2025年11月20日，西安市民李女士向媒體公開舉報，指稱西安交通大學第一附屬醫院在其父親住院期間存在多項違規醫療行為、過度診療與不合理收費。這起長達五年的醫療糾紛，經官方介入調查後，已確認醫院存在二十六項違規，並牽涉高額醫療費用、術式變更未告知、病歷紀錄缺失，以及醫療機構在診療與費用管理上的深層問題，引發廣泛社會關注。

李女士的父親於2020年因「主動脈瓣中度狹窄」入住西交大一附院接受治療。家屬指出，依國內外醫療指南，中度狹窄並非必然需要手術，但院方依然安排其父接受高風險的心臟瓣膜置換治療。他們更強調，術前醫生告知的是常規手術方式，但實際施行的卻是「經心尖TAVR」手術，此種手術方式自費高昂、風險更高，但相關風險與自費金額並未被充分說明。其父親在手術後僅存活四十六天便離世，家屬質疑治療必要性與醫療決策的合理性。此外，家屬在查看病歷時也發現部分記錄缺失、標籤脫落或內容不完整，增加了案件釐清的難度。

在醫療費用方面，李女士指出，其父親住院期間總費用超過六十萬元，其中自費部分達三十二萬元。她發現多項費用顯然不合理，包括男性患者卻出現三十四次「會陰清洗」、血氣分析高達九十六次、僅紗布費用就高達六千元，以及大量與病情不相符的高頻次耗材與檢查。許多收費項目在病歷中無對應記錄，使家屬懷疑醫院存在「過度醫療」與「不當收費」。

李女士於2024年正式向國家醫保局舉報。2025年8月，西安市醫保局完成核查，確認醫院存在二十六項違規行為，包括超量開藥、過度檢查、將不符合條件的醫療項目轉換為可報銷項目等，累計涉及違規使用医保基金七萬五千餘元。醫保局已責令追回基金，並依照醫保監督舉報獎勵規定，向李女士發放2234.41元獎勵。

在法律層面，李女士同時提起醫療損害訴訟。2024年的一審裁判認為，醫院未經家屬同意擅自變更手術方式，且病歷紀錄缺失，屬於明顯過錯，應承擔七成責任，判賠約六十九萬元。然而雙方均不服判決，案件於今年被發回重審，目前仍在西安法院體系中審理。與此同時，陝西省衛健委亦已對涉事醫院展開行政調查，後續處理仍在等待官方公布。

這起事件引發社會對醫療機構規範化管理、術前知情同意制度、過度醫療現象以及醫保基金安全的高度討論。李女士表示，她希望透過此案推動醫療行為更加透明，避免其他家庭重蹈覆轍；她也呼籲患者務必重視術前溝通，確保充分了解治療必要性、風險與費用。對於外界質疑，涉事醫院至今未正面回應，而西安市醫保局則強調將對違規問題依法依規處置，杜絕損害患者權益的行為再次發生。

On November 20, 2025, a woman in Xi’an, Ms. Li, publicly reported that the First Affiliated Hospital of Xi’an Jiaotong University had committed multiple violations during her father’s hospitalization in 2020—including improper medical procedures, unauthorized changes to the planned surgery, excessive treatments, and unreasonable charges. After a formal investigation, the Xi’an Medical Insurance Bureau confirmed twenty-six violations involving misuse of medical insurance funds, bringing the case back into the public spotlight and triggering widespread concern about medical compliance in China.

In 2020, Ms. Li’s father was admitted for treatment of moderate aortic valve stenosis. According to both Chinese and international clinical guidelines, a patient with a moderate degree of stenosis generally does not require immediate surgery. Despite this, the hospital recommended and performed a high-risk valve replacement procedure. The family emphasized that the hospital had originally explained a different, more standard procedure to them, yet the operation actually performed was a transapical TAVR, a minimally invasive but high-risk technique that also involves expensive self-paid imported valves. Ms. Li insisted that the hospital never properly informed the family about the surgical change, the associated risks, or the fact that the heart valve alone would cost 280,000 yuan out-of-pocket. Her father died forty-six days after the operation, and the family questioned both the necessity of the surgery and whether the hospital had strictly followed medical norms. Their concerns deepened when they discovered that parts of the medical records were missing, mislabeled, or incomplete.

The financial aspect of the case raised even more red flags. The total hospitalization cost exceeded 600,000 yuan, with 320,000 yuan paid by the family. Upon reviewing the bills, Ms. Li found numerous charges that appeared inconsistent with her father’s condition. These included thirty-four “perineal cleanings” on a male patient, ninety-six arterial blood-gas tests, 6,000 yuan billed solely for gauze, and 5,700 yuan for suture materials. Some billed items had no corresponding entries in the medical records, suggesting possible overcharging or fabrication of services.

In 2024, Ms. Li filed a formal complaint with the National Healthcare Security Administration. By August 2025, the Xi’an Medical Insurance Bureau completed its investigation and confirmed twenty-six violations committed by the hospital. These involved excessive prescriptions, unnecessary examinations, and the substitution of non-reimbursable procedures with reimbursable ones in order to draw from insurance funds. The bureau ordered the recovery of over 75,000 yuan in misused insurance money and issued Ms. Li a reward of 2,234.41 yuan for her whistleblowing.

Meanwhile, Ms. Li also pursued a medical malpractice lawsuit. In the 2024 first-instance judgment, the court found that the hospital had indeed changed the surgical plan without consent and had failed to maintain complete and规范 standard medical records—both considered significant breaches of medical duty. The court ruled that the hospital bore 70 percent of the responsibility for the patient’s death and awarded approximately 690,000 yuan in damages. However, neither side accepted the ruling, and the case was subsequently sent back for retrial, where it remains under review. The Shaanxi Provincial Health Commission has also launched an administrative investigation into the hospital.

The case has sparked heated public discussion about over-treatment, transparency in medical decision-making, and the need for stricter protections for patients. Ms. Li stated that her goal is not only to seek justice for her father but also to push for reforms in hospital compliance practices. She urged patients and families to insist on clear, thorough pre-surgery communication, especially regarding surgical risks and self-paid costs. While the hospital has not issued a direct response to the allegations, the Xi’an Medical Insurance Bureau said it will continue handling the violations strictly according to the law to ensure that patients’ rights and insurance funds are safeguarded.