Who Bears Liability When Gua Sha Therapy Causes Cerebral Infarction? Lawyer Analyzes Injury Claims and Fault Determination Standards in Traditional Chinese Medicine Wellness Practices

Lead

Recently, news of "Gua Sha causing a cerebral infarction" has sparked heated discussion. A middle-aged woman went to a wellness center for Gua Sha due to neck and shoulder discomfort, and suffered a sudden cerebral infarction the next day, requiring hospitalization. The diagnosis was related to improper stimulation of the neck. The wellness center refused to take responsibility, claiming that "Gua Sha is a traditional wellness practice, and individual constitutions differ." This is not an isolated case—every year, injuries caused by "wellness" practices such as cupping, Gua Sha, and bone setting are common. From a legal perspective, Gua Sha may seem simple, but it actually involves a series of legal issues, including the boundaries of medical practice, fault determination, and consumer rights protection. This article, based on the Civil Code, the Consumer Rights Protection Law, and relevant judicial practice, clarifies the allocation of liability and the paths for rights protection.

Is gua sha "wellness" or "medical treatment"? Legal classification is the key.

What does gua sha actually count as in law? This directly determines the liable party and the applicable law. According to Article 88 of the Implementation Rules for the Regulations on the Administration of Medical Institutions, medical behavior refers to "diagnosis and treatment activities carried out on patients by utilizing medical knowledge and techniques, with the aid of drugs, surgery, instruments, etc., for the purpose of treating diseases." Gua sha stimulates the meridians by scraping the skin; if it is conducted under the guise of health regulation or disease treatment, it carries a medical nature.

However, the vast majority of wellness centers and beauty salons in the market do not hold a "Medical Institution Practice License," and their practitioners are mostly employed after short-term training, lacking knowledge of medical anatomy and pathology. From a legal characterization perspective, if gua sha (scraping) practices go beyond the scope of general health care and involve disease diagnosis or treatment, they constitute illegal medical practice. The former Ministry of Health explicitly stated that non-medical institutions shall not carry out activities such as gua sha or cupping for the purpose of treating diseases.

Therefore, in this case, when the wellness center performed scraping therapy on a customer and claimed to "regulate the cervical spine," it had in fact entered the medical field. Once harm is caused, not only does the tort liability under the Civil Code apply, but the crime of unlicensed medical practice under the Criminal Law may also be triggered if the circumstances are serious. Consumers should recognize that there is an essential difference between "health care" in wellness centers and "treatment" in hospitals. The former's legal obligations and regulatory standards are far lower than the latter's, and the risks are correspondingly higher.

How is fault determined? Examining causation through "carotid artery dissection"

The medical mechanism behind the woman's cerebral infarction in the news is that gua sha caused an intimal tear in the carotid artery, forming a dissection, which in turn led to a thrombus breaking off and blocking cerebral blood vessels. Legally, to establish the wellness center's liability, it must be proven that it was at fault and that there is a causal relationship between the fault and the harm.

Article 1165 of the Civil Code establishes the principle of fault liability: "Where an actor infringes upon the civil rights and interests of another person through his or her fault, the actor shall bear tort liability." In cases of injury caused by gua sha (scraping therapy), fault is typically manifested in: rough operative techniques, improper selection of treatment location (such as the anterior cervical region), failure to inquire about medical history, failure to inform of risks, and the like. For example, the neck contains abundant blood vessels and nerves; professional gua sha should avoid dangerous areas, and the force applied must also be controlled. If the staff of a wellness center have not undergone systematic training, and the operation clearly violates safety standards, fault may be established.

In terms of causation, judicial practice often adopts the "adequate causation theory," which holds that causation is established as long as the act is ordinarily sufficient to cause the harm. In this case, if medical appraisal confirms a direct link between the cerebral infarction and the gua sha procedure, and the wellness center cannot prove that other causes (such as the patient's own illness) were the sole cause, the court tends to find that causation is established.

It is worth noting that if consumers themselves have underlying conditions such as cervical spondylosis or fragile blood vessels, this may constitute "mixed fault," and pursuant to Article 1173 of the Civil Code, the liability of the tortfeasor may be reduced. However, this does not mean that the wellness center is exempted from liability; rather, it is merely an adjustment of the liability ratio.

Rights Protection Path and Evidence Preservation: A Lawyer's Three-Step Guide

When suffering injury from gua sha, ordinary people often panic and don't know how to assert their rights. As a lawyer, I recommend following these steps:

**Step 1: Seek immediate medical attention and preserve evidence.** Keep the gua sha consumption records, payment receipts, and promotional materials from the wellness center (such as any materials stating "treats cervical spondylosis"), take photos of the gua sha area, and record the operator's name and employee ID. When seeking medical treatment, fully inform the doctor of the gua sha procedure, and ensure that the medical records reflect the chronological connection of "symptoms appearing after gua sha."

**Step 2: File an Administrative Complaint.** Report to the local health administrative department that the wellness center is suspected of illegal medical practice and request an investigation. If the allegation is confirmed, the administrative penalty decision can serve as strong evidence for determining fault in civil litigation.

**Step Three: File a civil lawsuit.** Pursuant to Article 1179 of the Civil Code, claims may be made for medical expenses, lost wages, nursing fees, transportation costs, disability compensation, and other damages. If a disability is established, compensation for emotional distress may also be claimed. During the proceedings, a judicial appraisal may be applied for to assess the extent of the damage, the causal relationship, and the degree of disability.

In practice, many victims lose their cases due to insufficient evidence. For example, in some cases, consumers are unable to prove the causal link between gua sha (scraping) and cerebral infarction, and the court rejects the claim. Therefore, securing evidence is the key to winning or losing a case, and it is advisable to consult a professional lawyer at the earliest opportunity.

How can consumers avoid risks? Choosing a legitimate institution is the first line of defense.

Legal protection is ex post facto; prevention beforehand is more important. When choosing services such as scraping (gua sha) and cupping (ba guan), consumers should observe three principles:

1. **Check qualifications**: Confirm whether the institution has a "Business License" and a health permit. If "treatment" is advertised, a medical institution practice license is mandatory. For wellness centers that claim to "cure cervical spondylosis," blacklist them immediately.

2. **Assess the personnel**: Ask whether the operators hold relevant vocational skill certificates and possess basic knowledge of anatomy. A legitimate TCM massage therapist should have undergone systematic training, not a short-term crash course.

3. **Know the risks**: Gua sha is not suitable for everyone. Pregnant women, and individuals with skin damage, coagulation disorders, or cardiovascular and cerebrovascular diseases should avoid it. Before the procedure, proactively disclose your medical history and ask the practitioner to assess the risks.

Moreover, if the wellness center induces consumption under the guise of "membership cards" or "treatment packages," it also involves legal risks associated with prepaid cards. According to Article 53 of the Consumer Rights Protection Law, if a business operator fails to provide services as agreed, it shall refund the advance payment and bear the interest.

Conclusion: The law safeguards health; assert your rights rationally without compromise.

Gua sha, originally a treasure of traditional medicine, carries risks that cannot be ignored once abused by commercial organizations. In this case, the victim's experience serves as a warning: health maintenance is no "trivial matter," and every step of the legal process follows established rules. From determination of fault to calculation of damages, from administrative complaints to civil litigation, professional lawyers can help you clarify the legal relationships and avoid losing a case due to insufficient evidence or procedural errors. Guangdong Zhiming Law Firm has long focused on the fields of medical injury and consumer rights. If you or your family members encounter similar issues, you are welcome to consult us. We will safeguard your lawful rights and interests from a professional perspective. Health is priceless, and the law has its limits; rational rights protection is the legal awareness every person should possess.