胎心音監測過失案：別讓醫師成了代罪羔羊！談醫療機構組織責任【學習式判解評析】 試閱
Negligence in Fetal Heart Beat Monitoring : Don't Let Physicians Become Scapegoats! A Discussion on the Organizational Liability of Medical Institutions
本案涉及醫院垂直分工運作，以及關鍵胎心音紀錄因醫院硬碟故障與行政流程缺失而滅失之爭議。高等法院雖基於武器平等原則將舉證責任倒置，惟未精確區辨「個人診療過失」與「機構系統性錯誤」，致使個別醫師被迫承擔不可歸責於己之組織過失責任。本文主張應引入「醫療機構組織責任」法理，確認垂直分工之監督管理、病歷保存及設備維護等，係屬醫療機構之獨立組織義務。對於違反組織義務者，應由醫療機構獨立負侵權責任，或單獨承擔證據滅失所生之不利益，藉此將醫師個人責任與機構組織責任脫鉤，避免個別醫師淪為體制缺失的代罪羔羊。
This article discusses a medical malpractice case involving the vertical division of labor and the controversy surrounding the spoliation of critical fetal heart monitoring records due to hospital hard drive failure and administrative flaws. Although the High Court shifted the burden of proof to the defendants based on the principle of equality of arms, it failed to clearly distinguish between “individual clinical negligence” and “institutional systemic errors.” Consequently, individual physicians are forced to bear liability for organizational faults that are not attributable to them. This article advocates for the introduction of “Medical Institution Organizational Liability”, asserting that the supervision of vertical division of labor, preservation of medical records, and maintenance of equipment are independent organizational duties of the medical institution. Liability or procedural disadvantages arising from the breach of these duties—such as the loss of evidence—should be borne solely by the medical institution. Decoupling individual physician liability from institutional organizational liability is essential to prevent individual physicians from becoming scapegoats for systemic deficiencies.
078-096
