Analysis of birth-related medical malpractice litigation cases in Japan: Review and discussion towards implementation of a no-fault compensation system
Analysis of birth-related medical malpractice litigation cases in Japan: Review and discussion towards implementation of a no-fault compensation system
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DOI：
10.1111/j.1447-0756.2010.01240.x
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发表时间：
2010-08-01
影响因子：
1.6
通讯作者：
Hirahara, Fumiki
中科院分区：
文献类型：
--
作者：
Uesugi, Nana;Yamanaka, Michiko;Hirahara, Fumiki
目的：分析日本2009年实施产科无过错赔偿制度的医疗事故民事诉讼案例。材料与方法：回顾性分析1987年以后分娩、1997年4月至2007年3月判决的64例医疗事故民事诉讼案例的法律的和医疗信息。从交付到判决日期的时间很长（总共90.1个月）。脑性瘫痪案件的平均赔偿额为97 810 000日元。早产儿和小于2500 g的婴儿在拒绝病例中的发生率较高。CP 32例（50.0%），婴儿死亡18例（28.1%），新生儿死亡10例（15.6%），胎儿死亡4例（6.3%）。44例接受病例中有23例（52.3%）和20例拒绝病例中有11例（55.0%）出生时胎龄超过33周，体重超过2000 g。45/64例（70.3%）进行了强迫分娩，28/64例（43.8%）进行了隆乳/引产。有13/16（81.3%）接受的情况下，进行真空和/或产钳提取后，劳动增强/induction.Conclusions：超过一半的情况下，可能是足够的无过错赔偿制度在日本。虽然该系统被认为存在一些需要解决的问题，但这一发现表明，许多儿童及其家庭可能受益于新系统，而不必提交申请。
Aim:We examined birth-related malpractice civil litigation cases in Japan to clarify the actual status related to the implementation of an obstetrical no-fault compensation system in 2009.Material & Methods:In this retrospective review, we analyzed legal and medical information from 64 cases with a delivery date after 1987 and a judgment date between April 1997 and March 2007.Results:The malpractice claim was accepted in 44 cases and rejected in 20 cases. The period from the delivery to the judgment date was lengthy (90.1 months overall). The average amount of damages awarded was yen97 810 000 for cases of cerebral palsy (CP). Preterm births and less than 2500 g infants represented a higher incidence rate in the rejected cases. There were 32 cases (50.0%) with CP, 18 (28.1%) with infant death, 10 (15.6%) with neonatal death, and 4 (6.3%) with fetal death. Twenty-three of 44 accepted cases (52.3%) and 11/20 rejected cases (55.0%) had a gestational age of more than 33 weeks at birth and weighed more than 2000 g. Forced deliveries were performed in 45/64 cases (70.3%), and augmentation/induction of labor was performed in 28/64 cases (43.8%). There were 13/16 (81.3%) accepted cases that underwent vacuum and/or forceps extraction after labor augmentation/induction.Conclusions:More than half of our cases could be sufficient for a no-fault compensation system in Japan. Though the system is considered to have some problems that need to be solved, this finding suggests that many children and their families may benefit from the new system without having to file.