使用催產劑違反分娩監視義務事例【寰宇醫事裁判】 試閱
A Case of Using Oxytocic which Violates the Obligation to Monitor the Delivery
原告產婦產檢期間，胎兒均無異常；破水後入院待產，由被告催生。被告於18時至22時，以每小時一次、共五次頻率投與口服前列腺素；22時22分又投與催產素，隨後調整投藥速度。被告並未使用分娩監視裝置，而僅片段性地監控胎心音。22時45分胎兒心率下降，被告以吸引方式處置，而令原告23時8分自然產出。胎兒出生後因呼吸困難而轉院，嗣後診斷缺氧性腦病變，並於4年後死亡。原告因而向被告訴請損害賠償。法院認為，依藥品使用單與醫學會報，被告違反催產素與前列腺素使用規則、亦未使用監視方式；惟被告雖有過失，但鑑於胎兒出生當下並無異常、原告子宮並無過度收縮且被告吸引處置迅速，因此被告過失行為與損害無因果關係，至多有相當程度之可能性。
The plaintiff’s labor examination revealed no fetal abnormalities; after her water broke, she was admitted to hospital to await delivery and the defendant induced labor. The defendant administered oral prostaglandin five times per hour between 6:00 p.m. and 10:00 p.m., and oxytocin at 10:22 p.m., and then adjusted the rate of administration. The defendant did not use a fetal monitor and only monitored the fetal heart rate intermittently. At 10:45 p.m., the fetal heart rate dropped, and defendant treated the fetus with suction, resulting in plaintiff ’s spontaneous delivery at 11:08 p.m. After birth, the fetus was taken to the hospital for respiratory distress and was subsequently diagnosed with anoxic encephalopathy and died four years later. The plaintiff claimed damages from the defendant. The court found that the defendant had violated the rules for the use of oxytocin and prostaglandin and had failed to use monitoring methods in accordance with the list of drugs to be used and the report of the medical association; however, although the defendant was negligent, given that the fetus was not abnormal at the time of birth, the plaintiff ’s uterus was not excessively contracted, and the defendant attracted prompt treatment, the defendant’s negligent conduct was not causally related to the damages and there was at most a substantial degree of probability.
096-101
