2020Da244511 Claims

National Health Insurance Corporation

A medical corporation, Samsung Medical Foundation

Attorney Yoon Jae-soo et al., Counsel for the defendant-appellant

Seoul Central District Court Decision 2019Na31060 Decided June 24, 2020

November 26, 2020

The judgment below is reversed, and the case is remanded to the Seoul Central District Court.

The grounds of appeal are examined.

1. The court below, citing the reasoning of the judgment of the court of first instance, acknowledged the facts as stated in its reasoning, and determined that the defendant is liable for damages on the ground that the Gangwonbuk Hospital (hereinafter referred to as the "Defendant Hospital") operated by the defendant was negligent in failing to perform its duty of care necessary for the prevention of the instant accident on the grounds

A. Comprehensively taking account of all the evidence revealed in the pleadings of the instant case, it cannot be clearly confirmed that Nonparty 1 suffered from the flood by any lapse of time, and whether the instant aquatic accident occurred.

B. However, Nonparty 1 appeared in waters at the time of the instant accident, and there is no other evidence to deem that Nonparty 1 had engaged in dangerous conduct, such as causing body in the beds. While the Defendant asserted that Nonparty 1 was unable to wear a sunken railet at the time of the instant accident, where Nonparty 1 was unable to properly carry out the said safety bell, Nonparty 1 was able to escape from the bed of the head in order for Nonparty 1 to go out of the bed, the width of the bridges should be wide. Nonparty 1, who had difficulty in driving out of the bed, was unable to escape from the bed.

D. If it is appropriate to properly keep the above safety level like the defendant's assertion, the non-party 1 went out of the above safety level and took considerable time to the death, and considerable noise was generated by accompanying it, but the employees of the defendant hospital at the time of service did not fully recognize it.

E. Although Nonparty 1 was a patient of high-risk group, at the time of the instant accident, Nonparty 1’s wife did not have a safety prevention box against the abortion at the time of the instant accident, and accordingly, the shock caused by the abortion seems to have been delivered to Nonparty 1’s head.

F. The place where the instant abortion accident occurred was a serious patient, and Nonparty 1 was a patient with a high risk of abortion to the extent that the Defendant Hospital was classified as a high risk group patient, and thus, the Defendant Hospital was required to pay more attention to the patient.

2. However, the lower court’s determination is difficult to accept for the following reasons.

A. When a doctor performs medical acts such as diagnosis and treatment, he/she has the duty of care to take the best measures required to prevent risks depending on the patient’s specific symptoms or circumstances in light of the nature of the duties of care for the life, body, and health of the patient. Such duty of care is determined on the basis of the level of medical acts performed in the clinical medicine field, such as a medical institution, etc. at the time of performing the medical act. As such, the level of medical practice refers to the so-called medical awareness known to, and known to, ordinary doctors at the time of performing the medical act, and recognized as being in time of the medical act, the level of medical practice ought to be grasped at a normative level by taking into account the medical environment, conditions, characteristics of the medical act, etc. (see, e.g., Supreme Court Decision 2002Da45185, Oct. 28, 2004). Therefore, in a case where a doctor is deemed to have done his/her best in view of the current medical level at the time, there is no negligence in violation of the duty of care required for diagnosis.

As long as it is reasonable, it belongs to the scope of the discretion of the relevant doctor as to which person is to choose, and only one of them is justifiable and taking other measures cannot be deemed to have been at fault (see, e.g., Supreme Court Decisions 98Da45379, Mar. 26, 1999; 45386, Mar. 26, 199).

On the other hand, since medical practice is an area requiring highly specialized knowledge and it is very difficult for a general person, not an expert, to clarify whether the doctor has violated the duty of care in the medical process or whether there exists a causal relationship between the breach of such duty of care and the damage, it is also possible to presume that the damage was due to medical negligence by proving indirect facts that it is difficult to see that the patient has any other cause than medical negligence. However, even in such a case, it is also possible to presume that the damage was due to medical negligence by proving indirect facts about the adverse consequences caused by the patient. However, even in such a case, it is not allowed to assume the burden of proving the causal relationship with the doctor's negligence by presumptioning the causal relationship with the doctor's negligence (see Supreme Court Decisions 2002Da45185, May 31, 2007; 2005Da5867, May 31, 2007).

B. According to the reasoning of the first instance judgment cited by the lower court, and the evidence duly admitted by the first instance court and the lower court, the following facts and circumstances are revealed.

1) 소외 1(생년 생략)은 2017. 12. 7. 급성담낭염으로 피고병원에 입원하여 경피적 담도배액술 및 도관 삽입술을 시행받았는데, 2017. 12. 8. 혈압저하, 고열, 패혈증이 생기자 중환자실로 옮겨져 고유량 비강 캐뉼라 산소투여법 등 치료를 받았다.

2) The Defendant Hospital assessed Nonparty 1 as a patient of high-risk control group in the abortion and attached the risk signs of the abortion accident to the maximum extent possible, set the risk signs to the extent possible, fixed the scopher, and took measures to prevent the abortion, such as raising the scopic and installing safety signs on the scopic rail, and provided education to Nonparty 1 on several occasions, such as informing Nonparty 1 of the precautions to prevent the abortion.

3) 소외 1은 2017. 12. 11. 04:00경 중환자실에서 침대에서 떨어져 뇌손상을 입는 이 사건 낙상사고를 당하였다. 피고병원이 작성한 당시 간호기록에 의하면, 간호사는 같은 날 03:25경 소외 1이 '뒤척임 없이 안정적인 자세로 수면 중'인 상태를 확인하였고, 03:45경 'PTGBD 배액 중'이었는데, 04:00경 '쿵하는 소리가 나서 돌아보니 침상 난간 안전벨트와 침대난간을 넘어와 소외 1의 엉덩이가 바닥에 닿음과 동시에 뒤로 넘어지면서 머리를 찧는 상황'을 즉시 발견한 것으로 되어 있다.

4) At intervals of one hour, the Defendant Hospital’s middle-patient room confirmed the patient’s condition at intervals of 45 minutes from each hour to each other, and operated the method of two or three persons or three persons to check whether the body change, the base return exchange, the tring lease, and the physical damage were inflicted upon the patient at intervals of two hours (a even number of hours). At the time of the instant abortion accident, three patients per nurse were examined in the middle-patient room.

5) At the time of the instant abortion accident, Nonparty 2 testified that “B, at the court of the court of the court of the court of the court below, knee-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kne-kn-kne-kn-kne-kn-kn-kn-kn-kn-kn-kn-kn-kn-kn-kn-kn-kn-kn-kn-kn-kn-k-k..

Furthermore, the lower court also cited the circumstances where Nonparty 1 did not have engaged in dangerous actions at the time, or could have failed to properly take the scambling safety level, but the lower court should have faithfully deliberated and determined whether Nonparty 1 was at the time of the instant scambling accident, and whether the instant scambling accident could not be seen as having occurred due to the negligence on the part of the Defendant Hospital, as recognized by the lower court. As seen earlier, the lower court should have sufficiently deliberated and determined whether the instant scambling accident was likely to have occurred, and whether the instant scambling accident could have been seen as having occurred due to the negligence on the part of the Defendant Hospital.

D. Nevertheless, the lower court recognized the Defendant’s liability for damages by deeming that there was negligence on the part of the Defendant Hospital based on the circumstance that the Defendant was negligent on the basis of the fact that the Defendant was not objectively supported or that the probability was not ensured. In so doing, the lower court erred by misapprehending the legal doctrine on the negligence of caution in medical practice and the burden of proof thereof, or by failing to exhaust all necessary deliberations, which affected the conclusion of the judgment.

For this reason, as long as the defendant's appeal is accepted, the plaintiff's ground of appeal on the premise that the defendant's liability for damages due to tort is recognized is not further determined.

3. Therefore, the lower judgment is reversed, and the case is remanded to the lower court for further proceedings consistent with this Opinion. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Kim Jae-sik, Counsel for the defendant

Justices Min Min-young

The chief Justice Justice shall mobilized

Justices Noh Tae-ok