醫療疏忽導致的損害賠償評估？申索得直

### 案件基本資料 - 案件名稱：Fung Chun Man v Hospital Authority and Secretary for Justice for and on behalf of Secretary for Food and Health - 法院：高等法院原訟法庭 (Court of First Instance, CFI) - 法官：Hon Bharwaney J - 判決日期：2011年11月11日 ### 案情摘要 原告於1990年7月23日出生，翌日被誤診為大動脈轉位 (Transposition of Great Arteries, TGA)，並於7月26日接受了不必要的手術，製造了一個房間隔缺損 (Atrial Septal Defect, ASD)，即「心臟有洞」。此缺損直至2003年2月5日才修補。原告聲稱因此手術及其後疏忽治療導致其生長發育受阻，並留下終身殘疾。第二被告（律政司司長代表食物及衞生局局長）承認診斷失誤及不必要手術，並同意賠償。第一被告（醫院管理局）的訴訟則獲准中止。本案主要為評估第二被告須支付的損害賠償 (assessment of damages)。 ### 核心法律爭議 本案主要爭議點在於評估原告因第二被告的醫療疏忽所造成的損害賠償金額。具體法律爭議包括：原告在2003年手術前是否出現症狀或殘疾；手術後是否持續出現症狀或殘疾；對其預期壽命的影響；對未來收入或賺取能力 (earning capacity) 的影響；以及靜脈滴注 (IV drip) 導致左腳跟壞死是否與誤診有關。雙方專家證人對原告術前術後狀況、運動耐量及心理影響存在分歧。 ### 判決理由 法官裁定，第二被告的誤診實質性地導致原告左腳跟壞死及住院時間延長。儘管原告的「心臟去適應化」(deconditioned heart) 表面上是自我造成，但其相信心臟受損的信念，加上父母的擔憂以及訴訟過程的加劇，均源於最初的侵權行為 (tort)。法官引用《Lam Pui Yi Anita v Secretary for Justice》一案，指出若侵權人通過不合理抗辯延長訴訟，導致受害人痛苦加劇，則侵權人須對全部損失負責。法官接納原告在兒童時期因房間隔缺損導致呼吸急促，但認為其水腫與急性腎炎有關。法官亦裁定原告術後的心臟去適應化及心因性胸痛與訴訟過程及其父母的擔憂有關，並認為這些均是最初侵權行為的後果。 ### 引用案例與條文 Lam Pui Yi Anita v Secretary for Justice [2011] 1 HKLRD 56：法院引用此案例，確立若侵權人通過不合理抗辯延長訴訟，導致受害人痛苦加劇，則侵權人須對全部損失負責，除非侵權人能成功證明受害人未能減輕損失。本案中，法官認為第二被告的行為導致原告的痛苦持續或加劇，因此須承擔責任。 Wang Sizhe v Ng Kwok Wah, HCPI 933 of 1999, 25 October 2000：此案被引用作為評估賺取能力損失的全球性賠償 (global award) 的參考。 Lam Yin Fong v Tsang Kam Cheong [2003] 3 HKLRD 501：此案亦被引用作為評估賺取能力損失的全球性賠償的參考。 Choy Wai Chung v Chun Wo Construction & Engineering Co. Ltd, HCPI No. 605 of 1999, 16 December 2003：此案同樣被引用作為評估賺取能力損失的全球性賠償的參考。 ### 裁決與命令 法庭裁定原告勝訴，並命令第二被告支付以下損害賠償：精神損害賠償 (PSLA) 500,000港元；未來收入損失/賺取能力損失 400,000港元；審前損失及開支 125,894港元；未來醫療及相關開支 345,800港元。總計1,371,694港元。法庭亦命令第二被告支付原告及第一被告的訴訟費用，並按法律援助規例評定原告的自身訟費。 ### 判決啟示 本案強調了醫療疏忽案件中，若被告方不合理地延長訴訟過程，導致原告的損害持續或加劇，則被告須對因此產生的全部損失負責。即使原告的某些狀況（如心臟去適應化和心因性胸痛）看似是自我造成或心理因素導致，但若其根源可追溯至最初的侵權行為，且被告未能及時提供輔導和康復服務，則被告仍需承擔責任。這對醫療疏忽案件中被告的訴訟策略和及時承認責任具有重要啟示。 --- ### 免責聲明 本摘要由人工智能自動生成，內容可能存在錯誤或遺漏，僅供參考，不構成法律意見。如需法律建議，請諮詢合資格律師。### Case Details - Case Name: Fung Chun Man v Hospital Authority and Secretary for Justice for and on behalf of Secretary for Food and Health - Court: Court of First Instance (CFI) - Judge: Hon Bharwaney J - Date of Judgment: 11 November 2011 ### Factual Background The plaintiff was born on 23 July 1990 and was misdiagnosed with Transposition of Great Arteries (TGA) the following day. On 26 July 1990, he underwent unnecessary surgery, resulting in an Atrial Septal Defect (ASD), commonly known as a "hole in the heart." This defect was not repaired until 5 February 2003. The plaintiff alleged that this surgery and subsequent negligent treatment stunted his growth and development and caused lifelong disabilities. The 2nd Defendant (Secretary for Justice on behalf of the Secretary for Food and Health) admitted to the negligent diagnosis and unnecessary surgery, agreeing to pay damages. The proceedings against the 1st Defendant (Hospital Authority) were discontinued. The case proceeded as an assessment of damages against the 2nd Defendant. ### Key Legal Issues The primary legal issue was the assessment of damages payable by the 2nd Defendant for medical negligence. Specific questions included: whether the plaintiff suffered symptoms or disabilities before the 2003 operation; whether symptoms or disabilities persisted after the successful operation; the impact on his life expectancy; the impact on his future earnings and/or earning capacity; and whether the IV drip causing left heel necrosis was related to the misdiagnosis. Expert witnesses for both parties presented conflicting views on the plaintiff's pre- and post-operative condition, exercise tolerance, and psychological impact. ### Ratio Decidendi The judge found that the 2nd Defendant's misdiagnosis materially contributed to the necrosis of the plaintiff's left heel and his prolonged hospital stay. While the plaintiff's "deconditioned heart" appeared self-induced, his belief in a damaged heart, reinforced by parental concerns and exacerbated by the litigation process, stemmed from the initial tort. Citing Lam Pui Yi Anita v Secretary for Justice, the judge stated that if a tortfeasor prolongs litigation through unmeritorious defence, aggravating the victim's suffering, they are responsible for the entirety of the loss, unless the victim failed to mitigate. The judge accepted that the plaintiff suffered shortness of breath due to the ASD during childhood but found his edema was related to acute nephritis. The judge also concluded that the plaintiff's post-operative deconditioning and psychosomatic chest pains were linked to the litigation and parental anxieties, all flowing from the initial tort. ### Key Precedents & Statutes Lam Pui Yi Anita v Secretary for Justice [2011] 1 HKLRD 56: This case was cited to establish that if a tortfeasor prolongs litigation by unmeritorious defence, aggravating the victim's suffering, the tortfeasor is responsible for the entirety of the loss, unless the victim failed to mitigate. In this case, the judge found the 2nd Defendant's actions prolonged or aggravated the plaintiff's suffering, thus incurring liability. Wang Sizhe v Ng Kwok Wah, HCPI 933 of 1999, 25 October 2000: This case was referenced as a comparable for assessing a global award for loss of earning capacity. Lam Yin Fong v Tsang Kam Cheong [2003] 3 HKLRD 501: This case was also cited as a comparable for assessing a global award for loss of earning capacity. Choy Wai Chung v Chun Wo Construction & Engineering Co. Ltd, HCPI No. 605 of 1999, 16 December 2003: This case was similarly cited as a comparable for assessing a global award for loss of earning capacity. ### Decision & Orders The court found in favour of the plaintiff and ordered the 2nd Defendant to pay damages totaling HK$1,371,694, comprising: HK$500,000 for pain, suffering, and loss of amenity (PSLA); HK$400,000 for future loss of earnings/earning capacity; HK$125,894 for pre-trial loss and expenses; and HK$345,800 for future medical and related expenses. The court also ordered the 2nd Defendant to pay the costs of the action for both the plaintiff and the 1st Defendant, to be taxed if not agreed, and the plaintiff's own costs to be taxed pursuant to the Legal Aid Regulations. ### Key Takeaways This judgment highlights that in medical negligence cases, if a defendant unreasonably prolongs litigation, leading to continued or aggravated harm to the plaintiff, the defendant is liable for the full extent of such losses. Even if some of the plaintiff's conditions (e.g., deconditioned heart, psychosomatic chest pain) appear self-induced or psychologically driven, if their origin can be traced back to the initial tort and the defendant failed to provide timely counselling and rehabilitation, the defendant remains responsible. This has significant implications for defendants' litigation strategies and the importance of timely admission of liability in medical negligence claims. --- ### Disclaimer This summary is AI-generated and may contain errors or omissions. It is for reference only and does not constitute legal advice. Please consult a qualified lawyer for professional legal advice.