Case 1
On April 6, 2007, Hu Hailong, a villager from Damao Banner, Inner Mongolia, sent his wife Li Lintao to the Maternal and Child Health Hospital of this banner to give birth. At the time of admission, the pregnant woman and fetus were in normal condition. But after more than two hours of hard work, the child was still not born. The doctor decided to have a caesarean section. At about 2 pm, it took Hu Hailong time to hand in blood, only to know that neither the hospital nor the Damaoqi blood bank had the same blood type as his wife, and they had to be transported from the blood station in Baotou city center. Because the blood station in the center of Baotou is a certain distance away from Damaoqi (it takes about 3 hours to get to the speed limit section at the earliest), the situation is critical, and the family members asked them to take blood themselves, but the hospital refused to agree on the grounds that "it is not allowed to take blood privately according to regulations". However, when the parturient needs blood transfusion under anesthesia, there is no blood source. When the blood station in the center of Baotou sent 1000 ml of blood into the maternal body, it was already three hours later, that is, more than 5 pm that day. After blood transfusion, the parturient had blood pressure. When the second blood transfusion was about 18, the parturient's breathing and heartbeat had stopped. Hu Hailong was told that neither children nor adults were raised. ...
Comprehensive analysis shows that the death of Li Lintao's mother and son was mainly caused by untimely blood transfusion. This case has constituted a first-class medical accident, and the hospital is mainly responsible. In other words, if there was enough blood to match the maternal blood type, Li Lintao and her son would not have died. The direct reason is that the blood bank of Damaoqi, which is responsible for the blood supply of Damaoqi, has no blood matching the maternal blood type. Because the blood bank in Damaoqi only has the function of storing blood and supplying blood, the blood stored in the blood bank needs to be submitted to the blood storage plan, which will be collected and distributed by the blood bank in Baotou city center. The day before Li Lintao's operation, an operation in Damaoqi Hospital used up the reserve blood of the blood bank, and the reserve blood was not replenished in time. According to relevant laws and regulations, blood banks are not allowed to collect blood, and maternal and child health hospitals are not qualified to collect blood. They can only watch the parturient step by step towards death, hoping that life-saving blood will come soon.
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At midnight on March 25, 2007, pregnant woman Cheng Guiyun suddenly felt abdominal pain and appeared labor symptoms. Because her husband Wu Zhongshan was not at home, the neighbor took Cheng to Hequ County People's Hospital in Shandong Province by motorcycle. After getting off the bus, Cheng Guiyun walked into obstetrics and gynecology. The doctor on duty immediately carries out routine prenatal examination. 1: 30, Cheng Guiyun had dystocia and bleeding symptoms. After more than an hour of preoperative preparation, Cheng Guiyun began to receive anesthesia at 3: 10. At 3: 40, Wu Zhongshan's brother Wu Zhongxiong signed on behalf of his family, and Cheng Guiyun started caesarean section. During the two-hour operation, the mother was bleeding, and the amount of bleeding was as high as 4000 ml. After using up two bags of type B plasma prepared in advance, she went to the laboratory in the technical building of the hospital to draw blood, and the plasma was gone. The doctor asked Cheng Guiyun's sister-in-law to run to the laboratory to draw blood. During the operation, because there is no plasma in the clinic, the surgical wound is bleeding, so the doctor can only temporarily maintain blood pressure with plasma substitutes and report to the dean on duty immediately. Near 6 o'clock in the morning, Ma Qingyun, the vice president on duty, called Li Meiqin, deputy section chief of hospital inspection, contacted Wuzhai blood supply point of Xinzhou blood station and quickly transported the plasma to Hequ County People's Hospital. Life-saving plasma arrived at Hequ People's Hospital more than two hours after receiving the transfer order, but it was useless.
The main cause of maternal death is hemorrhagic shock, which is caused by untimely blood transfusion. In more than two hours to save the mother. Family members, including maternal mothers, cried outside the operating room and repeatedly begged the hospital to draw blood to save their loved ones. All of them were rejected by the hospital on the grounds that blood collection must be carried out according to law, and county hospitals have no right to draw blood for clinical use.
The same tragedy happened again. On June 5th, Zhang Jianfang, a 36-year-old villager from Beiyijing Village, Xinfu District, Xinzhou City, Shandong Province, gave birth to a baby at Xinzhou Central Hospital around 8: 30 pm. After delivery, the medical staff could not take out the placenta for a while, resulting in postpartum hemorrhage. The doctor immediately arranged for the staff and their families to go to the blood bank in the city center to get plasma. When the plasma was taken at about 1 1 that night, the mother could not be treated and died at about 1 1: 30 that night.
Case 3
On June 8, 2005, the parturient Ruan Huailian suffered from uterine bleeding after caesarean section in Dongchuan District People's Hospital, Kunming City, Yunnan Province, and needed emergency blood transfusion. At that time, the hospital did not store AB blood, and it was unsuccessful to find a voluntary blood donor. Dean Tan Zhongneng of Dongchuan District People's Hospital, with the consent of the leaders of the District Health Bureau, agreed to donate 200 ml of blood to the attending doctor Lu Xinhua on the phone, so that Ruan Huailian turned the corner. The patient and his family are very grateful to Dr. Lu for his kindness. The hospital prepared to commend her, but Dr. Lu declined politely.
However, on August 15, the hospital received the "Decision on Administrative Punishment" issued by the Provincial Health Department, and found that the hospital had no blood collection and supply license, and the blood collection and supply behavior was illegal, ordered the hospital to immediately rectify and fined 60,000 yuan. According to the provincial health department, from June 65438+February 2004 17 to June 2005 16, our hospital carried out temporary emergency blood sampling on 7 patients with massive hemorrhage, of which 2 cases were not reported to the health administrative department of Dongchuan District for the record. From September 2004 to June 2005, the hospital collected 6200 ml of blood for clinical use. Article 18 of the Blood Donation Law of People's Republic of China (PRC) stipulates that illegal blood collection shall be banned by the health administrative department of the local people's government at or above the county level, the illegal income shall be confiscated, and a fine of less than100000 yuan may be imposed.
In this regard, Tan Zhongneng, dean of Dongchuan District People's Hospital, explained that it was a last resort for the hospital to take blood temporarily and urgently for many times. In September 2004, after the blood collection and supply station in Dongchuan District was revoked according to law, the first batch of clinical blood for medical institutions in this district was supplied by Kunming Blood Center. Dongchuan District is 0/60km away from Kunming/KLOC-,and it takes 5-6 hours to draw blood back and forth, which may delay the emergency rescue of some critically ill patients. The blood source of the blood station in Kunming city center is insufficient, so it can't supply the plasma required by the hospital many times. Moreover, the blood use plan is difficult to predict, and ischemia often occurs.
As can be seen from the above three cases, because the blood crisis directly threatens the lives of mothers and babies, the former takes national laws as a shield, watching pregnant women and babies sit back and wait with peace of mind, and letting their lives disappear in law-abiding. The latter was punished for violating the law, which saved the maternal life. If the Dongchuan District People's Hospital of Kunming follows the regulations, we may see the same result as the previous case.
We often say that the law is merciless. Indeed, the law is merciless. From a legal point of view, it is not wrong for these hospitals to refuse patients' family members' requests for blood transfusion for their loved ones, which can be regarded as the rights given to them by hospitals and above when enforcing the law. But when you think about it, things are far from legal or illegal. China's "Blood Donation Law" stipulates that in order to ensure emergency use of blood, medical institutions may temporarily collect blood, but it shall comply with the provisions of this law to ensure the safety of blood collection. The Ministry of Health has three unified principles: medical institutions can collect blood if they meet the following conditions: 1. There are no blood banks (or central blood banks) in medical institutions and places in remote areas; 2. The life of critically ill patients is in urgent need of blood transfusion, which cannot be replaced by other medical measures; 3. Have the conditions of cross matching and rapid diagnosis, and detect hepatitis B virus surface antigen, hepatitis C virus antibody and HIV antibody. In other words, for the safety of citizens' lives, the law provides for the handling of emergencies that may occur in the process of saving lives. It is not impossible to take blood temporarily, but it is completely possible under the condition of having three unified principles.
When I say this, I will definitely be opposed by some people. They will think: if the hospital has three unified conditions, how can they not take blood temporarily to save patients? In fact, this is precisely the contradiction. For hospitals, it is difficult for rapid diagnostic methods to detect hepatitis B virus surface antigen, hepatitis C virus antibody and HIV antibody to meet the three unified conditions. If we rashly take temporary blood collection to rescue patients, because blood safety problems will leave too many uncertain hidden dangers and troubles in the future. We can understand this problem, but why not consider all the problems before operating on the patient? If the preoperative preparation is sufficient and the possible problems are predicted more, it is impossible to think of the problem of insufficient blood use after cutting the pregnant woman's stomach.
According to statistics, more than 500,000 pregnant women die every year in the world, 99% of them are in developing countries, and 25% die of massive bleeding during childbirth. It can be seen that massive bleeding during childbirth is not uncommon for pregnant women. For hospitals, first of all, we should think about whether we have the ability to control and deal with sudden massive bleeding of pregnant women, not just to make money regardless of the consequences. For example, in the first case, doctors should know the blood preparation before deciding to have a caesarean section. Even if hospitals and blood banks don't have plasma matching with pregnant women, it's too late to find the blood bank in Baotou city for emergency allocation first. I have operated on the pregnant women here, and I didn't think about plasma until the bleeding stopped. It's no use cramming at the last minute. Obviously, it is the responsibility of the hospital itself. When faced with the choice between life and death, it does not try to take remedial measures. At this time, I remembered the qualification of blood collection and used national laws to cover up the doctor's mistakes. Do you think this is caused by the contradiction of blood transfusion?
Angels in white, once proud of saving lives, is now stinking with copper. For them, patients are the foundation and guarantee for creating economic benefits. Needless to say, the cost of having children in the past is very different from today's consumption. Driven by economic interests, they put the patient's life first and don't take giving birth seriously. Everything goes smoothly and they are at a loss when they encounter unexpected situations. There are technical reasons for this, but more are ideological problems. Therefore, when discussing this issue, we cannot talk about the ruthlessness of the law without seeing the obvious contradiction of blood transfusion. In fact, it is obviously inaccurate that we blame too many human errors on the ruthlessness of the law.