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Patients' Families Protest 'Wolves in White Coats'

Medicine: Malpractice complaints have soared in China along with the cost of care. But the odds are against victims in the outdated legal system.


SHANGHAI — Yu Jiyuan is the father of two dead sons--one a statistic in China's appalling medical malpractice record, the other a casualty of a legal system that protects doctors who do wrong.

A single thought keeps Yu going: His 21-year-old son never should have died from a routine asthma attack.

Yu has gathered evidence that doctors in a Shanghai hospital denied his son emergency medication, tied him up, forced oxygen on him and went out to lunch as the young man lay dying.

But 14 years and countless legal proceedings later, the courts still back the hospital, which insists it did nothing wrong.

Yu's other son couldn't bear to watch his father smash his head against China's great wall of bureaucracy. Two months before he was to be married last year, the 31-year-old leaped off the balcony of his fourth-floor apartment.

"My son had told me, 'You can't get justice in this life,' " Yu recalled recently. " 'I will avenge my brother's death in the afterworld.' "

Medical malpractice complaints have skyrocketed in China since market reforms in recent years have turned health care for the majority of Chinese from a government handout to an expensive privilege. Citizens of the world's most populous country are shedding their old image as demure comrades and standing up as defiant consumers.

They are declaring hospitals with dismal safety records "execution grounds." They are calling irresponsible doctors "wolves in white coats." They are learning to hire lawyers and use the media, flexing muscles of public opinion in an emerging civil society.

But except in the most sensational cases, many victims' families, like the Yus, find themselves abandoned by an inadequate judicial process, waging an uphill battle on a trail of tears.

"I have no hope," said Yu, sobbing in the sparse apartment the 58-year-old engineer shares with his wife. They have sold practically everything of value to finance his crusade, including their wedding bands. "Nothing will bring my sons back. But how can I let them die in vain?"

The Ministry of Health does not release official data on malpractice cases. But last year, a national consumer hotline received more than 17,000 medical complaints. Horror stories become screaming headlines. Live newborn twins are tossed into the garbage as dead fetuses. An appendectomy leads to a missing ovary. A loose tooth turns into death from an overdose of anesthetic.

It goes on and on.

"That's only the tip of the iceberg," said Yu Weihua (no relation to Yu Jiyuan), a 31-year-old surgeon whose newborn daughter died in a Guangdong delivery room because of what he calls hospital negligence. "The actual numbers are much higher."

Medical mistakes, of course, are not unique to China. In the U.S., a special alert issued last month by a hospital regulatory agency said that more and more surgeons are performing operations on the wrong patient or the wrong part of the body. The Joint Commission on Accreditation of Healthcare Organizations said 58 such errors had been reported last year, up from 16 in 1998.

U.S. physicians and hospitals, however, pay hefty premiums to insure themselves against liability for any mistakes they make--a concept all but unheard of in China.

In this country, by contrast, many cases go unreported because potential plaintiffs give up. At the heart of the matter is an outdated redress system that almost guarantees failure for the victims.

The single most important piece of evidence required to prove medical malpractice in court is a medical appraisal by the local branch of the national health bureau, the parent organization for all public hospitals. Without that, there is no case. But such reports almost invariably exonerate hospitals because most of the arbiters are local doctors with a vested interest in the outcome of the rulings. Many hospitals' rankings and revenues depend on avoiding malpractice blemishes.

Some Doctors Driven to Take Victims' Side

The system is so rigged against patients, according to Chen Zhihua, a Beijing lawyer who specializes in malpractice complaints, that they do not even have access to their own records. Hospitals can easily falsify or erase incriminating information to deny responsibility.

The senselessness of it all has pushed even some doctors, like Yu Weihua, to pick up the torch for disenfranchised patients by organizing and speaking up for victims' families from around the country.

"Open up the lawmaking process. Let us speak!" read an open letter Yu posted on the Internet on behalf of fellow victims seeking to scrap one old law that tips the scale in favor of doctors.

Hospital supporters, however, argue that no legislation will be good enough if victims don't temper the unrealistic expectation that doctors never make mistakes.

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