ABSTRACT
To enhance the quality and safety of medical care, the Ministry of Health, Labor and Welfare (MHLW) launched a model project in September 2005 for investigation and analysis of medical practice associated deaths in an attempt to move the existing system in a different direction. The project, initiated in Tokyo, Osaka, Nagoya, and Kobe, has now been implemented in nine prefectures. In the hope that the model project will lead to the nationwide development of medical safety investigating committees, the MHLW has submitted a provisional third plan. Based on our practical experience of the model project in Osaka, we present and discuss practical problems and legal issues involving surgeons' criminal punishment.
Subject(s)
Malpractice/legislation & jurisprudence , Medical Errors/legislation & jurisprudence , Quality Assurance, Health Care/organization & administration , Advisory Committees , Forensic Medicine/organization & administration , Humans , Japan , Medical Errors/prevention & control , Models, Organizational , Program Evaluation , SafetyABSTRACT
Obesity and cardiomegaly/hypertension may be strongly associated with sudden unexpected deaths (SUD) due to circulatory diseases. Six hundred and forty-nine SUD involving 402 postmortems, aged between 10 and 59 years in Osaka in 1997 were analyzed using the calculated body mass index (BMI) and the calculated degree of cardiac hypertrophy (DCH) by Hitosugi (Legal Med 1999;1:80). The percentage of individuals who died due to circulatory diseases was 54% in men and 64% in women, and at ages 50-59 years, 60% in men and 75% in women. It was 80% with DCH>/=20%, 84% for individuals with hypertension as a past illness and 80% with BMI>/=24. Thirty-four percent of all SUD have cardiomegaly more than 20%, 41% have BMI more than 24, and 17% have at least hypertension as a past illness.
