A doctor arrested Friday for alleged negligence in connection with a 12-year-old girl’s death at a Tokyo hospital last year also ordered that records be falsified, investigative sources alleged Tuesday.

Kazuki Sato, 38, who was turned over to prosecutors Sunday, is also suspected of ordering a 31-year-old clinical engineer to falsify records pertaining to a heart-lung machine that he was responsible for operating during surgery on Akika Hirayanagi on March 2, 2001, at Tokyo Women’s Medical University Hospital, the sources said.

Sato has denied giving the order, they added.

The head of the surgical team, Kazuhiro Seo, 46, has also been arrested and turned over to prosecutors on suspicion of destroying evidence related to Hirayanagi’s death.

According to investigations, Seo instructed a 54-year-old chief nurse and the clinical engineer to falsify data, including medical records and records from the heart-lung machine.

Because the chief nurse refused, Seo is also suspected of involvement in the falsification.

It is extremely rare for doctors to be arrested over suspected malpractice.

The girl, who was from Takasaki, Gunma Prefecture, was diagnosed with a hole in her heart shortly after birth. She was hospitalized in late February last year to undergo corrective surgery.

She fell into a coma after cardiopulmonary pumps stopped functioning during the operation and died three days later.

The malfunction occurred because a pump used to absorb blood was operating at more than double its normal revolution speed, resulting in abnormally high pressure in the machine, medical sources said. As a result, blood accumulated in the girl’s brain, they said.

Investigators found that Sato switched blood-pumping methods during the girl’s heart surgery after the first method failed.

Sato’s communication of his action, however, was inaudible to all but one nearby staff member, so the others were unaware of his decision, unable to understand why the girl’s condition abruptly changed and unable to prevent it from worsening, the investigators found.

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