曾经做法 Ever practice

　　10年前，各级法院为杜绝医患纠纷司法鉴定怪圈现象，曾内设司法鉴定机构。如今尴尬

Ten years ago,The courts at all levels to put an end to the doctor-patient dispute judicial appraisal circle phenomenon,Once inside the judicial authentication institutions.Now embarrassed

　　10年前的做法因涉嫌既当运动员又当裁判被废止，可又未规定终极鉴定机构。

The practice of 10 years ago because of suspected as both athletes and when the referee was abolished,Can not stipulated and ultimate appraisal institutions.

　　两三岁的小孩，本应是最讨人爱的。然而，即将满3周岁的李玉，就像一个出生仅3个月的婴儿——尿布24小时相伴，连坐都坐不稳，更不会张口叫爸爸妈妈。原来，李玉来到人世间的第一天起，便落下脑瘫后遗症。

Two or three years old children,This should be the most please love.however,The full 3 years old li yu,Like a born only 3 months baby diapers, accompanied by 24 hours,All sit sit instability,More won't mouth call mom and dad.The original,Li yu came to the world the first day,He fall cerebral palsy sequela.

　　让李玉患上脑瘫的原因，并非先天遗传，谁该对她负责？内江、泸州两家司法鉴定机构，先后作出两份结论相反的司法鉴定，导致该医患纠纷陷入了无休止的司法鉴定怪圈。最近，医患双方决定，开始寻求第三次司法鉴定。法律专家称，当下医患纠纷司法鉴定怪圈的出现，根本原因在于相关制度的缺陷。

Let li yu from the reason of cerebral palsy,Not congenital genetic,Who should responsible for her?neijiang/Luzhou two judicial authentication institutions,Successively make two conclusions instead of judicial authentication,Cause the doctor-patient dispute in the endless judicial appraisal circle.recently,Doctor-patient the two sides decided to,The third time began searching for judicial authentication.Legal experts say,Then the doctor-patient dispute the emergence of judicial authentication circle,Basic reason is that the relevant system defects.

产前体检正常却产下了患脑瘫女婴 Prenatal check-up normal but gave birth to the baby with cerebral palsy

　　泸州出租车司机李刚介绍，2010年1月18日凌晨1时许，他将妊娠41周即将临盆分娩的妻子吴蜀玉，送到泸州华龙妇外医院。凌晨2点半，医院与产妇及家属沟通后，按产妇要求进行顺产。

Luzhou taxi driver li gang is introduced,On January 18, 2010 at about 1 am,He will be 41 weeks of pregnancy to lying-in delivery wife wu shu jade,Luzhou hualong woman to the hospital.At 2 am,The hospital and maternity and their families after communication,According to the requirements of maternal eutocia.

　　据李刚提供的病历资料，产妇在分娩过程中出现人工破膜，发现羊水三度污染、胎儿宫内窘迫，已具剖腹产指征，接生医生未再与产妇及家属进行沟通，继续执行顺产。当日凌晨5点，历经母亲羊水三度污染和母体宫内窘迫、窒息缺氧2小时50分的女婴李玉，顺产降临人世。新生儿李玉，头部留下了一道明显的勒痕。

According to li gang provide medical records,In the process of delivery women appeared in amniotomy,Find amniotic fluid three degrees of pollution/Fetal intrauterine distress,Already a cesarean section indications,Deliver the doctor not to communicate with maternity and their families,Continue eutocia.At 5 a.m. on that day,After mother amniotic fluid three degrees of pollution and maternal intrauterine distress/Asphyxia anaerobic 2 hours 50 points, li yu baby girls,Eutocia tear.when.Neonatal li yu,Head left a obvious le mark.

　　6个月后，李玉因“咳嗽”入住泸州市人民医院，诊断为“小脑发育不良综合症、继发性癫痫”。直至今日，2岁零10个月的李玉，因脑瘫仍像一个襁褓中的婴儿，不能开口叫爸爸妈妈，大小便不能自解，不能坐立更不能行走，智力仅相当于2个月的婴儿，一切生活起居全靠父母照顾。

Six months after,Li yu because"cough"In LuZhouShi people's hospital,Diagnosis for"Cerebellar dysplasia syndrome/Secondary epilepsy".Until today,2 years, 10 months of li yu,For cerebral palsy is still like a infants,Can't open call mom and dad,Relieve oneself can't from solution,Can't sit stand more can't walk,Intelligence is only 2 months baby,All living all by parents to take care of.

　　妻子产前体检均一切正常，为何生下个脑瘫的女儿？李刚找到华龙妇外医院要求给个说法。“院方答复：要么赔偿5万元以下私了，要么找司法鉴定机构明确责任。”李刚说。

His wife prenatal check-up are all normal,Why gave birth to a daughter of cerebral palsy?Li gang find hualong woman outside the hospital requirements give parlance."The answer:Either pay 50000 yuan the following out of court,Or look for judicial authentication institutions clear responsibility."Li gang said.

　　华西城市读本记者试图就此事向华龙妇外医院求证，院方以“不方便透露”为由没有接受采访。

West China city reporter tried to book the woman to hualong outside the hospital verification,The hospital to"It is not convenient to reveal"Not for the interview.

寻求司法鉴定两机构得出相反结论 To seek judicial authentication institutions that two contrary conclusion

　　为弄清女儿脑瘫真相，同时为法律维权提供责任界定依据，8月16日，经医患双方认同，李刚前往内江协力司法鉴定中心，对泸州华龙妇外医院对李玉的损害后果是否有因果关系，进行司法鉴定。一个月后，内江协力司法鉴定中心认为：医院进行人工破膜术，见羊水三度污染，应尽快娩出胎儿，有剖宫产指征，未采取剖宫产，未再次沟通、告知，有一定过失行为；但此过失行为，与李玉“小脑发育不良综合症”没有关系。根据医疗过失行为与损害后果关系的判定原则，医院不存在损害参与。结论为：李玉患“小脑发育不良综合症”，现在的临床表现，与泸州华龙妇外医院的诊疗行为，无因果关系。

In order to make clear the daughter cerebral palsy,At the same time to provide legal rights according to the definition of liability,On August 16,,The doctor-patient mutually agreed,Li gang to neijiang together judicial authentication center,Luzhou hualong woman to the hospital to li yu's injury consequence if there is a causal relationship,Judicial appraisal.After a month,Neijiang together judicial authentication center think:Hospital for amniotomy technique,See amniotic fluid three degrees of pollution,Should give birth to the fetus as soon as possible,A cesarean section indications,Failed to take cesarean section,Not communicate again/told,Have certain negligence;But the negligence,And li yu"Cerebellar dysplasia syndrome"No matter.According to the medical negligence and injury consequence relations decision principle,The hospital does not exist in damage.Conclusion for:Li yu with"Cerebellar dysplasia syndrome",The clinical manifestations of now,And luzhou hualong woman outside the hospital medical behavior,No causal relationship.

　　10月8日，李刚将相同的病历资料，送到四川金沙(泸州)司法鉴定所，进行重新鉴定。21天后，金沙所作出与内江协力截然相反的司法鉴定结论：尽管小脑发育不良综合症的病因多种多样，但胎儿宫内窘迫后宫内缺氧缺血，对脑组织的损伤是毋庸置疑的；李玉不能说话、不能坐立等诸多征象，正是脑组织受损害的表现；泸州华龙妇外医院在产妇羊水三度污染、胎儿宫内窘迫的情况下，未及时进行剖宫产术或及时终止产程，以致胎儿宫内长时间缺氧缺血导致脑组织损伤，与李玉目前脑组织受损状况之间有明确的困果关系，建议医院承担70%的过失责任。法律专家双方无法协商一致省高院指定鉴定机构

October 8,Li gang will be the same medical records,Sent to sichuan sands(luzhou)Judicial appraisal institute,Revalidation will.21 days after,Sands made and neijiang together different judicial appraisal conclusion:Although cerebellar dysplasia the etiology of the syndrome is varied,But the fetus intrauterine distress in the imperial harem or seraglio hypoxia ischemia,The damage to the brain is beyond doubt;Li yu cannot speak/Can't sit many many signs,It is the performance of the brain damage;Luzhou hualong woman outside the hospital in maternal amniotic fluid three degrees of pollution/Fetal intrauterine distress cases,Not in pregnancy.laboratory or termination of labor in time,So that the fetus intrauterine hypoxia ischemia long time lead to brain damage,At present, li yu and brain damaged condition between the clear trapped fruit relationship,Suggestions for hospital 70% of the liability of fault.Legal experts both sides can't consensus ShengGaoYuan designated appraisal institutions

　　原泸州市中级人民法院政研室主任、泸州市法学会副秘书长白联洲认为：李刚与华龙妇外医院的医患纷，是今当全国性医患纠纷中非常典型的个案。造成医患纠纷司法鉴定怪圈的最直接原因，在于国家在处理医患纠纷关于司法鉴定的相关规定中，无明文规定终极鉴定机构。

The original LuZhouShi intermediate people's court ZhengYanShi director/LuZhouShi law deputy secretary general white United States think:Li gang and hualong woman outside the hospital doctor-patient dispute,Is today when national doctor-patient dispute very typical case.Doctor-patient dispute caused by judicial appraisal circle of the most direct reason,In countries in dealing with medical disputes about judicial identification of the relevant provisions,The absence of express stipulation ultimate appraisal institutions.

　　当今的医患纠纷，司法鉴定结论，成为法院划分责任认定的最有力证据。10年前，各级法院为杜绝医患纠纷司法鉴定怪圈现象，曾内设司法鉴定机构，以帮助法官审理案件。但法院此举因涉嫌既当运动员又当裁判员角色，对医患双方有失公正。因此，法院内设司法览鉴定机构的做法很快被废止。然而，立法机构在制度设置上，在医患纠纷的司法鉴定环节，又无相关的明文规定，留下了制度缺陷。医患双方为了自身利益，由此陷入无休止的司法鉴定怪圈。

The current doctor-patient dispute,Judicial appraisal conclusion,Become a court divided responsibility identification of the most powerful evidence.Ten years ago,The courts at all levels to put an end to the doctor-patient dispute judicial appraisal circle phenomenon,Once inside the judicial authentication institutions,To help the judge hear the case.But the court the move for suspected as both athletes and referees when role,The doctor-patient both sides beneath justice.therefore,The court has tabled judicial authentication institutions practice soon be abolished.however,The legislature in the system setting,Doctor-patient dispute in the judicial appraisal link,And have no related express terms,Leave the system defect.Doctor-patient both sides in order to their own interests,Thus in the endless judicial appraisal circle.

　　为解决这个制度缺陷问题，四川省高级人民法院曾出台文件：当事双方在不能协商选定司法鉴定机构时，由省高院指定鉴定机构，并下达备选司法鉴定机构名册，供各级法院操作执行。机构说法

To solve the defects of this system,Sichuan province higher people's court has issued documents:Both parties cannot negotiate in selected when the judicial authentication institutions,By ShengGaoYuan designated appraisal institutions,And give alternative judicial authentication institutions list,For all levels of courts operation execution.Agency statement

内江协力司法鉴定中心主任：人格担保鉴定无任何猫腻 Neijiang together, director of the center for judicial authentication:Personality guarantee identification without any issue

　　受访中，李刚怀疑内江协力司法鉴定中心的鉴定有猫腻。

In the surveyed,Li gang doubt neijiang together judicial authentication center appraisal have something fishy going on.

　　11月21日，内江协力司法鉴定中心主任向超，接受华西城市读本记者采访时表示：“我以人格担保，鉴定过程中绝对没有任何猫腻。”

On November 21st,Neijiang together, director of the center for judicial authentication to super,Accept, west China city reader reporter to interview said:"I guarantee to personality,The identification process of absolutely no any issue."

　　向超表示：“两名鉴定人都是非常正直的人，鉴定过程中绝对没有任何猫腻。说实话，到目前为止，华龙妇外医院没有任何一个人给我打过电话。鉴定过程中，我们与华龙的人，没任何联系。”

To super said:"Two appraiser is very honest man,The identification process of absolutely no any issue.To tell you the truth,So far,Hualong woman outside the hospital no one call me.Appraisal process,We and hualong people,No any contact."

　　向超说，按规定，司法鉴定机构的鉴定人，只是根据委托人提供的相关病历材料，本着客观、公正、公平的前提原则，作出鉴定意见。相同材料得出不同结论，也很正常，那是仁者见仁的事。比如，不同法官在审理同一个案件，都会出现看法和认识的不同，得出的结论也就不同。“鉴定报告达不到某一方的目的，不能说就是错的。当事一方不服，可以重新申请鉴定。”

To super said,In accordance with the provisions,Judicial authentication institutions of appraiser,But according to the client provide related medical record material,In line with the objective/justice/The premise of the fair principle,Make appraisal opinions.The same material come to different conclusions,Is also very normal,That is what opinion.For example,Different trial judge in the same case,Will appear different views and know,The conclusion is also different."Appraisal report can not reach the purpose of a party,Can't say is wrong.Party a party refuses to accept,Can apply for afresh appraisal."

　　“我是搞行政和管后勤的，鉴定报告是依据什么作出的，要问搞专业的人才晓得。说实话，我对李刚也很同情。”向超表示。

"I was to carry out administrative and tube of logistics,Appraisal report is based on what to make of,To ask make professional talented person know.To tell you the truth,I have also got a sympathy for li gang."To super said.

泸州金沙司法鉴定所：医院三大过失致婴儿脑瘫 Luzhou sands by judicial authentication:Hospital three negligence infant cerebral palsy

　　几乎相同的鉴定材料，为什么会得出截然不同的司法鉴定结论？金沙司法鉴定所鉴定人、四川医事卫生法治研究中心学术委员会委员、四川司法鉴定专家委员会专家王和斌，接受华西城市读本记者采访时表示：根据委托人李刚提供的病历，结合医疗机构是否符合“临床技术操作规范”，他们发现泸州华龙妇外医院存在重大医疗过失，且此过失与李玉的脑瘫后遗症，有着直接的因果关系。

Almost the same appraisal materials,Why would draw very different judicial appraisal conclusion?Sands judicial authentication the appraiser/Sichuan medical health law research center academic committee/Sichuan judicial appraisal committee of experts experts WangHeBin,Accept, west China city reader reporter to interview said:According to the principal li gang provide medical records,Combined with medical institutions in compliance with"Clinical technology operation specifications",They found that women luzhou hualong outside the hospital has a major medical negligence,And the negligence and li yu's cerebral palsy sequela,There is a direct causal relationship.

　　王和斌表示，金沙所推翻内江协力鉴定中心的依据有三：根据有关法规对医疗机构的相关规定，华龙妇外医院在产妇羊水三度污染、胎儿窘迫、胎儿情况逐渐变化的情况下，未按规定及时行剖宫产术或尽快结束产程，而是继续待产，存在明显失误；医院胎心临护不力，从3点半宫口全开到5点妇婴娱娩出整个第二产程，长达1个半小时时间里，明明已见羊水三度污染、胎儿宫内窘迫，本该加强胎心临护，却停止到没有一次胎心临测，明显违反了应每5至10分钟听一次胎心等有关规范，医院存在不作为的明显失误；医患沟通不彻底。(记者 杨元禄 摄影报道)

WangHeBin said,Sands was overthrown neijiang together appraisal center according to three:According to the relevant laws and regulations of the relevant provisions of the medical institution,Hualong woman outside the hospital in maternal amniotic fluid three degrees of pollution/Fetal distress/The fetus gradually changing circumstances,Not according to stipulations timely underwent cesarean section or as soon as the end of labor,But continue to lie in,Obvious mistakes;Hospital cardiac the lack of protection,At half past from three to five palace mouth open penetration in the entertainment childbirth goes out the second process,For one and a half hours of time,Clearly already see amniotic fluid three degrees of pollution/Fetal intrauterine distress,Should be strengthen in the cardiac protection,But stop to have no a cardiac velocity measurement,Obviously violates the should every 5 to 10 minutes to listen to a cardiac and other relevant specification,In the hospital as the obvious mistakes;Doctor-patient communication is not complete.(Reporter YangYuanLu photojournalism)