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PHYSIO  October 2003

PHYSIO October 2003

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Subject:

Novice manipulative PT

From:

Hiro Wood <[log in to unmask]>

Reply-To:

- for physiotherapists in education and practice <[log in to unmask]>

Date:

Sat, 4 Oct 2003 23:59:14 +0900

Content-Type:

text/plain

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Hello World!
There was a shocking medical malpractice affair recently in Japan.
Three urologists held over for patient's death.
Inexperienced doctors read from manual while performing surgery.

I treat a back pain patient with manual theray once a week.
I'm a regisrered PT but there is no licensure or qualification for
manipulative PT in Japan.
I'v only taken Paris S1 and Maitland introduction course and
only learned to read western manipulative PT's textbook.
So I'm a novice manipulative PT without supervisor.
I've heard there is a strict qualification and licence system of
manual therapy in some western countries.If manual therapy is
truly effective,it also have a possibility of doing one harm.
I'm afraid PT's inexperience of mine will cause a complication
that lead to man's paralysis or other serious incident.
Does my treatment amount to human experimentation like their
surgery?I'm confident that my treatment is more effective
for the moment than the one she has had before although.
If I progress carefully,don't I need to care about it?

Hiro Wood
Japan

Below is the detail of the affair from The Japan Times.

Police on Thursday arrested three urologists at a Tokyo hospital whose
inexperience in a surgical procedure allegedly caused the death last year of
a patient with prostate cancer.

Officials at Aoto Hospital, including hospital chief Kazuhiko Ochiai
(center), bow their heads during a news conference following the arrest of
three doctors for suspected malpractice.

Arrested on suspicion of professional negligence resulting in death were
urologists Jun Madarame, 38, Taro Hasegawa, 34, and Shigetake Maeda, 32, of
Aoto Hospital of the Jikei University School of Medicine in Katsushika Ward.

Police plan to turn over to prosecutors Friday their case against three
other doctors involved in the incident: a 52-year-old head of the hospital's
medical examination department and two anesthesiologists.

Kazuhiko Ochiai, head of Aoto Hospital, admitted in a news conference
Thursday that the urologists had erred during the operation. "I would like
to extend our apologies to the patient and his family," he said.

On Nov. 8, according to investigations, a 60-year-old man from Chiba
Prefecture underwent an operation at the hospital to remove the cancerous
cells. During the operation, however, the man suffered excessive bleeding
and required a blood transfusion. But under low-oxygen conditions, the man
suffered massive brain damage. He died a month later.

Police suspect that the doctors had insufficient experience using an
abdominoscope, a type of endoscope, during the operation, and performed the
procedure in an unprofessional manner.

While performing surgery, according to police, the doctors were taking
instructions from the supplier of the abdominoscope. The urologists went
ahead with the operation while simultaneously reading from the equipment
manual, they said.

Police also suspect that the doctors failed to obtain consent from the
deceased's family before going ahead with the surgical procedure.

Surgery using an abdominoscope has become common because it allows for
smaller surgical cuts compared with opening up the stomach, and requires a
shorter hospital stay.

But because the stomach is not opened, the surgeon needs to watch a
television monitor and have sufficient experience.

The police believe the urologists' inexperience caused the complications
that led to the man's death. Two of the three arrested urologists had only
trained at using an abdominoscope on animals. The other urologist had
meanwhile participated in several such operations only as an assistant,
according to investigators.

The urologists had also failed to prepare enough blood for transfusion as a
precaution against excessive blood loss.

Police said the urologists should have given up on the procedure and
switched to the safer option of cutting open the abdomen at a much earlier
stage in the operation.

Aoto Hospital had not obtained permission from the university's ethics
committee to conduct the operation.

Although the three urologists had informed the head of the medical
examination department that they were planning to perform the surgical
procedure, Ochiai gave them the go-ahead without reporting it to the
university's ethics committee, according to police.

Ochiai told Thursday's news conference that he "thought the doctors had
applied" for approval from the university panel.

One of the urologists had said he "wanted to perform an operation using an
abdominoscope," according to investigators.

When asked if the surgery amounted to human experimentation by the
urologists, Ochiai protested.

He also contradicted a police allegation that the urologists had failed to
inform the patient's family that they planned to use an abdominoscope. He
said he had heard that the family agreed to this method of surgery.

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