207dada 9913 Compensation (Definition)

1. ThisA1 (45 years old, female);

2. United StatesA2 (69 years of birth, women);

3. United StatesA3 (71years, South Korea)

4. United StatesA4 (73 years old, female).

5. United StatesA5 (76 years old, South Korea)

[Defendant-Appellee] Defendant 1

1. ▣의료공단

Representative Kim

2. KimB1

3. KimB2

[Defendant-Appellant] Plaintiff 1

Attorney Gyeong-chul et al.

September 11, 2009

October 23, 2009

1. The Defendants jointly and severally pay 8,181,818 won, Plaintiff UA2, UA3, UA4, UA5 won, and each of the above amounts with 5,454,545 won and 20% interest per annum from November 8, 2006 to October 23, 2009, respectively, to Plaintiff EA1, respectively.

2. The plaintiffs' remaining claims against the defendants are dismissed.

3. 2/3 of the costs of lawsuit are assessed against the Plaintiffs, and the remainder is assessed against the Defendants.

4. Paragraph 1 can be provisionally executed.

The Defendants jointly and severally pay to the Plaintiff EA1 38,461,523 won, Plaintiff UA2, UA3, UA4, UA4, and U.S. 5 14,09 won each of the above amounts, 5% per annum from November 8, 2006 to the pronouncement date of the instant judgment, and 20% per annum from the next day to the date of full payment.

1. Basic facts

가. 당사자관계 원고들은 피고 ▣의료공단 산하의 부산△병원(이하 '피고 병원'이라 한다)에서 관상동맥 조영술 및 성형술을 받다 부산▲ 병원으로 전원되어 사망한 망 유C1(이하 ‘망인’이라 한다)의 상속인들이고(상속지분 : 원고 이A1 3/11, 원고 유A2, 유A3, 유A4, 유A5 각 2/11), 피고 김B1, 김B2는 망인에 대하여 위 수술을 시행한 피고 병원 소속 의사들이다.

나. 마산☆병원의 시술 및 치료

(1) 망인은 1998. 10. 21. 흉통으로 마산☆병원에 내원하여 급성심근경색 진단을 받고 응급 입원한 후, 1998. 10. 26. 경피적 관상동맥중재술(확장성형술) 시술을 받았는데, 당시 망인의 우관상동맥의 병변에 대해서는 위 시술이 성공적으로 시행되었으나, 좌회선지 병변에 대해서는 유도철선이 통과하지 못하여 시술에 실패하였다.

(2) 망인은 1998. 10. 29. 흉통 없이 안정되어 마산☆병원을 퇴원한 후 2001. 8. 2.까지 위 병원에서 통원하면서 지속적으로 항협심증 약물 치료를 계속 받았으나, 간헐적인 흉통이 계속되고 2002. 3.경 개인 의원에서 시행한 운동부하검사에서 심근허혈 소견이 있어, 2002. 5. 3. 다시 마산☆병원에 내원하여 입원한 후 2002. 5. 7. 다시 경피적 관상동맥중재술을 시술받았다.

(3) However, the Deceased’s sponsor’s sponsor’s sponsor was unable to pass the sick part due to the chronic complete closure, and thus, the Masan Hospital failed to pass the sick part, and the Deceased discharged on May 8, 2002 without the cpherical chersption of symptoms.

(4) 마산☆병원은 망인의 증상을 진구성 심근경색증, 협심증, 당뇨병으로 진단하고 향후 망인의 상태가 악화될 때 다시 관상동맥중재술을 시행하기로 하여 2006. 5. 26.경까지 망인에 대하여 약물치료를 계속하였다.

(c) Practice at the Defendant Hospital;

(1) From May 2006, the Deceased received pain treatment at the Defendant Hospital. The medical team at the Defendant Hospital, who was aware of the failure of the above hospital’s exorculous extension surgery on more than two occasions, based on the medical report and examination records of the hospital, was urged the Deceased to undergo an exorculous and arbitration procedure, based on the fact that the medical team at the Defendant Hospital continues to have constant plebreculing surgery despite the deceased’s medical history and medication.

(2) Accordingly, on November 7, 2006, the Deceased was hospitalized at the Defendant Hospital on November 3, 2006. On November 6, 2006, the day immediately before the operation, the Deceased signed and sealed on the patient’s name column of the written consent on the ornamental beer and scopic surgery and the extension type surgery (A evidence 6-1, 2). On the other hand, each of the above written consent was signed and sealed by the Plaintiff U.S. 3 as the guardian, signed and sealed by the Plaintiff U.S. 3 as the guardian, and signed on each side of the printed phrase that he consented to the necessity of the procedure, method of the procedure, and the explanation of the merger certificate. The letter of consent on the extension of the ornamental beer is relatively safe, and the following was printed to the extent that the probability of occurrence of a fatal merger occurs to the patient during the procedure.

- In the course of, or immediately after, the procedure, the narrow Amarr's blood scambling is about 5% in cases where the scambling scam is caused by the Amarrosis or under emergency, and the death rate is about 1%. Other risk factors are about 0.2% in cases where the risk rate of the outbreak of cerebrovascular disease is 0.2% in addition, the risk rate of the outbreak of scamscams, and rapid scamscams is about 1.3% in cases where the risk rate of the outbreak of cerebrscular disease is 0.5% in cases where the scambling scamscamscamscam and scamscamscamscams are caused by the Amarrherosis, the scamrherosis's reaction by the Amarrherosis, and the scamcamrherosis in cases where patients are dangerous.

- These side effects are medically inevitable and may be done by death.

(3) 피고 김B1, 김B2는 2006. 11. 7. 08:40경부터 망인에게 관상동맥조영술을 시작하여, 08:55경 관상동맥중재술을 개시, 09:00경 망인의 대각지에 풍선확장 및 스텐트 삽입을 시행하였고, 09:10경에는 좌회선지(심장의 동맥)의 만성 완전폐색병변에 대한 시술이 시행되었는데, 시술 도중 유도 도관에 의한 좌주간지 관상동맥 박리가 발생되어 10:20 경망인이 흉통을 호소하고 심전도의 변화와 함께 맥박과 혈압이 하강하였다. 위 피고들은 10:30경 기도삽관과 심장박동기 및 대동맥내 보조펌프를 설치하는 등으로 응급조치를 하는 한편 10:40경 망인을 급히 부산▲ 병원으로 전원시켰다.

(4) 망인은 2006. 11. 7. 10:54경 혈압, 맥박, 호흡이 측정되지 않는 상태에서 부산 병원 응급실로 전원되었는데, 부산▲ 병원 의료진들에 의하여 응급심폐소생술, 응급 심장보조장치설치, 응급 관상동맥우회로시술 등이 실시되었음에도 불구하고, 2006. 11. 8. 01:50경 위 관상동맥확장술 중에 발생한 관상동맥박리증으로부터 비롯된 심근경색증에 의한 심인성 쇼크(저심박출증)와 다장기부전으로 사망하였다.

(d) Relevant medical knowledge;

(1) In the case of acute dynamics that mainly supply blood in the core of the cardio-scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic sc

(2) It is an inspection by inserting the pipe through ornamental beer beer and beer to observe the shape of the blood pipe with X-ray machinery by inserting it to the ornamental beer and beer through beer and beer.

(3) In order to find the location of the ornamental beerculing beer by inserting anesthesia it into the ornamental beer and sculing beerculatory beerculatory beerculatory beer and inserting it into the sculing beerculatory beer and reconculing reconculing beer by spreading the closed or sculatory beerculatory beer by using the sculing cable and its water network. serious mergers cause death (less than 1 per cent), heart (5-10 per cent), ornamental beer beerculatory beer (1.7 per cent), ornamental beer beerculatory beer (0.2-0.5%) and scult beerculatory beer than one per week when it is difficult to sculse complete culing beer in the face of the night beer. In such cases, it is difficult to see that it is difficult to see that it would be difficult to see that it will be sculpuling.

(4) The stuffing of ornamental beer and morromosome shall refer to the state in which the walls of ornamental beer are teared due to damage to the interior of the ornamental beer, breath, and external string, and may cause cardio-static voltage and ornamental beer. The morromosome of ornamental beer may lead to the state in which the heart voltage and ornamental beer can occur by going through gambling. Since the blood in the ornamental beer is directly leaked to the heart mouth, and the blood in the ornamental beer is directly leaked to the heart, it shall proceed at a speed higher than in the heart voltage. If the blood or crosion in the heart mouth is obstructed by the inflow and leakage of the blood into the heart inside and outside of the heart, and the degree of the decrease thereof may lead to low blood pressure, the heart pressure, respiratory, etc. may occur, and the corrosion, if the heart pressure, etc. is continuously discharged, and the corrosion, if it is found to fall.

【인정근거】다툼 없는 사실, 갑 1 내지 13호증(각 가지번호 포함), 을 1 내지 4호증(각 가지번호 포함)의 각 기재, 이 법원의 대한의사협회, 부산광역시 의사협회, 마산병원, 부산▲ 병원, 국민건강보험공단 창원지사에 대한 각 사실조회결과, 변론 전체의 취지

2. Determination

A. Judgment on the Defendants’ negligence as alleged by the Plaintiffs

(1) Fruits of forcibly performing an ornamental beeral malute

원고들은, 마산☆병원에서의 2차례에 걸친 관상동맥성형술 시술과정에서 망인의 심장동맥 중 좌회선지의 페쇄가 심해 유도철선이 통과할 수 없어 시술이 2번 모두 실패하였고 그로 인해 망인은 부득이 약 4년간에 걸쳐 약물치료만을 받아오고 있던 상황이었으므로, 그러한 망인의 시술전력과 좌회선지의 동맥페쇄상태에 비추어 망인에게는 관상동맥 조영술 및 확장성형술을 시술하여서는 안 됨에도 불구하고 피고 김B1, 김B2는 마산☆병원의 시술실패 사유 및 망인의 상태를 간과하거나 제대로 확인하지 않은 채 무리하게 시술을 강행한 과실이 있다고 주장한다.

살피건대, 의사가 진료를 행함에 있어 환자의 상황과 당시의 의료수준 그리고 자기의 전문적인 지식과 경험에 따라 생각할 수 있는 여러 조치 중에서 적절하다고 판단되는 진료방법을 선택할 수 있고, 그것이 합리적인 재량의 범위를 벗어난 것이 아닌 한 진료의 결과를 놓고 그 중 어느 하나만이 정당하고 그와 다른 조치를 취한 것에 과실이 있다고 할 수는 없다고 할 것인바(대법원 1996. 6. 25. 선고 94다13046 판결 참조), 위 인정사실 및 갑 12호증의 9, 10, 11, 을 1호증의 9의 각 기재, 이 법원의 마산병원, 부산▲ 병원, 부산광역시 의사협회에 대한 사실조회결과에 변론 전체의 취지를 종합하여 알 수 있는 다음 사정 즉, 망인은 마산☆병원에서 2회에 걸친 관상동맥성형술을 받고 지속적으로 약물치료를 받았으나 관상동맥 중 좌회선지의 폐쇄병변으로 인한 흉통이 계속되고 있었던 점, 약물치료에도 불구하고 호전됨이 없이 흉통이 계속될 경우에는 심근경색으로 사망할 위험성이 높은 점, 마산☆병원 의료진도 상태가 악화될 경우 재차 망인에 대하여 관상동맥중재술을 실시할 예정이었던 점, 피고 병원의 진료기록을 감정한 대한의사협회는 망인에 대하여 시술을 시행하는 것과 시술을 시행하지 않고 약물치료만 하는 것 중 어느 것이 의학적으로 옳은 선택이었는지 단정할 수 없고, 망인에 대한 관상동맥 조영술 및 확장술의 시술이 의료시술상의 일반 원칙에 비추어 잘못되었다고 할 수 없다고 회신하고 있는 점, 실패하였던 병변에 대하여 재차 시도된 관상동맥성형술이 이전의 시술과 비교하여 시술위험이나 부작용이 증가된다고 단정할 수 없고, 성공적으로 행하여지는 경우도 많으며, 또한 관상동맥 병변에 의한 환자의 주관적 증상이 약물치료에 의하여 적절하게 치료되지 않는 경우 등에는 관상동맥성형술을 재차 시행할 수 있어, 의학적으로 이전의 관상동맥성형시술의 실패 그 자체만으로는 동일부위에 대한 관상동맥 성형시술이 금지된다고 보기는 어려운 점, 관상동맥성형술의 시술도중 발생하는 관상 동맥의 박리는 예측하기가 사실상 불가능한 점 등에 비추어 보면, 피고 김B1, 김B2가 망인에 대하여 관상동맥 조영술 및 성형술 시술을 결정하고 시행함에 있어 현재의 임상의학 수준에서 어떠한 과실이 있다고 판단되지는 않으므로, 원고들의 위 주장은 이유 없다.

(2) Negligence in breach of prompt emergency measures and power supply obligations;

원고들은, 시술 당일 09:30경에 이미 망인의 관상동맥박리가 발생하였음에도 피고 김B1, 김B2가 망인을 즉시 부산▲ 병원으로 후송하지 않고 1시간 이상 지체하거나 응급상황에 즉시 대처할 의료진을 대기시켜 두지 않은 과실로 망인이 사망하게 되었다는 취지로 주장하므로 살피건대, 위 인정사실 및 갑 12호증의 9, 10, 11, 을 1호증의 9의 각 기재에 변론 전체의 취지를 종합하여 보면, 위 피고들은 시술 당일 10:20경 망인의 상태가 악화된 직후 응급조치 및 전원조치를 신속하게 실시한 것으로 보이고, 그와 같은 신속한 전원조치가 이루어진 이상 피고 병원 내에 응급 관상동맥우회로시술 등을 위한 의료진이 대기하지 않았다는 점만으로는 과실이 있다고 볼 수 없으므로, 원고들의 위 주장은 이유 없다.

(3) Breach of duty to explain

(A) Defendant KimB1 and KimB2 asserted that, although they were obligated to explain in detail the necessity and risk of the re-operation of the ornamental scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic sc

B. In addition, in a case where a doctor performs a surgery to a patient or a medical act that is likely to cause any subsequent bad result, unless there is an emergency patient or any other special circumstance, he/she is obligated to explain the symptoms of a disease, treatment method and necessity, anticipated risk of occurrence, etc. in light of the current medical level and to allow the patient or his/her guardian to choose whether to receive such medical act after sufficiently comparing the patient's necessity or risk. In addition, in order to achieve the purpose of the medical treatment, he/she has a duty to explain in detail the methods of medical care and other matters necessary for health care to the patient or his/her guardian and to prepare for legacy, etc. (see, e.g., Supreme Court Decision 95Da49608, Jul. 22, 1997). In order to ensure such patient's right of choice, in principle, he/she should explain the patient's symptoms, treatment method and possibility of occurrence, and explain the patient's specific and abstract symptoms and possibility to the general public sufficiently and sufficiently understand the patient's individual symptoms and possibility.

C. As seen earlier, it is difficult to see that the Defendants were subject to signature or fluoral consent from the deceased on Nov. 6, 206, the day immediately before the operation, and that they were subject to the above-mentioned Kim Jong-chul’s signature or fluoral consent. However, considering the above-mentioned facts and fluoral evidence, it is difficult to see that there is a chronic dluoral fluoral fluoral fluoralsium to the extent that it could not pass through the cluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluor’s fluoral fluoral fluor’s fluoral fluoral fluor’s fluoral fluoral fluoral fluor’s fluoral fluoral fluor’s fluor’s fluoral f.

B. Scope of damages liability

(1) In a case where the deceased’s intent to compensate for all damages resulting from a serious result, such as death, etc., by failing to comply with his/her duty to explain and performing an operation, there is a proximate causal relation between the deceased’s serious result and the doctor’s breach of duty to explain or the mistake in the process of acquiring consent. In that case, the duty to explain at that time to protect the patient’s right to self-determination or the opportunity to choose for treatment, should be the same degree as that of the patient’s breach of duty of care required in the specific process of treatment for the patient’s life and body (see, e.g., Supreme Court Decision 2005Da5867, May 31, 2007). In addition, it is difficult to view that there is a proximate causal relation between the deceased’s breach of duty to explain and the deceased’s death, and the non-violation of the explanation is not the same as that of the patient’s duty of care required in the specific process of treatment for the patient’s life and body. Therefore, the Defendants

However, as seen above, the Defendants were liable for compensation for consolation money to the deceased by infringing the deceased’s right to self-determination or choice of the deceased in violation of his duty to explain. Considering the various circumstances shown in the arguments in the instant case, such as health team, the deceased’s age (61 years old), occupation, occupation, medical history, health condition, procedure and result of the procedure, it is reasonable to determine 30,000,000 consolation money to the deceased as consolation money, and the consolation money of the deceased is in accordance with the legal share of inheritance.

Plaintiff EA1 respectively succeeded to Plaintiff U.S.A2, U.S.3, U.S.A4, U.S.4, and U.S.A5 won (=30 million won) 8,181,00 won (=30 million won x 3/11, less than won; hereinafter the same shall apply) 5,454,545 won (=30 million won).

(2) Judgment on consolation money of the plaintiffs

The plaintiff Lee Dong-A1 sought payment of consolation money of KRW 20 million and KRW 5 million for the remaining plaintiffs. However, the defendants' breach of duty to explain is the same as the medical personnel's duty of care required in the specific process of treating the patient's life and body, not the case where they are liable for all damages caused by bad faith. As seen earlier, as long as the violation of the patient's right to self-determination is just a violation of the patient's right to self-determination, there is no ground to recognize the claim of consolation money for the plaintiffs who are not the parties to the medical contract or

Therefore, the Defendants are jointly and severally obligated to pay to the Plaintiff EA1 the amount of KRW 8,181,818, the Plaintiff UA2, UA3, UA4, U.S.4, and each of the above amounts of KRW 5,454,545, respectively, from November 8, 2006, the date of the instant accident, to November 23, 2009, the date of the instant judgment, when the Defendants dispute over the existence or scope of the instant obligation, 5% per annum under the Civil Act until October 23, 2009, and 20% per annum under the Act on Special Cases Concerning the Promotion, etc. of Legal Proceedings from the next day to the date of full payment.

4. Conclusion

Therefore, the plaintiffs' claims against the defendants are accepted within the scope of the above recognition, and the remaining claims are dismissed as they are without merit. It is so decided as per Disposition.

Judges Nationwide