胎盤早期剝離造成後遺症因果關係之認定【寰宇醫事裁判】 試閱
Identifying the Causality between Early Placenta Abruption and Its After-Effects
產婦X1於被告醫院就診並服用安胎藥（Ritodrine）。分娩當日，X1兩次致電被告醫院有下腹痛與嘔吐症狀，且經被告A醫師指示用藥後仍未改善。當日7時X1抵達醫院，7時10分A醫師進行一般性檢查；7時20分助產士未能成功安裝分娩監測裝置，故25分由A醫師親自安裝並以超音波監測胎兒心率，30分發現胎兒心率嚴重過低。7時45分A醫師仍投與安胎藥卻未改善症狀，8時整懷疑是胎盤早期剝離而決定緊急剖腹。8時45分剖腹產出胎兒X3，但其已心跳停止，經急救後恢復心跳，卻因腦性麻痺等後遺症而需他人全日照顧。產婦X1、其夫X2與嬰兒X3起訴A醫師，認其有過失。法院認為，A醫師確實未能即時使用分娩監測裝置、未能盡早決定緊急剖腹而有過失；惟投與安胎藥是為了緊急剖腹，故其無過失。法院亦認為A醫師過失與X3後遺症並無因果關係，但仍有減輕X3後遺症之可能性，而仍判A醫師應賠償原告之損害。
A pregnant woman X1 was seen by the hospital as a defendant and was administered Ritodrine, an antiretroviral drug. On the day of delivery, X1 called the hospital twice with symptoms of lower abdominal pain and vomiting, which didn’t improve despite of the instruction of physician A as a defendant to administer medication. X1 arrived at the hospital at 7:00 on the day of delivery; at 7:10, A performed a general examination; at 7:20, the midwife failed to install the fetal monitoring device, so A installed a ultrasound monitoring device at 7:25 by himself to monitor the fetal heart rate, which was found at 7:30 to be grossly inadequate. At 7:45, A administered antitussive medication and yet the symptom couldn’t be improved; at 8:00, an emergency cesarean section was ordered for suspected placenta abruption. At 8:45, the cesarean section was performed to deliver the fetus X3, who was in cardiac arrest and resumed cardiac arrest after resuscitation, but required full-time care due to the cerebral and other sequelae. Maternity X1, her husband X2 and the baby X3 sued A for medical negligence consequently. The court held that A was negligent for failing to install the fetal monitoring device immediately and for failing to decide on tan emergency cesarean section as soon as possible. On the other hand, it was for the emergency cesarean section to administer the Ritodrine and there was no negligence. Furthermore, the court held that even though there was no causality between the negligence of A and the sequalae of X3, there might be possible to mitigate it if A didn’t practice negligently. A had to compensate the damage of the plaintiffs therefore.
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