Case 1
On April 16, 2007, Hu Hailong, a villager from Damao Banner in Inner Mongolia, sent his wife, Li Lintao, to the Banner's Maternal and Child Health Clinic to await delivery. At the time of admission, the condition of the pregnant woman and the fetus was normal. But after more than two hours of effort, the child was not born. Doctors decided to perform a cesarean section. At about 2 p.m., when Hu Hailong went to pay for the blood, he realized that the hospital and Damao Banner Blood Bank did not have any blood with the same blood type as his wife's, so he had to transfer the blood from Baotou Central Blood Station. Due to the Baotou Central Blood Station is a certain distance from Damaoqi (the fastest speed limit on the way will take about 3 hours), the situation is critical, the family asked to draw their own family blood, but the hospital to "according to the regulations do not allow private blood collection," for reasons, has not agreed. While the mother was under anesthesia and needed blood transfusion, there was no blood source, and when the Baotou Central Blood Station sent 1,000 ml of blood into the mother's body, it was already three hours later, i.e., more than 5:00 p.m. on the same day. After the transfusion, the woman had blood pressure, and when the second blood was delivered around 18:00, the woman's breathing and heartbeat had stopped. Hu Hailong was told that the child and adults were not saved ......
After a comprehensive analysis can be concluded that the cause of the death of Li Lin Tao mother and baby, mainly due to the lack of timely blood transfusion. This case has constituted a first-class A-class medical malpractice, by the hospital to bear the main responsibility. That is to say, if there were sufficient blood to match the maternal blood type, Li Lin Tao mother and baby could not have died. The direct cause was that the Damao Banner Blood Bank, which was responsible for the blood supply of Damao Banner, did not have blood that matched the blood type of the mother. Because Damao Banner Blood Bank only has the function of blood storage and blood supply, the blood bank needs to report the blood storage plan, collected and distributed by Baotou Central Blood Station. The day before Li Lintao's surgery, Damao Banner Hospital carried out a case of surgery to the blood bank's reserve blood used up, the reserve blood has not been replenished in a timely manner. According to relevant laws, the blood bank is not allowed to collect blood, maternal and child health clinics and no blood qualification, can only watch the mother step by step towards death looking forward to the arrival of life-saving blood as soon as possible.
Case 2
At midnight on March 25, 2007, the pregnant woman Cheng Guiyun suddenly felt a pain in the belly, the symptoms of labor, because her husband Wu Zhongshan was not at home, the neighbors used a motorcycle to Cheng sent to the People's Hospital of Hequ County, Shandong Province, Cheng Guiyun get off the car into the Department of Obstetrics and Gynecology themselves. The doctor on duty immediately carried out a routine prenatal examination. 1:30, Cheng Guiyun difficult labor and bleeding symptoms, after more than an hour of preoperative preparation, 3:10, began to implement anesthesia Cheng Guiyun. 3:40, Wu Zhongshan's brother, Wu Zhongxiong, on behalf of the family signed, Cheng Guiyun cesarean section operation. During the two-hour operation, the mother had more than enough bleeding, bleeding up to 4,000 milliliters, after using up two bags of pre-prepared B-type plasma, and then go to the hospital technical floor of the laboratory to get blood, there is no plasma. The doctor let Cheng Guiyun present sister-in-law ran to the laboratory to get blood. Surgery is in progress, due to clinical plasma, coupled with surgical wounds bleeding more than the doctor can only use plasma substitute for temporary emergency to maintain blood pressure, and immediately reported to the dean on duty. Near 6 a.m., on-duty vice president Ma Qingyun heard the doctor reported, only to inform the hospital by phone, deputy director of testing Li Meiqin, contact Xinzhou City Central Blood Station Wuchai blood supply point quickly to the Hequ County People's Hospital plasma delivery. The life-saving plasma in more than two hours after receiving the transfer order rushed to the Hequ County People's Hospital, but unfortunately has been useless.
The main cause of maternal death is hemorrhagic shock, which is caused by the lack of timely blood transfusion. In the more than two hours of maternal resuscitation. Including the mother of the mother's family outside the operating room crying into a ball, repeatedly begged the hospital to draw their own blood to save their loved ones, all were hospital refused, the reason is that the blood collection must be carried out according to law, the county hospital does not have the right to blood used for clinical purposes.
The same tragedy happened again in June 5, Xinfu District, Xinzhou City, Shandong Province, 36-year-old villager Zhang Jianfang, 8:30 pm or so in Xinzhou City Central Hospital gave birth to a baby. After delivery, medical personnel were unable to remove the placenta for a while, and postpartum hemorrhage occurred. Doctors then arranged for personnel and family members to go to the city center blood bank to get plasma, the evening around 11:00 p.m. to get plasma, maternal has been unable to save, died at about 11:30 p.m. that night.
Case three
June 8, 2005, the mother of Ruan Huailian in Kunming, Yunnan Province, Dongchuan District People's Hospital after a cesarean section, uterine hemorrhage, the need for emergency blood transfusion. At that time, the hospital did not store AB blood, looking for voluntary blood donors and unsuccessful, Dongchuan District People's Hospital Tan Zhongneng, president of the telephone to obtain the consent of the leadership of the District Health Bureau, agreed to the attending physician Lu Xinhua voluntary blood donation of 200 ml, so that Ruan Huailian turned from a critical situation to a safe one. Dr. Lu's righteousness, the patient and his family are grateful, the hospital is ready to recognize her, Dr. Lu politely declined.
However, on August 15, the hospital received the Provincial Department of Health issued an "administrative penalty decision", that the hospital did not have a blood supply license, blood collection and supply behavior is illegal, and ordered the hospital to immediately rectify the situation, and imposed a fine of 60,000 yuan. According to the provincial health department: December 17, 2004 to June 16, 2005, this hospital for seven patients with hemorrhage for temporary emergency blood collection, two of which were not reported to the Dongchuan District health administrative department for the record. 2004 September to June 2005, the hospital self-picked 6,200 milliliters of blood used for clinical purposes.
In this regard, Dongchuan District People's Hospital Director Tan Zhongneng explained that the hospital repeatedly temporary emergency blood collection is a last resort. 2004 September, Dongchuan District, according to the law was withdrawn from the blood collection station, the district's medical institutions, clinical blood supply unified by the Kunming Blood Center. Dongchuan District is 160 kilometers away from Kunming, the blood round trip takes 5 to 6 hours, may delay the emergency rescue of some critically ill patients. The blood supply from the Kunming Blood Center was insufficient, and the hospital was unable to supply the plasma requested by the hospital for many times. Moreover, it is difficult to estimate the blood plan, and there is often a lack of blood.
From the above three cases, we can see that, because the blood crisis is a direct threat to the lives of women and babies, the former take the national law as a shield, and feel comfortable to watch the pregnant women and babies sitting ducks, in compliance with the law to let life pass. The latter, in violation of the law was punished, but to save the life of the mother. If the people's hospital in Dongchuan District, Kunming City, according to the rules, we see the possibility of the same results as the previous case.
We often say that the law is unfeeling, and indeed, the law is unfeeling. From a legal point of view, these hospitals in the issue of blood transfusion refused the patient's family for the request of their loved ones blood transfusion is not at fault, can be counted on the hospital and above in the implementation of the law gives them the right. But seriously think about it, things are far from legal or illegal so simple. China's "Blood Donation Law" provides that in order to ensure emergency blood, medical institutions can temporarily collect blood, but should be in accordance with the provisions of the law to ensure the safety of blood collection and use of blood. The Ministry of Health has a three unified principles: medical institutions can collect blood when the following conditions exist: 1. medical institutions in remote areas and the location of no blood station (or central blood bank); 2. critical patients in urgent need of blood transfusion, and other medical measures can not be replaced; 3. with cross-matching and rapid diagnostic methods of testing the surface antigen of the hepatitis B virus, the antibody to the hepatitis C virus, the antibody to the AIDS virus (c) The conditions of the blood transfusion. That is to say, the law has already made provisions to deal with the emergencies that may occur in the process of treating the sick and saving the lives of the citizens for the sake of the safety of the lives of the citizens. It is not impossible to collect blood on an ad hoc basis, and it is possible to do so with the three principles of harmonization in place.
When I say this, I'm sure there will be some opposition from people who will argue that if hospitals have the three harmonized conditions, how can they not collect blood temporarily to save patients? And in fact, the contradiction lies precisely here, for the hospital, it is difficult to meet the three unified conditions is a rapid diagnostic method to test the surface antigen of hepatitis B virus, hepatitis C virus antibody, HIV antibody. If we hastily take temporary blood collection to rescue patients, because blood safety issues will leave too many uncertainties and trouble in the future. We can understand this problem, but why don't we consider all the issues thoroughly before performing surgery on the patient? If there had been adequate preoperative preparation and more anticipation of possible problems, it would not have been possible to cut open the mother's stomach before thinking of the problem of insufficient blood.
According to statistics, there are more than 500,000 maternal deaths globally each year, 99% of which are in developing countries, and 25% of which are due to hemorrhage during childbirth, so it's not uncommon to see hemorrhage during childbirth. For hospitals, the first thing to think about is whether you have the ability to control and manage sudden maternal hemorrhage, not just for the sake of making money regardless of the consequences. As in Case 1, the doctor decided to perform a cesarean section before the blood readiness to do a little understanding, even if the hospital and the blood bank have no plasma match with the mother, the first request for emergency allocation of the Baotou Central Blood Station can also be too late. This side has been on the maternal knife, the blood can not be stopped before thinking of plasma, temporary clasp the head in a hurry will not help. Obviously the hospital's own responsibility, facing a life-and-death decision not to find ways to take remedial measures, this time to think of the blood qualification to take the national law to cover up the doctor's mistakes. You say this is caused by blood transfusion contradictions?
Once to save lives and help the wounded proud of the white angel, now also has been full of brass breath, for them, the patient is the basis of its creation of economic benefits and protection. Needless to say, in the past, the cost of having a child and today's consumption compared to the world of difference, the economic interests of the drive so that they put the patient's life in the first place, do not take the birth of a child as a matter of priority, smooth and smooth everyone is safe and sound, an encounter with the unexpected situation on the hands and feet, which has the technical aspects of the reasons, but more is the problem of the mind. Therefore, the discussion of this issue can not see the surface of the blood transfusion contradiction to talk about the ruthlessness of the law, in fact, is too much human fault attributed to the ruthlessness of the law, obviously this is not accurate.