Hello, my answer to your question is that Article 54 of the Tort Liability Law stipulates that if a patient suffers damage in diagnosis and treatment activities and the medical institution and its medical staff are at fault, the medical institution shall be liable for compensation. This article clarifies that medical tort belongs to general tort, that is, the patient needs to provide evidence to prove all the elements of tort, which is specifically manifested in the need to provide evidence:
（1） Illegality of diagnosis and treatment;
（2） There are damage consequences;
（3） Fault in diagnosis and treatment;
（4） The wrong diagnosis and treatment behavior has a causal relationship with the damage consequences of the patient. It should be emphasized that the provisions of Article 54 of the Tort Liability Law are regarded as the provisions of Article 4 of the Several Provisions of the Supreme People on Civil Procedure Evidence
（8） The negation of the provision that "medical institutions shall bear the burden of proof for the infringement litigation caused by medical acts on the basis that there is no causal relationship between the medical acts and the damage results and there is no medical fault". However, Article 58 of the Tort Liability Law further stipulates that if a patient suffers damage, it is presumed that the medical institution is at fault due to one of the following circumstances:
（2） Conceal or refuse to provide medical records related to the dispute. That is, in the process of medical litigation, if a medical institution conceals or refuses to provide medical records related to the dispute, it can be directly presumed that its diagnosis and treatment act is at fault, and the medical institution is required to provide evidence to prove that its diagnosis and treatment act is not at fault. It is necessary to point out that what is presumed is that the medical institution's diagnosis and treatment act is wrong, but it cannot be directly presumed that the wrong diagnosis and treatment act has a causal relationship with the patient's damage consequences. In practice, if medical institutions can provide complete medical records, the burden of proof of causality still needs to be borne by the patient. The patient's burden of proof in the dispute of medical damage liability is the obligation to apply for identification. If the medical institution refuses to provide medical records or the medical records provided are incomplete, it may cause the appraisal institution to fail to conduct appraisal. In this link, there is a potential legal rule that the burden of proof of the patient must be based on the complete medical records provided by the medical institution. According to Article 64 of the Civil Procedure Law, the parties have the responsibility to provide evidence for their claims. This is the principle of "who advocates, who provides evidence". According to Article 10 of the Regulations on the Management of Medical Records in Medical Institutions, patients are in principle responsible for the custody of outpatient (emergency) medical records. If a medical institution has a medical record archive room for outpatient (emergency) treatment or has established an electronic medical record for outpatient (emergency) treatment, with the consent of the patient or his legal representative, his medical record for outpatient (emergency) treatment may be kept by the medical institution. Inpatient medical records shall be kept by medical institutions. In view of the fact that medical records are written by medical personnel and kept by medical institutions, except for some door (emergency) medical records. According to the "principle of evidence distance", the law requires the party holding evidence to have the obligation to provide evidence. This can be found in the provision of Article 75 of Several Provisions of the Supreme People on Evidence in Civil Procedure that "if there is evidence to prove that one party holds evidence and refuses to provide it without justified reasons, if the other party claims that the content of the evidence is not conducive to the evidence holder, it can be presumed that the claim is established".
