Reform vital to redress injustices - Taipei Times
Fri, May 11, 2018 - Page 8 News List

Reform vital to redress injustices

By Huang Hui-fu 黃慧夫

Modern medicine is based on the scientific methodology of continuous experiments and logical analysis. Every medical diagnosis and principle of treatment must be supported by sufficient evidence. Baseless assumptions are not permissible.

Medical rigor is really humility in the face of fearsome ailments, because the more you know about the mysteries of the human body, the more you will be amazed by the greatness of the creator, and the more clearly you will recognize that medicine has its limits.

As a surgeon, my mission is to cure illnesses and save people. It is therefore hard to accept that after doing everything I could to fight an illness, I found myself treated as a “criminal” under the Criminal Code.

A little after 4pm on Aug. 7, 2008, our hospital’s emergency room notified me that a seriously ill patient had come in with a badly swollen lower leg, and the symptoms indicated a critical condition known as compartment syndrome.

This syndrome is often seen in traffic accidents and if it is not treated promptly it has a mortality rate of about 40 percent.

The treatment for compartment syndrome is also very special. It requires performing a fasciotomy, which involves opening an incision about 20cm long in the affected part so that blood and other fluids can drain out.

This incision is left open until the swelling is completely reduced, which takes about two weeks, after which it can be closed up with sutures. While the incision is open, the open wound is not protected by skin, so it is essential to prevent bacterial infection.

Medical statistics show that fasciotomies have a success rate of about 70 percent, while 20 percent of cases require amputation and 10 percent of patients might die.

I performed the urgent operation at 6pm that day, hoping to save the young patient’s right lower leg, but unfortunately six days later it had to be amputated.

The patient’s father thought the amputation was the doctor’s fault, so he filed criminal charges against me. I was found not guilty in the first trial, but in the second trial the verdict was changed to guilty and I was sentenced to four months in prison.

Article 376 of the Code of Criminal Procedure (刑事訴訟法) states that cases involving offenses with a maximum punishment of no more than three years imprisonment cannot be appealed to the court of third instance.

This restriction applies no matter whether the second trial results in a guilty or not-guilty verdict, and it meant that I could not appeal the verdict of the second trial.

In the second trial, the judges said they overturned the first ruling because I had not paid close attention to the patient’s blood circulation and obstructed blood vessels.

The problem with this judgement is that, in addition to the case history, the patient’s care team took photographs of the wound every day, which clearly showed that the blood circulation in the leg was satisfactory. That is why the first trial arrived at a verdict of not guilty.

However, this was not even mentioned in the second ruling, suggesting that the judges did not even notice the existence of the photographs.

Furthermore the entire judgement conflicts with pathology. It plays with words and is based on groundless assumptions, and it misinterprets the opinions expressed in the medical review committee’s appraisal of the case.

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