Reporting from Beijing — Friends and relatives of a patient who died on the operating table marched on Nanchang Hospital No. 1 brandishing pitchforks and clubs. About 100 staff members, among them young doctors, prepared for the onslaught by arming themselves with long sticks and cans of mace, while the security guards donned police vests and helmets.
What followed was a pitched battle in the lobby atrium with horrified patients gawking from the floors above.
Although nobody was seriously injured in Tuesday's melee, the incident brought attention to a wave of violence in Chinese public hospitals. In Nanchang, a provincial capital 300 miles southwest of Shanghai, a young doctor reportedly suffered a serious head injury in June after the family of a deceased patient led a protest that turned violent.
Last year, a doctor and nurse were stabbed to death in the eastern province of Shandong by the son of a man who had died 13 years earlier of liver cancer, while a pediatrician was badly injured jumping from a fifth-floor window to escape relatives of a baby who had died.
Medical personnel advocates complain that the more violent incidents are staged by hired thugs, paid by families of the deceased in hopes of winning compensation from the hospitals. Sometimes the protesters are from the same village or are semi-professionals in causing trouble. The Chinese have even coined a word for the paid protesters: yinao, meaning "medical disturbance."
"It has become a very sophisticated system for chasing profits. Whenever somebody dies in a hospital, the yinao will get in touch with the family and offer their services in exchange for 30% to 40%," said Liu Di, who is setting up a social network for medical professionals.
Liu said the practice arose in the last few years as hospitals became more commercialized. "You see this mostly in second- or third-tier cities where the legal system is less developed."
In Tuesday morning's incident in Nanchang, hospital staff members learned that a mob of about 100 people was heading their way with crude weapons and took it upon themselves to mount a defense. Photographs and video posted on a local website showed men in white coats, apparently doctors, and T-shirted security guards brandishing what looked like oversize baseball bats.
"A lot of the young doctors and hospital security guards couldn't stand it anymore and decided to pick up sticks and defend themselves," a doctor from another Nanchang hospital, who gave his name as Lao Tang, wrote on his social networking site. "My fellow comrades, we fully support you! Well done!"
The switchboard at the hospital referred reporters Wednesday to the local Communist Party office, where telephones went unanswered.
Zhang Yuanxin, an Urumqi-based plaintiffs' lawyer, said it was difficult to sue for medical malpractice, even in the most egregious cases, and that tempted people to take matters into their own hands.
"This is the direct result of the lack of rule of law and the lack of a well-established social welfare system," Zhang said. "Conflicts like these are inevitable and there will be many more if people can't solve their problems through the law."
With overcrowded public hospitals, China has experienced a number of well-publicized scandals in which people were overcharged for unnecessary or dangerous treatments. In the 1990s, at a time when local governments were selling blood for profit, more than 1 million people contracted the AIDS virus through transfusions at public hospitals. Often victims in these cases have had little resource but to protest or petition — an archaic process that involves going to Beijing to file grievances with higher authorities.
There have also been numerous nonviolent demonstrations at hospitals, where families — or their representatives — dress themselves in the traditional Chinese mourning color of white and scatter fake paper money, an offering to the deceased in the afterlife.
This week alone, two major hospital protests were reported in addition to the one in Nanchang. The family of a 29-year-old man who died of stomach cancer in the eastern city of Nanjing picketed the hospital, claiming he hadn't been properly diagnosed and that they were threatened when they questioned his treatment.
In a public hospital in Guangdong, in the south, women staged a sit-in, wailing, screaming and refusing to leave, according to news reports.
Last month, a man who claimed to be a professional protester in Nanchang gave a newspaper interview in which he said that the local government usually chose to pay to quiet the protesters, "for the sake of social stability."
"I always tell my clients, if you start a big disturbance, you'll get a bigger compensation package. If you start a smaller disturbance, you'll get a smaller package. And if you don't do anything, you'll get nothing," the man, identified as 42-year-old Xiao Ming, was quoted as saying.
The Chinese government is getting tougher on hospital protesters. Last week, a court in the northeastern city of Qingdao handed down what was reported to be the first prison sentence in such a case, sending a man to jail for 18 months for staging a riot at a hospital after the death of his father in January.
Tommy Yang of The Times' Beijing bureau contributed to this report.