1. Facts and Background

This case involves a claim for damages filed by the bereaved family of an elderly patient (the Deceased) who passed away due to a ventilator tube disconnection while being treated in the general isolation unit of the client’s (Defendant Hospital) emergency room during the COVID-19 pandemic. The plaintiffs alleged negligence on the part of the medical staff.

The Deceased was an elderly patient with underlying conditions who was admitted for dyspnea and underwent endotracheal intubation. During treatment, the patient exhibited unstable behavior, such as failing to follow medical instructions, shaking their head, or pushing the tube with their tongue. The medical staff applied physical restraints and re-secured the tube. However, despite reconnection measures after a first disconnection, a second disconnection occurred shortly thereafter. The second disconnection was discovered by a guardian immediately after it happened. Although the medical staff performed CPR immediately, the patient passed away. The plaintiffs claimed that the medical staff were negligent for failing to take additional preventive measures (such as head fixation) after the first disconnection, for neglecting the patient during the second disconnection, and for failing to hear the alarm.

2. Key Legal Issues and LKP’s Role

The key issues in this case were: ▲ Whether there was a breach of the duty of observation (neglect) given the specific circumstances of an isolation ward, ▲ The medical validity of additional fixation measures (such as head fixation) to prevent ventilator tube disconnection, and ▲ Whether the mechanical alarm functioned and was perceived.

Representing the client, LKP presented the following medical and legal arguments:

* Demonstrating the Inevitability of the Medical Environment: We argued that treatment in the ER isolation unit rather than the ICU was unavoidable due to the pending COVID-19 confirmation status. We emphasized that, given the shortage of manpower and the need to treat other critically ill patients simultaneously, it was impossible for medical staff to reside in the isolation unit and monitor the patient 24/7.

* Presenting Medical Standards: We rebutted the plaintiff's claim regarding "head fixation" by citing medical grounds stating that such measures are not clinically recommended and could rather increase patient instability, potentially causing cervical injury or worsening vital signs. We also clarified that over-tightening the connection carries a higher risk of total tube extubation.

* Clarifying Causation and Fulfillment of Duty: We proved that the medical staff took the best possible measures, including using restraints and frequently checking the tube position. We also pointed out the plaintiff's lack of proof regarding the causal link between the time of discovery and death, as well as the alleged failure of the alarm.

3. Execution and Outcome

The court fully accepted LKP's arguments. The court ruled that: ① Given the manpower situation in the emergency room, the lapse of approximately 6 minutes alone cannot be deemed a failure of duty of care; ② Since the medical staff took measures such as applying restraints and re-securing the position, they cannot be seen as having a duty to take additional measures (such as head fixation); and ③ There is no evidence that the alarm did not sound or that the medical staff neglected it.

Consequently, the court dismissed all of the plaintiffs' claims and ordered them to bear the litigation costs, resulting in a complete victory for the client. This case is significant as it confirmed the reasonable scope of medical staff's duty of care during disastrous medical situations like a pandemic and clarified that medical staff cannot be held unlimitedly liable for results caused by a patient's sudden, unpredictable actions.