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Zodpovednosť za škodu pri odbere krvi


 | 25.3.2014 | komentárov: 302

Tento týždeň neprehliadnite rozhodnutie Nejvyššího soudu České republiky, v ktorom rozhodoval o zodpovednosti za škodu spočívajúcu vo vlastnostiach ihly používanej pri odbere krvi (sp. zn. 25 Cdo 797/2011).

Žalobkyňa V. P. sa žalobou podanou proti Fakultnej nemocnici v Motole domáhala zaplatenia náhrady škody. Tá jej bola spôsobená odberom krvi, ktorý spôsobila v rámci liečby flexotrombózy hlbokých žíl ľavej dolnej končatiny.  Pri odbere krvi pociťovala žalobkyňa brnenie prstov a následne u nej došlo k poruche ich citlivosti a vzniku rozsiahleho hematómu, čo spolu s ďalšími komplikáciami viedlo až k operácii, pri ktorej jej muselo byť odstránené odumreté svalstvo. Prvostupňový a ani odvolací súd jej nárok nepovažoval za odôvodnený, keďže považovali za dostatočne preukázané opatrenia, ktoré zdravotnícky personál vykonal po zistení hematómu. Za preukázanú považoval aj skutočnosť, že nedošlo k zanedbaniu zdravotnej starostlivosti a ich postup bol v súlade s lege artis, v dôsledku čoho „není splněna podmínka obecné odpovědnosti za škodu podle § 420 odst. 1 obč. zák. Vznik hematomu je nejčastější komplikací při odběru krve, jíž se nedá zabránit ani přes dodržování veškerých opatření a standardních postupů.“ V danom prípade teda neboli naplnené predpoklady zodpovednosti za škodu, a preto žalobkyni nebolo vyhovené. „Mezi zdravotními potížemi žalobkyně a lékařskými postupy a zákroky nebyla prokázána příčinná souvislost, neboť poranění loketní žíly injekční jehlou při odběru krve je s pouhou pravděpodobností primární příčinou následného krvácení a rozvoje hematomu za současného podávání kombinace léčiv s antikoagulačními účinky, přičemž k následku mohlo dojít i nedostatečným stiskem po odběru či porušením klidového režimu paže.“

Žalobkyňa s uvedenými závermi nesúhlasila a rozhodla sa podať dovolanie proti rozhodnutiu odvolacieho súdu. Medzi dôvody jeho podania uviedla rozpor s konštantnou judikatúrou najvyššieho súdu, keďže v danom prípade nepostačovalo „prokázání příčinné souvislosti „stoprocentně“ a nepostačovala-li pravděpodobnost vysoká, blížící se jistotě.“

Najvyšší súd ako dovolací súd sa rovnako ako súdy v konaniach, ktoré predchádzali podaniu dovolania, zaoberal otázkou existencie príčinnej súvislosti medzi postupom žalovaného zdravotníckeho zariadenia a škodou vzniknutou žalobkyni. „Existenci příčinné souvislosti je třeba vždy postavit najisto; pravděpodobnost škodlivého následku ve vztahu k úkonu odpovědného subjektu nepostačuje, neboť povinnost k náhradě škody lze ukládat pouze tehdy, jsou-li podmínky odpovědnosti splněny, nikoliv jsou-li pouze pravděpodobné. Jestliže tedy zdravotničtí pracovníci žalované nepostupovali při léčbě žalobkyně v rozporu s požadavky na správný postup (tzv. lege artis) a nebylo-li zároveň prokázáno, že újma žalobkyně byla vyvolána devastujícím účinkem ostré injekční jehly použité při odběru krve dne 17. 5. 2007, odpovědnost žalované nenastává.“

Na druhej strane najvyšší súd uviedol, že je nesporné, že poškodenie zdravia žalobkyne bolo spôsobené samotnými vlastnosťami injekčnej ihly, a teda išlo o škodu spôsobenú vlastnosťami, ktoré majú pôvod v povahe prístroja alebo inej veci použitej pri plnení záväzku. Ide teda o absolútnu objektívnu zodpovednosť, ktorá „však neznamená odpovědnost za všech okolností, nýbrž vzniká pouze tehdy, jsou-li splněny všechny její zákonné podmínky (okolnosti, které mají původ v povaze věci, vznik škody a příčinná souvislost mezi nimi). Pokud některá z podmínek chybí, nelze žalovaného k náhradě škody zavázat.“ V danom prípade však k poškodeniu zdravia žalobkyne nedošlo v dôsledku samotného použitia ihly pri odbere, keďže pri ňom nenastali žiadne komplikácie. „Škodlivý následek vyvolal teprve následný rozsáhlý hematom, tj. únik krve do tkáně tímto otvorem. Při zdravotním stavu žalobkyně byl rozsah krvácení ovlivněn především léčebným postupem, při němž jí byla vzhledem k trombóze žil a akutní hrozbě embolie podávána léčiva snižující srážlivost krve; v opačném případě hrozily závažnější následky na zdraví pacientky. Jestliže za této situace mohl být vznik hematomu způsoben rovněž nedostatečným klidovým režimem končetiny, nelze dovodit, že vzniklá škoda měla původ právě v povaze použité injekční jehly.“

Najvyšší súd po zhodnotení všetkých uvedených skutočností dospel k záveru, že žalované zdravotnícke zariadenie nenesie zodpovednosť za poškodenie zdravia žalobkyne, a preto dovolanie odmietol.

Celé znenie tu

Spracovala: Ľudmila MOĽOVÁ




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