Abstract
To date, there have been no systematic studies on anesthetic accidents in Japan. This study was conducted to clarify the present status of anesthetic accidents by sending a questionnaire to a group of plaintiff's lawyers specializing in medical malpractice. At present, because of manpower shortages, anesthesia is provided by either anesthesia specialists (anesthesiologists) or non-anesthesiologist physicians in Japan. Among 112 lawsuits which involved the use of anesthesia, 64 were analyzed as to the person primarily responsible for administering the anesthesia, the types of anesthesia, the details of major mishaps, and intraoperative monitoring. Of particular note was a large number of deaths from cardiac arrest and hypotension in spinal anesthesia administered by non-anesthesiologists. The results clearly showed that non-anesthesiologists had a substantial incidence of mortality cases among accidents compared with anesthesiologists. Human error was the most frequent cause, but a lack and/or a grave omission of intraoperative monitors was found in non-anesthesiologist-related cases.
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References
Wakasugi C, Shikata I (1976) Statistical study of therapeutic deaths for the past 10 years (in Japanese, with English abstract). Jpn J Legal Med 30:391–400
Investigation Committee of the Medico-Legal Society of Japan (1983) Reports on medico-legal data from the mass-investigation performed by the Medico-legal Society of Japan (in Japanese, with English abstract) Jpn J Legal Med 37:434–454
Cooper JB, Newbower RS, Kitz RJ (1994) An analysis of major errors and equipment failures in anesthesia management: considerations for prevention and detection. Anesthesiology 60:34–42
Caplan RA, Ward RJ, Posner K, Cheney FW (1988) Unexpected cardiac arrest during spinal anesthesia: a closed claims analysis of predisposing factors. Anesthesiology 68:5–11
Cheney FW, Posner K, Caplan RA, Ward RJ (1989) Standard of care and anesthesia liability. JAMA 261:1599–1603
Tinker JH, Dull DL, Caplan RA, Ward RJ, Cheney FW (1989) Role of monitoring devices in prevention of anesthetic mishaps: a closed claims analysis. Anesthesiology 71:541–546
Kroll DA, Caplan RA, Posner K, Ward RJ, Cheney FW (1990) Nerve injury associated with anesthesia. Anesthesiology 73:202–207
Rosen M, Fujimori M (1985) Maternal mortality and manpower. Comparisons in relation to anaesthetists, obstetricians, and paediatricians in England and Wales and in Japan. Anesthesia 40:892–895
Cooper JB, Newbower RS, Long CD, McPeek B (1978) Preventable anesthesia mishaps: a study of human factors. Anesthesiology 49:399–406
Keenan RL, Boyan CP (1985) Cardiac arrest due to anesthesia. JAMA 253:2373–2377
Gaba DM (1989) Human error in anesthetic mishaps. Int Anesthesiol Clin 27:137–147
Eichhorn JH (1989) Prevention of intraoperative anesthesia accidents and related severe injury through safety monitoring. Anesthesiology 70:572–577
Campling EA, Devling HB, Hoile RW, Lunn JN (1990) The report of the National Confidential Enquiry into Perioperative Deaths 1990. National Confidential Enquiry into Perioperative Deaths
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Shimada, Y., Kato, Y. Anesthesia mortality and morbidity in Japan: A study of lawsuit cases. J Anesth 8, 1–5 (1994). https://doi.org/10.1007/BF02482743
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DOI: https://doi.org/10.1007/BF02482743