轉移性癌症的追蹤觀察義務與因果關係【寰宇醫事裁判】 試閱
On Duty of Follow-Up and Observation of metastatic Cancer and its Causality
患者A於1990年12月18日接受被告醫師B的大腸X光檢查，雖A盲腸部分有顆粒狀變化，惟被告B考慮患者高齡及先前闌尾切除術後沾黏，而僅建議定期追蹤，並不安排大腸鏡檢查。直至1993年5月，A方才到院就診，惟無自覺症狀而B也未安排檢查；隔年5月12日，B才為A進行血液與糞便檢查，結果均為正常。1994年11月16日A之癌症指數極高，並經檢查而確定為肝癌，並出現相關症狀，至同年12月1日B診斷為腸下垂。最終A確診為大腸癌之肝轉移，雖經手術救治仍死亡。法院認為，B建議定期追蹤而為安排大腸鏡有其合理性，卻怠於追蹤觀察義務之履行，亦未診斷大腸癌之肝轉移，固有注意義務之違反，卻與A死亡結果並無因果關係，故A之繼承人原告X敗訴。
On December 18th 1990, patient A underwent a colon x-ray examination conducted by physician B as the defendant. Although there were granular changes in part of A’s cecum, B recommended regular follow-up, taking into account the patient’s age and previous post-appendectomy adhesions. A colonoscopy was not scheduled at that time. It appears that A did not seek medical consultation until May 1993. Although there were no symptoms at the time, B did not arrange for an examination. On May 12th of the following year, B conducted blood and stool tests on A, and the results were normal. However, on November 16th, 1994, A’s cancer index was found to be extremely high, and A was diagnosed with liver cancer and associated symptoms. Furthermore, on December 1st of the same year, B diagnosed A with intestinal prolapse. A eventually died despite receiving surgical intervention for hepatic metastasis of colorectal cancer. The court held that B’s recommendation to schedule a colonoscopy for regular follow-up was reasonable. However, it was found that B did not fulfill their obligation of follow-up and observation, and failed to diagnose liver metastasis of colorectal cancer. This was considered a breach of the duty of care, but it was not causally related to the result of A’s death. Consequently, Plaintiff X, A’s heir, did not succeed in the lawsuit.
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