Guangdong Provincial Medical Security Center

Legal subjectivity:

In order to effectively prevent and handle medical disputes, protect the legitimate rights and interests of both doctors and patients, and maintain medical order, in accordance with the "Tort Liability Law" and "Medical Accident Handling Regulations" , "Measures for the Prevention and Resolution of Medical Disputes in Guangdong Province", "Measures for the Management of Hospital Complaints (Trial)" and other relevant laws and regulations, this guideline is formulated based on the actual conditions of our province. 1. Medical institutions should set up a doctor-patient relations office to be responsible for the management of medical disputes (hereinafter collectively referred to as the hospital dispute management department), set up a special place for handling medical disputes, and install monitoring equipment. Publicize the office address and contact information of the hospital dispute management department in prominent locations in key departments such as outpatient and emergency departments, intensive care units, obstetrics and gynecology, pediatrics, etc., and hang laws and regulations on maintaining normal medical order and the handling of medical disputes in medical dispute handling areas. Process, patient rights and obligations, etc. 2. After a medical dispute occurs, the hospital dispute management department should intervene immediately, explain the complaint handling process and guidelines to the patient, and fully inform the patient of their rights and dispute resolution methods. 3. Medical disputes are divided into general medical disputes and major medical disputes based on the number of people, scope, nature, degree of harm, etc. involved in the events that caused them, and are handled at a graded level. 4. General medical disputes refer to behaviors in which patients or their family members are dissatisfied with the medical treatment, nursing and other services provided by medical institutions and their staff, and report problems, opinions and demands to the hospital through letters, phone calls, visits, etc. , the hospital can solve the problem in accordance with the "Hospital Complaint Management Measures (Trial)", or the patient can rationally choose legal channels to solve the problem after explanation and guidance. General medical dispute handling process: After receiving complaints from patients or reports of medical disputes in departments, the hospital dispute management department should immediately organize an investigation. If it can be coordinated and handled on the spot, it should be coordinated and resolved on the spot. If it cannot be coordinated and handled on the spot, it should be resolved or responded to within 5 to 10 working days. If the patient is not satisfied with the solution or answer, he should be informed of other legal ways to resolve the dispute: first, apply for mediation to the People's Mediation Committee for Medical Disputes or the People's Mediation Committee for Medical-Patient Disputes (hereinafter referred to as the Medical Mediation Committee); second, apply to the Health and Family Planning Commission for mediation The administrative department applies for administrative handling; the third is to file a lawsuit with the People's Court; the fourth is other ways stipulated in laws, regulations, and rules (if the compensation amount for a medical dispute exceeds 10,000 yuan, the public medical institution shall adopt the above four ways to resolve it, and shall not engage in disputes with the patient) Or their close relatives can negotiate on their own). 5. Major medical disputes refer to behaviors in which patients or their family members are dissatisfied with the medical treatment, nursing and other services provided by medical institutions and their staff, gather many people together, or use violent means to claim compensation from the hospital. The following situations should be classified as major medical disputes and an emergency response plan for major medical disputes should be initiated: The patient's death or severe disability, organ and tissue damage leading to severe functional impairment, more than 5 people visiting at one time, and the patient is emotionally excited and refuses to accept the situation Resolve disputes through legal channels; although the patient did not die or be severely disabled, more than 10 people visited at one time, and they were very emotional and refused to resolve disputes through legal channels; wearing mourning clothes, sitting quietly, or kneeling in or around medical institutions , setting up mourning halls, burning paper money, placing wreaths, holding banners and slogans, posting big-character posters, blocking doors, blocking traffic, etc., refusing to listen to dissuasion and refusing to deal with it in accordance with legal procedures; after the death of a patient, he refused to move the body to the morgue. Persuasion is ineffective; or the corpse is stored for longer than the prescribed time and prevents relevant departments from handling it in accordance with regulations; or the corpse is moved from the morgue to a medical place for display; medical institutions are beaten, smashed, looted and burned, and staff are assassinated, besieged, beaten, and intimidated Or restricting the personal freedom of medical staff; suspecting the involvement of professional medical troubles and social evil forces; threatening compensation by suicide, jumping off buildings, self-immolation, etc.; other behaviors that seriously violate the "Public Security Management Punishment Law" and seriously disrupt the normal order of diagnosis and treatment. Process for handling major medical disputes: Each medical institution should set up a major medical dispute handling team, with the president as the team leader and responsible for overall command of all work, and the deputy president in charge as the deputy team leader, responsible for on-site coordination and handling. After a major medical dispute occurs, medical institutions should immediately launch an emergency response plan for major medical disputes. The hospital dispute management department should rush to the scene within 5 minutes. Hospital leaders should arrive at the scene within 10 minutes to provide command and coordination. All relevant departments of the hospital need to Everyone performs their duties, works together in unity, and jointly handles major medical disputes.

1. Dispute Department: (1) Take active and effective measures to avoid or reduce the damage to the patient's health, prevent the consequences of damage from further expansion, and organize and improve medical care documents as soon as possible. (2) Organize discussion and analysis within the department within 6 hours, and report the patient’s basic information, diagnosis and treatment status, dispute history, department responsibilities, etc. to the hospital dispute management department and medical department. 2. Medical department: Review the discussion opinions of departments, organize relevant departments and experts to discuss and analyze cases of medical disputes, clarify the responsibilities of the hospital, and invite experts from outside hospitals when necessary. The conclusion of the discussion will be notified to the dispute management department, news and publicity department and security department. 3. Dispute management department: (1) Provide comfort and explanation to stabilize the patient’s emotions and prevent the situation from escalating; (2) Notify the hospital’s lawyer or legal consultant to arrive at the scene and participate in the handling in a timely manner. (3) Inform that if there is any objection to the medical record, it can be copied or sealed; if infusion, blood transfusion, injection, medicine, etc. are suspected to cause adverse consequences, the physical objects on site can be sealed; if the patient dies, the doctor and patient cannot determine the cause of death or the cause of death. If there is any objection, the autopsy should be conducted within 48 hours after the patient's death. If the conditions for freezing the body are met, it can be extended to 7 days, and the patient will be assisted in doing relevant work. (4) Summarize the discussion opinions of the dispute department and the medical department, report to the major medical dispute resolution team, formulate dispute resolution opinions, and communicate with patients. (5) If negotiation fails, inform the patient of other legal ways to handle the medical dispute, and actively assist other relevant departments in handling the matter. (6) Effectively implement the reporting system. Medical institutions must establish and improve the reporting system for medical disputes and standardize the reporting of medical disputes. Major medical disputes must not be concealed, delayed or lied. Medical disputes implement a quarterly and annual reporting system. Medical institutions should report major medical disputes that occurred in the previous quarter and their handling to the local health and family planning administrative department before the 10th of each quarter, and summarize and report the disputes in the previous year before January 10 of each year; For major medical disputes, medical institutions must immediately report to the health and family planning administrative department, local public security department, etc. Medical institutions should have dedicated personnel responsible for handling medical disputes and reporting relevant information statistics. 4. Security Section: (1) Designate a designated person to contact the public security department, request to be on-site for handling, and report the police situation in a timely manner. (2) Arrange enough personnel to the scene of the dispute in a timely manner. Security guards should promptly stop illegal and criminal activities, protect the personal and property safety of medical staff, avoid direct conflicts between medical staff and patients, and assist the public security department in maintaining and controlling order at the scene. 5. Medical records management department: (1) The patient applies for copying of medical records, which shall be copied in accordance with the provisions of Article 18 of the "Guangdong Provincial Measures for the Prevention and Resolution of Medical Disputes"; (2) If the patient applies for sealing of medical records, it must be agreed upon by both the doctor and the patient. The original or copy of the medical record will be sealed off-site, and the sealed medical record information will be kept by the medical record management department. 6. News and Publicity Department: (1) Establish a hospital spokesperson system to promptly and proactively announce the handling of medical disputes to the public; (2) Record, videotape, and take photos of the dispute scene to collect evidence based on the specific situation; (3) Produce disputes Responsible for communicating with the news media, making preparations for interviews with the news media, and striving to report medical disputes objectively and fairly.