腦腫瘤栓塞術致死二審逆轉判賠【寰宇醫事裁判】 試閱
A Death Case Due to Surgery for Brain Tumor Embolization Reversed in the Second Instance
患有輕度蜘蛛膜下腔出血之X，於2013年接受被告Y施行腦腫瘤栓塞手術；卻疑因線圈刺穿腦腫瘤左葉，致X腦血管再度破裂而亡，被告Y並未進行開顱手術予以搶救。原告X遺囑主張，被告Y並未於術前說明X之腦腫瘤有分左右葉，也未說明手術當下無法變更術式，因此才採信被告Y之建議而選擇栓塞術；若事前知有破裂危險，則不會選擇栓塞術。一審廣島地方法院判決原告敗訴，但二審廣島高等法院判決原告勝訴。蓋因被告Y確實未於術前說明X之身體狀況、手術之困難與危險性，但此違反說明義務與死亡結果無因果關係；其次，因高等法院認為「線圈置入血管必須形成立體框架」為一般醫療慣行，被告Y未達此水準又線圈口徑選擇錯誤，故違反注意義務而致X死亡；被告Y應負損害賠償責任。
X, who suffered from a mild subsarcoid hemorrhage, underwent a surgery for brain tumor embolization Y as the accused in 2013; however, it is suspected that the coil pierced the left lobe of the brain tumor, causing X’s cerebral blood vessel to rupture again and he died, but Y did not perform a craniotomy to save him. Plaintiff X’s will states that Y did not inform before the surgery that X’s brain tumor was divided into right and left lobes and that it was not possible to change the surgical procedure at that moment, so he chose embolization on the advice of Defendant Y. If he had known the risk of rupture beforehand, he wouldn’t have chosen embolization. The Hiroshima District Court ruled against the plaintiff in the first trial, but the Hiroshima High Court ruled in favor of the plaintiff in the second instance. Y didn’t disclose X’s physical condition and the difficulties as well as dangers of the surgery before it, but this breach of duty of disclosure wasn’t related to the result of death causally; secondly, the High Court held that “the placement of a coil into a blood vessel must form a three-dimensional frame” is a general medical practice, and Y failed to meet this standard and chose the wrong diameter of the coil, thus breaching the duty of care and causing X’s death. Y is therefore liable for damages.
084-090
