Analysis of Medical Disputes Related to Bone Plate Fixation Surgery

Common Causes of Disputes in Bone Plate Fixation Surgery

Surgical Technique Deficiencies

In a case involving a 13-year-old female patient with a left forearm double fracture, the medical institution only fixed the radius and ignored the ulna during the initial surgery. This non-standard surgical approach failed to ensure proper alignment and stability of both fractures. As a result, the unfixed ulna was prone to displacement, leading to complications such as bone nonunion and implant failure. During the second surgery, the medical staff also neglected to perform bone grafting at the fracture site, which is a crucial step to promote bone healing and prevent delayed union or nonunion. This case highlights that improper surgical techniques, including incomplete fixation and failure to follow established protocols, are significant causes of medical disputes in bone plate fixation surgery.

Implant Quality Issues

In a 1998 case, a patient underwent bone plate fixation surgery for a right lower leg fracture. However, the steel plate and screws used were later found to be of substandard quality through professional testing. The poor-quality implants led to complications such as plate bending, screw breakage, and fracture displacement, forcing the patient to undergo a second surgery. This incident underscores the importance of implant quality in bone plate fixation surgery. Medical institutions have a responsibility to ensure that the implants they use are of high quality and meet relevant standards to avoid such disputes.

Postoperative Management and Rehabilitation Neglect

In a case involving a patient with a humeral condyle fracture, the patient and their family did not follow the doctor’s instructions for postoperative rehabilitation, such as not performing timely and proper functional exercises. Additionally, the patient left the hospital prematurely after the second surgery, disrupting the planned rehabilitation program. Although the medical institution’s initial diagnosis and surgical approach were appropriate, the patient’s non-compliance and premature discharge contributed to the limited range of motion in the affected elbow joint. This case shows that while medical institutions play a crucial role in treatment, patients’ active participation in postoperative rehabilitation is equally important. When disputes arise due to such factors, it becomes complex to determine liability.

Legal Liability Determination in Medical Disputes

Medical Institution’s Liability Based on Fault Principle

In most medical disputes related to bone plate fixation surgery, the liability of medical institutions is determined based on the fault principle. If a medical institution’s surgical technique is deficient, such as improper implant placement, incomplete fixation, or failure to perform necessary procedures like bone grafting, and these deficiencies are directly related to the patient’s adverse outcomes, the medical institution will be held liable. For example, in the case of the 13-year-old female patient with a forearm double fracture, the medical institution’s failure to fix both bones and perform bone grafting during the second surgery was deemed as negligence, and it was held primarily responsible for the patient’s prolonged treatment and functional impairment.

Product Liability of Implant Manufacturers

When implant quality issues lead to medical disputes, implant manufacturers may also be held liable. If it can be proven that the implants used in the surgery are defective or do not meet quality standards, and these defects are the direct cause of the patient’s complications, the manufacturer should bear corresponding赔偿责任. In the 1998 case of the right lower leg fracture, although the medical institution used the substandard implants, the manufacturer of the steel plate and screws was also found to be at fault for producing and supplying defective products, and both the medical institution and the manufacturer were held liable to varying degrees.

Patient’s Own Contributory Negligence

In some cases, patients’ own actions or omissions may contribute to the occurrence of disputes. For example, if patients do not follow the doctor’s instructions for postoperative rehabilitation, engage in strenuous activities prematurely, or fail to attend follow-up appointments regularly, these behaviors may affect the surgical outcome and rehabilitation progress. When determining liability, the patient’s contributory negligence will be taken into account, and the medical institution’s liability may be reduced accordingly. However, the medical institution still has an obligation to adequately inform patients about postoperative precautions and rehabilitation plans and to provide necessary guidance and supervision.

Strategies for Resolving Medical Disputes

Mediation and Negotiation

Mediation and negotiation are common methods for resolving medical disputes related to bone plate fixation surgery. Through mediation, a neutral third party can facilitate communication between the medical institution and the patient, helping both parties understand each other’s positions and interests. In negotiation, the medical institution and the patient can directly discuss compensation and other issues to reach a mutually acceptable agreement. These methods have the advantages of being time-saving, cost-effective, and maintaining a good relationship between the parties. For example, in some cases, after mediation, the medical institution may agree to provide free follow-up treatment, cover certain medical expenses, or offer appropriate compensation to the patient, thereby resolving the dispute amicably.

Medical Malpractice Identification

When mediation and negotiation fail, medical malpractice identification becomes a crucial step in resolving disputes. Professional medical malpractice identification institutions will conduct a comprehensive assessment of the medical process, including preoperative diagnosis, surgical technique, implant selection, and postoperative management. Based on the identification results, it can be determined whether the medical institution has violated medical regulations and norms and whether there is a causal relationship between its actions and the patient’s adverse outcomes. The identification report provides a scientific and objective basis for subsequent legal proceedings and helps ensure fair and just resolution of the dispute.

Legal Proceedings

If the dispute cannot be resolved through mediation, negotiation, or medical malpractice identification, the patient can initiate legal proceedings. In court, both parties will present evidence and arguments, and the judge will make a judgment based on the law and the facts of the case. Legal proceedings provide a formal and authoritative way to resolve medical disputes, ensuring that the rights and interests of both parties are protected. However, legal proceedings are usually time-consuming and costly, and the relationship between the medical institution and the patient may become more tense. Therefore, legal proceedings should be considered as a last resort when other methods fail to resolve the dispute.