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Case analysis of adverse drug reactions?

[ Case] On February 11, 1999, Zhang went to the clinic opened by Wanmou (a retired individual doctor) for treatment because of shoulder pain. In the course of treatment, Zhang claimed that he had ascaris, and Wan prescribed 12 levamisole tablets with batch number of 991323, 25mg each, which were produced by a pharmaceutical factory, and the doctor ordered them to be taken in two nights. After taking the medicine, Zhang began to have symptoms such as unstable walking, dizziness and unconsciousness on the 24th of the same month. Zhang was diagnosed as demyelinating encephalopathy (inflammation) caused by levamisole by a hospital in Ganzhou and was hospitalized. After targeted treatment, Zhang's condition improved obviously and he was discharged on March 6, 2111. When he was discharged from the hospital, Zhang was basically able to stand, walk and urinate, but his intelligence was impaired, and his computing ability, memory and binocular vision decreased significantly. After that, Zhang continued outpatient treatment. On March 28th, 2113, according to the medical appraisal of a hospital affiliated to a medical college in Wenzhou, the clinical diagnosis of allergic demyelinating encephalopathy (inflammation) caused by levamisole was established, and there was a causal relationship between them. Zhang spent RMB 58,719.41 yuan on reasonable medical expenses for treating this disease, and was comprehensively assessed as Grade IV disability. For this reason, Zhang believes that his drug allergic demyelinating encephalopathy (hereinafter referred to as "encephalopathy") is related to taking levamisole drugs produced by a pharmaceutical factory, and appealed to the court, demanding that a pharmaceutical factory compensate him for various losses amounting to RMB 381,381.98. [Trial] After trial, the court held that, according to pharmacological records, the meaning of adverse drug reactions refers to "harmful reactions unrelated to the purpose of drug use or unexpected under normal usage and dosage of qualified drugs". It contains three elements: First, drugs must be qualified. Personal injury caused by fake and shoddy drugs and other substandard drugs cannot be regarded as "adverse reactions". Second, medication must strictly comply with the express provisions of drugs, or comply with the correct medical advice of doctors. Abnormal and unreasonable drug use is not included. Third, a harmful reaction has occurred, and this harmful reaction has nothing to do with the purpose of treatment or is unexpected. Zhang suffered from "encephalopathy" after taking levamisole produced by a pharmaceutical factory. Forensic identification showed that there was a causal relationship between the drug and the "encephalopathy", and at the same time, it met the above three elements, so it could be considered as the result of adverse drug reactions of levamisole. Accordingly, according to Articles 4 and 132 of the General Principles of the People's Republic of China and the Civil Law of the People's Republic of China, the court sentenced a pharmaceutical factory to compensate Zhang for 31% of the losses, amounting to RMB 114,114.29. After the verdict, neither party appealed. [Comment] Adverse drug reactions are almost as long as the history of drug invention, and people with mild symptoms in good health generally have no reaction; In severe cases, some pathological reactions occur and their health is damaged; Extremely serious cases can be life-threatening. Limited by the level of scientific and technological development, human beings are still unable to develop drugs that are effective and harmless to all people (adverse drug reactions). As a patient, when his life and health are endangered and there is no beneficial and harmless substitute medicine in the market, the patient has no choice but to endure (adverse drug reactions). The drug market is risky for patients, which may be effective and harmful, but fortunately, the benefits outweigh the harm. For pharmaceutical research, production, sales and hospitals, the profits are rolling, and there is no risk. Adverse drug reactions will not harm their interests, but will bring benefits. There is no worry except the pressure of similar competition. As China has not yet established a compensation system for drug injury, it is unfortunate to encounter serious adverse drug reactions, and it is inconsistent with the modern society ruled by law to let the "unfortunate" bear the responsibility for the damage alone, obviously unfair. In this case, Zhang, as a patient, took the medicine according to the doctor's advice, and Wan wrote a prescription for Zhang according to the regulations within the scope of his post. His subjective purpose was to relieve the patient's pain. A pharmaceutical factory produced and sold qualified products according to the regulations, and the three parties were not at fault and should not bear the fault responsibility. However, at present, China has not established a system of compensation for drug injury, and Zhang can't get the compensation from the relevant departments. It is extremely unreasonable for Zhang, who is not at fault, to bear such a huge loss completely, which obviously violates the principle of fairness stipulated in Article 4 of the General Principles of Civil Law of China. Therefore, the loss of serious adverse drug reactions suffered by Zhang should be shared by the profit-makers in the pharmaceutical market. Article 132 of China's General Principles of Civil Law stipulates: "If the parties are not at fault for causing damage, they may bear it according to the actual situation." The actual situation is: Zhang was a leading cadre and engineer in a chemical fertilizer plant in a county, with a fixed monthly income of nearly 1,111 yuan. After suffering from "encephalopathy", he had no source of income. In addition to spending huge medical expenses, he also caused a fourth-grade disability and could not take care of himself completely. At present, there are two elderly people in their seventies and children who are still studying in their families. The life of the whole family depends entirely on the difficult subsidies after their husband and wife are laid off, and life is extremely difficult. Wan is a retired doctor, living on a pension, and his total income in the act of giving Zhang 12 tablets of levamisole is only a few cents, with little profit; A pharmaceutical factory is a pharmaceutical enterprise that produces levamisole in batches. Only 991323 produces 8 million levamisole tablets in a batch number. As a production enterprise, it can make more profits in mass production of drugs, and its ability to resist risks is obviously greater than that of Zhang. Therefore, according to Article 132 of General Principles of Civil Law, a pharmaceutical factory should bear the corresponding compensation responsibility. After retirement, Wan worked as a self-employed doctor, and he was old, so he made little profit and could not take responsibility. As a rare susceptible person, Zhang's internal cause is an important cause of his illness, and he should bear most of the responsibility.