Hainan joke king

There is no result yet, and we are all waiting for the law to deal with it according to law.

A well-known entrepreneur nicknamed "Beer King" in Hubei Province, known as "the medical special zone" and "the best hospital" in Hainan, died of brain death because of a suspected operation. The patient's family is arguing with the hospital about compensation.

At first glance, this incident is a beer king on one side and a super hospital on the other, much like the tear between the rich and the sky-high private hospitals. Even if patients sympathize, quacks need to be punished, which seems to have little to do with you and me.

However, this is really not the case. Behind the bizarre brain death is the tip of the iceberg that was previously unknown in China's medical system.

In the eyes of many people, Hainan's medical care is not developed, let alone compared with Beijing and Shanghai, and compared with Wuhan near the Lao Li family, the gap is not small. Therefore, for a long time, rich and powerful Hainanese will try their best to go out to treat diseases.

Why does Lao Li, who obviously has not too bad money, want to go to the island instead?

Behind this, a so-called medical innovation is happening quietly.

That's what happened. 20 19, Li Dahong's hearing decreased. After diagnosis, he had a benign acoustic neuroma in his right ear. Following the logic of normal people seeking medical treatment, he went north to the Imperial Capital and found a well-known national expert in a well-known digital hospital.

Experts advised him to have an operation, remove the tumor and implant a cochlear implant to restore his hearing. He did the operation himself, but not in our hospital, but in Boao Super Hospital in Hainan thousands of miles away.

Why go further and further? It turns out that this scary for-profit hospital, which just opened on 20 18, is located in the pioneer area of international medical tourism in Boao Lecheng, Hainan. It has an innovative privilege that can't catch up with the Third Association, allowing the use of new drugs, new devices and new vaccines that have not been approved for marketing in China, including the latest model of cochlear implants that can withstand the 3.0T magnetic field environment.

For Li Dahong, compared with Hainan's pleasant climate and far more comfortable environment and services than public hospitals, the latest version of cochlea in experts' mouth is the key to his decision to embark on a journey of brain death.

And why do super hospitals have no doctors of their own and need experts to fly from Beijing to the south?

This is also an innovation.

Boao Super Hospital is a platform hospital with a team of experts from all over the country led by Academician 18. In other words, "flying knife" is its normal state.

Under the current multi-point practice standard of doctors, the "flying knife" with complete procedures is not illegal, and it helps relatively backward medical areas to obtain resources flexibly. There is no need to stare at the doctor's pocket all the time to see how much money there is.

However, for modern difficult surgery, is the overall software and hardware strength of this hospital as a flying knife platform excellent, except for the surgeon from afar? Are the auxiliary team and anesthesia team good? Do you have enough experience in dealing with complications and rescue? How is the team running in?

Every link can be a fatal weakness.

Li Dahong will have two operations. It is relatively easy to do cochlear implant alone. However, the resection of acoustic nerve tumor needs careful operation in the brain, and the tiny nerves that are not involved in the tumor should be protected as much as possible. This is indeed a complicated and difficult operation.

For a young novice like Boao Super Hospital, although hardware can rely on money, other problems faced by complicated and difficult surgery are not easy to solve. No matter how loud the names of academicians and experts are and how innovative the system is, it may not be helpful.

In some ways, it may not really be better than a county hospital that has existed for a long time.

Li Dahong, who flew from Beijing to Boao Super Hospital, embarked on a journey of brain death.

He underwent a five-hour operation at 8: 20 am on September 17, and fell into dizziness, vomiting and deep coma after operation. The next day, he was transferred to a general hospital.

165438+1October 10, he was declared brain dead and has been living on a ventilator until now.

And after the operation, before coma briefly awake, lee hom said the last sentence is:

Cheated again, cheated.

Did the hospital make any mistakes in the whole process of operation and postoperative rescue? This also depends on the professional conclusion of medical malpractice appraisal.

However, judging from the medical records and course records published by both parties, many problems are exposed, which deserve attention.

First, the 69-year-old patient was written as "sick child" in the medical record, and the cause became "congenital deafness". The hospital explained that it was a clerical error. Such a low-level mistake definitely does not meet the standard of "super hospital". Although it is not directly related to brain death, it is enough to make people suspect that "children" and "congenital deafness" are actually the usual templates for cochlear surgery in hospitals, lacking Li Dahong's experience in such complicated surgery. So I directly copied and pasted the previous medical record template.

The problem is that it is a joke that the medical record template follows the pattern of cochlear surgery for children. What will happen if the operation follows this pattern?

Second, the signature of the surgeon is suspected of fraud. Similarly, the impact is not direct, but it will make people doubt the credibility of medical records and hospital operations.

Third, there is no preoperative coagulation checklist in the sealed medical records, and the checklist in Beijing has been separated for one month. As a rule, even minor operations such as tooth extraction must carefully check the coagulation mechanism to avoid uncontrollable bleeding. Craniotomy in a super hospital is unnecessary.

The direct cause of Li Dahong's brain death is postoperative intracranial hemorrhage.

Fourth, Li Dahong has a history of hypertension. In this case, it is reasonable to pay close attention to blood pressure during craniotomy. But the super hospital said that they didn't always have antihypertensive drugs, didn't prepare in advance, and didn't even have an ICU.

Li Dahong's family members were puzzled by the operation of the super hospital. After the operation, Li Dahong began to have headaches, dizziness and chills at around 13: 50, and his blood pressure rose to19196 at 14: 57, but he didn't go to the hospital until/kloc-0.

What happened in this hour?

Fifth, at 15:40, Li Dahong took a deep breath under the instructions of the doctor in the super hospital, then vomited quickly and fell into a serious coma.

When blood pressure is already high and cerebrovascular symptoms have appeared, it is risky to take a deep breath blindly. It may cause stress regulation of the body, narrow the caliber of blood vessels, lead to a sharp rise in blood pressure, and even lead to rupture and bleeding in fragile parts of blood vessels.

Indeed, after taking a deep breath this time, Li Dahong never woke up.

Sixth, after Li Dahong fell into a serious coma, the hospital arranged a second operation, which lasted 10 hours, but there were still two and a half hours waiting for the neurosurgeon who came from Sanya.

The operation was a complete failure.

Human medicine is far from perfect, and perfect operation may not bring perfect results. However, judging from the above-mentioned series of dazzling operations, I am afraid it is inseparable from the innate defects of the innovative model of the ultra-far "flying knife" platform.

Is Li Dahong's brain dead a victim of so-called innovation?

Brain death is irreversible. At present, the focus of dispute between relatives of patients and hospitals is mainly the amount of compensation besides the fault and responsibility identification in the process of diagnosis and treatment.

Relatives hope to consider Li Dahong's economic loss as an entrepreneur with strong ability to make money in the amount of compensation.

The hospital insisted that it was a lion's mouth, and in the official response, it also took out the angry words in the quarrel between relatives as the quotation of the other party, as if to incite the whole network to share the same enemy with the rich. Once the wind blows, even if relatives say they want to donate most of the compensation, they can't escape the scolding of the original sin.

Calm down, how much is reasonable? Both sides have their own games, and the people who eat melons in the media also have their own views. Even if there are different opinions, it is not good to label the other party as "queuing" and "collecting money".

Apart from a few obvious rhythms, such as disputes between patients and hospitals, local rich people who are described as red-haired medicinal liquor bully doctors across provinces. Anyone with a discerning eye will know at a glance that the "beer king" in a small place is really not enough to look at the front of the super hospital by opening the hospital website.

However, from a reasonable point of view, it is reasonable for patients to fight for compensation according to their actual losses and hospitals to take responsibility according to the influence of their own faults.

This is not because the life of the rich is inherently valuable. There are at least three reasons behind this.

First, super hospitals are for-profit hospitals, which specialize in high-end markets.

Unlike the public hospitals we often go to, there is capital behind them. It focuses on the high-end market where the rich pursue exquisite and comfortable services and high profits, and naturally it should have the awareness of taking high risks. Moreover, its losses are not like those of public hospitals, and its finances have a bottom. It has to pay for it by itself, not by taxpayers.

There is a rhythmic saying that rich people have a medical accident and demand high compensation, so they must be sent to the rich people's hospital.

But those who have a rhythm forget that the super hospital is such a hospital serving the rich.

If the hospital can seriously compensate all the losses caused by its own mistakes, and do not play tricks, let alone super hospitals, even Putian Hospital is estimated to be honest.

Second, Boao Super Hospital focuses on overseas medical substitution for wealthy people. When it opened, its main publicity was "500,000 China patients don't need to go abroad for medical treatment".

While obtaining the privilege of applying for new drugs and devices abroad, we strive to be in line with foreign countries in terms of diagnosis and treatment conditions, environment and services, and at the same time strive to be in line with foreign countries in terms of fees. If not, how to attract academicians and experts from all over the world to fly knives from thousands of miles away?

However, in terms of medical malpractice compensation, should it also be in line?

What happens when the tracks are connected? According to statistics, more than half of the medical malpractice compensation in the United States exceeds $6.5438+0 million, many of which only cause mild disability. A China woman died of massive hemorrhage by caesarean section in the United States. After mediation, the amount of compensation was $5.2 million.

Of course, this is supported by the medical accident insurance system, and it also has its disadvantages. But if we turn a blind eye to integration, business will be too easy to do.

From another point of view, it is also a good opportunity to improve the medical accident insurance system in for-profit hospitals, and it can also protect the medical staff.

Thirdly, this is the most important point, because it affects everyone of us. Although it may last for a lifetime, it may not meet the customer standards of super hospitals.

That is, only by fully covering the compensation for faults and losses can the inherent defects of this flying knife platform in super hospitals be fully exposed.

At the same time, it will prevent the public medical system from being hollowed out in an extremely inefficient and meaningless way.

Looking back, the whole process of Li Dahong's brain death fully exposed the weakness of this super hospital in the face of complex and difficult diseases. It is not necessarily that the expert is not worthy of the name. The bigger problem is that the whole team is lax, lacking cooperation experience, background and experience, and cannot handle "big" and "urgent" things at the same time.

There are some problems here, which may be improved over time. However, if the super hospital can't produce its own excellent team, the problem can't be fundamentally solved.

Looking back, the surgeon in charge, the neurosurgeon who has to wait for him for two and a half hours in the immature local cooperative medical care and brain surgery, is not super at all.

On the other hand, super hospitals are also hollowing out the top medical resources of the public medical system in this way. Although academicians and experts have more mature platforms and teams in their own public hospitals and their output is more stable, they are not far from Wan Li. Even if they come and go to the operating table, their level may be discounted, and even their brands may be smashed.

Of course, there are interests in this, and they are not saints, so there is no need to be ashamed of interests. However, only considering the benefits, risks and possible defects in this resource transfer, it is possible to accelerate the mismatch of medical resources.

This is the result. On the one hand, the quality of the mixed flying knife service that the rich get at super price may not be too super. On the other hand, ordinary people unconsciously suffer from the accelerated deterioration of public medical services.

The expert you want to meet becomes more difficult, and even if you do, you become more impatient. You wait in line for three to five months, and he sends you away in three to five minutes-this is because he is in a hurry to go to the super hospital, or something similar, and is unwilling to be an "innovation" platform for the team honestly.

How to alleviate this trend?

For the risks that have been exposed now, the most direct idea is to let the flying knife platform bear the cost completely and lose money according to its influence. Only in this way can they face this problem honestly and the mismatch of resources behind this innovation can be alleviated and corrected.

In the final analysis, the innovation of hollowing out the public medical system must pay a price.

Once the trend spreads, the hole becomes a collapse, and I'm afraid it's not just the brains of the rich who suffer.