be implemented in accordance with the provisions of relevant laws and administrative regulations.

Article 13 Medical institutions shall strengthen the laws, regulations, diagnosis and treatment norms, routine training and professional ethics education of medical services, and establish and improve the accountability system for medical personnel violating laws and regulations, the monitoring and evaluation system for medical quality and the responsibility system for medical safety.

Medical institutions should establish and improve the communication system between doctors and patients, set up reception places, equip full-time (part-time) staff, accept consultations and complaints from patients or their close relatives, and promptly answer and deal with related problems.

Fourteenth medical institutions shall formulate emergency plans for medical disputes and report them to the local health administrative departments and public security organs for the record.

Fifteenth patients should abide by the rules and regulations of medical institutions, truthfully inform the medical staff of the illness and medical history related to the diagnosis and treatment activities, and cooperate with the medical staff to carry out necessary examination, treatment and nursing. Patients who have objections to medical behavior should express their opinions and demands through legal channels.

Sixteenth provincial health administrative departments should establish and improve the reporting system of major medical disputes. Medical institutions shall perform their reporting obligations in accordance with the provisions of the reporting system, and shall not conceal, delay or make false reports.

Seventeenth after the occurrence of medical disputes, medical institutions should take the following corresponding measures according to the actual situation of medical disputes:

(a) to inform patients or their close relatives of the specific measures and procedures for handling medical disputes; Patients or their close relatives request consultation, they shall be informed to nominate no more than 3 representatives to participate in the consultation.

(two) to organize expert consultation or discussion on the medical behavior in dispute, and to inform the patients or their close relatives of the opinions of consultation or discussion.

(three) cooperate with patients or their close relatives to seal and unseal the physical objects and related medical records.

(four) the patient died in a medical institution, and the body should be moved to the funeral home according to the regulations; If the close relatives of the deceased disagree with the cause of death, an autopsy shall be conducted in accordance with the regulations.

(five) due to medical disputes affect the normal order of medical work, timely report to the local public security organs.

(six) to cooperate with the administrative department of health, public security organs, medical departments and institutions to do a good job in investigation and evidence collection.

If it is necessary to start the emergency plan immediately to deal with medical disputes, corresponding measures should be taken in accordance with the provisions of the plan to prevent the situation from expanding.

Article 18 After receiving a report of a medical dispute, the administrative department of health shall order the medical institution to take effective measures immediately, and send people to the scene to guide and coordinate the disposal work when necessary, so as to guide both parties to properly resolve the medical dispute according to law.

Nineteenth public security organs should immediately organize the police to rush to the scene after receiving the public security warning of medical disputes, and discourage both sides from excessive behavior; If dissuasion is ineffective, it should be stopped according to law, to control the expansion of the situation, and to maintain the normal medical work order; If the mortuary or funeral parlour of a medical institution is ineffective after being discouraged, the public security organ shall order it to stop the illegal act and deal with it according to law.

Twentieth after the occurrence of medical disputes, the two sides can resolve them through consultation, or apply to the medical association where the medical institution is located for mediation; Unwilling to negotiate or mediate, or if negotiation or mediation fails, you may apply to the administrative department of health for administrative handling of medical malpractice disputes, or bring a lawsuit to the people's court.

If the amount of medical dispute claims is more than 1 000 yuan, public medical institutions shall not negotiate on their own.

If both parties apply for mediation by the Medical Commission, and the claim amount is more than 654.38+10,000 yuan, they should first entrust a technical appraisal of medical malpractice to clarify their responsibilities.

Twenty-first medical disputes caused by adverse drug reactions or medical device adverse events, medical institutions should pay compensation to the injured party according to the appraisal conclusion. Specific compensation measures shall be formulated by the provincial food and drug supervision and administration department in conjunction with the provincial finance, health and civil affairs departments.

After paying the compensation fee, a medical institution may claim compensation from the manufacturer or operator of drugs or medical devices according to law. Article 22 The Medical Association shall undertake the following duties:

(1) Mediation of medical disputes;

(2) Disseminating relevant laws, regulations, rules and medical knowledge through mediation;

(three) report to the health, judicial and administrative departments on medical disputes and mediation;

(four) to analyze the causes of medical disputes and put forward opinions and suggestions to medical institutions to prevent medical disputes;

(five) to provide consulting services related to medical dispute mediation;

(six) other duties prescribed by the people's governments at or above the county level.

Article 23 People's mediators of medical associations should be fair and upright, have good conduct, have medical and legal professional knowledge and mediation work experience, and be enthusiastic about people's mediation work.

Article 24 A medical association shall establish an expert database composed of relevant medical, pharmaceutical and legal experts to provide technical advice for the investigation, evaluation and mediation of medical disputes.

Twenty-fifth medical mediation will apply to the parties for mediation of medical disputes, which meets the acceptance conditions and shall be accepted within 3 working days; Do not meet the conditions for acceptance, shall not be accepted, notify the parties in writing and explain the reasons.

After accepting the application for mediation, the Medical Commission shall inform both parties of their rights and obligations in mediation activities.

Twenty-sixth medical dispute mediation application in any of the following circumstances, the medical adjustment will not be accepted; If it has been accepted, the mediation shall be terminated:

(a) a party has brought a lawsuit to the people's court;

(two) one party has applied to the administrative department of health for administrative handling of medical malpractice disputes;

(three) one party refuses to mediate by the Medical Commission;

(four) the mediation agreement has not been reached by the Medical Commission, and one party applies for mediation again;

(five) disputes caused by illegal medical practice.

If the mediation is terminated, it shall notify the parties in writing and explain the reasons.

Article 27 After accepting the application for mediation of medical disputes, the Medical Commission shall designate 1 people's mediators as mediators, and may designate several people's mediators to participate in mediation as needed; If a party requests the people's mediator to withdraw, it shall be replaced.

Both parties may entrust lawyers and other agents to participate in mediation activities, and the client shall submit a power of attorney to the medical commission.

Twenty-eighth medical mediation committee shall, within 7 working days from the date of accepting the application for medical dispute mediation, respectively, to understand the relevant facts and circumstances from both parties, and organize investigation, verification and evaluation according to the requirements of the parties.

In the process of medical dispute mediation, if the people's mediators need to consult medical records and consult or inquire with relevant experts and personnel, the relevant units and personnel shall cooperate.

Article 29 A mediation agreement shall be made for medical disputes settled through mediation. The conciliation statement shall be signed, sealed or fingerprinted by both parties, and shall take effect after being signed and sealed by the mediator.

The mediation agreement reached according to law shall be consciously performed by both parties.

Thirtieth medical commission shall conduct mediation within 30 working days from the date of accepting the application for mediation. If it is necessary to extend the mediation period due to special circumstances, the Medical Commission and both parties may agree to extend the period; If no mediation agreement is reached within the agreed time limit, it shall be regarded as a failure of mediation. Thirty-first city and county (city, district) public medical institutions that implement the medical liability insurance system shall participate in medical liability insurance in accordance with the relevant provisions of the state and province, and non-public medical institutions may voluntarily participate in medical liability insurance.

Encourage medical institutions to insure all kinds of insurance involving public liability with insurance institutions that underwrite medical liability insurance.

Article 32 An insurance institution that underwrites medical liability insurance shall follow the principle of guaranteed capital and meager profit, reasonably determine the insurance premium rate, and implement a floating premium rate system according to the compensation for medical disputes of different medical institutions over the years.

Thirty-third medical institutions to participate in medical liability insurance, the medical liability insurance expenses, from the medical institutions operating expenses, according to the provisions included in the medical costs.

Thirty-fourth medical disputes, the need for insurance claims, medical institutions should truthfully provide the insurance institutions with relevant information of medical disputes. Insurance institutions shall participate in the handling of medical disputes in a timely manner and bear the liability for compensation in accordance with the provisions of the medical liability insurance contract.

An insurance institution shall take the agreement reached through consultation between the two parties, the agreement reached through mediation by the Medical Association, and the effective mediation book or judgment made by the people's court as the basis for medical liability insurance claims, and make compensation in time.

Thirty-fifth city and county (city, district) public medical institutions that implement the medical liability risk fund system shall pay the medical liability risk fund in accordance with the provisions of the people's government at the same level, and non-public medical institutions may voluntarily pay the medical liability risk fund.

The medical liability risk fund system mentioned in the preceding paragraph refers to a mutual aid system established by a number of medical institutions paying funds according to a certain proportion, implementing unified management and overall use, so as to disperse the medical liability risks of medical institutions and ensure that patients suffering from medical damage receive timely compensation.

Article 36 The medical liability risk fund shall be stored in a special account and used for special purposes in accordance with the principles of fixed income by expenditure, balanced income and expenditure and appropriate guarantee.

The medical liability risk premium paid by medical institutions shall be charged from the business funds of medical institutions and included in the cost of medical institutions.

After the occurrence of medical disputes, it is necessary to pay medical liability compensation, and the medical liability risk fund management institution shall take the agreement reached through consultation between the two parties, the agreement reached through mediation by the medical commission, and the effective mediation book or judgment made by the people's court as the basis for paying compensation, and pay it in time.

Thirty-seventh specific measures for the payment, use and management of the medical risk responsibility fund shall be formulated by the people's governments of the cities and counties (cities, districts) that have established the medical risk responsibility fund system. Thirty-eighth medical institutions and their medical staff have one of the following acts, which shall be ordered by the administrative department of health to make corrections; If the circumstances are serious, the responsible person in charge and other directly responsible personnel shall be punished according to law:

(a) in violation of health administrative rules and regulations or technical operation norms;

(two) due to irresponsible delay in the rescue and diagnosis and treatment of critically ill patients;

(3) Concealing, forging or destroying medical documents and related materials without authorization;

(4) Failing to inform the patient of his illness, medical measures and medical risks in accordance with regulations;

(5) Failing to carry out operation, special examination, special treatment or experimental clinical treatment with the consent of the patient or his close relatives in accordance with regulations;

(6) Failing to formulate an emergency plan for medical disputes;

(seven) failing to report major medical disputes to the local health administrative department in accordance with the regulations;

(eight) other acts that should be punished according to law.

Thirty-ninth patients or their close relatives and related personnel have one of the following acts, which shall be dealt with by the public security organs according to law:

(1) occupying a consulting room or office space, or pulling banners, setting up a mourning hall or posting slogans in the consulting room or office space, or refusing to move the remains to a funeral home, etc. , thus disrupting the normal order of medical institutions;

(2) Obstructing doctors from practicing according to law, insulting, slandering, threatening or beating medical personnel, or infringing on their personal freedom or interfering with their normal life;

(3) robbing or damaging the facilities, equipment or medical records, files and other important materials of medical institutions;

(four) other acts that should be dealt with according to law.

Fortieth medical mediation committee and its people's mediators in the mediation of medical disputes, serious dereliction of duty or violation of law and discipline, by the competent authorities in accordance with the law.

Article 41 Where the health, judicial administration, public security and other departments of the people's government at or above the county level and the insurance supervision and administration institutions and their staff violate the provisions of these measures, they neglect their duties, abuse their powers, engage in malpractices for selfish ends, and the relevant competent departments shall, in accordance with the law, punish the responsible person in charge and other directly responsible personnel.

Forty-second acts in violation of the provisions of these measures, which constitute a crime, shall be investigated for criminal responsibility according to law. Article 43 These Measures shall come into force on March 1 day, 2065.