Detainee dies after choking on food in Saitama police station cell

Via European Resuscitation Council Guidelines, Resuscitation 95 (2015) 1–80 http://goo.gl/RpE76u

...The International Liaison Committee on Resuscitation (ILCOR, www.ilcor.org) includes representatives from the American Heart Association (AHA), the European Resuscitation Council (ERC), the Heart and Stroke Foundation of Canada (HSFC), the Australian and New Zealand Committee on Resuscitation (ANZCOR), the Resuscitation Council of Southern Africa (RCSA), the Inter-American Heart Foundation (IAHF), and the Resuscitation Council of Asia (RCA).

...Treatment for severe airway obstruction

For conscious adults and children over one year of age with complete FBAO [Foreign Body Airway Obstruction], case reports have demonstrated the effectiveness of back blows or ‘slaps’, abdominal thrusts and chest thrusts. The likelihood of success is increased when combinations of back blows or slaps, and abdominal and chest thrusts are used.

I'm liking where this comment section is going!

I caught a factual error and a half-truth in my sister Janet Heimlich's post. I've also posted links to a first-rate 2009 Australian Broadcasting documentary re: the history of our father's namesake anti-choking treatment and a thought-provoking recent blog item by a U.S. cardiologist.

The American Heart Association (and most first aid agencies worldwide) recommend back blows as an effective treatment for responding to a choking emergency. More via this page on my website http://tinyurl.com/hnuxyxs "One study shows that back blows can drive an object deeper into the throat."

Janet -- a former journalist who edited our dad's 2014 memoir http://tinyurl.com/yau8h6nd -- is presumably referring to the now-tainted study by the late Richard Day L. MD et al of Yale published by the journal Pediatrics in 1982.

Research by my wife Karen M. Shulman and me revealed that our dad, the late Henry J. Heimlich MD, clandestinely funded the study.

Prior to 2005, AHA guidelines included citations of the Day study. That year I shared our research with Jerry Potts, PhD, Director of Science at the AHA's ECC Programs. The citation has not appeared in subsequent AHA guidelines.

Because of the Yale connection, I also shared our research with veteran medical reporter Abram Katz at the New Haven Register which resulted in this 10/23/06 report http://tinyurl.com/zvesjs9

Also see this 6/7/82 thank-you letter from dad to Dr. Day which I obtained from the Yale archives http://tinyurl.com/j3n8jbk

"The Heimlich manoeuvre" by Aviva Ziegler, Australian Broadcasting Corporation, 7/27/09 http://tinyurl.com/y92fwr6w "A Call To Reconsider The Heimlich Experiment: Let’s Scientifically Determine The Best Approach To Choking Victims" by Anthony Pearson MD, The Skeptical Cardiologist (Dr. Pearson's blog), 8/15/18 http://tinyurl.com/ybnxkqvs

My father, Dr. Henry Heimlich, invented the Heimlich maneuver. He passed away in 2016. He would have been distraught to hear of this case, not only because no one attempted to save the man with the Heimlich maneuver but because they used back blows, which, unsurprisingly were unsuccessful. Unlike the American Heart Association, the Red Cross tells people to use back blows as a first response for choking. The say to administer 5 back blows and then 5 Heimlich maneuvers (or "abdominal thrusts.") The trouble is, the Red Cross has never produced evidence that shows back blows are superior to the Heimlich maneuver, while the maneuver saves people's lives every day, according to press reports. One study shows that back blows can drive an object deeper into the throat. Furthermore, with the Red Cross focusing so much on back blows, no one learns that they can also use the Heimlich maneuver to save yourself (as someone above pointed out) or an unconscious or heavy person (you do that lying down). You can't use back blows to accomplish either of those things. The Red Cross should take this life-and-death matter more seriously and go back to teaching people to first use the Heimlich maneuver when someone is choking. Since a person can die in 4 minutes, seconds count.

Brilliant post because it refutes a naked assertion with cites.

Brilliant? I take it you didnt take the time to even check if the information was accurate or otherwise.

Also, the person who replied, did not even take the time to check what I actually wrote. It was cherry-picked and taken out of context to support their own opinion.

You assist someone who is bleeding or whatever, you make a mistake, they die or are incapacitated for whatever reason, YOU can be charged!

Notice the codifiers? Also it was in response to a comment about why people do not get involved, and what I wrote is correct as well.

.

Simply not true, as long as you provide care that a reasonable person would consider appropriate - even if the outcome for the victim is poor. That's the law - Civil Code Article 698 and Penal Code Article 37 to be precise.

Civil Code Article 698

> （緊急事務管理） (Urgent Management of Business) 第六百九十八条　管理者は、本人の身体、名誉又は財産に対する急迫の危害を免れさせるため に事務管理をしたときは、悪意又は重大な過失があるのでなければ、これによって生じた 損害を賠償する責任を負わない。 Article 698 If a Manager engages in the Management of Business in order to allow a principal to escape imminent danger to the principal's person, reputation or property, the Manager shall not be liable to compensate for damages resulting from the same unless he/she has acted in bad faith or with gross negligence.

Ok...so, according to you right?

And the penal code,

> 第三十七条　自己又は他人の生命、身体、自由又は財産に対する現在の危難を避けるため、やむを得ずにした行為は、これによって生じた害が避けようとした害の程度を超えなかった場合に限り、罰しない。ただし、その程度を超えた行為は、情状により、その刑を減軽し、又は免除することができる。

Article 37　(1)　An act unavoidably performed to avert a present danger to the life, body, liberty or property of oneself or any other person is not punishable only when the harm produced by such act does not exceed the harm to be averted; provided, however, that an act causing excessive harm may lead to the punishment being reduced or may exculpate the offender in light of the 

People do not get involved out of fear of responsibility.

If you dont know what the hell you are doing, it's better to stay out of the way and let those that do assist.

read what the Mayo Clinic and British Red Cross have to say about blows to the back.

But those aren't Japanese sources so don't hold much water in Japan. (Yes, that was sarcasm.)

Simply not true, as long as you provide care that a reasonable person would consider appropriate - even if the outcome for the victim is poor. That's the law - Civil Code Article 698 and Penal Code Article 37 to be precise.

No layperson (excluding medical professionals) has ever been held criminally or civilly liable after providing emergency first aid in Japan. Not even once. 

Please, stop providing misinformation that might dissuade someone from doing the right thing.

Brilliant post because it refutes a naked assertion with cites.

Goodlucktoyou.

Did you see a judge within 72 hours? If so did you file a complaint?

Choking at 6pm. Pronounced dead the next morning. What happened in between, say 12 or more hours? What care was he given? What negligence.

@Garthgoyle

Thanks for the info. If one has to time the back blows just right, it makes sense for a novice to try the Heimlich instead as it is much easier except if the person choking is rather large. I suspect it would be difficult to even attempt it. In that case it makes sense for the medical groups to recommend administering back blows.

When I was arrested for jaywalking, I was refused my medicine and locked in a small room for 7 hours with no water. At around 12 o’clock, I was offered a meal as I hadn’t eaten that day. I told the officer that I’m a vegetarian. The food had meat in it and I vomited. I was handcuffed and tied to the chair while the officer left to get water. I kept vomiting while he was away for 5 minutes. I can understand how this happened to this young man.

The man was in the slammer because he allegedly broke the law...

I thought that in Japan a person is presumed innocent until proven guilty.

The man was in the slammer because he allegedly broke the law. The police are only there to maintain order and make sure that none of the inmates escape. First Aid training would most likely be the maximum medical training that they would have had so if anyone gets ill while locked up thats about all they can expect.

The pen thing just doesn't work. Movies are not real life.

Next they had 10 people from different walks of life - lawyers, police officers and students - attempt to use the pens to perform a cricothyroidotomy on the bodies of 10 people who had died within the past two days.

Six of the participants punctured the neck too low and stabbed the thyroid gland. Three of the participants punctured the neck at the right spot.

Only one person was able to break the skin, ligaments and airway wall to establish airflow. For that person, it took more than 5 minutes, three attempts and “a lot of patience” and force. The person also caused damage to the neck and airway.

https://www.reuters.com/article/us-health-breathing-pen-idUSKCN0XP32Q

@hooktrunk2

You're totally right, Heimlich maneuvers work pretty awesome. And so does back blows (you've gotta time it as the person coughs for it to work more effective). Depending on the situation you'd have to decide which maneuver to follow. This is currently being taught in Wilderness First Aid courses in United States, Canada and Japan.

This man was in police custody, therefore one way or another the police have failed in their duty of care.

we all know the technique of piercing the windpipe below the Adams Apple with a pen or something.

Yeah, I know it, but only because I happened to have seen that one episode of MASH decades ago where Hawkeye uses it to save someone.

With all the disagreements above about how to save the guy, I suspect that if we were all in the same cell, this poor guy would have died long before we aggreed on which technique to use.

Yubaru  09:02 am JST

Oh and folks here do not assist not because of "it's not my job", it's because they can be held legally liable if they screw up. You assist someone who is bleeding or whatever, you make a mistake, they die or are incapacitated for whatever reason, YOU can be charged!

Simply not true, as long as you provide care that a reasonable person would consider appropriate - even if the outcome for the victim is poor. That's the law - Civil Code Article 698 and Penal Code Article 37 to be precise.

No layperson (excluding medical professionals) has ever been held criminally or civilly liable after providing emergency first aid in Japan. Not even once. 

Please, stop providing misinformation that might dissuade someone from doing the right thing.

Both the links posted above give specific directions, both of which require the person choking to be standing, and bent forward from the waist, and for the person helping them to hit them in a specific way. A panicking layperson who hasn't been trained in this, tend to slap the person in trouble on the back without considering position or direction.

It seems from the article that the man was lying down, and remained so:

the officer turned him over and started hitting his back to try and dislodge the food item from his throat.

Slapping him on the back as he's lying down, be it on his front or side, would have done FA good.

Will Goode  09:28 am JST

It would be asking a lot of anyone to perform a tracheotomy on the spot, although we all know the technique of piercing the windpipe below the Adams Apple with a pen or something.

Hahahahahahaha. No. No, we don't all know it, and thank goodness. In Japan that's outside the reasonable standard of care from a bystander, and a great recipe for a criminal charge and a civil suit.

@Educator60

With all due respect, I don't care who endorses back blows, I have used the Heimlich twice and seen it used a 3rd time and knows it works. It is mind-blowing and life changing to see it in action.

Well if you believe that every mans Destinee is pre written than I guess it was his time to die and only he is to blame for dying as a common criminal in jail.

not so fast we don't know precise cause of death - a 40 year old British friend living in BKK began choking on food while eating and died. turns out he had a weak heart and it couldn't take the strain.

Until (if) an autopsy is done comments on the cause of death are sheer speculation.

@Garthgoyle

Back blows are like shaking a bag of cereal. Whatever is in the throat will just settle down lower. The Heimlich uses pressure to like a pop gun to free the food. I have saved both of my children, once on an airplane and once at home, using the one handed Heimlich maneuver(for children) and I have seen it used first hand at camp when the boy sitting next to me was chocking on a piece of steak. Why they don't teach it here is baffling. Never hit someone on the back if they are sitting upright for sure.

Supposedly you can even do the Heimlich yourself by placing your fist on your diaphragm and thrusting yourself over the back of a chair. Never seen that in use though.

When the man started choking, the officer turned him over and started hitting his back to try and dislodge the food item from his throat

Bwahaha! The cop probably killed him by doing this. You are more likely to wedge food stuffs further down someone’s throat hitting them on the back. I guess basic first aid is not part of police training in Japan.

It would be asking a lot of anyone to perform a tracheotomy on the spot, although we all know the technique of piercing the windpipe below the Adams Apple with a pen or something.

I don't think he "was on anything", as he had been held for over ten days, and most things would leave the body in that time, no it was just a tragic accident.

Insane Wayne, what on earth are you talking about?

Back blows on a tripod position as totally acceptable for someone choking. As well as Heimlich maneuvers and even chest compressions against a wall (standing position)

The explanation for the heart massage is written on the story, "the guy went unconscious".

If someone choking goes unconscious you could start CPR on them. The compressions could push the foreign object up the airway. At which point someone could swipe a finger or tilt the head/body to the side in case of liquid.

It's unfair to blame the cop for not being able to save the poor guy's life.

I don’t think it is their intention to appear so stupid and inhuman. In Japan the “it’s not my job” is rooted very deep within them.

So many people bleed to death and the simple Hemlich maneuver might be thought of as a doctors work. Kind of hard to explain the heart massage. My best guess is it is kind of like saying “Gomen” for not wanting to get involved in the problems of the dying man.

No, it's not the "it's not my job" syndrome! Even as you noted "hard to explain the heart massage".

It was his job, and he was poorly trained if he did not know the proper procedure to assist the man.

Oh and folks here do not assist not because of "it's not my job", it's because they can be held legally liable if they screw up. You assist someone who is bleeding or whatever, you make a mistake, they die or are incapacitated for whatever reason, YOU can be charged!

Your best guess is off the mark.

One of the leading countries in the field of technology in the world. Still don't/can't practice the Heimlich to save someone's live. But credit where credit is due. They tried to save him.

46 is not so old. Agreed it's a bad way to go. Have to wonder if he was on something. That probably wouldn't have helped.

I don’t think it is their intention to appear so stupid and inhuman. In Japan the “it’s not my job” is rooted very deep within them.

So many people bleed to death and the simple Hemlich maneuver might be thought of as a doctors work. Kind of hard to explain the heart massage. My best guess is it is kind of like saying “Gomen” for not wanting to get involved in the problems of the dying man.

Poor man. So young. That's no way to go.

When the man started choking, the officer turned him over and started hitting his back to try and dislodge the food item from his throat.

Sophisticated. Apparently the Heimlich maneuver hasn't caught on in Japan yet.