Defendant

Defendant

Egynam

Law Firm Rate, Attorney Yoon Hong-san

Seoul District Court Decision 2003Ma1681 Delivered on August 14, 2003

Seoul District Court Decision 2003No7379 Delivered on October 15, 2003

Supreme Court Decision 2003Do6570 Delivered on March 26, 2004

The judgment of the court below is reversed.

The defendant shall be innocent.

1. Summary of grounds for appeal;

① The Defendant, while performing his duty of care as a midwife, examined Non-Indicted 1, and did not neglect the victim as shown in the facts charged, the Defendant did not commit occupational negligence with respect to the death of the fetus in this case. ② Even if the Defendant’s occupational negligence is recognized, there is no evidence to prove that the fetus died due to the Defendant’s act. Therefore, even though it cannot be said that the Defendant was injured by an emergency king operation for the removal of the fetus that the victim died due to the Defendant’s mistake, the lower court found the Defendant guilty of the facts charged in this case, thereby affecting the conclusion of the judgment.

2. Determination

A. Determination as to the Defendant’s assertion that there was no occupational negligence

(1) Facts

In full view of the evidence duly examined and adopted by the court below, in particular, the statement at the court below's court of original instance, response to the request for cooperation in investigation by the head of the National Institute of Scientific Investigation to the preparation of the National Institute of Scientific Investigation, response to the request for advice by the head of the Korean Association of Medical Doctors, prior diagnosis records of the preparation of the defendant, prior diagnosis records of the preparation of the defendant, and the fact-finding answers on the preparation of urology and the preparation of the Korean Association of Medical Doctors, respectively.

① The Defendant, as a midwife operating a “(trade name omitted) midwifery clinic” in Dongdaemun-gu Seoul (Seongdong omitted), was engaged in the work of assistance in child delivery, health of pregnant or nursing women and newborn babies, etc.;

② Around April 13, 2001, the Defendant was requested by Nonindicted 1, who was her husband to the foregoing midwifery clinic for a period of five months of pregnancy, for natural childbirth by “quality delivery,” and as a result of the medical examination and consultation, the victim was aged 37 years of age, and the above victim was an old pregnant woman with the experience of giving birth by the method of the king operation at the previous two times, and there was no experience of giving birth, and the above victim became aware of the urology of urology;

③ Around June 12, 2001, the victim was diagnosed by the hospital located in Sungnam-si to cause urology and urology to be hospitalized in the hospital because urology and urology were transferred to another hospital, and the victim knew of the fact. However, the victim and the fetus did not have any problem, and the defendant said that only natural urology can be performed, as there was no problem between the victim and the fetus;

④ 피해자의 혈당수치가 2001. 6. 27.경에는 공복시 116㎎/㎗,식후 220㎎/㎗, 2001. 7. 7.경에는 공복시 111㎎/㎗, 식후 230㎎/㎗로 측정되었으나, 피고인은 피해자를 산부인과 전문병원으로 전원시키지 아니하였을 뿐만 아니라, 피고인이 특별히 피해자의 혈당수치를 예의주시하지 아니한 채 피해자로 하여금 스스로 혈당을 측정하게 하면서 식이요법이나 운동으로 그 혈당수치를 관리하도록 한 사실,

⑤ The Defendant, even though the victim attempted on July 28, 2001, which was the scheduled date for giving birth, failed to immediately transfer the victim to a mountain father and a specialized hospital equipped with comprehensive medical treatment facilities to the victim for about two weeks in order to verify whether the abnormal growth of the fetus, and whether the natural delivery is possible, and left the victim by leaving the victim left the victim at a more than two weeks thereafter. On August 11, 2001, the fetus grow up to approximately 5.2 kilograms within the victim’s own womb;

④ Around 00:30 on August 11, 2001, with respect to the victim who was pregnant 42th day, the fetus did not confirm the fact that the victim was born to the baby, even though it was conducted at around 03:00 on the same day, even though it was conducted an early-wave inspection, etc. on the same day, and the fetus did not continuously observe or measure the changes in the number of the hearts of the fetus and the heart of the fetus, and without continuously observing or measuring the changes in the number of the hearts of the fetus by using an electronic monitoring device, flus, etc., and the fact that the victim was left in the hospital from around 03:00 on the same day to

(7) Around that time, the fetus died of a cardiopulmonary suspension due to damage to the nature of a child within the victim’s own womb;

8. On August 11, 2001, the victim may recognize the fact that he/she received an emergency scopic operation to remove the fetus that died at the Human University Offset Hospital located in Nowon-gu in Seoul Special Metropolitan City, Nowon-gu.

(2) the duty of care of a midwife to a pregnant woman with symptoms of urology or urology;

위 증거들에 의하면, 자연분만의 경험이 없는 고령의 임신부인 경우 사산, 난산 및 신생아 사망의 위험성이 높은 사실, 특히 당뇨 증상이 있는 임신부의 경우에는 정상 임신부에 비하여 선천성 기형, 자연 유산의 발생율과 저산소성 손상(자궁 내 태아곤란증)으로 인한 주산기 사망의 위험성, 호흡곤란증 등으로 인한 신생아 사망의 위험성이 높고, 당뇨병 임신부의 태아는 비대칭적 성장으로 가슴이 머리보다 더 큰 경우가 많아 난산의 위험성도 높은 사실, 또한 당뇨 증상이 있는 임신부의 경우 임신 중기 및 말기에 그 당뇨 증상으로 인하여 태아의 성장이 촉진되어 거대아가 되기 쉬운데, 그렇게 되면 태아가 자궁 내 태아곤란증으로 인하여 사산될 위험성이 매우 높기 때문에, 임신 중기 및 말기에 모세혈관 혈당이 공복시에는 60~90㎎/㎗을 유지하고, 식후 2시간 후에는 120㎎/㎗ 이하를 유지하도록 하여야 하는 사실을 각 인정할 수 있는바, 위 인정사실들에 의하면, 조산과 임산부 및 신생아에 대한 보건 등의 업무에 종사하는 피고인으로서는 당뇨 증상이 있는 임산부에 대하여 임신 중기 및 말기에 위와 같은 혈당수치가 유지되는지 여부를 지속적으로 측정·관찰하고, 그 수치가 초과된 경우에는 그 임산부를 종합진료시설을 갖춘 산부인과 전문병원으로 전원시켜 산부인과 전문의로 하여금 비정상적인 당대사의 정확한 발견 및 평가, 모체 고혈당 조절, 이에 따른 태아의 예후 판정, 태아감시와 성숙도에 대한 평가를 실시하게 하여 출산가능여부와 출산 가능할 경우 임산부의 과거력, 임산부 및 태아의 검진결과에 따른 가장 적합한 분만방법을 결정하도록 하여 그 태아를 안전하게 분만토록 함으로써 임산부 및 태아에 대한 건강상의 위험을 미리 막아야 하고, 나아가 위와 같은 당뇨 증상이 있는 고령·고위험의 임산부가 출산예정일을 약 2주 도과하였을 경우에는 태아의 크기 등을 고려하여 자연분만을 포기하고 즉시 임산부를 산부인과 전문병원으로 전원시켜 산부인과 전문의로 하여금 유도분만이나 제왕절개의 방법으로 태아를 안전하게 출산하도록 조치하는 등 임산부 및 그 태아에 대한 건강을 확보하기 위하여 필요한 최선의 노력을 기울여야 할 업무상 주의의무가 있다고 봄이 상당하다.

(3) Determination

Therefore, as seen above, the victim was found to have been given birth only 37 years old, who had no experience in giving birth by means of natural delivery, and the victim was diagnosed on July 28, 2001 with symptoms of about 6 weeks before the scheduled date of delivery, and the victim was diagnosed to have been given hospital at the Hadern University on June 27, 2001. On July 7, 2001 and July 7, 2001, the victim was found to have been negligent in performing 10 days after the victim was given birth, so that the victim's blood transfusion is still over normal water, and that the victim's disease can not be seen as safe enough for the victim's health care hospital or 20 days after his/her birth, despite the fact that the victim was unable to give birth, and the defendant, who is a midwife, should be found to have been negligent in performing 20 days after his/her childbirth surgery by safely measuring the victim's disease and safe means of childbirth treatment.

Therefore, the above argument that there is no occupational negligence on the defendant is without merit.

(b) Amendment of indictment ex officio.

Before determining the Defendant’s assertion that there was no causal relationship between the Defendant’s occupational negligence and the victim’s injury, the Prosecutor changed the charged facts of this case to the first instance court of first instance No. 15 of the facts charged, and then the Defendant applied for the amendment of the indictment to the effect that “A fetus was killed due to a cardiopulmonary suspension due to the injury of low obscencies in the victim’s own womb by causing the fetus to die within the victim’s own womb due to the injury of low obscencies, such as cerebral dysium and cerebral dysium, and cerebral dysium, etc.” (i) around 09:29 of the same day, the Defendant had the victim suffer an injury due to an emergency dyscen operation to take out the fetus that died at the victim’s own womb, and (ii) he applied for the amendment of the indictment to the indictment by occupational negligence on the part of a member of the victim.

3. Conclusion

Therefore, the judgment of the court below is reversed in accordance with Article 364 (2) and (6) of the Criminal Procedure Act without a further determination as to the assertion that there is no causation between the defendant's occupational negligence and the victim's injury on the grounds of ex officio reversal, and the judgment below is ruled as follows.

1. Summary of the facts charged

A. Summary of the facts charged

The Defendant is a midwife who operates a “(trade name omitted) midwifery clinic” in Dongdaemun-gu Seoul (Seongdong omitted).

2001. 4. 13.경 임신 5개월째에 내원한 공소외 1로부터 질식분만에 의한 자연분만을 의뢰받으면서 피해자가 이미 제왕절개 방법으로 두 딸을 출산하였을 뿐 자연분만의 경험이 없는데다가 당뇨증상 및 양수과다증상이 있음을 알게 되었는바, 이러한 경우 산모의 당뇨증상으로 인하여 태아가 거대아가 되어 저산소성 태아곤란증으로 사산의 위험이 크고, 그렇지 않다 하더라도 난산이나 기형출산 등의 위험이 크므로, 피고인으로서는 피해자의 혈당치가 공복시 90㎎/㎗, 식후 2시간 후 120㎎/㎗이 유지되는지 여부를 지속적으로 측정·관찰하여 만약 위 수치를 초과하는 경우에는 피해자를 산부인과 전문병원으로 전원시켜 비정상적인 당대사의 정확한 발견, 평가 및 혈당조절, 태아감시와 성숙도에 대한 평가 등을 받게 하여 가장 적합한 분만방법을 결정하도록 조치하여야 하고, 더구나 위와 같은 임산부가 출산예정일을 2주나 도과한 때에는 당뇨증상으로 인하여 태아의 성장이 더욱 촉진되어 사산의 위험성이 매우 높으므로 즉시 자연분만을 포기하고 피해자를 산부인과 전문병원으로 전원시켜 전문의로 하여금 유도분만이나 제왕절개 등의 방법으로 태아를 안전하게 출산하도록 조치하여야 함에도 불구하고, 피해자의 혈당치가 같은 해 6. 27.경 공복시 116㎎/㎗, 식후 220㎎/㎗, 같은 해 7. 7.경 공복시 111㎎/㎗, 식후 230㎎/㎗로 각 측정되었으나, 피해자를 산부인과 전문병원으로 전원시키지 아니하고 또 피고인이라도 피해자의 혈당치를 예의주시 하여야 하는데도 이를 하지 아니하였을 뿐만 아니라, 나아가 출산예정일에서 약 2주가 지난 같은 해 8. 11. 00:30경 내원한 피해자에 대하여 초음파검사 등을 실시하고서도 태아가 이미 5.2kg의 거대아로 성장한 사실조차 확인하지 못하였고, 피해자가 계속 진통을 하고 있음에도 태아의 심박동수의 변화 등을 지속적으로 관찰하지 아니한 채 자연분만을 위하여 피해자를 같은 날 06:20경까지 대기실에 방치한 과실로 그 무렵 태아가 피해자의 자궁 내에서 뇌지주막하출혈 및 뇌실질내출혈 등 분만전 저산소성 손상으로 인한 심폐정지로 사망하게 하여 피해자로 하여금 치료일수 미상의 상해를 입게 하였다.

B. Summary of the facts charged alternatively

The Defendant is a midwife who operates a “(trade name omitted) midwifery clinic” in Dongdaemun-gu Seoul (Seongdong omitted).

2001. 4. 13.경 임신 5개월째에 내원한 공소외 1로부터 질식분만에 의한 자연분만을 의뢰받으면서 피해자가 이미 제왕절개 방법으로 두 딸을 출산하였을 뿐 자연분만의 경험이 없는데다가 당뇨증상 및 양수과다증상이 있음을 알게 되었는바, 이러한 경우 조산사로서는 위 가.항 공소사실 기재와 같은 주의의무가 있음에도 불구하고, 피해자의 혈당치가 같은 해 6. 27.경 공복시 116㎎/㎗, 식후 220㎎/㎗, 같은 해 7. 7.경 공복시 111㎎/㎗, 식후 230㎎/㎗로 각 측정되었으나, 피해자를 산부인과 전문병원으로 전원시키지 아니하고 또 피고인이라도 피해자의 혈당치를 예의주시 하여야 하는데도 이를 하지 아니하였을 뿐만 아니라, 나아가 출산예정일에서 약 2주가 지난 같은 해 8. 11. 00:30경 내원한 피해자에 대하여 초음파검사 등을 실시하고서도 태아가 이미 5.2kg의 거대아로 성장한 사실조차 확인하지 못하고, 피해자가 계속 진통을 하면서 자궁경부가 약 3㎝ 가량 열려 분만이 개시되고 있었음에도 태아의 심박동수의 변화 등을 지속적으로 관찰하지도 아니한 채 자연분만을 위하여 피해자를 같은 날 06:20경까지 대기실에 방치한 과실로 그 무렵 피해자의 당뇨증상으로 위와 같이 거대아로 성장한 피해자 신생아가 피해자의 자궁 내에서 뇌지주막하출혈 및 부분적인 뇌실질내출혈 등 분만전 저산소성 손상으로 인한 심폐정지로 사망하게 하였다.

2. Determination

A. Factual relations

The facts of the instant case are as stated in Section 2-A (1).

B. Determination on Defendant’s occupational negligence

As examined in the above 2-A (2) and (3), the defendant is a midwife engaged in the duties of health, etc. of early childbirth and pregnant or nursing women and newborn babies, and the defendant is negligent in the course of performing all necessary measures for pregnant women with symptoms of aged urology from pregnancy to delivery.

C. Determination of facts charged

As seen above, as to whether the fetus may be deemed to have suffered bodily injury due to the death of the victim in the victim's womb, the victim died from the heart suspension due to low oxygen damage in the victim's womb from around 03:00 on August 11, 2001 to 06:20, the victim took out the fetus as above after undergoing an emergency operation at the Human University Offset Hospital located in the off-gu Seoul Special Metropolitan City, Nowon-gu around 09:29 on the same day. The fact that the fetus died in the victim's mother body cannot be deemed as injury to the victim's complete body, and there is no other evidence to acknowledge that the victim suffered bodily injury, such as blood injury, disability, etc. due to the death of the fetus in the victim (the fact-finding by the President of the Korea Medical Association). According to the fact-finding inquiry by the President of the Korea Medical Association, the fetus cannot be recovered from the victim's blood injury immediately after the death in the mother body and there is no special function to recover the fetus within one month after the death.

D. Determination of selective facts charged

With respect to whether the fetus in this case is "person", it is reasonable to view that the fetus is "person" as "person," only when the fetus started to leave the fetus while being accompanied by a regular medical pain, i.e., when only a minute starts (However, in the case of a fetus to start only artificially due to transfer, or when a minute begins regardless of a periodic progress, such as a case where a woman starts to do so through an operation, regardless of whether it is a periodic progress, when a fetus begins to start a delivery corresponding to the commencement of a delivery in a natural part). It cannot be viewed that the fetus is "person," just because the fetus was hospitalized for a childbirth.

However, according to the defendant's statements in the court below and in this court, each statement of the non-indicted 1 and 2 in each court below's judgment, the defendant's prior examination records, and the record of the progress of delivery, the scheduled date of delivery of the victim was July 28, 2001, but the victim was informed about the defendant before the above scheduled date of delivery, and the defendant was found to have been found. The defendant suggested that "if there is no prior diagnosis until August 10, 2001, the victim was hospitalized into a midwifery clinic, and there was no prior diagnosis until 0 days, the victim did not appear to have been hospitalized," and that the victim did not have a prior statement of 3:0 on August 10, 201, and that the victim was no more than 1:0 on August 10, 2001, and again 1:0 on August 10, 200, the victim was no more than 3:00 on the day of birth, and the victim was no more than 1:0 on the date of birth.

3. Conclusion

Thus, the facts charged by occupational injury under the premise that the victim suffered bodily injury due to the fetus death and the facts charged by occupational occupational injury under the premise that the fetus had already been "human" at the time of the fetus death are all the facts charged by the occupational injury and the facts charged by occupational injury, etc. fall under the case where there is no proof of criminal facts and thus

Judges Heungn (Presiding Judge)