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의료사고과실비율 20:80  
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(영문) 서울고등법원 2014.7.10.선고 2013나21330 판결
손해배상(의)
Cases

2013Na2130 Damages (Definition)

Plaintiff-Appellant

A

Defendant Appellant

Korea

The first instance judgment

Seoul Central District Court Decision 2010Kahap101597 Decided February 19, 2013

Conclusion of Pleadings

May 29, 2014

Imposition of Judgment

July 10, 2014

Text

1. Of the judgment of the court of first instance, the part against the defendant in excess of the amount ordered to be paid below shall be revoked, and the plaintiff's claim corresponding to the revoked part

The defendant shall pay to the plaintiff 79,136,295 won with 5% interest per annum from August 7, 2010 to July 10, 2014, and 20% interest per annum from the next day to the day of full payment.

2. The defendant's remaining appeal is dismissed.

3. Of the total litigation costs, 65% is borne by the Plaintiff, and the remainder is borne by the Defendant, respectively.

Purport of claim and appeal

1. Purport of claim

The defendant shall pay to the plaintiff 25,629,390 won with 5% interest per annum from August 7, 2010 to the service date of a copy of the complaint of this case, and 20% interest per annum from the next day to the day of complete payment.

2. Purport of appeal

The part of the judgment of the first instance against the defendant shall be revoked, and the plaintiff's claim corresponding to the above revocation shall be dismissed.

Reasons

1. Basic facts

The court's explanation on this part is consistent with the reasoning of the judgment of the court of first instance, except in the following cases: (a) Nos. 3, 12, and 14 of the judgment of the court of first instance; and (b) as such, this part of the reasoning of the judgment of the court of first instance is cited in accordance with the main sentence of

4) On July 5, 2010, July 7, 2010, July 9, 2010, July 9, 2010; July 12, 2010; July 12, 2010; July 14, 2010; and July 16, 2010, the Deceased was transferred to E and received medical care and blood speculation for the chronic renal status.

2. Occurrence of liability for damages;

A. Judgment on the plaintiff's assertion

1) The plaintiff asserts that the medical officers in the Seoul detention center had the duty of care to find early the symptoms of the disease and to take measures to ensure appropriate diagnosis and treatment at the time, but did not provide early detection or appropriate diagnosis and treatment for narrow rice tuberculosis of the deceased, and caused the death of the deceased due to the narrow rice that could not be recovered at the time when the deceased was transferred to the sexual heart hospital emergency room of the Korea Forestry University. As such, the medical officers in the Seoul detention center claimed that the medical officers in charge of the Seoul detention center were negligent in the violation of the duty of care to protect the deceased from early detection of narrow rice tuberculosis of the deceased and to take measures to ensure appropriate diagnosis and treatment.

Where a prisoner shows a disease or any other similar symptoms, a prison officer is obligated to protect the body of the prisoner by taking necessary measures, such as having the prisoner undergo a medical examination and treatment from a medical professional or transferring the prisoner to a medical institution according to the degree of the latter. In particular, the medical officer of a correctional institution takes the best measure required to prevent danger depending on the patient's specific symptoms or circumstances, in light of the nature of the duties of managing the life, body, and health of the prisoner where the prisoner provides medical treatment, such as a medical examination

The duty of care to perform (see, e.g., Supreme Court Decision 2004Da65121, Mar. 10, 2005). The content and degree of the duty of care to ensure the safety of the facility manager ought to be determined in detail on a case-by-case basis, without regard to the physical and mental conditions of the inmate, physical and personal conditions of the facility, time and location of the facility, etc. (see, e.g., Supreme Court Decision 2008Da75768, Jan. 28, 2010).

살피건대, 앞서 든 증거들 및 당심 법원의 삼성서울병원장에 대한 진료기록감 정촉탁결과에 변론 전체의 취지를 종합하면 인정되는 사정 즉, 전신성 홍반성 루프스 질환 자체가 면역력이 감소하는 질환이고 흔히 스테로이드 치료(면역력이 감소되는 부작용이 있다)를 받는 경우가 많으며 스테로이드를 복용하고 있던 망인과 같은 전신성 홍반성 루프스 환자는 결핵 발병의 고위험군에 속하고 주의를 기울여 관찰하여야 하는 점, 망인이 2010. 7. 1. 서울의료원에서 무릎 통증을 호소하여 무릎 천자를 하였고, 서울구치소에 수감된 2010. 7. 3. 이후 무릎 통증을 계속 호소하였으며, 2010. 7. 13. 한 림대학교 성심병원에서 시행한 좌측 무릎 관절 천자 검사 결과 AFB 4+가 나와 매우 많은 결핵균이 존재하는 중증의 결핵이 상당히 진행된 상태였고, 한림대학교 성심병원의 의무기록지에는 망인이 입원 2주 전인 2010. 7. 5.경부터 기침과 좌측 무릎 통증이 발생하였고 입원 2일 전인 2010. 7. 17.경 호흡곤란이 시작되었으며 2010. 7. 19. 응급실 입원 당시 주증상이 호흡곤란으로 기재되어 있는바, 이러한 사정에 비추어 보면 망인의 좌측 무릎 통증은 결핵성 관절염으로 발생한 것으로 그 증상은 2010, 7. 1. 이전에 시작되었다고 볼 수 있는 점, 일반적인 결핵 진단은 흙부 X-선 촬영 및 객담 결핵균 도말, 배양검사가 가장 빠르고 효과적인 진단 방법인 점(서울구치소는 흉부 X-선 촬영 장비를 보유하고 있고, 흉부 X-선 촬영이 물적, 인적 장비가 필요한 고도의 전문적인 의료검사로도 보이지 않는다), 서울구치소 의무관들은 망인이 수감될 당시인 2010. 7. 3. 내지 망인에 대한 신체검사를 한 2010. 7. 4.경부터는 망인의 전신성 홍반성 루프스 질환과 무릎 통증을 알고 있었음에도 망인의 무릎 통증을 관절통으로만 판단하여 흉부 X-선 촬영을 한 바가 없는 점, 수용자의료관리지침에 의하면 수용자에 대한 신체검사시 결핵 등 전염병 발견에 주의하여야 하고(동 지침 제3조 제3항 제6호), 활동성 폐결핵환자의 경우 결핵 집중치료기관으로 이송하는 등(동 지침 제22조) 수용자의 폐결핵의 경우 다른 질병과 달리 엄격하게 관리되고 있음에도 결핵 발병 고위험군에 해당하는 망인에 대하여 결핵 진단의 기본적인 흉부 X-선 촬영을 하지 아니한 점 등에 비추어 보면, 망인은 오랫동안 루푸스 신장염에 의한 만성신장질환을 앓아 온 신장장애 2급 장애인으로서 결핵에 걸릴 확률이 매우 높을 뿐만 아니라 수감 전부터도 결핵균을 보유하고 있을 가능성이 있었던 것으로 보이는바, 서울구치소 의무관들로서는 망인에 대한 신체검사결과, 망인에 대한 문진결과, 망인의 기존 질환, 망인의 상태를 종합적으로 고려하여 망인이 계속적으로 무릎 통상을 호소하는 경우 결핵 감염 여부를 확인하기 위한 기본적인 조치로서 흉부 X-선 검사를 시행하는 등의 방법으로 조기에 망인의 결핵 감염 여부 등을 확인하여 그에 따라 전문 의료인의 검진 또는 치료를 받게 하거나 전문 의료기관으로 이송하는 등의 필요한 조치를 취해야 할 직무상 보호의무 내지 주의의무가 있다. 그럼에도 불구하고 서울구치소 의무관들은 좁쌀결핵 발견을 위한 기본적인 흉부 X-선 검사를 하지 아니하였고 2007. 7. 13. 한림대학교 성심 병원에서 시행된 좌측 무릎 관절강 내 삼출액 천자, 혈액검사, 균배양검사에서 비로소 좁쌀결핵이 발견되었고 그 이후 좁쌀결핵으로 인한 급성호흡곤란증후군으로 망인이 사망하였다.

Therefore, it is reasonable to deem that the deceased caused the death by negligence in breach of his duty to protect the deceased in the course of performing his duties or duty of care. Therefore, the defendant is liable to compensate the deceased and the plaintiff for the damages caused by the negligence committed by a public official in the course of performing his duties.

2) The Plaintiff asserted that the deceased did not provide appropriate medical treatment at the Seoul detention center even though he/she had been administered three times a week. However, the Seoul detention center’s correctional officer had the deceased receive blood injection treatment on six occasions from July 5, 2010 to July 16, 2010, and on July 19, 2010, when the symptoms of the deceased have deteriorated, the fact that he/she transferred the deceased to an emergency room at the Korea Forestry University and received medical treatment is as seen earlier. Therefore, the above assertion is without merit.

3) The Plaintiff asserted that the Seoul detention center’s correctional officer neglected to provide medical treatment to the deceased on July 13, 2010, despite the fact that it was necessary for the correctional officer to provide medical treatment within a knee knee knee knee kne kne knee knee knee knee knee knee knee knee kne. However, as seen earlier, on July 4, 2010, the deceased stated that he had no difficulty in daily life when he was in society, it is inevitable for the Seoul detention center’s correctional officer to delayed medical treatment according to the schedule of the Korea Forestry University Sae kne kne knee knee knee knee kn, and that the deceased continued to be subject to medical care by a medical officer even before he received the medical treatment at the above hospital, it is difficult to view that the Seoul detention center’s correctional officer intentionally neglected or delayed medical treatment.

4) The Plaintiff asserted that there was negligence by failing to take necessary measures, such as recommendation to suspend the execution of prison duties, in cooperation with related agencies, since it is apparent that it is difficult for the Seoul detention center to implement the custody of the deceased in light of the health condition of the deceased. However, in full view of the descriptions and the overall purport of the evidence Nos. 6 through 9, No. 1-2, and No. 1-2, and No. 2, the deceased’s hospitalization on July 19, 2010, which is the aftermath of the hospital, and was hospitalized in the patient room at the Han River University Sungsung University Sung-si Hospital of the same day, and the medical officer at the Seoul detention center received a decision to suspend the execution of prison duties on July 20, 2010, the deceased was subject to the suspension of the execution of prison duties on the same day. Unless there is any evidence to prove that the deceased had been serious symptoms to the extent that he could continue his prison life even before July 19, 2010, the Plaintiff’s negligence cannot be justified.

B. Judgment on the defendant's argument

1) The Defendant asserted that the Defendant’s narrow rice of the deceased could not be found solely on the basis of the chest X-ray test on June 1, 2010, which was conducted on the part of the Seoul Medical Center before the Deceased was able to find tuberculosis germs through the guest lave test, the ple-ray test, and the physical organization test. The chest X-ray test was conducted on the part of the deceased at the time of the operation, and the chest X-ray test was conducted on the part of the Seoul Medical Center on July 3, 2010, which was conducted on the part of the deceased, and the ple-ray test was conducted on the part of the deceased to find tuberculosis germs, and that the ple-ray test was merely conducted on the part of the deceased at the chest X-ray test at the time of the operation, which was conducted on the part of the Seoul Medical Center on June 1, 2010. Thus, even if the deceased’s chest X-ray test was conducted on the part of the Seoul Medical Center around July 3, 2010.

According to the result of the request for the examination of medical records to the head of the Seoul Hospital at the Seoul Medical Center from May 17, 2010 to July 1, 2010, the appraiser presented that there was no clear opinion suggesting that the deceased would be narrow rice tuberculosis on the chest X-ray image that was implemented five times at the Seoul Medical Center from May 17, 2010. Considering the fact that the deceased was hospitalized at the Seoul Medical Center as an acute pyroconitis, it is presumed that the pulmonary symptoms at the time of the hospitalization did not have any medical record, even if the pulmonary infection was caused, it was presumed that the scar X-ray was caused by the scarb during the locked period. On July 3, 2010, it cannot be presumed that there was no objective evidence that there was a narrow rice tuberculosis on the deceased at the time of such examination or inspection.

However, in light of the above evidence and the overall purport of the oral argument, the general tuberculosis diagnosis method is the fastest and effective method of chest X-ray-ray shooting and guest-to-door tuberculosis therapy, and the result of the examination of knee-vise knee knee knee knee knee (AFB 4+4+4), which was conducted by the Sungwon University on July 13, 2010, is serious tuberculosis germs in the case of the deceased.

증의 결핵이 상당히 진행된 상태였던 점, 한림대학교 성심병원의 의무기록지에는 망인이 입원 2주 전인 2010. 7. 5.경부터 기침과 좌측 무릎 통증이 발생하였고 입원 2일 전인 2010. 7. 17.경 호흡곤란이 시작되었으며 2010. 7. 19. 응급실 입원 당시 주증상이 호흡곤란으로 기재되어 있는 점(설령 망인의 위 기침과 호흡곤란이 좁쌀결핵의 증세라고 단정할 수는 없다 하더라도 일반적인 좁쌀결핵은 호흡곤란이 없는 경우가 더 많고 흔하기 때문에 호흡곤란이 없어도 흉부 X-선 사진에 좁쌀결핵을 의심할 수 있는 소견이 발견되는 경우가 많고, 망인과 같은 전신성 홍반성 루프스 환자는 결핵 발병 고위 험군에 속하며, 한림대학교 성심병원 응급실 입원 당시인 2010. 7. 19. 망인을 진찰한 의사가 흉부 X-선 사진을 통해 좁쌀결핵을 의심하여 추정 진단한 사정에 비추어 보면 서울구치소 의무관들이 망인에 대하여 좁쌀결핵을 예상할 수 없었다고 보기는 어렵다), 2010. 7. 13. 한림대학교 성심병원에서 시행한 좌측 무릎 관절 천자 검사 결과(AFB 4+), 2010. 7. 1. 서울의료원에서 시행한 무릎 통증에 대한 무릎 천자, 서울구치소에 수감된 2010. 7. 3.부터 한림대학교 성심병원 응급실에 이송된 2010. 7. 19.까지 망인의 무릎 통증 정도, 망인이 2010. 7. 5.경부터 기침과 무릎 통증을 호소하였고 2010. 7. 17.경 호흡곤란이 있었다는 한림대학교 성심병원의 진료기록 등에 비추어 망인의 좌측 무릎 통증은 결핵성 관절염으로 발생한 것으로 그 증상이 2010. 7. 1. 이전에 시작되었다고 볼 수 있는 점을 종합하면, 서울구치소 의무관들이 2010. 7. 3. 망인을 수감한 이후 2010. 7. 4. 망인에 대한 신체검사를 하고 망인이 무릎 통증을 계속 호소하다 한림대학교 성심병원 응급실에 이송된 2010. 7. 19.까지 망인에 대한 흉부 X-선 촬영을 하였다면 중증으로 진행된 좁쌀결핵을 발견할 수 있었다고 봄이 상당하고, 앞서 본 사정만으로 망인에 대한 흉부 X-선 촬영을 하였어도 좁쌀결핵을 발견할 수 없었다고 단정할 수는 없으므로, 피고의 위 주장은 이유 없다(더구나 망인이 서울구치소에 수감된 2010. 7. 3.부터 좁쌀결핵으로 한림대학교 성심병원 응급실에 이송된 2010. 7. 19.까지 서울구치소 의무관들은 흉부 X-선 촬영 장비를 보유하고 있고 결핵 발병 고위험군인 망인의 전신성 홍반성 루푸스 질환을 알고 있었음에도 결핵 발견을 위한 기본적인 흉부 X-선 촬영을 실시한 바가 없고, 결국 2010. 7. 13. 한림대학교 성심병원의 균배양검사에서 중증의 결핵균이 발견되었다는 점에서 망인에 대한 흉부 X-선 촬영만으로 망인의 좁쌀결핵은 진단할 수 없었다 하더라도 서울구치소 의무관들이 수용자의 생명. 신체 · 건강을 관리하고 환자의 구체적인 증상이나 상황에 따라 위험을 방지하기 위하

It is difficult to see that the best measure required has been fully taken.

2) The Defendant asserts that there is no causal link between the examination of narrow rice tuberculosis by the director of the Seoul detention center and the death of the deceased, because the breath-man's breath-man's breath-man's breath-man's breath-man's breath-man's breath-man's b

In full view of the aforementioned evidence and the overall purport of the oral argument, i.e., narrow rice tuberculosis is generated as soon as possible through dystrophism. Although clinical symptoms have occurred rapidly due to heat between several months, paralysis, dystrophism, decrease in body, etc., but it is also rapidly developing into the dystrophism dystrophism, and the general death rate of the rice narrow tuberculosis is more than 16-38%. The general death rate of the dystrophism after dystrophism is more than 30-70%, even if the dystrophism is treated as a heavy dystrophism, it is difficult to find that there is considerable possibility that the dystrophism might have been treated as an early dystrophy, and that there was no significant possibility that the dystrophy might have been treated as a dystrophy, and that there were no significant reasons for early treatment or treatment of the death of the deceased.

However, even if the harmful act and the victim's side side were caused or expanded by concurrent treatment of losses, the victim's side effects were irrelevant to the victim's side's causes, such as the risk of physical injury or disease, if compensation for all damages is contrary to the principle of fairness, the court may apply the legal principles of comparative negligence to determine the amount of compensation, and consider the victim's side who contributed to the occurrence or expansion of the damages (see, e.g., Supreme Court Decision 98Da1270, Jul. 24, 198).In light of the above evidence and the overall purport of oral argument, the deceased's treatment, namely, if he/she was provided with a medical officer's care on the day immediately following his/her identification, knee, and knee, and he/she did not have any difficulty in treating the deceased's daily life, and if he/she did not suffer from a sudden increase in the symptoms of a new tuberculosis care center due to a rapid decrease in the treatment of the deceased's cirratum.

3. Scope of liability for damages;

(a) The deceased’s lost income;

1) Gender on the basis of the basic matter, male, F date of birth, age 43, age 11, 29 at the time of the accident.

(ii) monthly income and operation period;

(3) The cost of living shall be assessed on the basis of the amount of income each 2th day of October 1, 2010, which is the day before the Plaintiff reaches the age of 60, which is the day after the scheduled date of expiration of the term, based on the daily wage of an ordinary worker for urban use in the report on the survey of the actual status of construction works issued by the Korea Construction Association.

[Based on the recognition] Evidence No. 1-1, Evidence No. 10, Evidence No. 10, Evidence No. 1-1, and Facts to the court of competent trial, and the purport of the whole pleadings

4) Calculation: calculated at the present price at the time of the occurrence of the loss in accordance with the discount method that deducts intermediary interest at the rate of 170,681,479 per month of 5/12 per cent, and the number of headings for the convenience of calculation shall be calculated only up to four decimal places, and any amount below the won shall be discarded.

A person shall be appointed.

5) Property damages 170,681,479 won x 20% = 34,136,295 won after limitation of liability.

(b) consolation money;

1) Reasons for taking into account: All the circumstances shown in the arguments of this case, such as the deceased’s age, health status, family relationship, and circumstances leading to the death of the deceased.

(2) The amount of recognition: 30,000,000 won for the Deceased, Plaintiffs 15,000,000. Socsium.

Therefore, the defendant is obligated to pay to the plaintiff 79,136,295 won [the inherited amount + KRW 34,136,295 of the deceased's property damage + KRW 30,000 of consolation money + KRW 15,000,000 of consolation money] and to pay damages for delay calculated at each rate of 20% per annum under the Civil Act from August 7, 2010, which is the date of death of the deceased until July 10, 2014, which is deemed reasonable for the defendant to dispute the existence or scope of his/her duty of performance, until July 10, 2014, and from the next day to the date of full payment.

4. Conclusion

Therefore, the plaintiff's claim shall be accepted within the scope of the above recognition, and the remaining claims shall be dismissed for lack of merit. Since the part against the defendant who ordered payment in excess of the above recognition amount among the judgment of the court of first instance which partially different conclusions is unfair, it shall be revoked and the plaintiff's claim corresponding to the revoked part shall be dismissed. The defendant's remaining appeal shall be dismissed for lack of merit. It is so decided as per Disposition

Judges

Senior Judge of the presiding judge;

Judge Lee Jin-hun

Judge Choi Jin

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