If you have doubts about treatment, request to seal the medical records on the spot; both parties must be present, a list must be drawn up, and each side gets a copy.

6. If you have doubts about treatment, request to seal the medical records on the spot; both parties must be present, a list must be drawn up, and each side gets a copy.

Cost: No cost at all. Simply ask the hospital to seal the records; both you and the medical staff must be present to complete the paperwork. The real challenge is mustering the courage to say this out loud in front of the doctors.

In plain terms: If you’re unsure about any aspect of your treatment, you have the right to request that your medical records be sealed. Both you and the medical staff must be present for this process, which involves creating a detailed list, signing and stamping it, and each side receiving a copy. If the records aren’t fully completed yet, only the finished portions should be sealed first; the rest can be sealed later. Should you suspect that an intravenous infusion, blood transfusion, injection, or medication caused a problem, the actual fluid bag, medicine vial, and infusion set must also be sealed together with the records.

Benefit: Regulations clearly state that “whenever a medical dispute arises and it is necessary to seal or unseal medical records, this must be done while both the patient and medical staff are present.” The sealed documents may be either originals or copies, which the hospital then stores. If the records are still being written, only the completed sections should be sealed first; the remainder can be sealed later. The hospital must produce a sealing list, signed or stamped by both parties, with each side keeping a copy. In cases where an adverse effect is suspected to stem from an IV, blood transfusion, injection, or medication, both parties must jointly seal and later unseal any related physical items. If testing is required, both parties must jointly appoint a qualified laboratory; should they fail to agree, the local health authority at the county level where the hospital is located will make the appointment. Should a transfusion-related problem be suspected and blood samples need sealing, the hospital must notify the blood bank to send representatives to the scene. Additionally, there is a strict rule: “No organization or individual may alter, forge, conceal, destroy, or seize medical records.” Once a dispute is resolved or three years pass without any further claims, the hospital may unseal the documents on its own initiative (nationwide, effective 1 October 2018).

Evidence grade: A

Sources: State Council of China (2018). Regulations on the Prevention and Handling of Medical Disputes (State Council of China Order No. 701, Articles 15, 24, and 25). <https://www.gov.cn/zhengce/zhengceku/2018-08/31/content_5318057.htm>

Notes: Sealing records and making copies are two distinct actions. Copying records is something you should do proactively, as explained in item 7 (always keep your own copies of medical records and imaging). Sealing, on the other hand, serves to preserve evidence at the moment a dispute arises, preventing any later alterations or additions. If you suspect that an IV, blood transfusion, injection, or medication caused a problem, you must seal not only the records but also the fluid bag, medicine vial, and infusion set; otherwise they might be removed or discarded. Hospitals are required to prominently display information about dispute resolution procedures, contact details, and to maintain a dedicated complaints department. In case of any issue, approach that department rather than confronting the attending physician directly.