207 Gaz. 19955 Damage, Claim

1. P1 (54 Yearss and Females);

2. P2 (Year 52, Female)

3. P3 (Age 81, South Korea)

4. P4 (P43years and Females)

[Defendant-Appellant] Defendant 1

Attorney Yellow Jae-in

School Foundation D Private Teaching Institutes

Attorney Park Ha-nam, Counsel for the plaintiff-appellant

November 19, 2008

December 10, 2008

1. The defendant shall pay to the plaintiff P1 the amount of KRW 20,000,000, KRW 5,000,000 to the plaintiff P2, and KRW 2,000,00 to the plaintiff P3 and P4, respectively, and 5% per annum from August 17, 2006 to December 10, 208, and 20% per annum from the next day to the date of full payment.

2. Each of the plaintiffs' remaining claims is dismissed.

3. Ten percent of the costs of lawsuit are assessed against the defendant, and the remainder is assessed against the plaintiffs.

4. Paragraph 1 can be provisionally executed.

The defendant shall pay 614,834,964 won to the plaintiff P1 and 15,00,000 won to the plaintiff P2, and 5,000,000 won to the plaintiff P3 and P4 respectively, and 5% per annum from August 17, 2006 to the delivery date of a copy of the application for change of claim and cause of claim, and 20% per annum from the next day to the day of full payment.

1. Facts of recognition;

A. The relationship between the parties

Plaintiff P1 is a person who has undergone a chronological surgery on the right-hand beer type at D University XX Hospital (hereinafter referred to as the “Defendant Hospital”) operated by the Defendant, and caused cerebral blood transfusion and led to the left-hand paralysis. Plaintiff P2 is her husband, Plaintiff P3, and P4 are her children.

(b) Progress of treatment;

(1) Although Plaintiff P1 had a flat sporactic doubles, the Plaintiff’s medical examination conducted Masana Hospital on July 14, 2006 without undergoing any specific treatment, and as a result, the Masana Hospital found the upper right-hand Macrom type (scale 3 x 3 cm), Plaintiff P1 was hospitalized on August 11, 2006 by visiting the Defendant Hospital for the precise diagnosis and treatment of this, and there was no symptoms of special appeal, such as that the Macro was normal and the Macro, and that there was no symptoms of appeal.

(2) On August 14, 198 of the same year, the medical personnel of the Defendant Hospital performed the chronological surgery to the above plaintiff on August 14, 2007, confirming that the chronology of the same year is located on the right side side side side side side side side side side side side side side side side side, that blood has been supplied from the upper right side brain be flown out by the chronum beratum beral ber (the ber under the right side side) and that blood has been flown out to the above plaintiff. The medical personnel of the Defendant Hospital performed the chronological surgery to the above plaintiff on August 17, 200.

(3) However, after the above plaintiff had been hospitalized and returned to the hospitalization room, pulmonal distress disorder, the face-to- left part of the mouth disorder was shown, and cerebral typosis was found as a result of brain CT photographing, and the above plaintiff showed cerebral typosis in an anti-conceptic condition, and the medical personnel of the defendant hospital performed typical typology and typology removal for the above plaintiff. As a result of the above surgery, it was found that the above plaintiff had blood transfusion in the part of the body of the right side and the left part of the upper part of the cryposis, other than the cryp type and cerebral typosis, and as a result, it was found on August 18, 196 that there was an increase in the shape of cryposis and the upper part of the upper part of the upper part of the cryposis and the upper part of the upper part of the cerebral typosis in the central upper part of the upper part.

(4) The above plaintiff has continued to be treated in a state of complete paralysis on the left-hand side, walking disability, liver quality, vision disorder, memory disorder, recognition function low-income bracket, and urine urine disorder, etc. due to the aftermab hospitals after being discharged from the defendant hospital on January 7, 2007.

(c) Relevant medical knowledge;

(a) Brain beer type;

(A) Definition volume must normally flow out in the order of the meterosis. The brain beer type refers to the form of sulpherosis directly performing relationship with the same connection because it does not occur between the connection and the relationship. In such a case, the high pressure of the same is the cause of cerebrovasphering immediately due to a relatively weak tension with the blood, which is the cause of cerebrsphering, due to low voltage and low constant voltage, resulting in a cerebrspherosis into the surrounding brain system. On the long-term exposure to this situation, the primary brain structure causes nephism and robbery, and the surrounding blood is likely to cause trouble prior to automatic control, and thus, the most serious disorder is likely to occur prior to the automatic control. Under such circumstances, when the cerebrspherosis type was removed or cut into the malphere surgery, it would be difficult to discharge the surrounding cerebrspherral system to cause severe exposure to cerebrspherral surgery and thus, it would be impossible to discharge the surrounding cerebrspher function.

As a result of the complication of the cerebral typosis, the cerebral typosis is the representative of the cerebral typosis, and depending on the degree of the cerebral typism, the cerebral typism can cause various mergers such as unknown consciousness from death, anti-pathy expenditure

(B) Diagnosis and towing brain beer type is diagnosed through a large-scale brain CT or MRI photographing, and such diagnosis is conducted in order to verify the inflow, connection, and outflow and connection of the engine type, and to accurately grasp the size and the parts of the sick.

In general, it is known that approximately 70 to 80% of the cerebral marisome type may cause blood transfusion (if there are 30 years or more, the possibility of blood transfusion is almost 100%). If the marithal marithal marithal marithal is two, the 2-4% cumulative risk level exists, and the exchange rate and death rate due to marithal mathal is about 50%. approximately 23 to 67% of the patient who suffered from marithal mathal mathal mathy. The mathal mathal mathal mathalthy is about 6%, the malithal mathal mathal mathal, and the mathal mathal mathal mathal mathal mathal mathal mathal mathal mathal mathal mathal mathic ma.

(다) 치료방법 뇌동정맥기형의 치료목적은 출혈을 방지하고 동정맥기형으로 가는 혈류를 없애 정상뇌조직으로 혈류를 보내는 것인데, 뇌동정맥기형에 의한 두개강내 출혈의 예방에 보존적 치료는 근본치료가 될 수 없고, ① 도관(catheter)을 혈관에 삽입하고 혈관 내로 코일 등 색전물질을 주사하여 일부 뇌동정맥기형을 폐색시키는 색전술, ② 방사선을 기형 부위에 정확하게 위치시켜 조사(照射)함으로써 기형을 치료하는 정위적 방사선 수술(감마나이프 수술), ③ 외과적 수술을 통해 기형혈관을 제거하는 것이 근본적인 치료방법이라 할 수 있다.

Among them, the most abnormal treatment method is to remove the crypology completely through the surgery without any psychotropic deficit, not only one method but also maximizes the effects of the cypological treatment at the beginning of the past. While there have been a tendency to mainly treat the cypological treatment at the beginning of the past, it has shown a tendency to actively treat the crypological treatment through accumulation of surgery experience by gypical surgery with the development of surgery and surgery techniques, and the development of crypological surgery through crypary selection by supphers.In other words, it is not just to perform the chypological operation, but to maximizes the effect of the surgery by means of reducing the size of the crypine by using the crypological as a supplementary operation to reduce the size of the crypine in a way suitable to reduce the size of the crypine, etc., due to the difficulty of complete removal of the cypine type surgery and the complete removal rate of the cypical surgery.

(2) The coloring of the function and side effects of the chronology is used as auxiliary methods, such as facilitating the operation by inserting the chronology into the cerebrovascular, partially melting the chronology into the cerebrovascular, reducing the size of the sick, or reducing the size of the sick at the heart that is difficult to access in the process of the operation through the operation before the operation, or increasing the treatment performance rate by reducing the size of the sick at the time of treatment through the constant radioactive operation. Although the chronology alone can only be treated at once only with the chronology, the chronology can be used in such a way as to reduce the scope of the operation by performing the operation before the operation, before the operation, or after the aftermathy operation. On the face of the chronology, the chronic chronology can be used as a method that reduces the range of operation by performing a chronological operation due to a large size of radiation in the surrounding parts at the time of the operation.

In the case of color transfer, there are advantages that can avoid psychotropic loss due to external surgery, but there are problems such as the movement of color electric material to the beer of abandonment, the closure of normal blood cells, the transfer to the original abandonment of color electric material, and the problem of color transfer itself such as influoring, and the color transfer only when it is impossible to completely fluorize the clisome, such as the re-exiting of symptoms before the symptoms, the re-exploiting, re-exploiting, and the fluoring type due to sudden changes in blood.

[Grounds for Recognition: omitted]

2. Whether liability for damages arises;

A. Whether the procedure is negligent

(1) The plaintiffs' assertion

The plaintiff P1, who was hospitalized due to the absence of any impediment to daily life, and the plaintiff P1, was hospitalized and returned to the hospitalization room immediately after he administered the instant e-mail, and immediately after he returned to the entrance, physical changes occurred as long as it is difficult to view it as a e-mail after chronological disorder, which occurred in the left-hand e-mail, and it is difficult to view it as a e-mail after the e-mail. After the e-mail of this case, 10 minutes after the e-mail of this case, the e-mail of this case was discovered, and the e-mail of this case was made up to the second surgery. As a result of the e-mail photographs immediately after the e-mail of this case, the e-mail of this case is necessary to perform 40% coloring surgery of the right-hand e-mail and supplied the e-mail of this case, and the defendant is responsible for performing the above e-mail surgery due to the rapid changes in the user's e-cerebr surgery of this case.

(2) Determination

Medical practice is an area requiring highly specialized knowledge, and it is extremely difficult for a general person, not an expert, to clarify whether he/she has violated the duty of care in the course of medical practice, or whether there exists causation between the violation of the duty of care and the occurrence of losses. Therefore, when symptoms causing death to a patient during the surgery occur, it is possible to presume that such symptoms are based on medical negligence by proving indirect facts that it is difficult to deem that there are any other causes than medical negligence. However, even in such a case, it does not allow a doctor to bear the burden of proof of negligence by estimating the causal relationship between the doctor's negligence and the result of gross negligence (see, e.g., Supreme Court Decisions 2005Da5867, May 31, 2007; 2002Da45185, Oct. 28, 2004).

이 사건 색전술 시행 후 위 원고에게 뇌출혈이 관찰되었고, 뇌 CT촬영 결과 뇌의 중앙선이 좌측으로 밀려나서 뇌실 내 조직들이 커진 상태로 나타난 사실은 앞서 본 바와 같으나, 앞서 본 인정사실과 앞서 든 각 증거 및 이 법원의 YY대학교 YY 병원장에 대한 신체감정촉탁결과에 의하여 인정되는 다음과 같은 사정, 즉 뇌동정맥기형의 자연경과에 따른 뇌출혈의 위험도가 매우 높고, 위 원고의 경우 색전술 시술과 상관없이 이 사건 색전술 당일 뇌출혈이 발생할 가능성이 매우 높았으며 언제든지 출혈이 가능할 정도로 뇌동맥기형의 상태가 나빴던 점, 외과적 수술을 용이하게 하거나 방사선 수술에 의한 치료시 병소의 크기를 감소시켜 치료성공률을 높이기 위하여 색전술을 통하여 동정맥기형 부분을 부분적으로 폐색시키는 방법이 많이 사용되고 있는 점, 색전술 시술 후 급격한 뇌혈류의 변화에 의하여 뇌출혈이 발생할 수 있는 점, 색전술의 시술에 있어서 시술자가 아무리 주의를 기울이더라도 의학적으로 예측불가능한 상황이 발생할 수 있는 점 등에 비추어 보면, 위 인정사실만으로는 피고 병원 의료진의 시술상의 과실을 인정하기 부족하고 달리 이를 인정할 증거가 없으므로, 원고들의 위 주장은 이유 없다.

B. Whether the duty of explanation is violated

(1) The plaintiffs' assertion

As the treatment method for the East Macro type, the medical professionals at the Defendant hospital did not fully explain whether color pre-treatment is the best choice, the short point of each operation, the side effects of color pre-treatment, etc. and did not cause the Plaintiffs to lose the opportunity to choose other treatment methods.

(2) Determination

In general, in the event that a doctor performs a medical act that is likely to cause a bad result, such as surgery, etc. to a patient, or perform a medical act that is anticipated to cause a death, etc., he/she is obligated to explain the patient or his/her legal representative about the symptoms of the disease, the contents and necessity of the treatment method, the potential risk of the occurrence, etc. in light of the current medical level and to fully compare the patient's necessity or risk and select whether the patient is to receive such medical act.

In the instant case, the treatment method for the brain male type has problems such as the removal of cryposis, coloring, radiation surgery, etc. Of them, chronology has advantages that can reduce loss by avoiding psychotropic loss caused by the surgery for the outer surgery or parallel with the external surgery. However, in the implementation of chronology, there is no problem that the treatment method for the male type has increased due to the maleing of the male type, but it is difficult for the Plaintiffs to fully explain the problems and coloring of the male type, such as moving of the male substance to the malecule, closing of normal blood transfusion, moving of the color electric material to the malecule, and the malecul type only with the male type, and thus, it is difficult for them to fully explain the problems of the treatment method of the Plaintiffs to the above malecule type, and there is no problem in selecting the treatment method of the Plaintiffs to the above 1 malecul type.

(갑 제1호증의 1, 갑 제3호증의 기재에 의하면, 피고 병원의 의료진은 원고 P4에게 수술과정 및 방법에 대하여 "뇌 자기공명영상 → 뇌혈관조영술 → 우측 전두엽 뇌동정맥 기형 발견 → 경기 가능성 또는 출혈 ⇒ 크기 크나 → 혈관색전술, 감마나이프 방사선 수술"을, 수술 후 발생가능한 합병증, 후유증 및 기능장애에 대하여 혈종, 뇌출혈, 혈관박리 등 출혈 가능성, 감염, 조영제 부작용 등, 특히 뇌출혈이 큰 경우는 수술이 필요하고 사망할 가능성이 있으며, 뇌출혈이 적은 경우 약물치료로 경과관찰이 필요하다는 점 등을 설명한 사실은 인정되나, 위와 같은 사정만으로 피고 병원 의료진이 위와 같은 설명의무를 다하였다고 할 수 없다.)

3. Scope of damages and amount of damages;

A. Scope of damages

If a doctor violates his/her duty to explain and claims consolation money on the patient's loss of opportunity to choose and the impossibility of exercising his/her right to self-determination, it is sufficient to prove only the fact that he/she has lost the opportunity to choose due to a doctor's breach of duty to explain, and there is no need to prove the relationship that the result would not have occurred if he/she received the explanation. However, there is a proximate causal relationship between the significant result and the doctor's breach of duty to explain if he/she claims all damages as a result, and in such a case, the violation of the duty to explain must be the same as the degree of violation of the duty to explain caused by medical invasion on the patient's life and body in light of the purpose of protecting the patient

(b) the existence of causation;

As seen earlier, as a general rule, approximately 70-80% of the brain cryposis type causes blood transfusion, and if the cryposis level increases every year, most patients are subject to active treatment and preservation treatment cannot be a fundamental treatment. In treatment of the crypryposis type, rather than using only one method depending on the degree of disease in treatment of the cryposis type, it is used as a supplementary method in order to facilitate treatment of the crypryp type or enhance the treatment rate of radiation surgery, and the size of the crypryp type of the P1 is at least 3 cm and 3 cm, and it is difficult to deem that there is a risk of crypyposis type in light of the fact that the crypryp type of the crypryp type of the cryp type of the cryp type of the cryp type of the cryp type of the cryp type of the cryp type of the cryp.

Therefore, due to the breach of duty of explanation by the medical personnel of the defendant hospital, the scope of damages that the defendant should compensate is limited to consolation money.

(c) Compensation money;

Considering the developments and results of the instant medical treatment, degree of violation of the duty to explain, gender and age of Plaintiff P1, the relationship between Plaintiff P1 and all other circumstances indicated in the instant medical proceedings, it is reasonable to determine that Plaintiff P1 is consolation money of KRW 20,000,000 for Plaintiff P1, KRW 5,000 for Plaintiff P2, and KRW 2,000 for Plaintiff P3 and P4 for Plaintiff P3 and P4.

4. Conclusion

Therefore, the defendant is obligated to pay the plaintiff PI for delay damages at each rate of 20,000,000 won and 5,000,000,000 won to the plaintiff P2, and 2,000,000 won for each of the plaintiff P3 and P4, and 2,000,000 won for each of the defendant's default or tort after August 17, 2006, which is sought by the plaintiff, and it is reasonable for the defendant to dispute about the existence and scope of the duty of performance from August 17, 2006 to December 10, 2008, and 20% per annum under the Civil Act for the next day to the day of full payment. Thus, the plaintiff's claim is justified within the scope of the above recognition, and the remaining claims are dismissed, and it is so decided as per Disposition.

Judges of the presiding judge, Kim Dong-ho

Judge Choi Jong-in

Judges Nam Sung-woo