5 doctors found liable for child's death due to excessive drug use

60M yen? The kid, when grown, would have made that in two or three years, tops, when he began working. It should be AT LEAST that amount in US dollars, the doctors and hospital(s) in question all lose their licensing, permanently, and there should be some jail time, too.

Sorry, was thinking 6M yen, not 60M. Still, it's far too low.

This type of thing happens pretty much everywhere.

Though one thing that Japan or at least Tokyo doesn't really have is/are "Children's" hospitals.

I know there are many small children or pediatric clinics/ hospitals, or dedicated departments connected to a major hospital ( like Children's medical center of the university of Tokyo hospital).

But a purely Children's hospital, like most major cities have, where only children are treated and the staff specialise in pediatric cases this includes surgical, anesthetics, etc...

I partly agree. Without all those outstanding technologically sophisticated equipment they are no doctors anymore and you could better trust your newspaper horoscope or a dice or even better, your own common sense. But of course, there are also a few exemptions, some extraordinarily good experts, but you need quite a luck to find one of those needles in the hay heaps.

I re-read the article and now understand there were 3 anesthesiologists involved, but I still don't get why the other 2 doctors were negligent. It's usually the role of the anesthesiologists to also explain the risks.

Well that is because of the way Tokyo Women's Medical University Hospital has structured it internal system.

Because of past problems when surgery or serious illness like cancer is involved the patient is assigned a team usually consisting of 3 doctors of different specialties, who must agree on how to proceed, if even one is not in agreement then a second team of 3 is brought in to break the impasse.

Seeing 5 doctors are included I am guessing one objected to the procedure in the first team but the 3 from the second team sided with the other 2 so 5 signed off on it.

Now again I am only guessing on how it went but that was how things were done when my late wife was treated for cancer and when my son was treated and had several surgeries at that hospital.

They call it "internal second opinion".

Terribly sad story. But I'm a little confused how 5 doctors were negligent here. I can understand 2 anesthesiologists being involved and being responsible, but what were the roles of the other 3 doctors?

Sad tragedy and it is still possible the doctors did their best to save the child, but acting against a very specific ban means that they have to assume completely the responsibility if anything goes wrong. The rules and laws are there for a reason, and if they considered the benefits outweighed the risks that also means the risks for themselves.

I always pray that when my time comes, it will be Super short and super fast, please.

the hospital management should be put in to some form of oversight until they have proven increased competence

Sadly the system I described was put in place because of a previous situation and was supposed to avoid just such things.

One thing to be said about  Tokyo Women's Medical University Hospital  is They were open and honest having a third party do the investigation.

This is rarely done by other hospitals that generally close ranks and try as hard as possible to block any outside investigation.

anesthesiologists are the experts the doctors decide what surgery needs to be done and how it will be done the anesthesiologists decide on the sedatives 

I would agree if the death had occurred as part of the surgery.

But

The operation was completed in around seven minutes but he died three days later after being administered high amounts of propofol while in ICU,

Sedatives can be prescribed by the doctor as these are not technically the same as anesthesia.

It may seem to be a technicality but many people are prescribed sedatives every day by their regular doctor.

We do not know who exactly made the final decision but I will point out the court had all the information and I am going to guess they know more than we do and made their decision on that information.

This is like punishing a seismologist for not predicting an earthquake.

It's the parents' choice to have their kid undergo surgery. They know the risks. You cut a person open, they might die.

Punishing doctors will just make them not perform surgery even when necessary. This verdict sets a very dangerous precedent.

Not really, this would e like punishing a seismologist for not communicating the risk of an earthquake when some previously agreed process was not followed.

If a procedure is banned, it means it should not be done because it has been deemed too risky, if a doctor chooses to disregard the ban that means they take the responsibility into themselves. When this happens the doctor knows that if something bad happens they do not have the protection of following the best practices and instead they rely on their personal judgment. If they are found doing anything differently from the very best to safeguard the patient under those circumstances they are going to fall hard.

Doctors have to know this, so they do not take that risk lightly.

I worked in a US surgical ICU for nine years. I understand the Japanese collaborative methods, but it would be strange if the lead surgeon didn’t have final say-so in the administration of propofol. Surgeons have over-arching control of their patients until they leave ICU.

Anesthesiologists are consulted, but surgeons are considered to be the most knowledgeable and experienced physicians in an ICU setting. There is more to this story and it appears the anesthesiologists, the lowest in the MD hierarchy, may be taking a disproportionate share of the blame. The lead surgeon(s) are ultimately responsible for the patient, unless others did things without their consent.

I re-read the article and now understand there were 3 anesthesiologists involved, but I still don't get why the other 2 doctors were negligent. It's usually the role of the anesthesiologists to also explain the risks.

@Antiquesaving

You may well be right. But even with this system you describe I would think that each doctor would be responsible for their part of the treatment i.e. the part they specialize in. In this case, it was the drugs adminsitered by the anesthesiologists that caused the death. The surgeon, or other specialists involved in the treatment of this child are not experts in anesthesia and therefore not qualified to make those calls.

This is like punishing a seismologist for not predicting an earthquake.

It's the parents' choice to have their kid undergo surgery. They know the risks. You cut a person open, they might die.

Punishing doctors will just make them not perform surgery even when necessary. This verdict sets a very dangerous precedent.

Did you read the article?

The doctors administered the sedative propofol to the boy, Kosuke, after he underwent neck surgery in February 2014, even though its use to children requiring artificial ventilation is banned in principle.

a drug that is not recommended for use on children!

Parents expect the doctors know what they are doing, one cannot expect parents that are not medical specialists to know about the medication being used.

They expect the doctors to follow proper procedures and not be using medication not recommended even less banned for use on children.

This was on the news last night and I was confused at to what the real punishment was for the doctors.

There were found guilty and fines 60 million yen. They did not need to pay this to the parents as the hospital had already paid compensation. Have I missed something, was there any punishment?

The report said the administration was reasonable and that the ban is only in principle.

The situation is still the same, when something goes wrong while a doctor is doing the best standard of care then it has the protection of all the evidence that supports that standard. Deviating from that means he can only use his personal judgment. Because of this other doctors can disagree and when something bad happens the doctor responsible has a much harder job to prove he was doing the best possible for the patient (since he choose to make an exception). The punishment is not because they ignored a ban, it was because they were found not to provide the best treatment possible while ignoring the ban.

If a patient has chronic tonsilitis, the doctors will perform tonsilectomy even though the patient can ingest antibiotics for the rest of his life. There are risks involved in the surgery and there's a chance of death.

That has no relevance, if the standard of care for tonsilitis contemplates the surgery then the doctor can use this as an argument in his defense, things may go wrong but he was doing the best possible treatment according to medical science. Now, if the surgery is explicitly eliminated as an option (for example because the patient is an uncontrolled hemophiliac or have shown allergies to anesthetics/sedatives) but the doctor chooses to do it anyway then he can no longer use this argument anymore, he can only use his personal opinion, and if that is found to do anything wrong then he must take all responsibility.

They certainly should lose their licences to practice and the hospital management should be put in to some form of oversight until they have proven increased competence.

anesthesiologists are the experts the doctors decide what surgery needs to be done and how it will be done the anesthesiologists decide on the sedatives to ease the pain. In this case the anesthesiologists are at fault their license should be revoked and they should pay fines. In the US anesthesiologists insurance rates are the highest they are paid the highest salaries and sued the most of all doctors.

Good for the family, good for the justice system, good for Japan.

tonsilitis

Have we gone off on another subject?

It was a benign tumor in his neck not even close to the same.

The report said the administration was reasonable and that the ban is only in principle.

no it didn't. It said:

even if the administration was reasonable, the amount given largely exceeded the standard level and doctors "lacked discretion."

Note the "if" it did not say it was reasonable but even had it been reasonable.

Very different things.

@virusrex, @Antiquesaving

The report said the administration was reasonable and that the ban is only in principle.

That means, the risk was known but deemed necessary. Just like any other procedures.

If a patient has chronic tonsilitis, the doctors will perform tonsilectomy even though the patient can ingest antibiotics for the rest of his life. There are risks involved in the surgery and there's a chance of death.

With this case, the doctors will no longer recommend tonsilectomy, because they are afraid of getting punished when they make a mistake. Good luck with that.

Have we gone off on another subject?

I'm talking about the doctors doing procedures that they will not do now because of a ruling that makes them liable. Tonsilitis is just an example so it's easier to understand.

This is like punishing a seismologist for not predicting an earthquake.

It's the parents' choice to have their kid undergo surgery. They know the risks. You cut a person open, they might die.

Punishing doctors will just make them not perform surgery even when necessary. This verdict sets a very dangerous precedent.