Medical malpractice litigation related to gastrointestinal endoscopy in Japan: a two-decade review of civil court cases.
OBJECTIVE
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 esophagogastroduodenoscopy, 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%).


CONCLUSIONS
These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.
Hiyama
Toru
T
Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima 739-8521, Japan. tohiyama@hiroshima-u.ac.jp
Tanaka
Shinji
S
Yoshihara
Masaharu
M
Fukuhara
Tatsuma
T
Mukai
Shinichi
S
Chayama
Kazuaki
K
D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D006801:Humans; D007564:Japan; D008318:Malpractice / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000331:legislation & jurisprudence; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012308:Risk Management / Q000331:legislation & jurisprudence