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World J Gastroenterol. Nov 14, 2006; 12(42): 6857-6860
Published online Nov 14, 2006. doi: 10.3748/wjg.v12.i42.6857
Medical malpractice litigation related to gastrointestinal endoscopy in Japan: A two-decade review of civil court cases
Toru Hiyama, Shinji Tanaka, Masaharu Yoshihara, Tatsuma Fukuhara, Shinichi Mukai, Kazuaki Chayama
Toru Hiyama, Masaharu Yoshihara, Health Service Center, Hiroshima University, Higashihiroshima
Shinji Tanaka, Department of Endoscopy, Hiroshima University Hospital, Hiroshima
Tatsuma Fukuhara, Shinichi Mukai, Kazuaki Chayama, Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Toru Hiyama, MD, PhD, Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima 739-8521, Japan. tohiyama@hiroshima-u.ac.jp
Telephone: +81-82-4246191 Fax: +81-82-4227156
Received: August 19, 2006
Revised: September 17, 2006
Accepted: September 22, 2006
Published online: November 14, 2006
Abstract

AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan.

METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken.

RESULTS: Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to eso-phagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%).

CONCLUSION: These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.

Keywords: Gastrointestinal endoscopy, Malpractice, Litigation, Risk management