Doctors privately charge 100000 "liver source fees" to liver transplant patients? The Red Cross responds to liver source fees | donors | liver source fees? Red Cross Society

"Organ donation should be voluntary and free. Was this 100000 yuan liver source fee collected and withheld by the hospital without authorization, or was it really transferred to the donor?" On August 14th, Mr. Jiang posted a report stating that his father underwent liver transplantation surgery at Xiangya Third Hospital, and the doctor privately requested 100000 yuan in cash for the liver source fee, stating that it would be transferred to the donor as a subsidy through the Red Cross. But he learned from the Red Cross that according to relevant regulations, donors will not pay cash to other individuals except for the normal payment of organ transplant surgery fees.

Mr. Jiang claimed that after multiple complaints from him and third-party mediation, the hospital recognized the cash as the cost of organ transplantation and refunded Mr. Jiang 98000 yuan in the name of compensation.

The payment process for cash captured by the patient's family members

The Cover News reporter learned from the Hunan Red Cross Society that they do indeed provide subsidies to donors, but the main source of subsidies is social forces. Some donors may also donate to the Red Cross Society out of gratitude, but it will not be point-to-point subsidies for both donors and recipients. "These are public accounts for auditing purposes, and doctors are prohibited from privately collecting cash. There is no mention of liver source fees."

The staff of the Propaganda Department of Xiangya Third Hospital stated that the incident has been resolved through mediation. If patients are dissatisfied or have any questions, they can report or take legal action.

Men receiving liver transplantation are charged a liver source fee of 100000 yuan

The doctor said, "Transferred from the Red Cross to the donor."

Mr. Jiang introduced that in August 2018, his father Jiang was treated in two hospitals in Hunan for viral hepatitis before being transferred to Xiangya Third Hospital.

"It is said that Xiangya Third Hospital has a matching liver donor. It was transferred in in the early morning and the transplant surgery started after dawn. Before the surgery, the doctor said that in addition to paying the normal organ transplant surgery fee, a cash liver source fee of 200000 yuan should also be prepared, which the hospital will hand over to the Red Cross, and the red cross will be used as a subsidy to transfer to the donor." Mr. Jiang said that the surgery schedule was very tight at the time, and the doctor said that if the transplant was not performed, there were other patients waiting in line.

Mr. Jiang and his family raised 200000 yuan, of which 100000 yuan was paid to the hospital as surgical treatment expenses, and another 100000 yuan in cash was paid to the doctor in the name of liver source fees. It was agreed that the remaining 100000 yuan would be paid after the surgery.

The surgery did not go smoothly, and Jiang's condition worsened a few days after being transferred to the ICU for treatment. He died in the ambulance when he returned home.

"Because the entire treatment has already cost nearly 300000 yuan, which involves social security reimbursement issues. I wanted to get a receipt from the hospital for the 100000 yuan liver source fee, but the hospital said it was not. I suspect it may be an illegal transaction," Mr. Jiang said, recording a conversation with the hospital.

In the 40 minute recording, the doctor stated that the money was not a transaction. Before the surgery, the family members were informed that many donors were elderly and young, and they could not even afford hospital expenses. This cash has been transferred to the donor as a subsidy through the Red Cross, and it is impossible to retrieve it. "The money was not collected by me personally, nor was it collected by the hospital. If the family members initially did not accept or understand this matter, we could not do it. There were audio and video recordings of the conversation at that time."

The doctor stated that the money is all operated by the Red Cross, and the family and doctors do not know who the donor is or who the recipient is. Only the Red Cross knows, and the donor does not know who used the organ or who provided the subsidy. "The simplest way to solve this cost issue is to consult the Red Cross. Alternatively, it can be done through judicial channels, which is the most authoritative way."

Mr. Jiang claimed that because the hospital did not provide proof of the Red Cross receiving the money, they did not know which Red Cross organization handled it and were unable to verify the specific situation. "I just inquired about the policy with the Hunan Red Cross Society, saying that there is no claim of liver source fees, and it is also prohibited for doctors to privately collect cash from donors."

Mediation agreement

Two judgments have determined that the hospital has no medical fault

The hospital refunded 98000 yuan in the name of "treatment fee"

In 2019 and 2020, Mr. Jiang sued three hospitals that had treated Jiang for medical negligence, accusing Xiangya Third Hospital of illegally collecting 100000 yuan in liver source fees.

The verdict shows that Jiang died after being discharged from the hospital, and the Changsha Medical Association determined that Jiang's death did not belong to a medical accident. The court found that in order to perform a liver transplant, Jiang's family paid a liver source fee of 100000 yuan.

The first instance judgment shows that Jiang's family believes that doctors at Xiangya Third Hospital illegally collected 100000 yuan of liver source fees from patients, refused to provide invoices or receipts, and were unable to provide a reasonable explanation of the whereabouts of the fees, indicating an illegal situation. In this regard, the court believes that Xiangya Third Hospital provided a "confirmation letter for organ reception at the transplantation center", and the liver transplant donor received by patient Jiang was obtained through the legitimate channels of the OPO alliance, so there is no presumption of fault by the plaintiff's claim that Xiangya Third Hospital is at fault.

The second instance judgment shows that Jiang's family claimed that Xiangya Third Hospital had illegally collected a liver source fee of 100000 yuan. Their family did not file a lawsuit on this fee during the first instance, and the appeal was not clear. Xiangya Third Hospital did not agree to mediation during the second instance. According to judicial interpretation, Jiang's family can file a separate lawsuit on this matter, and the second instance court will not review this fact and corresponding requests.

In January 2021, under the mediation of the local street mediation committee in Changsha, Xiangya Third Hospital reached an agreement with Jiang's family: Jiang's family understood and recognized the cash collection of organ transplant fees during the treatment process as the duty of the hospital's organ transplant department doctors. After voluntary negotiation, the hospital paid a one-time compensation of 98000 yuan to the family. The agreement is a one-time termination agreement, with no further disputes between the two parties.

Mr. Jiang said that after losing the second trial, the hospital worked for him, and even if he won the lawsuit, it would still be a matter of compensation. It would be better to settle out of court and return the money to his family. "At that time, our family did indeed need this money, so we agreed. But I have always been confused whether this liver source fee is illegal and whether it was actually given to the donor."

The Red Cross claims that doctors who illegally collect cash can be reported

Hospital: Mediated and resolved. If not satisfied, please contact the court

Who collected the "liver source fee" and is it in compliance with regulations? The cover news reporter contacted Xiangya Third Hospital and Hunan Red Cross Society successively.

The staff of the Propaganda Department of Xiangya Third Hospital stated that after verifying with the department, the matter has been resolved through mediation. "The court also ruled, and after mediation, the money was refunded to him. I don't know what he's still struggling with. As for whether it's a violation or where the money went, if he's not satisfied with the current outcome, he can file a complaint and seek help from the court."

According to the staff of the Organ Donation Department of the Hunan Red Cross Society, according to relevant management regulations, organ donation is voluntary and unpaid. However, considering that donors have made contributions to society and many donors have paid high treatment costs, the Red Cross Society provides subsidies to the families of organ donors through social donation efforts, "such as solving funeral expenses and partial treatment expenses for them. The funds mainly come from social forces, but there are also organ recipients who, out of gratitude, will donate to the Red Cross Society. After being placed in the fund pool, non targeted subsidies will be given to donors in difficulty, without point-to-point subsidies from both the donor and recipient sides."

The staff also stated that organ donors are required to pay normal surgical fees, organ transportation costs, and other expenses, but there is no liver source fee. Even if they donate to the Red Cross, it is still done through a public account and there are vouchers to be kept for audit by the auditing department. "It will not be collected privately by doctors or hospitals in cash. If this situation occurs, it can be reported to the disciplinary inspection department of the National Health Commission."

Professor Wang Yue from the School of Medical Humanities at Peking University stated that there is a unified legal channel for organ transplantation, and there is no such thing as a "liver source fee" during this period. It is also impossible for doctors to collect cash and then transfer it to donors. If doctors collect fees without authorization, it may be suspected of buying and selling organs, which is considered illegal behavior.

According to relevant cases on the Judgment Document Network, there are different penalties for "liver source fees" in different regions.

Among them, in a joint judgment by the Wuhan District Court in 2014, it was found that the 180000 yuan liver source fee collected by the hospital was not recognized, on the grounds that "no organization or individual is allowed to buy or sell human organs in any form" in the Organ Transplantation Regulations.

In another judgment by the Wuhan District Court in 2017, the patient's family accused the hospital of illegally collecting 220000 yuan of liver source fees. The court determined that the fees were related to organ transplant materials and were not inappropriate.

In a judgment by the Beijing District Court in 2019, the court held that the patient's voluntary payment of 360000 yuan in liver source fees was an economic compensation from the patient to the donor. The hospital had fulfilled its obligations after finding the donor and completing the surgery. Therefore, the plaintiff requested the defendant to return the fees, which the court did not support.

Cover News Reporter Shi Wei