Precautions When Transferring a Patient to Another Medical Institution
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A physician's duty of care for the health and safety of a patient does not end at the diagnosis or surgical stages. Post-treatment care and monitoring are essential until the patient recovers. If the patient's condition worsens, it is necessary to promptly transfer them to another specialist or medical institution.
When a patient's illness falls outside the physician's area of expertise, the physician has a duty to actively evaluate the need for treatment at a higher-level medical institution based on the patient's condition.
First, if the patient's disease falls outside the physician's specialty, and the physician judges that the patient's condition is difficult to manage with the available medical facilities or the physician’s clinical experience, the patient must be transferred to a hospital where they can receive proper treatment. The transfer should occur before the patient's condition deteriorates beyond a point where treatment can be effective. Furthermore, there must be a medical institution with appropriate facilities and specialists in the area to which the patient can be transferred. Lastly, the transfer should be expected to potentially avoid significant harm or improve the patient's prognosis.
In this regard, the Supreme Court has ruled that if it is difficult to provide proper treatment, the physician must promptly take steps to transfer the patient to another hospital where specialized care is available.
In such cases, unless there are special circumstances, the physician must promptly explain to the patient or their legal representative (e.g., parents or legal guardians) the patient's specific symptoms, the necessity of transfer, and the risks of not transferring, in a manner consistent with the current medical standards. The patient should then be allowed to make an informed decision about whether to move to another hospital and receive medical treatment, weighing the necessity and risks of the transfer (Supreme Court rulings 2006Da41327, 2013Da33485).
When transferring a patient, consent from the patient or their guardian is required. However, according to Article 47-2 of the Medical Law, in situations such as natural disasters, suspected infectious diseases, or mass casualty incidents, where transferring hospitalized patients without consent is essential to prevent significant harm to their life or health, transfer can occur without the patient's or guardian's consent.
Regarding patient transfer, it is important to confirm the following details:
- Whether the patient's condition has been adequately communicated to the receiving institution.
- Whether medical personnel accompanied the patient during the transfer.
- Whether necessary emergency measures, such as oxygen supply, were provided during the transfer.
- Whether appropriate steps were taken to avoid potential adverse outcomes during the transfer.
- Whether the patient’s condition worsened prior to the transfer.
- Whether the medical procedure could not be performed at the original institution.
- Whether the patient had any specific physical traits or medical history that could affect the transfer.
Systematically, it is crucial to establish a rapid transport system in coordination with specialist hospitals, large hospitals with emergency departments, and emergency service providers such as the fire department. Additionally, ensuring quick and seamless integration with emergency institutions is essential.
To prevent medical disputes related to transfer, detailed documentation of the checks and verifications, including medical records and, when necessary, recordings or recordings made on mobile phones, are essential.
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