A former top authority on hemophilia was acquitted Wednesday of professional negligence resulting in the death of a male patient through the use of HIV-tainted blood coagulants at Teikyo University Hospital in Tokyo.
The Tokyo District Court ruled that Takeshi Abe, 84, former vice president of the university, could not have clearly anticipated the consequences of using the blood products due to the limited knowledge available on the nature of HIV at the time.
The trial dealt with the death of one patient among dozens of hemophiliacs who were infected with HIV at the hospital. The patient died of AIDS in December 1991 after being infected with HIV through imported blood products administered by Abe’s subordinate on three occasions in May and June 1985.
Presiding Judge Toshio Nagai said Abe should not be held responsible for the death because the mechanism and scale of the HIV infection through the imported coagulants was not fully understood at the time.
“The court cannot see the defendant’s conduct as having constituted professional negligence, as it is considered that any other doctor (would) have done the same in the same position as Abe,” the judge said.
Nagai also said the unheated products were praised for their efficiency in stopping bleeding and reducing side effects. He said Abe should not be held liable for failing to halt their use.
“Obtaining high efficiency in the treatment by using unheated blood products and taking every measure to prevent AIDS hardly went hand in hand at the time,” Nagai said.
“Experts with advanced knowledge were explaining the virus, while doctors in charge of treatment were studying practical measures to deal with the situation,” he said.
Nagai also pointed out the importance of closely examining Abe’s liability in context, at certain times and places and with objective materials, such as theses available to the public at the time. He also emphasized the importance of considering the prevailing knowledge of the time in judging the case.
Nagai said giving the unheated blood products to hemophiliacs was “clearly the intention of” Abe, whose influence was considerable as leader of the university’s blood research laboratory.
But he added that although the HIV scandal involving Abe was grave and tragic, there are no grounds to expand the scope of charges against him.
Prosecutors immediately announced they would file an appeal. They had demanded a three-year term for Abe.
During the trial, two of Abe’s junior colleagues testified that they had suggested to him that the unheated blood products be replaced by cryoprecipitate, an older but safer product made from domestically donated blood.
Abe rejected their suggestion, however, referring to the efficiency of the imported product, they said.
The judge disqualified their testimony, however, claiming it was an attempt to lay the blame on Abe’s shoulders.
Jugo Hanai, the head of a group of plaintiffs in Osaka who filed a civil suit in 1989 against five drug makers that distributed tainted blood products and the government that approved the drugs, denounced the ruling and said it forgave the irresponsible acts of a medical authority.
“Patients had no option but to fully trust Abe and other doctors at the time, and he bore the responsibility of protecting them by ensuring their medicine’s safety,” he said.
Lawyers representing the HIV-infected plaintiffs in the civil suit severely criticized the ruling, saying its standard of professional negligence is unrealistic.
“No medical authority will be punished as long as the doctor does not make a mistake so big that nobody would make it,” Toshihiro Suzuki, one of the lawyers, said.
The lawyers denounced the 90-minute ruling for not dealing with the specific case and instead focusing on what the judge called “the limitation of medical science at the time.”
According to his lawyer Junichiro Hironaka, after hearing the ruling, Abe looked calm and said he is satisfied with the ruling.
“I still feel very sorry for the victims of the HIV debacle . . . and I, as a doctor, will make more efforts for the research of hemophilia,” Hironaka quoted Abe as saying.
Abe’s lawyers said the ruling was appropriate and that it fully took into account the limitation of medical science at the time. They blamed the media and prosecutors for making Abe a scapegoat for the HIV fiasco, which was “inevitable,” due to the lack of knowledge about the disease at the time.
Abe’s trial is one of three criminal trials over the HIV debacle, in which at least 1,430 hemophiliacs, about one-third of the country’s hemophiliac population, were infected through unheated blood products mainly imported from the United States. More than 500 of those infected have died of AIDS.
The scandal was laid to a “vicious triangle” of bureaucrats, doctors and pharmaceutical companies, in which firms sway scholars by covering their research expenses and promise bureaucrats positions after they retire.
Prosecutors alleged that Abe continued to use unheated blood products due to his cozy ties with Osaka-based Green Cross Corp. The now defunct drugmaker had allegedly financed Abe’s research expenses and had large stocks of imported blood products at the time.
Akihito Matsumura, 59, a former high-ranking official of the then Health and Welfare Ministry who was in charge of authorizing the production and importation of blood products between 1984 and 1986, also stands accused before the Tokyo court for the death of two hemophiliacs.
Matsumura pleaded not guilty earlier this month. Wednesday’s ruling is expected to influence his trial, scheduled for September, as one of the two victims for whom Matsumura is being accused is the patient in Abe’s trial, and Judge Nagai will also preside over his trial.
In February 2000, three former presidents of Green Cross were sentenced to prison terms by the Osaka District Court for professional negligence resulting in the death of a liver-disease patient in 1995. They continued to sell HIV-tainted coagulants even after they started selling heat-treated blood products that were free of the virus. They have appealed the rulings to a higher court.
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