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Case: Guoqiang Yan vs. Beijing Haidian Obstetrics and Gynecology Hospital Facts: Plaintiff was a pregnant woman who had regular examinations at Defendant’s hospital. At the tenth examination, the doctor found there was too much amniotic fluid and unusual fetal movement. However, the doctor did not take the findings seriously and just arranged an oxygen uptake for Plaintiff. Lastly, the doctor asked the Plaintiff to come back the next morning. However, during her examination the next morning, Plaintiff had a stillbirth. Issue: What level of duty of care is owed to the patient by a hospital? Holding: Because of the importance of medical treatment for a patient’s life and health, a medical professional bears a duty of care to every patient. In this case, the doctor-patient relationship had been established. When the unusual symptom was found, Defendant did not notify Plaintiff of the danger and the possibility of an accident, nor ask her to stay in hospital for observation. Therefore, the hospital, as an institution for medical professionals, was at fault for its failure to fulfill the duty of care and notification. The stillbirth might also be attributed to Plaintiff’s personal reason. However, since it could not be concluded that the fetus would have died even if Plaintiff stayed in hospital, there was causation between the medical treatment and Plaintiff’s damage. Therefore, Defendant was liable in this case. Given Plaintiff’s personal reason and the uncertainty of stillbirth, Defendant shall bear partial liability. Rule: Where any damage is caused to a patient during the course of medical treatment, the medical institution shall be held liable if it failed to fulfill its professional duty of care.

The Instituto Mexicano del Seguro Social (IMSS) is the federal government medical institution with many hospitals around the country. Usually, the surgical operating areas within hospitals are constantly requested for emergency surgeries which trigger continuous changes in the established schedule, and having an effect in other factors such as doctors, nurses and patients, as well. In this paper, we tackle this type of dynamic scheduling problem with minimal perturbation by using and comparing two types of approaches: A Segmentation-based heuristic and a Genetic-Algorithm-based schema. The GA-based model which includes homogenous population (GA-HPop) obtains the best performance when tested with a set of real instances. It gets the best characteristics of Genetic Algorithm and adding changes, ensuring a new solution as possible close to original solution.

A multi-objective optimization model is proposed as a decision aid designed to standardize the interfacility patient transfer system in Bogota, Colombia. This model considers different patients’ preferences and the different situations in which a patient may be found, using multiple objectives, seeking to respect the patient’s right to choose the medical institution that will treat him or her, and while providing efficient solutions in terms of appointment wait time and travel distance.An ex-post study was done to evaluate the advantages of the model versus the previously usedmethod based on nurses’ empirical experience. The experiment took place in one of the largest and best-rated public hospitals in Colombia, which serves as benchmark for other hospitals in the country. The results of this comparison demonstrate that there are important advantages to using the model, because it delivers benefits in respect to improved patient choice and more prompt medical care.

Sick building syndrome patients often aggravate their symptoms because they do not recognize their condition or are unable to take appropriate radical measures due to financial, physical, or psychological reasons. In this chapter, we describe those reasons and give possible solutions. Sick building syndrome patients suffer from head-related symptoms, cognitive symptoms, affective symptoms, neuromuscular symptoms, musculoskeletal symptoms, skin-related symptoms, genitourinary symptoms, gastrointestinal symptoms, heart/chest-related symptoms, and airway and/or mucous membrane-related symptoms. These symptoms resemble symptoms caused by exhaustion, a cold, and/or aging. Therefore, patients are not able to recognize that their symptoms are caused by sick building syndrome, which leads to them aggravate their condition. In addition, psychosocial reasons may be responsible for symptom aggravation. The author’s main subject of research is sick building syndrome, and this chapter describes the reasons for symptom aggravation of sick building syndrome and possible solutions based on experience.

A survey of patient exposure in interventional cardiology is being conducted in Dubai Hospital, as part of the IAEA regional project on patient exposure in radiology. Because of the limited number of Gafchromic films available, the survey was conducted only in Dubai Hospital, a major medical institution in the City of Dubai. This Hospital receives a large number of patients annually for diagnosis and therapy purposes. The aim of the survey is to assess the Peak Skin Doses (PSD) incurred by cardiac patients undergoing angioplasty procedures. The technique adopted for this work uses a special Gafchromic film type XR-RV2 and is very practical for localizing the irradiated areas and determining the relevant PSD. Using a comparison tablet provided by the manufacturer with the films, the dose range resulting from the procedure can be rapidly estimated. A more refined method using a film digitizer (dedicated scanner) and appropriate software such as ImageJ allows the determination of the PSD.

As far as we know, the first medical X-ray in the Netherlands was made on January 28th, 1896, exactly 1 month after the announcement of Rontgen’s discovery of the X-ray (Hofmann 1896; Hart 1988). Even after an exposure time of 75 min the structure of the hand is not clearly visible enough to determine the skeletal age of the “patient”, but we know that it was a young lady of 22 years, daughter of the director (M.D.) of a medical institution. This experiment was described in a brochure of a secondary school in Maastricht (Hofmann 1896). It was the first publication in the Netherlands on radiology. The first certain paediatric X-ray was made at March 12, 1896. It shows the hand of a 10- to 11-year-old child after an exposure time of 1 h and 18 min. The X-ray was made in the same laboratory as the above-mentioned picture (Fig. 1).

According to the prevailing opinion of Soviet legal theory, and in practice, the civil responsibility of medical institutions for damage caused by treatment contrary to regulations is of a non-contractual, i.e. tort, character.30 It is considered that the duty of medical institutions to render medical aid to citizens is based directly on the law. The content of that duty is determined by the character of the special activities performed by medical institutions; these activities are regulated in more details in their statutes. The prevailing view is that relations between a medical institution and the patient regarding his life and health are not regulated by civil law norms; rather, they come into the sphere which is otherwise regulated by civil law norms only if the medical institution completely or partially fails to fulfil its duties towards the patient, thus causing him damage.31 The protection of life and health of citizens by means of civil law is thus effected not directly, but indirectly.

A patient’s right to compensation for irregular medical treatment exists exclusively against the medical institution whose worker caused the damage. Only the institution can be sued, not the medical worker directly responsible for the damage. That standpoint has been valid since 1962, namely since the enactment of the GCL. Until that time the judiciary had answered in a negative way to the issue of responsibility of medical institutions for damage caused by medical treatment, since there were no grounds for such litigation in the existing laws.60

Soviet law distinguishes four types of violations of duty committed by medical personnel and medical institutions: disciplinary, administrative, civil and criminal. Disciplinary and administrative regulations are invoked if a medical worker commits a disciplinary or administrative violation. However, if such violations are also punishable under criminal legislation, criminal proceedings are taken. Disciplinary and administrative violations are characterized by a lesser degree of danger. Therefore an act with a small degree of danger is not considered criminal even if it has the formal characteristics of a criminal act laid down in the criminal law.17 Such an act invokes only disciplinary and administrative (and possibly civil) responsibility.