Japanese health care: Unclear on the concept...
Ryan Ginstrom
Japan. For this person's privacy, I will call them Bill.
We were told that the surgery went well, and were relieved. That is, until a
couple days later when they admitted that they had accidentally left a
needle inside Bill's heart. I was a bit upset by the hospital's handling of
the matter, especially when they didn't want to "ichi ichi" explain the
situation to Bill's mother because "they already explained the situation to
Bill and Bill's sister."
Typical o-erai-san complex of Japanese doctors. So to put a little fear of
GAWD into him, I told him that if this was the United States, I would sue
this hospital out of existence and ensure that he never practiced medicine
again, and although I realized things are done differently in Japan,
transparency and accountability are still paramount, and the doctor thus has
an obligation to inform the patient/the patient's family of any problems
immediately, and to explain the situation to the satisfaction of all
concerned parties.
This appeared to change his thinking on the subject slightly, and he was a
bit more responsive after this (I think more than a lawsuit, he and the
hospital are quite rightly worried about negative press exposure -- they are
particularly vulnerable right now).
As I said the doctor turned around after a bit of the old gaiatsu, and
offered to support any actions by us to seek a second opinion (ie should
the needle be left in there, or should they open up Bill again and remove
it). One might rightly be suspicious of the motivations behind the medical
opinions of the doctor who left the needle in there in the first place!
But that's just the buildup to what really has me bum-fluckered astonished.
We phoned another hospital that treated Bill several years ago, explained
the situation, and said they could have access to all of Bill's records, and
speak directly with the doctors who are treating him, and that the doctor
had in fact suggested we seek a second opinion.
The hospital's response: we are not treating him presently, so we cannot
give any opinion. We suggest you follow the advice of the doctor who is
treating Bill.
Talk about a freaking code of silence! Heaven forbid that a doctor in Japan
should contradict the opinion of another doctor. People might stop thinking
that they are infallible. Well, if Bill didn't think this already, I think
losing a needle inside his heart probably clinched it.
We are not parents or siblings of Bill, so we want to leave what is
done up to them. Bill's brother thinks the solution is to demand an isharyou
of ~500,000 yen -- "that'll be a sign of their remorse." I personally have
no idea what a piece of chump-change like that is going to resolve, but
that's their decision to make.
--
Regards,
Ryan Ginstrom
Eric Takabayashi
Yes, as doctors have reported, because the medical community is so small, with
children of doctors who themselves intend to be doctors, studying or working
under acquaintances or doctors their parents are indebted to and such, that
doing something as terrible as doing what's right, could screw them all for
life.
> People might stop thinking
> that they are infallible. Well, if Bill didn't think this already, I think
> losing a needle inside his heart probably clinched it.
>
> We are not parents or siblings of Bill, so we want to leave what is
> done up to them. Bill's brother thinks the solution is to demand an isharyou
> of ~500,000 yen -- "that'll be a sign of their remorse." I personally have
> no idea what a piece of chump-change like that is going to resolve, but
> that's their decision to make.
It's pretty hard to deny a needle in the heart if it's still there. They should
record all interactions with that hospital, as well as get a lawyer and go to
the news.
cc
"Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
> It's pretty hard to deny a needle in the heart if it's still there.
They didn't deny.
>They should
> record all interactions with that hospital, as well as get a lawyer and go
to
> the news.
A lawyer can take the needle off ?
Mistakes during operations happen everyday. Only people that never do
nothing never make mistakes. If you go for an operation, you take the risk
of getting a forgotten needle, you also take the risk the operation fails a
little or completely or that the anesthesics kill you. And if you don't want
to take the risk, you stay like that, unoperated.
I don't see why surgeons should lose their time and nerves with idiot
judiciary fights and talk to families that want to hear "remorses" as if the
hospital team was a gang of criminals. Justice has enough to do with the
real abuses like when hospitals cover the mistakes.
Bill is not dead, the hospital will probably make the best to be sure the
needle doesn't pose problem or they'll operate to take it away. For the
second doctor, Bill should have asked his family doctor or the surgeon to
contact him, because calling him directly may sound like "Be our support
against the other hospital. ", and no professionnal wants to lose time in
vendettas.Maybe Ryan can try again that way.
A hospital made a spectacular series of mistake on my grand-mother : too
many patients, not enough staff (even with the sisters or other volunteers),
and that's sad to say, but things are getting even worse as the staff have
to cope with the attitude of patients and their "consumer mentality", and
surgeons are stressed with the threats of absurd trials.
Well, that's life. For my grand-ma, we've asked the doctors to try to
repare. Not one person in the family talked about asking money or justice.
CC
Eric Takabayashi
> "Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
>
> > It's pretty hard to deny a needle in the heart if it's still there.
>
> They didn't deny.
Then it will be pretty awkward at best to publicly remain silent if confronted
by a lawyer or mass media, yes?
> >They should
> > record all interactions with that hospital, as well as get a lawyer and go
> to
> > the news.
>
> A lawyer can take the needle off ?
No, but a lawyer could "negotiate" a fairer settlement, if not try to find an
actual punishment.
> Mistakes during operations happen everyday.
Yes, it is alleged in the US that nearly 100,000 deaths per year are caused by
hospital error, which would make hospital error one of the leading causes of
death. It needs to be stopped.
> Only people that never do nothing never make mistakes.
And would you believe people such as medical professionals who deal in human
life should be among the most damned careful and competent imaginable, and not
make the amazing screwups they do, not even just the ones that come to light in
Japan?
> If you go for an operation, you take the risk
> of getting a forgotten needle, you also take the risk the operation fails a
> little or completely or that the anesthesics kill you. And if you don't want
> to take the risk, you stay like that, unoperated.
I'll take the risk I'll die during treatment or lack of it, because my
condition is so serious, such as having cancer or being brought in after a
traffic accident, NOT because the medical staff screwed up by operating on the
wrong (healthy) side of the body, operated on the wrong patients with similar
names or in the same ward, transplanted the wrong organs, left instruments in,
hooked up the heart lung machine backwards, put toxic material into the IV,
etc.
> I don't see why surgeons should lose their time and nerves with idiot
> judiciary fights and talk to families that want to hear "remorses" as if the
> hospital team was a gang of criminals.
Did you read the story? Are you one of those believe doctors are above the rest
of humanity? If businesspeople screw up by losing a lot of money and only
money, or a truck driver causes an accident resulting in injury or death; even
accidentally, they may pay for it out of their own pocket or face serious
consequences in their careers. People like truck drivers may end up in jail.
> Justice has enough to do with the
> real abuses like when hospitals cover the mistakes.
>
> Bill is not dead, the hospital will probably make the best to be sure the
> needle doesn't pose problem or they'll operate to take it away.
Are you sure?
> For the
> second doctor, Bill should have asked his family doctor or the surgeon to
> contact him, because calling him directly may sound like "Be our support
> against the other hospital. ",
Note the hospital "SUGGESTED" they get a second opinion, yes? Note the other
hospital would HAVE had access to the records, yes? Note that some pressure was
needed to get some results from the first hospital, yes? Did you see any
mention that they wanted to resolve it on their own? Is being against "ichi
ichi" explanation or being "o-erai" the proper attitude in a situation like
this?
> and no professionnal wants to lose time in
> vendettas.
This is not about vendetta. It's about the hospital doing what's right, and
what should be done about them if they aren't willing do so on their own.
> Maybe Ryan can try again that way.
>
> A hospital made a spectacular series of mistake on my grand-mother : too
> many patients, not enough staff (even with the sisters or other volunteers),
> and that's sad to say, but things are getting even worse as the staff have
> to cope with the attitude of patients and their "consumer mentality",
Imagine that. A "consumer mentality" when lives are on the line. Hospitals
could be LESS busy or stressed if they didn't make these "mistakes" possibly
resulting in more work, in the first place.
> and
> surgeons are stressed with the threats of absurd trials.
What is "absurd" to you in this incident? NOT the hospital(s) actions or
attitudes?
> Well, that's life. For my grand-ma, we've asked the doctors to try to
> repare. Not one person in the family talked about asking money or justice.
You'd just have them go back in, open your grandmother up (again) and go after
the needle in her heart if it were your family? You think another operation in
itself carries no life threatening risk? No concern for what the RESULT of
trying to "repair" her would be?
And do you believe that such "repair" or treatment for any resulting condition
from this error or the second operation which should never have been necessary
in the first place should be paid for by the family, the hospital, or the
national insurance system?
And the "absurd" family, who allegedly harbors this "consumer mentality" over
their family member's HEART operation, should "get" nothing at all? Not even,
apparently, an apology? I am shocked that the Japanese doctors made an
admission of error in the first place, WITHOUT a lawsuit or media attention.
Ryan Ginstrom
> Ryan Ginstrom wrote:
> > Talk about a freaking code of silence! Heaven forbid that a doctor in
Japan
> > should contradict the opinion of another doctor.
>
> Yes, as doctors have reported, because the medical community is so small,
with
> children of doctors who themselves intend to be doctors, studying or
working
> under acquaintances or doctors their parents are indebted to and such,
that
> doing something as terrible as doing what's right, could screw them all
for
> life.
IOW an old boy's network, like so many things in Japan.
> It's pretty hard to deny a needle in the heart if it's still there. They
should
> record all interactions with that hospital, as well as get a lawyer and go
to
> the news.
I have no doubt that they would have denied it -- or more accurately kept
quiet about it -- if they thought they could get away with it.
I won't be the one who goes to the press, but I happen to know that negative
exposure would be very harmful to the hospital and the doctor at this time.
--
Regards,
Ryan Ginstrom
Ryan Ginstrom
"cc" <cpasune...@spam.com> wrote in message
news:bksgsg$1m1$1...@bgsv5648.tk.mesh.ad.jp...
>
> "Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
>
> > It's pretty hard to deny a needle in the heart if it's still there.
>
> They didn't deny.
No, but it took them two days to come clean. And that only because it is
impossible to hide a needle in the heart.
The doctor actually told me, during one of his lame excuses, that the
patient does not need to be told everything if it does not harm them. For
instance, he said, doctors sometimes forget gauze and other items in their
patients, but never tell the patients because it does not do them any harm
(and probably more importantly, doesn't show up on an X-ray).
Now, I am not a doctor so I will take his word that having gauze sewn up
inside your chest will not harm you. However, this shows a major problem
with the attitudes of Japanese doctors in general.
When I undergo surgery or any medical treatment, I am putting my body, and
even my life, in my doctor's hands. But it is still my body, and my life. I
have a right to know everything that happens to my body under my doctor's
care, even if it is inconvenient for the doctor to tell me.
> Mistakes during operations happen everyday. Only people that never do
> nothing never make mistakes.
<snippage>
> and that's sad to say, but things are getting even worse as the staff have
> to cope with the attitude of patients and their "consumer mentality", and
> surgeons are stressed with the threats of absurd trials.
You can't have it both ways. Either doctors are humans who make mistakes, or
they are special. If they are humans who make mistakes, they are treated as
humans, ie as providers of a service. That makes the patients consumers of
that service. If they are somehow special, then the relationship is not a
simple one of service provider/consumer, but we must hold them to a higher
standard. That means that mistakes that would be understandable normally are
not acceptable in the case of a surgeon.
> Well, that's life.
That's quite an attitude, but as France also has national health care, I
guess you are used to such a system. However, even if you accept that
doctors make mistakes, even in Japan there is a standard to which they are
held: 業務上過失 (professional negligence). No, a lawyer cannot remove a
needle from a heart, but thanks to the code of silence in Japanese medicine,
they may be the only ones who can decide whether professional negligence was
the case here.
And for that reason, we may never know.
--
Regards,
Ryan Ginstrom
Ryan Ginstrom
> I'll take the risk I'll die during treatment or lack of it, because my
> condition is so serious, such as having cancer or being brought in after a
> traffic accident, NOT because the medical staff screwed up by operating on
the
> wrong (healthy) side of the body, operated on the wrong patients with
similar
> names or in the same ward, transplanted the wrong organs, left instruments
in,
> hooked up the heart lung machine backwards, put toxic material into the
IV,
> etc.
The doctor explained to me the safety precautions that they take with the
needles. Periodically during the surgery, they count all the needles to
ensure that they are accounted for. Then after the surgery, before the
patient is closed up, they count the needles one more time.
In this case, they noticed that one of the needles was missing during one of
their periodic counts. As the surgery progressed, they were also looking for
the missing needle, but failed to find it. After 3 hours with Bill's heart
stopped, they could not spend any more time looking for the needle, so they
sewed him back up and prayed for the best.
Now, the question that immediately came to my mind was, why don't they keep
track of every needle, instead of just counting them periodically? Nurses
are cheap in Japan, so if manpower is an issue they could just bring in an
extra nurse whose only job is to keep track of needles.
Perhaps there is a good answer for why each and every needle is not tracked.
An answer that would satisfy Bill. The problem is, if there is such an
answer, the doctors aren't telling. And the system is stacked against anyone
who would want to get such an answer.
--
Regards,
Ryan Ginstrom
mtfe...@netmapsonscape.net
> Mistakes during operations happen everyday. Only people that never do
> nothing never make mistakes. If you go for an operation, you take the risk
True. So, the hospital should simply remove the needle, at no cost to the
consumer.
Mie
another fool
simply that from a cost perspective it has the US system beat to hell.
The total cost for delivery of our son with an epi and the doctor
having to come in at 2am when my wife decided to go into labor was ~US
$4000. The birth of our first son cost us over US $14000 in the US.
The second birth had 5 days and 4 nights of hospitol care and baby
care. The first had 3 days and 2 nights - and the hospitol stay cost
more then the whole 2nd birth, baby care was extra and not included in
the $14000. I know the costs because my wonderful company decided to
tell us 'oh don't get the national health plan, we have great
insurance!' that only covers 80% of anything they decide is reasonable
after a $250 deductable - and will not pay the hospitol directly.
As far as 'tracking' every needle - how? Should they take a video of
where they put every needle? Should they use a digital camera? What
if they make a mistake and take the wrong needle out then think
they've got them all? They take every reasonable precaution. Maybe
you would have liked it if your friend died on the table while they
looked for the needle?
Mistakes happen and sometimes they are just that, mistakes. The
wonderful US sentiment that 'someone must be responsible' is just
assinine. I love the parks and playgrounds around my home - my kid
loves them too. You'd never see them in the US because the
city/county/etc. should have 'known someone would get hurt' and would
have been sued to death the first kid who fell down and broke a bone.
Seems like a simplification but it directly shows the difference in
legal system and mindset.
I do agree though that he and his family should have been notified
immediatly of the situation though. And have they done an x-ray to
find the needle and determine if it needs to come out? Also I do wish
him the best in his recovery.
Eric Takabayashi
> "Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
> news:3F71CFEC...@yahoo.co.jp...
> > I'll take the risk I'll die during treatment or lack of it, because my
> > condition is so serious, such as having cancer or being brought in after a
> > traffic accident, NOT because the medical staff screwed up by operating on
> the
> > wrong (healthy) side of the body, operated on the wrong patients with
> similar
> > names or in the same ward, transplanted the wrong organs, left instruments
> in,
> > hooked up the heart lung machine backwards, put toxic material into the
> IV,
> > etc.
>
> The doctor explained to me the safety precautions that they take with the
> needles. Periodically during the surgery, they count all the needles to
> ensure that they are accounted for. Then after the surgery, before the
> patient is closed up, they count the needles one more time.
I have heard of such instrument counts during open surgeries, but as can be
seen in Japan and elsewhere, they still lose things large and small, even large
clamps or scissors.
> In this case, they noticed that one of the needles was missing during one of
> their periodic counts. As the surgery progressed, they were also looking for
> the missing needle, but failed to find it. After 3 hours with Bill's heart
> stopped, they could not spend any more time looking for the needle, so they
> sewed him back up and prayed for the best.
I am sure they were not malicious or deliberately negligent, but that later
attitude is quite something.
> Now, the question that immediately came to my mind was, why don't they keep
> track of every needle, instead of just counting them periodically? Nurses
> are cheap in Japan, so if manpower is an issue they could just bring in an
> extra nurse whose only job is to keep track of needles.
Now this I can sympathize with. No, Japan does not have enough nurses. I know
women who want to become nurses and those are currently studying to become
nurses. Their misgivings over workload, and hospital staffing policies create a
vicious circle. As long as nurses are kept so busy and work is so stressful
(responsibility over twice the number of beds that U.S. nurses have, and the
U.S. has a need as well), there are not going to be enough people who are
willing to become nurses to relieve that workload. And Japanese nurses'
salaries are not like nurses' salaries in the US, where they can get more than
public school teachers, and compare favorably with what physicians make.
> Perhaps there is a good answer for why each and every needle is not tracked.
> An answer that would satisfy Bill. The problem is, if there is such an
> answer, the doctors aren't telling. And the system is stacked against anyone
> who would want to get such an answer.
I am very surprised that this hospital is one that will allow others to review
its records or suggest a second opinion.
Eric Takabayashi
> "cc" <cpasune...@spam.com> wrote in message
> news:bksgsg$1m1$1...@bgsv5648.tk.mesh.ad.jp...
> >
> > "Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
> >
> > > It's pretty hard to deny a needle in the heart if it's still there.
> >
> > They didn't deny.
>
> No, but it took them two days to come clean. And that only because it is
> impossible to hide a needle in the heart.
>
> The doctor actually told me, during one of his lame excuses, that the
> patient does not need to be told everything if it does not harm them.
When I was on the JET Program, we lost the school's principal to what was
officially called an ulcer. He was out of it for months at a time over a period
of two years, had to be hospitalized, and required surgery. School business was
seriously affected. Then he died.
I've known people with ulcers, such as my grandfather back home or people in
Japan, who were successfully treated for their ulcers.
I really doubt that the principal had ulcers or died of ulcers. My grandfather
was nearly 80, collapsed in a Las Vegas casino during a vacation, and was found
to have had x pints (I forget) of blood in his stomach from a bleeding ulcer.
He could have died if their had not been someone to find him. The doctors
simply removed that part of the stomach, sewed him back up, and he was back
gambling, walking and traveling by air, in about three days.
I don't believe that 7th grade boy from my homeroom suddenly collapsed and
later died of a week old circulatory blockage in his large intestines, either,
very coincidentally collapsing shortly after a PE teacher kicked him in the
back while down. But if that is what the hospital and school claim, or what the
family believes, what can be done?
> For
> instance, he said, doctors sometimes forget gauze and other items in their
> patients, but never tell the patients because it does not do them any harm
> (and probably more importantly, doesn't show up on an X-ray).
I don't remember the source or if it was Japan or the US, but just last week
there was the news story of a patient dying with gauze in them, and it being
attributed to the gauze.
> Now, I am not a doctor so I will take his word that having gauze sewn up
> inside your chest will not harm you.
Perhaps he would not mind if it happened to him, or if gauze were left in his
relative's body, or better yet, volunteered.
> However, this shows a major problem
> with the attitudes of Japanese doctors in general.
>
> When I undergo surgery or any medical treatment, I am putting my body, and
> even my life, in my doctor's hands. But it is still my body, and my life. I
> have a right to know everything that happens to my body under my doctor's
> care, even if it is inconvenient for the doctor to tell me.
Note I am not suggesting an "absurd" trial or some sort of vendetta in this
case, unless there are some lasting effects. But those people need to realize
they need to change their ways, even if it costs them face or money.
Eric Takabayashi
And pay isharyou. If the family is satisfied with 500,000 yen, which seems to
be a common enough figure on popular TV shows covering legal issues (Japanese
don't usually ask for much, and courts don't usually award much), then that's
what they should get.
Eric Takabayashi
> Having had to deal with the Japanese medical system recently I can say
> simply that from a cost perspective it has the US system beat to hell.
True. But long life span notwithstanding, I still do not believe it
provides better quality care than the US system. I've told the story of
when my mother fractured her foot in Japan, and I saw that the local
"national" hospital was like my hometown hospital 30 years ago,
understaffed, with primitive technology, and poor interpersonal skills.
But it did cost only 10,000 yen for the examination and x-ray.
> The total cost for delivery of our son with an epi and the doctor
> having to come in at 2am when my wife decided to go into labor was ~US
> $4000. The birth of our first son cost us over US $14000 in the US.
> The second birth had 5 days and 4 nights of hospitol care and baby
> care. The first had 3 days and 2 nights - and the hospitol stay cost
> more then the whole 2nd birth, baby care was extra and not included in
> the $14000. I know the costs because my wonderful company decided to
> tell us 'oh don't get the national health plan, we have great
> insurance!' that only covers 80% of anything they decide is reasonable
> after a $250 deductable - and will not pay the hospitol directly.
Childbirth, not being a "disease", is not usually covered by national
insurance. I paid a similar amount, completely out of pocket. The way
Japanese hospitals handle expectant mothers and childbirth is terrible.
Yes, infant mortality in Japan is lower than in the US, but that still
doesn't mean that such impersonal and invasive treatment is warranted.
> As far as 'tracking' every needle - how?
Counting them.
> Should they take a video of where they put every needle?
The people who handle the needles know what they did with them, or
should.
I'd like to know more about this needle, such as if it was a suturing
needle which was not snipped off, or something that simply fell back in.
> Should they use a digital camera?
A medical scanning device, such as an x-ray machine or a metal detector
in this case.
> What if they make a mistake and take the wrong needle out
You mean, there are needles which are supposed to be left in?
> then think they've got them all?
That's what the count is for.
> They take every reasonable precaution.
It seems the people are upset about the attitude of the hospital, not the
simple fact that something was left in.
> Maybe
> you would have liked it if your friend died on the table while they
> looked for the needle?
>
> Mistakes happen and sometimes they are just that, mistakes.
Patient dies after doctors perform 'human experiment'
"Before the operation doctors reportedly ignored formalities such as
gaining approval for the operation from the university's ethics
committee, and went ahead with the procedure despite a lack of
experience."
Comment, please. You and "CC". Also recall the story of the American man
who woke up without a penis, removed by doctors without his permission in
the apparently mistaken belief it was cancerous.
Just mistakes, huh? Would you like to try living with such mistakes, and
without considering responsibility?
> The wonderful US sentiment that 'someone must be responsible' is just
> assinine.
If not the doctor or the hospital, who should or will do something about
it? Who is going to pay to cover any necessary treatment? Is his mother
supposed to do something about it herself or take care of him if
something goes wrong with the needle simply left in place? This is not a
"US" sentiment. This is a case where someone MUST be held responsible, or
through inaction, that responsibility WILL fall upon the family.
> I love the parks and playgrounds around my home - my kid
> loves them too. You'd never see them in the US because the
> city/county/etc. should have 'known someone would get hurt' and would
> have been sued to death the first kid who fell down and broke a bone.
> Seems like a simplification but it directly shows the difference in
> legal system and mindset.
And precisely why people in Japan are so often and easily screwed, even
if and when lives are actually lost as in incredible hospital screw ups
that sometimes make the news, like the "human experimentation" death at
the hands of unqualified doctors performing a procedure without
permission. Japanese "apologies" for the benefit of news cameras and
token unnecessary resignations of officials who had nothing to do with
the problem is expected to settle most problems here. The Texas man is
fortunate that a simple "I'm sorry" is not accepted in the US for a lost
penis.
Michael Cash
belched the alphabet and kept on going with:
>Having had to deal with the Japanese medical system recently I can say
>simply that from a cost perspective it has the US system beat to hell.
> The total cost for delivery of our son with an epi and the doctor
>having to come in at 2am when my wife decided to go into labor was ~US
>$4000.
You got gypped.
My two cost about 300,000 each, and it was practically 100% covered.
If I had an out-of-pocket expense associated with the delivery or the
subsequent hospital stays (two weeks each time), I sure as hell don't
recall it.
And lots of cities are so desperate for shoring up their population
that they will spring for 100% coverage on medical costs up until
about 5 years of age.
>As far as 'tracking' every needle - how?
I believe the standard procedure is to COUNT *everything* associated
with the procedure prior to starting and again prior to sewing the
patient back up. Needles, gauze, retractors, etc.
>Should they take a video of
>where they put every needle? Should they use a digital camera? What
>if they make a mistake and take the wrong needle out then think
>they've got them all? They take every reasonable precaution.
Obviously not. Japanese gaff off standard procedure all the time. Were
you around when they had the nuclear near-disaster in Ibaraki Pref?
>Maybe
>you would have liked it if your friend died on the table while they
>looked for the needle?
Is there a need to be so dramatic?
Probably he would have liked it if they had followed procedure and
kept up with the goddamned thing to begin with. We're not talking
about rebuilding a transmission and having a couple of parts left over
here; this is heart surgery on a human being. Hell, I'd expect better
than that even if it were heart surgery on a dog.
>
>Mistakes happen and sometimes they are just that, mistakes.
Yes, and doctors usually get to bury theirs.
What you (and cc) are missing out on here is that this is sort of a
rampant fucking problem in Japanese hospitals.
>The
>wonderful US sentiment that 'someone must be responsible' is just
>assinine.
Goody. So when I'm distracted by something while driving and run over
you, there'll be no hard feelings, right? Hell, mistakes happen.
>I love the parks and playgrounds around my home - my kid
>loves them too. You'd never see them in the US because the
>city/county/etc. should have 'known someone would get hurt' and would
>have been sued to death the first kid who fell down and broke a bone.
>Seems like a simplification but it directly shows the difference in
>legal system and mindset.
No, it shows an inability to come to some reasonable middle ground.
Americans all too often these days go to one extreme, trying to
forestall every conceivable eventuality, while Japan all too often
goes to the other extreme, deciding to start worrying about safety
only AFTER someone has been injured or killed. Know what Japanese term
pisses me off more than anything? "Saihatsu boushi".
>
>I do agree though that he and his family should have been notified
>immediatly of the situation though. And have they done an x-ray to
>find the needle and determine if it needs to come out?
Seems like a no-brainer to me. Something pointy on both ends and very
sharp on one, specifically designed for the purpose of PIERCING FLESH
and in the immediate vicinity of the heart.
Eric Takabayashi
> On 25 Sep 2003 04:54:48 -0700, anoth...@hotmail.com (another fool)
> belched the alphabet and kept on going with:
>
> >Having had to deal with the Japanese medical system recently I can say
> >simply that from a cost perspective it has the US system beat to hell.
> > The total cost for delivery of our son with an epi and the doctor
> >having to come in at 2am when my wife decided to go into labor was ~US
> >$4000.
>
> You got gypped.
>
> My two cost about 300,000 each, and it was practically 100% covered.
That's what each of mine cost, despite being born in different
prefectures. It seems to be a set price. Yours were covered by some sort
of insurance?
> If I had an out-of-pocket expense associated with the delivery or the
> subsequent hospital stays (two weeks each time), I sure as hell don't
> recall it.
We paid when it was time to leave.
> And lots of cities are so desperate for shoring up their population
> that they will spring for 100% coverage on medical costs up until
> about 5 years of age.
The local government gave my wife an amount equivalent to almost 100% of
the up front, out of pocket cost of childbirth. I consider that
generosity, not insurance. And considering we don't go to hospital often,
I have paid into the medical system multiples more than I take out,
anyway. It's not my fault that Japan can't find money to cover the elderly
for their care.
> >As far as 'tracking' every needle - how?
>
> I believe the standard procedure is to COUNT *everything* associated
> with the procedure prior to starting and again prior to sewing the
> patient back up. Needles, gauze, retractors, etc.
I do admit to amazement that it is done. I believe medical professionals
are highly intelligent and skilled people however, and can be expected to
do so.
> >Mistakes happen and sometimes they are just that, mistakes.
>
> Yes, and doctors usually get to bury theirs.
http://tinyurl.com/on19
http://tinyurl.com/on1f
[Note: This is what doctors THEMSELVES admit to.]
Writing in the Journal of the American Medical Association (JAMA), Dr.
Starfield has documented the tragedy of the traditional medical paradigm
in the following statistics:
Deaths Per Year Cause
106,000 Non-error, negative effects of drugs
80,000 Infections in hospitals
45,000 Other errors in hospitals
12,000 Unnecessary surgery
7,000 Medication errors in hospitals
250,000 Total deaths per year from iatrogenic* causes
* The term iatrogenic is defined as "induced in a patient by a physician's
activity, manner, or therapy. Used especially to pertain to a complication
of treatment."
Furthermore, these estimates of death due to error are lower than those in
a recent Institutes of Medicine report. If the higher estimates are used,
the deaths due to iatrogenic causes would range from 230,000 to 284,000.
Even at the lower estimate of 225,000 deaths per year, this constitutes
the third leading cause of death in the U.S.
Dr. Starfield offers several caveats in the interpretations of these
numbers:
First, most of the data are derived from studies in hospitalized patients.
Second, these estimates are for deaths only and do not include the many
negative effects that are associated with disability or discomfort.
Third, the estimates of death due to error are lower than those in the IOM
report. If the higher estimates are used, the deaths due to iatrogenic
causes would range from 230,000 to 284,000. In any case, 225,000 deaths
per year constitutes the third leading cause of death in the United
States, after deaths from heart disease and cancer. Even if these figures
are overestimated, there is a wide margin between these numbers of deaths
and the next leading cause of death (cerebro-vascular disease).
Another analysis concluded that between 4% and 18% of consecutive patients
experience negative effects in outpatient settings, with:
* 116 million extra physician visits
* 77 million extra prescriptions
* 17 million emergency department visits
* 8 million hospitalizations
* 3 million long-term admissions
* 199,000 additional deaths
* $77 billion in extra costs
The high cost of the health care system is considered to be a deficit, but
it seems to be tolerated under the assumption that better health results
from more expensive care. However, evidence from a few studies indicates
that as many as 20% to 30% of patients receive inappropriate care. An
estimated 44,000 to 98,000 among these patients die each year as a result
of medical errors.
[snip]
Health care's deadly secret: Accidents routinely happen
Lucian Leape, a Harvard University professor who conducted the most
comprehensive study of medical errors in the United States, has estimated
that one million patients nationwide are injured by errors during hospital
treatment each year and that 120,000 die as a result.
That number of deaths is the equivalent of what would occur if a jumbo jet
crashed every day; it is three times the 43,000 people killed each year in
U.S. automobile accidents.
"It's by far the number one problem" in health care, said Leape, an
adjunct professor of health policy at the Harvard School of Public Health.
In their study, Leape and his colleagues examined patient records at
hospitals throughout the state of New York. Their 1991 report found that
one of every 200 patients admitted to a hospital died as a result of a
hospital error.
Researchers such as Leape say that not only are medical errors not
reported to the public, but those reported to hospital authorities
represent roughly 5 to 10 percent of the number of actual medical mistakes
at a typical hospital.
[snip]
But what the hell, even the third leading cause of death in the case of
the US, God only knows what kind of screwups other than "human
experimentation" Japanese hospitals are committing, are just mistakes.
Patient dies after doctors perform 'human experiment'
Before the operation doctors reportedly ignored formalities such as
gaining approval for the operation from the university's ethics committee,
and went ahead with the procedure despite a lack of experience.
Police who questioned medical experts were reportedly told that a doctor
would need to have acted as an assistant in about 10 previous operations
before taking on such an operation without the guidance of a supervising
surgeon. However, Madarame had only acted as an assistant two times and
the other doctors, 34-year-old Taro Hasegawa and 32-year-old Shigetaka
Maeda, had only gone through the operation on animals. Furthermore, no
supervising doctor was present.
During the operation the doctors reportedly had to refer to a manual on
how to perform it, and had to have an endoscope tradesman present to tell
them how to use their equipment.
A veteran doctor would normally be able to sew the patient's bladder and
urethra together in 20 minutes after removing the prostate gland, but
Madarame and the other doctors failed to properly sew up the patient
despite spending two hours, resulting in major bleeding.
"It was equivalent to a human experiment behind closed doors," an official
investigating the case said.
One of the nurses present at the operation said: "I just wanted them to
stop."
[snip]
"Investigators said they could not determine whether the failed operation
was a mistake or an accident."
Hell, just simple mistakes. I'll just silently submit myself and my
children to some system that is known to result in DEATH for one in 200
people due to simple ERROR. No need to assign responsibility, or have
"absurd" trials.
> >The
> >wonderful US sentiment that 'someone must be responsible' is just
> >assinine.
>
> Goody. So when I'm distracted by something while driving and run over
> you, there'll be no hard feelings, right? Hell, mistakes happen.
Tell him about the recent drunk driving incidents. I liked the story of
the bus driver who made a practice of taking alcohol along on his all
night drives, and the driver who deliberately worked without sleep.
cc
"Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
> Yes, it is alleged in the US that nearly 100,000 deaths per year are
caused by
> hospital error, which would make hospital error one of the leading causes
of
> death. It needs to be stopped.
If you shut all the hospitals and execute the doctors, Americans will no
longer die ?
>If businesspeople screw up by losing a lot of money and only
> money, or a truck driver causes an accident resulting in injury or death;
even
> accidentally, they may pay for it out of their own pocket or face serious
> consequences in their careers. People like truck drivers may end up in
jail.
I'm pretty sure you're not a businesspeople, a truck driver and certainly
not a physician.
I know why I am not a surgeon or a hospital manager. I lack the strength.
I've met enough of these people to know they take everyday responsabilities
bigger than the ones an Eric will take in his whole career.
A surgeon can make a "mistake" resulting in death every second during a
heart operation that lasts hours.
> Hospitals
> could be LESS busy or stressed if they didn't make these "mistakes"
possibly
> resulting in more work, in the first place.
Oh I see, they make mistakes because they are lazy ?
> You'd just have them go back in, open your grandmother up (again) and go
after
> the needle in her heart if it were your family?
They re-operated my grand-mother, as they couldn't let her like that..
> And do you believe that such "repair" or treatment for any resulting
condition
> from this error or the second operation which should never have been
necessary
> in the first place should be paid for by the family, the hospital, or the
> national insurance system?
That's part of the budget of the hospital, like any other organisation has a
budget for things that are out of control (earthquakes, accidents, etc) or
they take insurances.
> And the "absurd" family, who allegedly harbors this "consumer mentality"
over
> their family member's HEART operation, should "get" nothing at all?
> Not even,
> apparently, an apology?
They've got the operation + the admission of error + the doctors willing to
do something to solve the problem. For apologies, I was not there.
> What is "absurd" to you in this incident? NOT the hospital(s) actions or
> attitudes?
The 500 000 yen isharyo story. Those people watch too many stupid TV shows.
Who is supposed to pay that fine ? The surgeon ? Well, fine, he'll get that
problem twice and then he'll calculate if he raises the price of his
operations of 100% in order to pay future fines and hire a full time lawyer
(that's what American hospital do) or he'll give up heart operations and
open a liposuccion clinic, as that's easier to count the needles on legs
than inside hearts (that's what American surgeons did years ago, to the
point that now your hospitals work essentially with foreign staff).
CC
cc
"Ryan Ginstrom" <gins...@hotmail.com> wrote in message
> No, but it took them two days to come clean. And that only because it is
> impossible to hide a needle in the heart.
That's not so long 2 days, maybe the time to wake up completely and to
recheck everything to be sure there was really a needle.
> The doctor actually told me, during one of his lame excuses, that the
> patient does not need to be told everything if it does not harm them. For
> instance, he said, doctors sometimes forget gauze and other items in their
> patients, but never tell the patients because it does not do them any harm
> (and probably more importantly, doesn't show up on an X-ray).
Well, he was honest and told you the facts. In another hospital, they'd
have re-operated Bill under another pretext just to take off the needle and
cover their mistake. I don't think it's that difficult to hide.
Did you consider the possibility they didn't give you more details about
what happened because they don't know themselves ?
> Now, I am not a doctor so I will take his word that having gauze sewn up
> inside your chest will not harm you. However, this shows a major problem
> with the attitudes of Japanese doctors in general.
I know that in average Japanese doctors lack of communication skills
, but
that's easy to make that the source of every problem.
What is special with Japan in this case ?
What would they do in your country? Tell you BS with a big smile ? The
surgeon would pat Bill on the arm saying :"Great, you were so courageous
Bill, everything is OK, except a little needle we had to let inside for a
while, for your good,...er yeah, I'm gonna tell you why...well..er...as your
cardiathingus was more stuffus toizatus ittuti than we expected, we pinustux
im tiagma... but don't worry, the second operation will be shorter...".
You'd prefer ?
I wonder if the coverage of little mistakes is not even more common than in
Japan in a context were doctors are sure to be sued anytime a familly sees
an opportunity to get a few bucks..
> When I undergo surgery or any medical treatment, I am putting my body, and
> even my life, in my doctor's hands. But it is still my body, and my life.
>I
> have a right to know everything that happens to my body under my doctor's
> care, even if it is inconvenient for the doctor to tell me.
I prefer to know too.
But I am not sure this is a right in Japan. In France, it is not. That has
no relation with the fact there is a public service of health, private
medicine is very developped and the rules are similar.
Doctors have no obligation to let you see your file and tell you every
detail. But, that does not mean they are free to hide informations
if they consider knowing would not help you or if you're not
psychologically strong enough to hear. In case you have a doubt, you can ask
a second doctor, that will be able to see the file (without obligation to
tell you everything), and irregularity are investigated by the
medical association.
In fact, I don't know anybody in France or Japan that was not told
everything when he/she asked. There are people that don't want to know.
> You can't have it both ways. Either doctors are humans who make mistakes,
or
> they are special. If they are humans who make mistakes, they are treated
as
> humans, ie as providers of a service.
Nothing forces you to sell dangerous things and perform operations you don't
master at 100%..
Medicine is a special activity, not a business.
Doctors have an obligation to give you a treatment. They can't stop doing
aneastesia because 1 case in 100 000 results in the
death of the patient. They can't stop doing operations because only 1/3 will
be a success. They can't close the emergency room or shorten the scheduled
operations if they feel tired.
I remind you that not so long ago, heart operations failed most of the
times and that was exceptional that the patient survive.
A surgeon I know often told me that the hardest in his job was that he had
to *fail* several operations and study the mistakes before finding a new
technique and getting a success. Well, that said, in average 60% to 70%
of his patients can walk again after the operations, while 20 years ago,
nobody operated that and 100% ended up in a wheelchair.
I am glad that the doctors didn't give up and step by step improved their
techniques.
>If they are somehow special, then the relationship is not a
> simple one of service provider/consumer, but we must hold them to a higher
> standard.
I don't understand your logic. They are normal, what they do is special.
>that means that mistakes that would be understandable normally are
> not acceptable in the case of a surgeon.
We call that a mistake. That's an interpretation.
Have you already participated to an operation or seen one ? From the videos
I've seen, that's awfully complicated, even with the new high tech
equipment.
What makes you assume it's possible to count the needles ? How do you know
the solution is as easy as adding a nurse ? They are dealing with the human
body, tons of unexpected problems can happen.
I'd be the first to whine if a doctor makes me a dress and forgets a needle,
he has no excuse, the fabric doesn't swallow needles and he has all his time
to check..
> even in Japan there is a standard to which they are
> held: 業務上過失 (professional negligence).
Is the negligence "not doing the best to count the needles" or "forgetting
the needles" ?
> No, a lawyer cannot remove a
> needle from a heart, but thanks to the code of silence in Japanese
medicine,
> they may be the only ones who can decide whether professional negligence
was
> the case here.
No, lawyers cannot decide if anything is a negligence, is illegal or
whatever.
That's the job of judges ,and in the case of medicine, medical experts.
If there was a real code of silence, you wouldn't know about the needle.
CC
Eric Takabayashi
> "Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
>
> > Yes, it is alleged in the US that nearly 100,000 deaths per year are
> caused by
> > hospital error, which would make hospital error one of the leading causes
> of
> > death. It needs to be stopped.
>
> If you shut all the hospitals and execute the doctors, Americans will no
> longer die ?
Who proposed this? And you seem completely unfazed by medical officials and
researchers calling widespread hospital error the third leading cause of death
in the US..
> >If businesspeople screw up by losing a lot of money and only
> > money, or a truck driver causes an accident resulting in injury or death;
> even
> > accidentally, they may pay for it out of their own pocket or face serious
> > consequences in their careers. People like truck drivers may end up in
> jail.
>
> I'm pretty sure you're not a businesspeople, a truck driver and certainly
> not a physician.
And thus far, have killed no people, accidentally, through incompetence,
malice, or otherwise. Because even if I were qualified, I would not want that
responsibility. And if one did accept it, then they should live with that
responsibility.
> I know why I am not a surgeon or a hospital manager. I lack the strength.
> I've met enough of these people to know they take everyday responsabilities
> bigger than the ones an Eric will take in his whole career.
Perhaps I would care about your intended insult if I cared about becoming a
doctor or envied them, but I do not. Sorry.
> A surgeon can make a "mistake" resulting in death every second during a
> heart operation that lasts hours.
If you expect people to avoid hospitals and treatment to avoid risk, then you
can also expect skittish doctors and would be medical professionals to either
take themselves more seriously, be more careful, or avoid the profession, like
you do.
> > Hospitals
> > could be LESS busy or stressed if they didn't make these "mistakes"
> possibly
> > resulting in more work, in the first place.
>
> Oh I see, they make mistakes because they are lazy ?
Not all, but some errors and resulting complications and deaths are indeed due
to laziness. Try reading up on it. Please do comment on recent news items of
hospital errors, or findings of medical officials and researchers themselves on
the crisis of hospital error and death, telling us they are simply human
mistakes that happen.
> > You'd just have them go back in, open your grandmother up (again) and go
> after
> > the needle in her heart if it were your family?
>
> They re-operated my grand-mother, as they couldn't let her like that..
And the doctors in Bill's case are clearly different, and should be thought of
or treated differently.
> > And do you believe that such "repair" or treatment for any resulting
> condition
> > from this error or the second operation which should never have been
> necessary
> > in the first place should be paid for by the family, the hospital, or the
> > national insurance system?
>
> That's part of the budget of the hospital, like any other organisation has a
> budget for things that are out of control (earthquakes, accidents, etc) or
> they take insurances.
Does this mean you think the hospital should pay for or waive the cost of any
further treatment for this incident? That much is good.
> > And the "absurd" family, who allegedly harbors this "consumer mentality"
> over
> > their family member's HEART operation, should "get" nothing at all?
> > Not even,
> > apparently, an apology?
>
> They've got the operation + the admission of error + the doctors willing to
> do something to solve the problem. For apologies, I was not there.
Not an apology for you or me. For the patient or his family.
> > What is "absurd" to you in this incident? NOT the hospital(s) actions or
> > attitudes?
>
> The 500 000 yen isharyo story. Those people watch too many stupid TV shows.
>
> Who is supposed to pay that fine ? The surgeon ?
That would be nice, for the punishment to befall the one responsible, rather
than their employer or the taxpayers.
> Well, fine, he'll get that problem twice
Or they could be more careful, and not have any problems even once.
> and then he'll calculate if he raises the price of his
> operations of 100% in order to pay future fines
That's one thing nice about national health care.
> and hire a full time lawyer (that's what American hospital do)
Yes, their own lawyer would also be wise. But being more careful or competent,
to make it all unnecessary, would be best of all.
> or he'll give up heart operations
No, people will remain who want the prestige and money, or who have a genuine
desire to help people, despite any risks. In places like the former Soviet
Union, physicians did not enjoy high status or income, but they did it anyway.
It is such people whom I admire all the more than those who do it for the
former reasons. And mind you, I do know people who are trying to do it for the
money.
> and open a liposuccion clinic,
There's more of that sort of thing in Japan, too.
> as that's easier to count the needles on legs
> than inside hearts (that's what American surgeons did years ago, to the
> point that now your hospitals work essentially with foreign staff).
See? There are the people. Admittedly, ob/gyn is facing a crisis in numerous
regions.
Eric Takabayashi
> "Ryan Ginstrom" <gins...@hotmail.com> wrote in message
>
> > No, but it took them two days to come clean. And that only because it is
> > impossible to hide a needle in the heart.
>
> That's not so long 2 days, maybe the time to wake up completely and to
> recheck everything to be sure there was really a needle.
>
> > The doctor actually told me, during one of his lame excuses, that the
> > patient does not need to be told everything if it does not harm them. For
> > instance, he said, doctors sometimes forget gauze and other items in their
> > patients, but never tell the patients because it does not do them any harm
> > (and probably more importantly, doesn't show up on an X-ray).
>
> Well, he was honest and told you the facts. In another hospital, they'd
> have re-operated Bill under another pretext just to take off the needle and
> cover their mistake.
Oh, so you believe or know there are such people, but continue to universally
make excuses for doctors and hospitals?
> I don't think it's that difficult to hide.
Oh, so you know this, but continue to make your excuses?
> Did you consider the possibility they didn't give you more details about
> what happened because they don't know themselves ?
And none of this seems to bother you? I've had doctors tell me they don't know,
or they can't do anything more about it, and we accepted it.
And people died.
We quietly accepted that, too. No "absurd" trials, no "consumer mentality", and
no looking for "an opportunity to make a few bucks."
Surprised?
> > Now, I am not a doctor so I will take his word that having gauze sewn up
> > inside your chest will not harm you. However, this shows a major problem
> > with the attitudes of Japanese doctors in general.
>
> I know that in average Japanese doctors lack of communication skills
Oh, you know this, too?
> , but
> that's easy to make that the source of every problem.
It's not the source of every problem. Incompetence and error are also to blame
for millions of complications and hundreds of thousands of deaths at the hands
of doctors, according to research conducted by national medical organizations
and doctors.
> What is special with Japan in this case ?
The attitudes people have about "sensei" and the attitudes of the "sensei"
themselves.
> What would they do in your country?
Research by medical officials and doctors themselves allege vast underreporting
of error, as high as 95%, most of which will never see the light of day.
> Tell you BS with a big smile ?
No, I imagine they would be afraid to smile.
> The
> surgeon would pat Bill on the arm saying :"Great, you were so courageous
> Bill, everything is OK, except a little needle we had to let inside for a
> while, for your good,...er yeah, I'm gonna tell you why...well..er...as your
> cardiathingus was more stuffus toizatus ittuti than we expected, we pinustux
> im tiagma... but don't worry, the second operation will be shorter...".
> You'd prefer ?
I would be much more understanding and likely to be forgiving, of an honest
doctor. Not so of a devious or defensive one. I can and have dealt with doctors
who tell me they don't know or can't do anything more.
Even when people died. And that was the end of the matter.
> I wonder if the coverage of little mistakes is not even more common than in
> Japan in a context were doctors are sure to be sued anytime a familly sees
> an opportunity to get a few bucks.
I do not know why are are generalizing people who are suffering in the
millions, or even dying by the hundreds of thousands at the hands of those from
whom they sought help, to be looking for an opportunity to get a few bucks. It
is true that people in the US are quick to sue for millions of dollars, but
have a look at what happened to them first, such as losing a family member,
being crippled, or having parts removed and amputated by mistake, or receiving
unnecessary or unjustifiable treatment, as has been judged by national medical
organizations and doctors themselves.
> > When I undergo surgery or any medical treatment, I am putting my body, and
> > even my life, in my doctor's hands. But it is still my body, and my life.
> >I
> > have a right to know everything that happens to my body under my doctor's
> > care, even if it is inconvenient for the doctor to tell me.
>
> I prefer to know too. But I am not sure this is a right in Japan. In France,
> it is not.
Damn. Your reaction? How would you have liked it if they simply covered up or
lied about your grandmother's case, AND it had not turned out well?
> That has
> no relation with the fact there is a public service of health, private
> medicine is very developped and the rules are similar.
> Doctors have no obligation to let you see your file and tell you every
> detail.
Damn. Then how will you ever know that you are receiving the proper care or
whether or not you should go elsewhere? Just because the UN claims France has
the number one health care system?
> But, that does not mean they are free to hide informations
> if they consider knowing would not help you or if you're not
> psychologically strong enough to hear.
Then how would you know whether or not they are hiding anything, and how do the
doctors know you are not strong enough?
> In case you have a doubt,
And how would one make this informed judgment, or do these doubts occur often
in this country where people do not have the right to see their file or know
what the doctors know?
> you can ask
> a second doctor, that will be able to see the file (without obligation to
> tell you everything),
And how is this an improvement?
> and irregularity are investigated by the
> medical association.
And how would they find out?
> In fact, I don't know anybody in France or Japan that was not told
> everything when he/she asked. There are people that don't want to know.
Yes, there are many people in Japan who don't want to be told they have cancer
or some other serious or terminal condition. On the other hand, there are those
who would want to know the truth of the seriousness of their condition, but
through tradition, don't know to ask, are not inclined to ask, or are not the
judge of whether or not what they are being told is truthful. Unfortunately I
do not have on hand that survey conducted of doctors in Japan which showed how
many would or would not tell such patients the truth of their serious
condition. But it was hardly overwhelmingly in favor, and even now, a good
proportion of doctors continue to hide the truth about patients' conditions
from them (if not their families) as a matter of policy.
> > You can't have it both ways. Either doctors are humans who make mistakes,
> or
> > they are special. If they are humans who make mistakes, they are treated
> as
> > humans, ie as providers of a service.
>
> Nothing forces you to sell dangerous things and perform operations you don't
> master at 100%..
Are you alleging that doctors have mastered the operations 100%, or accept that
they made the choice (and should therefore accept the responsibility, just like
you claim patients should by seeking care) to perform operations they have NOT
mastered 100% or could actually screw up?
Then perhaps you could explain today's "human experimentation" incident.
Patient dies after doctors perform 'human experiment'
Before the operation doctors reportedly ignored formalities such as gaining
approval for the operation from the university's ethics committee, and went
ahead with the procedure despite a lack of experience.
Police who questioned medical experts were reportedly told that a doctor would
need to have acted as an assistant in about 10 previous operations before
taking on such an operation without the guidance of a supervising surgeon.
However, Madarame had only acted as an assistant two times and the other
doctors, 34-year-old Taro Hasegawa and 32-year-old Shigetaka Maeda, had only
gone through the operation on animals. Furthermore, no supervising doctor was
present.
During the operation the doctors reportedly had to refer to a manual on how to
perform it, and had to have an endoscope tradesman present to tell them how to
use their equipment.
A veteran doctor would normally be able to sew the patient's bladder and
urethra together in 20 minutes after removing the prostate gland, but Madarame
and the other doctors failed to properly sew up the patient despite spending
two hours, resulting in major bleeding.
"It was equivalent to a human experiment behind closed doors," an official
investigating the case said.
One of the nurses present at the operation said: "I just wanted them to stop."
[snip]
Defend these doctors and this hospital, please. Tell us all about how great and
good and noble doctors are, and how they as humans, naturally make mistakes.
Which kill people.
> Medicine is a special activity, not a business.
> Doctors have an obligation to give you a treatment. They can't stop doing
> aneastesia because 1 case in 100 000 results in the
> death of the patient.
More. Much more.
> They can't stop doing operations because only 1/3 will
> be a success.
You are talking about risk, which is discussed with patients and families
before the procedure, not errors, accidents and incompetence. Did doctors tell
Bill before the operation the odds a needle would be left in his heart, as
opposed to the prognosis of the treatment itself?
> They can't close the emergency room or shorten the scheduled
> operations if they feel tired.
> I remind you that not so long ago, heart operations failed most of the
> times and that was exceptional that the patient survive.
That was not the fault of the doctors. I do not blame doctors or hospitals that
people in my family are prematurely dead. But then, those doctors appeared to
be honest, forthcoming and sensitive. They told us what could and couldn't be
done, and what they did and didn't know, and offered options, including ceasing
ICU treatment, or going home without treatment, both of which would surely
result in a messy or painful and prolonged death.
And did. And we accepted it.
> A surgeon I know often told me that the hardest in his job was that he had
> to *fail* several operations and study the mistakes before finding a new
> technique and getting a success. Well, that said, in average 60% to 70%
> of his patients can walk again after the operations, while 20 years ago,
> nobody operated that and 100% ended up in a wheelchair.
> I am glad that the doctors didn't give up and step by step improved their
> techniques.
You are talking about progress in medical technology, not errors, accidents or
incompetence. And I certainly hope you are not talking about "training" or
acquisition of "skill" in the manner of the "human experimentation" incident.
> >If they are somehow special, then the relationship is not a
> > simple one of service provider/consumer, but we must hold them to a higher
> > standard.
>
> I don't understand your logic. They are normal, what they do is special.
>
> >that means that mistakes that would be understandable normally are
> > not acceptable in the case of a surgeon.
>
> We call that a mistake.
Which cause complications in millions, and the deaths of hundreds of thousands,
what could be called the third leading cause of death in the US, according to
the findings of doctors themselves.
Simple mistakes. Tsk.
> That's an interpretation.
> Have you already participated to an operation or seen one ?
I love seeing such things as open heart surgery on TV.
> From the videos
> I've seen, that's awfully complicated,
Luckily doctors have the training to deal with situations ordinary people would
consider complicated or even impossible.
> even with the new high tech
> equipment.
> What makes you assume it's possible to count the needles ?
Doctors and nurses can do arithmetic.
> How do you know
> the solution is as easy as adding a nurse ? They are dealing with the human
> body, tons of unexpected problems can happen.
Luckily they are trained professionals.
> I'd be the first to whine if a doctor makes me a dress and forgets a needle,
> he has no excuse, the fabric doesn't swallow needles and he has all his time
> to check..
>
> > even in Japan there is a standard to which they are
> > held: 業務上過失 (professional negligence).
>
> Is the negligence "not doing the best to count the needles" or "forgetting
> the needles" ?
>
> > No, a lawyer cannot remove a
> > needle from a heart, but thanks to the code of silence in Japanese
> medicine,
> > they may be the only ones who can decide whether professional negligence
> was
> > the case here.
>
> No, lawyers cannot decide if anything is a negligence, is illegal or
> whatever.
> That's the job of judges ,and in the case of medicine, medical experts.
> If there was a real code of silence, you wouldn't know about the needle.
The needle CANNOT be hidden, as has been explained to you. On the other hand,
it HAS been reported "The doctor actually told me, during one of his lame
excuses, patient does not need to be told everything if it does not harm them.
For instance, he said, doctors sometimes forget gauze and other items in their
patients, but never tell the patients because it does not do them any harm (and
probably more importantly, doesn't show up on an X-ray)."
"Sometimes forget"
"Never tell"
I hope you are not ignorant enough to believe that being told something once
means there is no code of silence, particularly when the doctors themselves
will tell people there is one, and the possible consequences of going against
it.
Ryan Ginstrom
"another fool" <anoth...@hotmail.com> wrote in message
news:44845040.03092...@posting.google.com...
> Having had to deal with the Japanese medical system recently I can say
> simply that from a cost perspective it has the US system beat to hell.
Both systems have their advantages, but forgive me for not being thrilled
about a system that is not as good, but cheaper.
> As far as 'tracking' every needle - how? Should they take a video of
> where they put every needle? Should they use a digital camera? What
> if they make a mistake and take the wrong needle out then think
> they've got them all?
Well, as a layman it doesn't seem too complicated. Obviously at one point,
the doctor was handed the needle, and did something with it. At that point,
the surgeon obviously knew exactly where the needle was. To turn the
question on its head, at what point is it OK to lose track of the needle? If
a doctor can be expected to forget having done something with that needle,
are there precautions that should be put in place against this eventuality?
Are such precautions feasible?
As I said, there may be good explanations for these things. The problem is,
Bill and Bill's family are not getting such explanations, and in fact the
doctors seemed pretty annoyed that we should actually be asking them.
> Mistakes happen and sometimes they are just that, mistakes.
Yes, sometimes they are mistakes, and sometimes they are negligence. There
is a process for distinguishing between the two in even in Japan, except in
Japan this process is largely broken.
> I do agree though that he and his family should have been notified
> immediatly of the situation though. And have they done an x-ray to
> find the needle and determine if it needs to come out?
That is what the second opinion was supposed to be about, an opinion that
was not forthcoming due to Japan's OB network and cronyism.
--
Regards,
Ryan Ginstrom
Ryan Ginstrom
> another fool wrote:
> > They take every reasonable precaution.
>
> It seems the people are upset about the attitude of the hospital, not the
> simple fact that something was left in.
This is true. I can accept that mistakes happen, but the handling by the
hospital was attrocious. They covered it up for two days, at first refused
to even tell Bill's mother what was up, and talked at us like we were
somehow being unreasonable to demand an explanation of what happened.
Like I told the doctor, transparency and accountability. These are two
things that are sorely lacking in Japanese medical care.
--
Regards,
Ryan Ginstrom
Eric Takabayashi
What kind of needle was it, or what was its intended function?
Ryan Ginstrom
> What kind of needle was it, or what was its intended function?
I don't want to go too much into the details of Bill's surgery, but it was a
needle used for sewing. It is thin and curved, about 3 cm long and half as
thick as a small fishing hook. The doctor thinks it must have flown out of
his hand as he was putting it back on the tray (hence my question, why
wasn't this noticed right then?)
They took an X-ray during surgery, but couldn't see it. It was visible right
after surgery though, an artificially straight line around the heart. But
two days would pass before Bill or Bill's family would see that X-ray or the
subsequent ones. The doctor tells me that he could only notice it in the
first few X-rays in hindsight, after getting a clearer picture two days
later, but even if I take him at his word, he should have told Bill that a
needle was missing right away (where else was it going to be?).
--
Regards,
Ryan Ginstrom
another fool
> Michael Cash wrote:
>
> > On 25 Sep 2003 04:54:48 -0700, anoth...@hotmail.com (another fool)
> > belched the alphabet and kept on going with:
> >
> > >Having had to deal with the Japanese medical system recently I can say
> > >simply that from a cost perspective it has the US system beat to hell.
> > > The total cost for delivery of our son with an epi and the doctor
> > >having to come in at 2am when my wife decided to go into labor was ~US
> > >$4000.
> >
> > You got gypped.
> >
> > My two cost about 300,000 each, and it was practically 100% covered.
>
> That's what each of mine cost, despite being born in different
> prefectures. It seems to be a set price. Yours were covered by some sort
> of insurance?
>
We will hopefully get reimburse for the new guy, I just have no idea
how long it will take (and considering the insurance company probably
months). Ours cost almost exactly 450,000. This might be 'Japan' but
we did not go to what I would consider a "traditional" hospitol, it
was more like a birthing center (1 doctor, about 10 nurses, they only
do prenatal/child birth/first few months baby care). I do know her
prenatal exams for the last 3 months before the delivery were all
12,000 yen each at the 3 docs she tried before she finally found one
she liked. She tells me she was VERY happy with the care by the Dr
and nurses - part of the reason she picked this Doc was he did epi's
and the only other Doc she could find who did them said he didn't
suggest them and she was afraid he would decide not to give her an epi
once she went into labor (if anyones in the Kobe area I will be happy
to provide a recommendation).
> > And lots of cities are so desperate for shoring up their population
> > that they will spring for 100% coverage on medical costs up until
> > about 5 years of age.
>
> The local government gave my wife an amount equivalent to almost 100% of
> the up front, out of pocket cost of childbirth. I consider that
> generosity, not insurance. And considering we don't go to hospital often,
> I have paid into the medical system multiples more than I take out,
> anyway. It's not my fault that Japan can't find money to cover the elderly
> for their care.
>
I'll have to check this out. I know the local government gave us some
money when we moved here for the little one we already have. I also
know we are getting I want to say about 10,000 per month for him
(didn't know this was the reason, I was afraid it was some sort of
welfare, glad to hear that's not the case). Any idea if the fact that
we live in Kanagawa Pref. and she had the baby in Kobe (Hyogo) will
make a difference?
> > >As far as 'tracking' every needle - how?
> >
> > I believe the standard procedure is to COUNT *everything* associated
> > with the procedure prior to starting and again prior to sewing the
> > patient back up. Needles, gauze, retractors, etc.
>
I believe the original post said they did count everything. They
could not find everything. They looked for everything but decided to
close him up since the risk posed by the needle was probably less then
the risk of leaving his heart stopped for >3 hours.
More then likely they will wait for him to heal before attempting to
remove the needle. Bullets are left in all the time if the risk of
removing them is greater then the risk of leaving them. Now that is
something I would definitely get a 2nd opinion on.
A friend reading over my shoulder here at work suggests a more
sinister reason they might have waited to tell your friend and his
family. He suggests that the Doc's might have been afraid that your
friend would die. If they told his family/him and he died there would
be 2 potential backlashes. First the obvious publicity backlash of
his family going to the press with 'the hospitol/dr's killed him',
second potentially criminal charges (is this true?) for the needle
potentially having been what killed him.
cc
"Ryan Ginstrom" <gins...@hotmail.com> wrote in message
> I don't want to go too much into the details of Bill's surgery, but it was
a
> needle used for sewing. It is thin and curved, about 3 cm long and half as
> thick as a small fishing hook. The doctor thinks it must have flown out of
> his hand as he was putting it back on the tray
>(hence my question, why
> wasn't this noticed right then?)
If the surgeon says : because there were 4 other needles and lot of blood on
the tray, and they noticed it only 10 minutes later as they recount every 15
minutes. You'll ask "why don't you have a nurse clean the tray each time you
a put a needle ? Why don't you recount every 2 minutes ? "and so on...
> They took an X-ray during surgery, but couldn't see it. It was visible
right
> after surgery though, an artificially straight line around the heart. But
> two days would pass before Bill or Bill's family would see that X-ray or
the
> subsequent ones. The doctor tells me that he could only notice it in the
> first few X-rays in hindsight, after getting a clearer picture two days
> later, but even if I take him at his word, he should have told Bill that a
> needle was missing right away (where else was it going to be?).
I can't imagine what more explanation they could have given, all your
questions have been answered.
Next time, find an hospital that let all the family see the operation filmed
by 3 or 4 videos, and accept that you tell to the surgeons what to do step
by step. Even in Sepponia, I doubt that exists.
CC
cc
"Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
> Oh, so you believe or know there are such people, but continue to
universally
> make excuses for doctors and hospitals?
I don't excuse them universally.
> Damn. Then how will you ever know that you are receiving the proper care
or
> whether or not you should go elsewhere?
Even if they give you a copy of your file, how do you know ? You know what
about medicine except the sensational articles you collect on the web ? That
brings you what to be able to compare your XRays with those of your
fishmonger's niece ?
> Then how would you know whether or not they are hiding anything,
You never know, whatever the system.
> and how do the
> doctors know you are not strong enough?
They take a guess. It's part of their job.
>But it was hardly overwhelmingly in favor, and even now, a good
> proportion of doctors continue to hide the truth about patients'
conditions
> from them (if not their families) as a matter of policy.
I've read that, but that survey dates back..
Now in Osaka, everybody or his grand-mother has a cancer or fatal
cholesterol. The average local sensei has 3 diagnostics : netsu, kaze or gan
kamoshirenai. In clear : eat chicken stock or I can't tell before I get the
results of the analysis. That's more that attitude people reproach them
with, they frighten you in advance and are cold like jail doors.
> Are you alleging that doctors have mastered the operations 100%,
No, exactly the contrary. They are dealing with human body, even for the
simpler cases, treatment or operations can fail and provoke segundary
effects.
> or accept that
> they made the choice (and should therefore accept the responsibility, just
like
> you claim patients should by seeking care) to perform operations they have
NOT
> mastered 100% or could actually screw up?
As you like browsing, you should look like for efficiency of different
treatments, of diagnostic techniques, of operations... Sometimes, the
success rate is extremely low.
They do perform operations they don't master all the time, they give
prescription when they are no 100% certitude that's the good one all the
time, as the other choice is let people die without trying anything.
> Then perhaps you could explain today's "human experimentation" incident.
I knew you'd come with the story of those 3 butchers. Between that and a
successful heart operation with just a small needle problem, there is a
world.
> You are talking about risk, which is discussed with patients and families
> before the procedure, not errors, accidents and incompetence.
I'm talking about that cumulated risk that comes from errors, accidents and
incompetence.
>Did doctors tell
> Bill before the operation the odds a needle would be left in his heart, as
> opposed to the prognosis of the treatment itself?
Ten thousands things can happen during an operation, so should the doctors
have each patient read the list and statistics before any operation ?
> > I remind you that not so long ago, heart operations failed most of the
> > times and that was exceptional that the patient survive.
>
> That was not the fault of the doctors.
That was no more no less their fault than in the case of Bill.
Anyway now, they are in average more competent, better organised, etc. The
proof : sucess rate has increased.
Your doctors covered up their "errors" much more than now, and that was
accepted, nobody reopened the corpses to find they had forgotten a bone or a
the surgeon's Rolex.
>But then, those doctors appeared to
> be honest,
Yeah, appeared...
Because medical associations had not started to investigate about mistakes
and didn't do systematic analysis of the causes of death. They started that
recently, and until 15 years ago there was no systematic evaluation of the
number of errors and no research to reduce their number.
In France, there are people whose job is to redesign hospital equipment to
be sure you can't put the oxygene bottle at the place of the blood one, to
make machines ring in case of mistakes, to put medicines in individual dosis
of different colors, etc to avoid errors.
> forthcoming and sensitive.
That's subjective. Strangely, life expectancy progresses at the rate those
good "sensitive" doctors retire.
Find yourself a family doctor that likes pampering patients and tell them
errors arrive only to other uncompetent doctors.
> You are talking about progress in medical technology, not errors,
accidents or
> incompetence.
The progress is a better management of errors and accidents, competence is
technology.
>And I certainly hope you are not talking about "training" or
> acquisition of "skill"
I do too...
>in the manner of the "human experimentation" incident.
No, that's a Frankenstein story about guys that cheated with all the rules
and had nothing to do in hospitals. They are like the doctor in Madame
Bovary.
That surgeon I know is no longer at the top of his operating skills because
of age (he is close to 60,
and no longer has the physical strength for amputations etc, so now he
supervises and trains), he explained me than from 20 to 30, he was studying
and helping in easy general medicine operations that are not so often
failed. Then, he participated in difficult ones (about replacing bones and
articulations, tranplanting bones and now nerves from other parts of the
body) and became good when he was 40. And even at his top, each time he did
a new type of operation, he failed it several times before succeeding.
So that could have been safe to decide once he "got" a technique he'd do all
the operations of the same type, and they didn't put a new surgeon in that
technique to save a few screw-ups. But that was not a solution as each time
they did something new, there were hundreds of patients that wanted it. So,
they train new surgeons all the time, they team them up with trained ones.
They don't tell the patients if they are the lucky ones (opration with only
trained surgeons and high success rate) or unlucky (with trainees and low
success rate). And if they think that failed because the trainee was not yet
competent enough, they can't tell it either. Of course, the "failures" are
not deaths, and most times the situation after the operation is better than
before. But if they were told, no patient would accept to be operated by a
*trainee* (=a surgeon with 20 year of experience).
This guy participates in international seminars in Europe and the US and
says they do the same thing everywhere, and try to share their findings.
There has been tries to improve trainings on animals or dolls, computer
assisted simulations, but that doesn't work yet to replace real training.
There is no code of silence : you don't want to hear the truth as you want
to believe you'll find perfect doctors that cannot drop a needle in the fire
of action.
CC
Eric Takabayashi
> "Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
>
> > Oh, so you believe or know there are such people, but continue to
> universally
> > make excuses for doctors and hospitals?
>
> I don't excuse them universally.
Then please try not to sound like it.
Also take not that I am not condemning doctors for the simple fact that
complications and death occur, or that there are people who cannot be saved.
> > Damn. Then how will you ever know that you are receiving the proper care
> or
> > whether or not you should go elsewhere?
>
> Even if they give you a copy of your file, how do you know ?
Why don't you let the patients make that decision, instead of denying them that
right out of hand? And even a lay person like myself can determine things such
as a doctor removing a healthy part of my body, not the one I was told was
diseased, like my left lung instead of my right; or that I did not get the
procedure that the doctor had told me I was going in for, or that I had got
something they had not told me or asked me permission to perform. It would be
hard to miss things like waking up without a penis, getting a vasectomy by
mistake, or having a needle pierce my brain by accident. And ending up dead
without any prior warning or with a minor procedure would certainly raise some
questions.
> You know what about medicine except the sensational articles you collect on
> the web ?
What I get from mainstream periodicals and references, of course. And what I
may get from doctors themselves when I ask. What do you know of the scale of
medical error outside your universally sympathetic, anti suffering patient
rantings? You obviously know nothing of the closed nature of the Japanese
medical system.
> That
> brings you what to be able to compare your XRays with those of your
> fishmonger's niece ?
I have received certain injuries and surgeries in my upper body at least, which
would allow me to recognize my own x-rays, thank you, particularly if focusing
of parts of the body I would be concerned about.
> > Then how would you know whether or not they are hiding anything,
>
> You never know, whatever the system.
Then why don't you allow people to have the chance? And more openness would
allow better opportunities for patients to communicate with their doctors or
have concerns addressed; or allow for a greater sense of trust, at the very
least, if it cannot be perfect.
> > and how do the
> > doctors know you are not strong enough?
>
> They take a guess. It's part of their job.
And would you believe they can make errors there, as well? At least claim it is
an "educated" guess.
> >But it was hardly overwhelmingly in favor, and even now, a good
> > proportion of doctors continue to hide the truth about patients'
> conditions
> > from them (if not their families) as a matter of policy.
>
> I've read that,
Good.
> but that survey dates back..
So?
>
> Now in Osaka,
Try talking for regions outside of yours.
> everybody or his grand-mother has a cancer or fatal
> cholesterol.
Also not what doctors themselves tell me, though I currently know two people
with cancer, and two with cholesterol high enough to require attention.
> The average local sensei has 3 diagnostics : netsu, kaze or gan
> kamoshirenai. In clear : eat chicken stock or I can't tell before I get the
> results of the analysis. That's more that attitude people reproach them
> with, they frighten you in advance and are cold like jail doors.
>
> > Are you alleging that doctors have mastered the operations 100%,
>
> No, exactly the contrary. They are dealing with human body, even for the
> simpler cases, treatment or operations can fail and provoke segundary
> effects.
Kindly separate simple failure and risks from actual screwups, if you please. I
never had a realistic expectation that my family members would make it through
alive, for example, and therefore hold the doctors responsible for nothing
despite the unpleasant nature of their deaths. I accept they did their best
while treatment was administered. Their deaths was simply something that
happened.
> > or accept that
> > they made the choice (and should therefore accept the responsibility, just
> like
> > you claim patients should by seeking care) to perform operations they have
> NOT
> > mastered 100% or could actually screw up?
>
> As you like browsing, you should look like for efficiency of different
> treatments, of diagnostic techniques, of operations... Sometimes, the
> success rate is extremely low.
Separate risks and success rate from actual screwups, please.
> They do perform operations they don't master all the time, they give
> prescription when they are no 100% certitude that's the good one all the
> time, as the other choice is let people die without trying anything.
No, the alternative is not always death, when doctors cause death, which is
precisely the problem when doctors cause complications and death. If I'm going
to die, anyway, I will hardly care.
> > Then perhaps you could explain today's "human experimentation" incident.
>
> I knew you'd come with the story of those 3 butchers.
Defend them, please.
> Between that and a
> successful heart operation with just a small needle problem, there is a
> world.
Yes, perhaps the doctors will not get away with what they have done in the
Osaka case, unlike what usually happens when doctors secretly injure and kill
people.
> > You are talking about risk, which is discussed with patients and families
> > before the procedure, not errors, accidents and incompetence.
>
> I'm talking about that cumulated risk that comes from errors, accidents and
> incompetence.
No, you are not; you are excusing bad outcomes because the human body is so
difficult to understand under even the best of conditions when one is not
stressed, NOT addressing such as incompetence, which I will also separate from
simple ignorance or inexperience.
> >Did doctors tell
> > Bill before the operation the odds a needle would be left in his heart, as
> > opposed to the prognosis of the treatment itself?
>
> Ten thousands things can happen during an operation,
You do not want to claim this, or would you like me to ask?
> so should the doctors
> have each patient read the list and statistics before any operation ?
Give the patient the right to have a choice to know.
> > > I remind you that not so long ago, heart operations failed most of the
> > > times and that was exceptional that the patient survive.
> >
> > That was not the fault of the doctors.
>
> That was no more no less their fault than in the case of Bill.
You mean doctors without the technology, techniques or procedures to save their
patients back then and are thus free of blame, as free of blame as the doctors
who could not save my family members, are as culpable as in the case of Bill,
where doctors and hospitals refused to deal with his current situation and can
be doing something about it?
> Anyway now, they are in average more competent, better organised, etc. The
> proof : sucess rate has increased.
Yes.
> Your doctors covered up their "errors" much more than now, and that was
> accepted, nobody reopened the corpses to find they had forgotten a bone or a
> the surgeon's Rolex.
Are you now suggesting it IS better to know the truth, or should people remain
blissfully ignorant while doctors are protected by that ignorance and their own
silence? Please make up your mind.
> >But then, those doctors appeared to
> > be honest,
>
> Yeah, appeared...
Are you now suggesting that the doctors in your grandmother's case were less
than forthcoming or that you harbor some suspicions?
> Because medical associations had not started to investigate about mistakes
> and didn't do systematic analysis of the causes of death.
Are you now suggesting that it IS better to investigate doctors and their
mistakes, instead of simply making excuses for them?
> They started that
> recently, and until 15 years ago there was no systematic evaluation of the
> number of errors and no research to reduce their number.
You tell us. Such a system exists in the US, and the general public can have
access to their findings though the medical periodicals, and through the
mainstream media. Does such a system or such openness exist in Japan? Can you
find Japanese websites and respectable sources such as the links I have
provided you about problems in the US?
> In France, there are people whose job is to redesign hospital equipment to
> be sure you can't put the oxygene bottle at the place of the blood one, to
> make machines ring in case of mistakes, to put medicines in individual dosis
> of different colors, etc to avoid errors.
That's good. And how can this be done in Japan, when they don't know about such
errors?
> > forthcoming and sensitive.
>
> That's subjective. Strangely, life expectancy progresses at the rate those
> good "sensitive" doctors retire.
> Find yourself a family doctor that likes pampering patients and tell them
> errors arrive only to other uncompetent doctors.
I am not claiming that forthcoming and sensitive doctors do not commit errors
or outright screw up. I am saying that I would me much more understanding and
possibly forgiving, when doctors are forthcoming and sensitive about any errors
and screwups, instead of being ignored, lied to, or me finding out later.
> > You are talking about progress in medical technology, not errors,
> accidents or
> > incompetence.
>
> The progress is a better management of errors and accidents, competence is
> technology.
If this is what you insist, then doctors need *better* than "better" management
of errors. "Accidents" I can be willing to accept.
> >And I certainly hope you are not talking about "training" or
> > acquisition of "skill"
>
> I do too...
>
> >in the manner of the "human experimentation" incident.
>
> No, that's a Frankenstein story about guys that cheated with all the rules
> and had nothing to do in hospitals. They are like the doctor in Madame
> Bovary.
Oh, thank you. You are willing to admit there are "bad" doctors. What do you
believe should be done about such people, the surgeons, the doctors who simply
stood by, and the doctors and administrators who gave permission?
> That surgeon I know is no longer at the top of his operating skills because
> of age (he is close to 60,
> and no longer has the physical strength for amputations etc, so now he
> supervises and trains), he explained me than from 20 to 30, he was studying
> and helping in easy general medicine operations that are not so often
> failed. Then, he participated in difficult ones (about replacing bones and
> articulations, tranplanting bones and now nerves from other parts of the
> body) and became good when he was 40. And even at his top, each time he did
> a new type of operation, he failed it several times before succeeding.
Unless you are claiming failure due to error, please keep the issues separate.
> So that could have been safe to decide once he "got" a technique he'd do all
> the operations of the same type, and they didn't put a new surgeon in that
> technique to save a few screw-ups. But that was not a solution as each time
> they did something new, there were hundreds of patients that wanted it. So,
> they train new surgeons all the time, they team them up with trained ones.
To train more surgeons, and prevent errors, and be prepared to act if there are
any. Precisely. And I don't suppose they'll let doctors who aren't ready, make
the attempt, either.
> They don't tell the patients if they are the lucky ones (opration with only
> trained surgeons and high success rate) or unlucky (with trainees and low
> success rate).
Is there such a great difference, even with the more experienced surgeons
assisting? Do patients in that place have the opportunity to request a surgeon?
> And if they think that failed because the trainee was not yet
> competent enough, they can't tell it either.
Why not?
> Of course, the "failures"
Is this due to error?
> are not deaths, and most times the situation after the operation is better
> than before.
Good. But we are not talking about that.
> But if they were told, no patient would accept to be operated by a
> *trainee* (=a surgeon with 20 year of experience).
Why not? I know doctors are not equal. But I most often don't express a
preference, anyway.
> This guy participates in international seminars in Europe and the US and
> says they do the same thing everywhere, and try to share their findings.
> There has been tries to improve trainings on animals or dolls, computer
> assisted simulations, but that doesn't work yet to replace real training.
>
> There is no code of silence :
Are the readily identifiable doctors who say so on national television, simply
lying, then?
> you don't want to hear the truth
Yes, I do. Even if it means someone will die.
> as you want
> to believe you'll find perfect doctors that cannot drop a needle in the fire
> of action.
I did not claim there are perfect doctors, though I know doctors who have not
crippled or killed anyone. I claimed there are doctors who handle their errors
better, or have better attitudes than are often found in Japan, and that I
would be much more understanding, and possibly forgiving, of doctors who were
truthful.
Eric Takabayashi
> "Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
> news:3F73A31E...@yahoo.co.jp...
> > What kind of needle was it, or what was its intended function?
>
> I don't want to go too much into the details of Bill's surgery,
Thank you.
Eric Takabayashi
> We will hopefully get reimburse for the new guy, I just have no idea
> how long it will take (and considering the insurance company probably
> months). Ours cost almost exactly 450,000.
That's pretty high. My wife's hospital for our second child was a tastefully appointed local
private hospital nearest our home on the main road, which was much better than the sterile public
hospital in the in-laws' town, for our first.
Cost the same despite being prefectures and years apart.
> This might be 'Japan' but
> we did not go to what I would consider a "traditional" hospitol, it
> was more like a birthing center (1 doctor, about 10 nurses, they only
> do prenatal/child birth/first few months baby care). I do know her
> prenatal exams for the last 3 months before the delivery were all
> 12,000 yen each at the 3 docs she tried before she finally found one
> she liked. She tells me she was VERY happy with the care by the Dr
> and nurses -
My wife wasn't picky. Culture, I guess.
> part of the reason she picked this Doc was he did epi's
My wife believes in labor pain. She also believes in the sensitive and invasive procedures during
pregnancy and up through childbirth, and did not question why mothers at the hospitals were not
allowed to hold or feed their babies until 24 hours later, or have the babies in the room until
maybe three days later. Didn't question being bored out of her skull laying in bed at home for a
month after her first childbirth, not allowed to even read, write letters or watch television lest
she tire herself or her eyes, either.
> and the only other Doc she could find who did them said he didn't
> suggest them and she was afraid he would decide not to give her an epi
> once she went into labor (if anyones in the Kobe area I will be happy
> to provide a recommendation).
>
> > > And lots of cities are so desperate for shoring up their population
> > > that they will spring for 100% coverage on medical costs up until
> > > about 5 years of age.
> >
> > The local government gave my wife an amount equivalent to almost 100% of
> > the up front, out of pocket cost of childbirth. I consider that
> > generosity, not insurance. And considering we don't go to hospital often,
> > I have paid into the medical system multiples more than I take out,
> > anyway. It's not my fault that Japan can't find money to cover the elderly
> > for their care.
>
> I'll have to check this out. I know the local government gave us some
> money when we moved here for the little one we already have. I also
> know we are getting I want to say about 10,000 per month for him
> (didn't know this was the reason, I was afraid it was some sort of
> welfare, glad to hear that's not the case).
In Fukuyama at least, there is some monthly sum for each child, for people with what they consider
to be low incomes. I do not know what that "low income" figure is, but that sum would be like
welfare. All medical service for children is also free up to maybe three, and treatment but not
drugs were covered, I believe it was, to some later age, maybe six.
> Any idea if the fact that
> we live in Kanagawa Pref. and she had the baby in Kobe (Hyogo) will
> make a difference?
I don't know about your case, but my wife had the first child in the city where she has her family
register, and our second child in another prefecture where we are official residents, so it
probably didn't make a difference.
Ryan Ginstrom
> I can't imagine what more explanation they could have given, all your
> questions have been answered.
Yes, he answered my questions, after much prodding and convincing him that I
wasn't going away. The problem is one of trust. The hospital's handling of
the incident was horrible, and the lack of transparency and accountability
has destroyed my sense of trust in what they say and their motives.
Of course, this is not just an academic question -- the needle is still in
Bill's heart, and a decision needs to be made as to what to do about it. Now
cc is the trusting soul, she might just take the doctors at their word and
trust they have only her best interest in mind. I on the other hand am a
cynical bastard, and have to think that a doctor who already admitted he
would have covered this up if he could have gotten away with it is going to
have saving his own skin pretty high up on the list of priorities when
dispensing medical advice.
That's what the second opinion was supposed to be about, what to do next.
Not necessarily to spot negligence -- as I said, the Japanese system just
isn't set up for that. But unfortunately, we still haven't found a hospital
that will look at Bill's case.
--
Regards,
Ryan Ginstrom
Eric Takabayashi
> "cc" <cpasune...@spam.com> wrote in message
> news:bl19fn$nev$2...@bgsv5647.tk.mesh.ad.jp...
> > I can't imagine what more explanation they could have given, all your
> > questions have been answered.
>
> Yes, he answered my questions, after much prodding and convincing him that I
> wasn't going away. The problem is one of trust. The hospital's handling of
> the incident was horrible, and the lack of transparency and accountability
> has destroyed my sense of trust in what they say and their motives.
>
> Of course, this is not just an academic question -- the needle is still in
> Bill's heart, and a decision needs to be made as to what to do about it. Now
> cc is the trusting soul,
Worse than that. She thinks patients and families have "consumer mentality" who
look for "opportunities to get a few bucks" through "absurd" trials, are stupid
people who watch too much TV. Not until confronted with such a story as the
Osaka "butchers" that came out on the same day, did she even acknowledge that
such ever goes on.
According to the same news item containing the story of the Osaka "human
experiment" case today is the finding there have been ZERO arrests for
malpractice between 1988 and 2002.
Let's read that again: ZERO arrests for malpractice between 1988 and 2002.
There is no code of silence in Japan. CC just expects us to believe that until
now, there have been no other "butchers" like the ones in Osaka. All the other
complications and deaths caused by doctors (if indeed there are any in Japan, I
am still waiting for her to demonstrate Japan has the openness to conduct
investigation to even find such figures, which readily exist in the US,
published by the medical community itself) are simple human errors.
cc
"Ryan Ginstrom" <gins...@hotmail.com> wrote in message
>But unfortunately, we still haven't found a hospital
> that will look at Bill's case.
I'm sorry to hear that. What you and I think about what should be a good
system is irrelevant to this problem. I don't like to see people driving
into a wall. No idea if that wall is a "code of silence" or a complicated
organisation that doesn't handle well relation with outsiders.
You should definitely find a doctor (there are 10 of thousands, even a few
foreigners) and have him use his knowledge of the system and his relations
to arrange Bill's transfer to another hospital. Normally, that takes weeks
or months to get an appointment with a "professor", if nobody helps you to
find a short-cut.
CC
Michael Cash
belched the alphabet and kept on going with:
>
>"Ryan Ginstrom" <gins...@hotmail.com> wrote in message
>
>
>>But unfortunately, we still haven't found a hospital
>> that will look at Bill's case.
>
>I'm sorry to hear that. What you and I think about what should be a good
>system is irrelevant to this problem. I don't like to see people driving
>into a wall. No idea if that wall is a "code of silence" or a complicated
>organisation that doesn't handle well relation with outsiders.
>You should definitely find a doctor (there are 10 of thousands, even a few
>foreigners)
Could you point to some foreigners who are licensed to practice
medicine in Japan? I recall in the foreword of Nelson's kanji
dictionary the author commenting on his son passing the exam. But
that's the only one I've ever heard of. I did hear about a medical
doctor from somewhere in South America who is working in Japan....in a
factory on the assembly line. Because his Japanese wasn't good enough
to take the licensing exam in Japan, you see.
Do you really know of any? Or are you just speculating?
Eric Takabayashi
> Could you point to some foreigners who are licensed to practice
> medicine in Japan? I recall in the foreword of Nelson's kanji
> dictionary the author commenting on his son passing the exam.
That was cool.
cc
"Michael Cash" <mike...@sunfield.ne.jp> wrote in message
> Could you point to some foreigners who are licensed to practice
> medicine in Japan?
The French consulate works with an English one. In Kobe, if I remember well.
That's sure he exists, many of my students met him.
And I have heard of and seen ads about American ones in the area, maybe in
Rokko Island.
I don't say they studied in Japan universities, but they are allowed to work
here, even with Japanese patients.
About foreign nurses, I've met dozens. Many Chinese, they took the Japanese
profiency test, then studied in Senmon Gakko.
> I did hear about a medical
> doctor from somewhere in South America who is working in Japan....in a
> factory on the assembly line. Because his Japanese wasn't good enough
> to take the licensing exam in Japan, you see.
I've met him in New-York, there they said his eigo was not good enough.
A woman I taught to (half-Japanese, raised in Hong-Kong) never studied in
the Japanese system, she did her medicine studies in the US, worked 10 years
in Switzerland. When I met her, she was working on a 2 year stint in a
Japanese hospital, not as cleaning staff, but as specialist doctor. She
didn't talk about a licensing exam, maybe it's not required with temporary
researchers. Not the kind of doctor you have long communications with. She
can't speak Japanese (she said she could read and write), her English is
very approximate (idem)
and her French...er...she said she could understand everything about
medicine, but I wonder how she did her shopping during 10 years. I suppose
she speaks a Chinese dialect, but she said she didn't know the medicine
terms in Chinese...
CC
Louise Bremner
> Could you point to some foreigners who are licensed to practice
> medicine in Japan?
There are some. Dunno if it's a good idea to specify here in public, but
I could in private if anyone is interesting.
________________________________________________________________________
Louise Bremner (log at gol dot com)
If you want a reply by e-mail, don't write to my Yahoo address!
another fool
Don't know if this qualifies but there is an American Dentist working
in Tokyo (wish I could remember his name). Maybe not an MD but it is
medicine of a sort.
Rafael Caetano
> Could you point to some foreigners who are licensed to practice
> medicine in Japan? I recall in the foreword of Nelson's kanji
> dictionary the author commenting on his son passing the exam. But
> that's the only one I've ever heard of. I did hear about a medical
> doctor from somewhere in South America who is working in Japan....in a
> factory on the assembly line. Because his Japanese wasn't good enough
> to take the licensing exam in Japan, you see.
>
> Do you really know of any? Or are you just speculating?
In Fukuoka there's a clinic run by a Dutch doctor. He's a go player
and had lived in Japan before, to study go.
[]s
Rafael