Abnormal findings in men's physical examination have not been reported

Nanjing citizen Qi Qi went to a hospital in the city for physical examination. The reference index for lung cancer was positive. However, there were no specific prompts in the conclusion of the physical examination report issued by the hospital, and he was not recommended to review it. Mr. Qi was also not seriously involved. He knew that after two years, he did not attend the hospital and was diagnosed with lung cancer. At the beginning of 2012, Mr. Qi sued the medical examination hospital to the court and demanded compensation for all treatment expenses of more than 230,000 yuan and mental loss of 50,000 yuan.

The court of first instance found that the hospital did not fulfill its duty of prompting, but there was no causal relationship with his cancer, and the hospital was awarded compensation for Mr. Qi’s mental loss of 50,000 yuan. Mr. Qi’s family disapproved and appealed, and the court of second instance upheld the original verdict. But before the results came out, Mr. Qi had already passed away.

Physical discomfort, a review of lung cancer late replay two years ago: positive has been checked, the hospital did not remind

In August 2011, Mr. Qi, a 56-year-old citizen in Nanjing, always felt uncomfortable breathing. He came to a hospital in downtown Nanjing, the diagnosis made him unacceptable, even advanced lung cancer. The doctor said that there has been a brain metastasis and missed the best treatment opportunity. At that time, the doctor reminded Mr. Qi that he had not done the corresponding check before? He remembered that the unit had organized a physical examination two years ago, including a cancer project. Only he remembered that there was nothing special about this item and no doctor reminded him anything.

He went home and found the test report at that time. The result of the cancer reference indicator CEA (CEA indicator) was impressively written - positive!

That was in August 2009. Mr. Qi went to a hospital in Hexi for physical examination and received a medical report in September. In the column of tumor markers, "The test result of CEA index is positive". Later, doctors described cancer antigens as a tumor marker that could reflect the presence of many types of tumors, with positives representing diseases or viruses. In the conclusion of the general inspection, the hospital made explicit recommendations on some diseases such as hypertension and rhinitis, and did not mention the issue of cancer. Mr. Qi was not seriously involved and did not conduct any review afterwards.

Sue the hospital and demand compensation of 280,000 for two controversial points: Is there a fault in the medical examination? Is there a causal relationship with cancer?

Although missed the opportunity of surgery, Mr. Qi still tried to receive treatment and spent more than 230,000 yuan. Years of savings are almost spent and the condition is still serious. Mr. Qi’s family was informed that although the test was positive at the time, cancer could not be determined, but only a relatively high risk of cancer. Well, if you actively examine the treatment at that time, cancer may be completely cured. It was precisely because the hospital had not reminded itself at the time that it was causing the current evils. "This is a major hospital error!"

According to media reports at the time, a director of the hospital interviewed said: “The report was written by a 60-year-old retired director who wanted to see hundreds of reports on his computer. He was negligent to understand.” Mr. Qi was infuriated by this. He filed a lawsuit in the court and demanded that the hospital providing medical examinations at the time pay his own medical expenses of more than 230,000 yuan and 50,000 yuan for spiritual soothing payment, and asked the hospital to apologize to him. The court accepted the medical injury dispute.

After investigation, the court found that the health examination report issued by the hospital had no description or suggestion about its positive signs and abnormal conditions. The hospital did not make any special prompts, including asking Mr. Qi to make further inspections. According to Article 14 of the Provisional Regulations for Health Examination of the Ministry of Health, “the report shall include general information of the examinee, physical examination records, records of positive physical signs and abnormal conditions, and relevant recommendations”. Contrary to this provision, the hospital did not notice any discrepancy with the positive signs. The court found that the hospital's medical examination was faulty.

In addition, the family of Mr. Qi believes that the negligence of the medical examination hospital directly led Mr. Qi to miss the opportunity for treatment. The two parties hold their own words. The court consulted a number of medical experts. According to experts, CEA is not a specific indicator for the diagnosis of lung cancer, but a reference indicator. In addition, experts believe that he discovered that he had lung cancer in August 2011. It has been two years since the physical examination. It is impossible to determine the causal relationship between lung cancer and the medical examination of the hospital.

The court held that the opinions of the pooled experts are based on years of clinical practice experience and have certain reference value. It is believed that the causal relationship between the hospital's dereliction of duty and Mr Qi’s early detection of cancer cannot be established.

Court decision:

There is a medical examination in the hospital supporting 50,000 yuan in mental loss

The court held that since the medical examination of the hospital was not directly related to Mr. Qi’s cancer, Mr. Qi’s treatment costs are the fees that must be paid for the treatment of his own illness. Therefore, the hospital did not have the responsibility of paying medical expenses and apologizing.

However, Mr. Qi’s behavior in physical examination in hospitals is for his own health and improves the quality of life. The medical examination of the hospital damaged Mr. Qi’s health expectations and led him to lose the opportunity for further examination. The hospital was required to pay Qi’s mental soothing payment of RMB 50,000.

Mr. Qi’s family was dissatisfied with the verdict and appealed to the Nanjing Intermediate People’s Court. However, the Intermediate Court still maintained the original judgment. According to the judge, it was regrettable that Mr. Qi had passed away due to illness before the outcome of the second instance verdict.

This case tells us more...

What are the indicators of physical examination easily overlooked?

1. In the medical examination report, the word "ophthalmology" in the "Ophthalmology" column should be selected for eye examination for glaucoma.

2. The pulmonary nodules are only a few millimeters in size and have no clinical symptoms. The test tumor markers are also negative. The doctor will also recommend regular review to track the changes in the nodules.

3, many people give up the anal finger examination and stool routine examination. In fact, rectal examination can find diseases such as rectal cancer and prostate cancer. The stool routine mainly includes stool color, morphology, cells, and occult blood, and has important reference value for the diagnosis of digestive system diseases and benign and malignant tumors. Such as fecal occult blood positive, suggesting that there may be gastrointestinal tumors or ulcers.

4 It is advisable that everyone should save the medical examination report every year. After the new report comes out, it is read together with the previous years to see the trends of some indicators and what new changes have been made.

What items need to be added outside the routine medical examination?

1 Ms. should increase the gynecological examination, uterus attachment B ultrasound and other specialist examinations, men should check the prostate regularly.

2 40-year-old or older can increase blood viscosity examination and other items to prevent the occurrence of stroke. People over the age of 50, especially those with a family history of colorectal neoplasms, should consider anal screening and colonoscopy.

3 After middle age, people with high blood lipids, little exercise, and family history are high-risk groups with heart problems, and they should improve their heart examinations.

Why should we attach importance to the screening of tumor markers?

What is a "tumor marker"? Experts from the Department of Oncology of the People's Hospital of Jiangsu Province said that tumor markers are specific substances that are produced or secreted by the tumor cells and released into the blood, cells, and body fluids in the process of tumor development and proliferation, reflecting the presence and growth of tumors. Detecting whether various tumor markers are elevated in the blood can identify and identify various malignant tumors, which provides a possible way to achieve early detection of tumors.

Generally, the smaller the number, the better. If within the reference range, close to or slightly exceed the upper limit, and your family has a history of cancer, it is advisable to perform a review within 1-3 months. If during the review process, the data of some projects continues to rise, further inspections are required.

However, the increased indicators of tumor markers does not necessarily mean that they have cancer! Sometimes inflammation or other causes can also cause indicators to rise. If blood tests show that the CA125 tumor marker rises, it may mean that the patient has ovarian cancer; but it may also be pelvic inflammation, liver disease, and may even be caused by menstruation or pregnancy.