Asian Focus
Outrage at Japan's
hospital foul-ups
MARI YAMAGUCHI of Associated Press
Instead of fixing a 74-year-old man's heart
problem, surgeons removed part of his right
lung. Then they gave the 84-year-old with the
lung problem heart surgery.
But that's not all. Eight hours later, as the
mis-identified patients were receiving post-op
transfusions, the hospital staff realised their
error. Fortunately, the patients both had the
same type blood - or the transfusions might
have killed them, too.
Few cases of medical bungling in Japan have
received as much publicity - or generated so
much outrage - as this one at the Yokohama
City University Hospital earlier this year.
Many experts, however, say there is little being
done to address the underlying problems:
overworked doctors and a dangerously cavalier
attitude towards the quality of care.
"Patients are treated like machine parts on a
conveyer belt. Doctors often don't care about
each patient, they don't even remember their
faces," said Makoto Kondo, a radiologist at
Keio University Hospital, one of the best
medical facilities in Japan.
Since the botched surgeries in this city just
south of Tokyo were revealed in January,
Japan's media has focused on similar, and at
times worse, mistakes around the country:
In February, a 58-year-old housewife died
after a nurse accidentally injected her with
disinfectant instead of blood medication.
Also in February, a 61-year-old housewife
went into shock after receiving transfusions of
the wrong blood type.
In March, a seven-year-old boy had to
undergo an operation to remove part of a
surgical instrument mistakenly left inside his
skull.
Doctors say fatigue from chronic overwork
contributes to such errors.
But critics of the medical status quo in Japan
say such problems would not be so bad if
more was done to supervise doctors.
Medical records, for example, are usually
off-limits to patients. Doctors need not even
renew their licences. Rarely are mistakes made
public.
Shunya Ito, a member of Medio, a civil group
investigating malpractice, said the medical
community's treatment of patients reflects its
hierarchical structure - with patients on the
lowest rung.
"We patients feel so intimidated that it's even
difficult to ask doctors any questions," he said.
Mr Ito's 72-year-old father died six years ago
at a hospital an hour after beginning to receive
an intravenous injection containing potassium.
Mr Ito sued, and had medical experts saying
the injection may have contributed to his
father's death. The hospital denied any
wrongdoing, and Ito lost the suit.
Shigemi Oshida, professor of forensic
medicine at Nihon University of Medicine, said
hospitals routinely destroy evidence of
operating room foul-ups.
"Japanese hospitals haven't tried to learn from
mistakes," he said. "And by covering up, they
fail to share valuable lessons."
Because of the secrecy and difficulty in
obtaining documents, victims of hospital
mistakes are rarely able to take legal action.
But according to the latest Supreme Court
statistics, more are willing to try. Malpractice
suits have nearly doubled to 2,700 in 1998
from 1,508 cases 10 years ago.
Shamed into action, the government has
formed an investigative panel and is expected
to announce its recommendations later this
month.
Staff at the Yokohama hospital, meanwhile,
are taking more care to clearly identify their
patients.
"We learned an important lesson," said
spokesman Nobuo Uchida. "Next time we
make a mistake, there will be no future for our
hospital."