Around 12:30 p.m. on June 8, Tomohiro Kato, a disaffected 25-year-old factory worker, used his rented truck to run down several pedestrians on the street in Akihabara. Then brandishing a dagger he assaulted over a dozen others until subdued by police. Seven died and 10 were injured in the random assault, which was not only premeditated, but proclaimed by Kato beforehand on electronic bulletin boards.
Now a new aspect of the tragedy has come to light. In the first of a series of articles in collaboration with Shukan Bunshun (July 24), Shunya Ito, a medical journalist, exposes serious flaws in the triage system used for prioritizing medical emergencies.
The article suggests Mai Muto, a 21-year-old student who was one of the seven fatalities that day, would possibly have survived her stab wounds if the injury had been correctly identified and she had been transported to a hospital more promptly.
Akihabara, the magazine notes, is located in the center of Tokyo’s “Hospital Ginza,” with some 32 emergency treatment centers within a 5-kilometer radius, including Juntendeno Hospital, University of Tokyo Hospital and St. Luke’s International Medical Center. Three were less than 1 kilometer away from the scene of Kato’s assault.
That Sunday, Muto was in Akihabara working at a part-time job posting flyers when the incident began. She received a stab wound in the abdomen while dialing the police emergency number on her mobile phone.
Ambulances, summoned from nearby fire stations, began arriving on the scene within 7 minutes and immediately began prioritizing casualties based the four-color code, tagging the most urgent cases red (extremely critical), followed by yellow (urgent but not immediate), then green (condition stabilized) and black (dead or moribund).
Dr Akihiko Yamamoto, head of intensive care at Oita Prefectural Hospital and in Tokyo for a conference, happened to arrive at the scene shortly after the incident and offered assistance.
While other victims were being stabilized in ambulances or already on the way to hospitals, he noticed Muto, who had been classified with yellow tag, was still lying on the street.
While external bleeding was scant, Yamamoto noticed Muto’s skin pallor indicated she was going into shock with internal bleeding. He shouted for the paramedics to upgrade her status to red and to connect an IV drip.
Muto was taken to Tokyo Medical and Dental University Hospital in nearby Ochanomizu, but declared dead at 16:30.
The article speculates that one reason for Muto’s classification as yellow instead of red was her close proximity to the truck Kato used to run down the first victims, which may have led to her having been mistaken as having been hit by the vehicle rather than stabbed. But the handling of the whole incident raises numerous questions.
“I got the impression that the accident scene wasn’t under unified control, and the rescuers were responding on a case-by-case basis,” a physician whose hospital received some of the serious injuries tells Shukan Bunshun.
Toru Ishihara, head of the Shirahigebashi Hospital in Arakawa Ward, believes the triage system should not be applied to stab victims in any case. “Or if they do apply it, victims should be tagged red. As soon as the paramedics arrive, they should load and go,” he tells Shukan Bunshun.
Despite the best efforts of paramedics and medical teams, does Muto’s death point to fatal flaws in the emergency rescue system? The magazine promises to shed more light in its next issue.© Japan Today