If the police had had their way, the sudden death of a young sumo wrestler three years ago would have been simply a tragic event quickly swept under the rug, dismissed, as it initially was, as heart failure from unknown causes.

But when the parents of Takashi Saito saw their son’s heavily battered corpse, they demanded police order an autopsy. It was apparent more sinister events led to the death: the young man’s heart had stopped, but it was because he was beaten to death.

The teen’s stable master and other wrestlers were charged with the beating, sparking a major scandal that rocked the sumo world.

Experts say this case of initial dismissal is just the tip of the iceberg. Autopsies are performed for the most part only when police suspect foul play, and around 90 percent of “unnatural deaths” are not subject to postmortem examination. Compounding the problem is a shortage of autopsy experts, and inadequate financial and material resources to support them.

This is in sharp contrast to other developed countries. In the United States, United Kingdom and Australia, for example, autopsies are conducted in about 40 percent to 50 percent of cases of unnatural death, and where coroners, who act as independent forensic examiners, decide if such scrutiny is necessary.

The term “unnatural death” is used in cases where the cause is not immediately clear. Police usually make the “unnatural death” determination by a visual inspection of the corpse, and send only “suspicious” cases to qualified universities for an autopsy.

Only five major cities have their own autopsy staff outside universities, and their budgets and manpower are extremely tight, experts say.

Forensic scientists argue autopsies are needed to determine the true cause of any death and to determine if a crime has been committed.

Experts say the government has long neglected the importance of determining the cause of death in general, and for years has allocated little money and manpower to independent experts outside the police.

Outside Tokyo, budgets for autopsies are extremely tight, said Hirotaro Iwase, a professor in the forensic medicine department at Chiba University who performs autopsies in Chiba Prefecture.

“(In 2003 in Chiba) the university was using kitchen knives (to conduct autopsies). I was shocked,” said Iwase, who moved to Chiba from the University of Tokyo in 2003. “We only had 30-year-old examination instruments.”

According to the Japan Forensic Medicine Society, there were only 143 full-timers in university forensic medicine departments nationwide in 2009, and the number is on the decline. They conducted 6,569 autopsies that police suspected were linked to crimes in 2008.

“Far fewer autopsies are performed in Japan than in other countries, like the U.S. or U.K. . . . And there are not enough specialists to perform autopsies,” the professor said.

Iwase said even though an autopsy can cost as much as ¥300,000 to carry out, only ¥70,000 was paid per body until 2006, when Chiba University started receiving about ¥100,000 to ¥300,000.

Thanks to some modest budget increases, he was able to update the facilities at Chiba, but the university cannot employee any more staff in its forensic medicine department, Iwase said.

“I’ve been asking the university to hire more full-timers because we have enough of a budget. But they’re afraid the subsidy from the education ministry may be cut in line with their personnel reduction goals.

“Nobody in Japan is held accountable for failing to uncover the cause of unnatural deaths. Not even the police,” Iwase said, adding it is very difficult to determine if a crime is involved without conducting an autopsy.

In November, Hirosaki University in Aomori Prefecture stopped performing autopsies because there was only one professor left in its forensic medicine department, and police started sending bodies in Aomori to Iwate and Akita prefectures for autopsies.

“Other forensic medicine departments may fall into a similar situation,” Iwase warned.

University forensic medicine departments are responsible for conducting autopsies in the event police suspect a crime.

Only Tokyo, Yokohama, Nagoya, Kobe and Osaka have their own medical examiner systems to conduct autopsies for unnatural deaths, said professor Yasuhiro Aoki of the forensic medicine department at Nagoya City University.

Even the Tokyo Medical Examiner’s Office, where all unnatural deaths in the 23 wards are examined, faces a manpower shortage.

The Tokyo office examines more than 12,000 bodies annually. In 2008, of the 12,989 “unnatural deaths” listed only 20.5 percent led to an autopsy — a high figure for Japan but low compared to other countries.

“But the staff numbers remain the same as when there were 5,000 cases annually in the 1970s,” said Director Tatsushige Fukunaga, who has been pressing the metropolitan government to increase hiring.

“Our staffers are aging. We haven’t hired any new technical specialists for nearly 20 years,” he said.

To improve the detection of crime-related deaths, the National Police Agency launched a study group in late January.

“I expect (the panel discussion) will help improve the situation,” professor Iwase said.

In addition to crime detection, experts say looking into the cause of death has other merits, including contributing to disease or suicide prevention, and are calling on regional governments to allocate more resources to the medical examiner system.

For instance, the examiner’s office in Tokyo has compiled reports on “economy class syndrome,” or deep-vein thrombosis, found as a result of autopsies, and have urged hospitals to massage patients to prevent blood clots.

Deep vein thrombosis is a condition in which a blood clot forms in a leg vein due to inactivity. The clot can travel to the lungs or heart, resulting in sudden death.

Thanks to the reports, devices to prevent the syndrome are now provided to hospitals and have been covered by the public health insurance since 2004, Fukunaga said.

The medical examiner’s office in Tokyo also revealed the first case of suicide using hydrogen sulfide gas in 2008.

After discovering Web sites detailing how to commit suicide with the gas, the office urged the Metropolitan Police Department to act, including by requesting Web site operators to remove the information, Fukunaga said.

“We collaborate with other institutions to prevent further development of such incidents,” he said.

Nevertheless, the number of suicide by gas cases increased, likely due to widespread media coverage. “Twenty-six cases were reported in Tokyo within a month,” said Fukunaga.

It is crucial to examine the cause of death because the results are reflected in the government’s health policy, according to Fukunaga. But since autopsies are not performed in most parts of Japan in deaths where foul play isn’t suspected, “the statistics of the cause of death in Japan are inaccurate,” he said.

The current top three causes of death in Japan are cancer, cerebrovascular disease and heart disease. But, Fukunaga said, “(the cause of death) was mostly heart failure until 1995,” when the health ministry changed the death certificate format. “Now heart failure is replaced by ‘unknown’ as the cause of death,” he said.

Although medical examiner’s offices have proven they serve an important role, the health ministry has done little to improve the death investigation system, the director argued.

“They should recognize the causes of death listed in Japan are far from precise, and realize how this affects citizens (in the future),” he said.