A doctor in the central Chinese city of Wuhan who was hailed as a hero in the fight against Covid-19 is locked in a drawn-out medical dispute over her claim that a private hospital’s negligence left her nearly blind in one eye.
Ai Fen, director of Wuhan Central Hospital’s emergency department, is best known for providing an early genetic analysis report identifying the new coronavirus to her colleague Li Wenliang, a whistle-blower doctor who was reprimanded by his superiors and police for trying to raise awareness of the disease. He later died from Covid-19.
Ai has accused private hospital group Aier Eye Hospital of negligence in its preoperative testing and care for failing to diagnose retinal detachment in her right eye in May last year. Instead, she was given cataract surgery. The saga became public in January when she shared details of the dispute with her 2.15 million followers on social media platform Weibo.
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On Tuesday, the hospital group said an internal investigation found Ai’s deteriorated eyesight was not directly related to the surgery but admitted shortcomings in its patient care management. The group also alleged she was spreading false claims but said it wished to mediate with her to resolve the issue.
Ai hit back on Weibo, saying the group’s statement was full of holes and accusing it of lying. She told the South China Morning Post she was acting not only for herself, but to prevent others from suffering a similar ordeal.
The dispute has highlighted the complexities surrounding the protection of patients’ rights in China, including the determination of appropriate fault in claims of medical negligence.
“Aier Eye Hospital needs to admit its mistake. If it doesn’t own up, how will mistakes be corrected?” Ai said. “I feel it is relatively difficult for patients to protect their rights. Medical workers need to treat patients with their hearts, because even a small mistake can lead to irreparable damage to patients for the rest of their lives.”
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After the surgery, which included an artificial lens implant to improve vision in her right eye, Ai found her condition worsened. Five months after the operation, she was diagnosed at Wuhan Central Hospital with a detached retina – an emergency condition that can lead to permanent loss of vision the longer it is left untreated. Ai had another operation to treat the detached retina at her own hospital in October.
Ai said Aier Eye Hospital should have discovered the condition during tests before and after the original surgery. The implant would not have helped her vision in the case of a retina detachment. She alleged the private medical group had put too much focus on selling her a lens implant and failed to detect serious issues with her right eye, leading her to miss the best treatment time.
According to China’s court judgments repository, the hospital chain and its subsidiaries have been involved in at least a dozen medical dispute lawsuits.
Ai’s Weibo page has become a place for other users to share their complaints about their experiences with mostly private medical facilities. Many have spoken of their challenges, with claims that hospitals have dragged out disputes over a long time or that the doctors involved had tampered with their medical records.
The number of claims for inadequate treatment, negligence and malpractice has been increasing with China’s ageing population and growing demand for medical services. The uneven distribution of medical resources and varying quality of care in the country’s private health sector are also behind the increasing number of disputes.
Between 2006 and 2016, the number of medical-related lawsuits doubled from 10,248 to 21,480, according to a 2018 report by online media platform NetEase News.
Of particular concern is the small number of medical disputes that turn into violent incidents targeting doctors and hospitals. In January, a disgruntled patient detonated a home-made explosive in a hospital in the eastern city of Hangzhou, wounding four people. Statistics from the Chinese Society of Criminology show there were 54 attacks in 2016, and 15 in 2019.
In January 2020, Beijing ophthalmologist Tao Yong was stabbed repeatedly in the head by a patient, suffering a fractured skull. He survived but lost the use of his left hand. According to Southern People Weekly magazine, Tao had done everything he could for the patient and did not know why he was attacked.
Tao spoke out in support of Ai in January, posting on Weibo that he admired her bravery for going public and that he wanted to work with her to reduce the number of patients with detached retinas.
Beijing-based lawyer Li Enze said Ai’s case had attracted a lot of attention because of her high profile. Many medical disputes did not even make a splash, with most ordinary people lacking the resources to go up against institutions.
“If the patient had been an average person, they probably would have had to let this go. But Ai Fen is a VIP patient, and her professional background, resources, fame and capabilities are a lot stronger than an average patient. The laws on medical disputes are established but compared to hospitals, normal patients usually lack the resources to dispute or litigate cases,” he said.
Zhang Li, a doctor turned lawyer who specialises in medical disputes, said institutions generally had more power and technical expertise than patients, who were in a weaker position. Some issues may exist that specialists were used to and did not consider a problem and, without intervention from the media or civil society, it was hard to attract attention.
More often, said Zhang, disputes arose for a range of cultural and technical reasons, including a lack of trust and communication between doctors and their patients, as well as an insufficient medical forensic capability in the country.
“The public doesn’t know or finds it hard to understand the risks, complications and uncertainties associated with some medical procedures. They see treatments that haven’t brought expected results or that lead to any adverse effects as simply medical malpractice,” Zhang told the Post.
Zhang said medical practitioners needed to improve their communication with patients and educate them on their expectations. Patients should have a stronger awareness of legal processes and how to protect their rights. Lastly, while the legal framework to resolve medical disputes had continuously improved in recent years, he said more work needed to be done to offer fair medical forensic assessments.
In 2019, China’s National Health Commission said private hospitals would be incorporated into the same medical quality management platform as public hospitals, in response to concerns over the quality of services offered by fast-growing private facilities.
Additional reporting by Guo Rui
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