The Tokyo District Court sentenced a heart surgeon Monday to a suspended one-year prison term for destroying evidence related to the malpractice death of a 12-year-old girl in 2001.

Kazuhiro Seo, 48, a former surgeon at Tokyo Women’s Medical University Hospital in Shinjuku Ward, was found guilty of falsifying medical records on the death of Akika Hirayanagi of Takasaki, Gunma Prefecture, during an operation at the hospital on March 2, 2001.

This was the first case in which doctors were arrested for malpractice, seriously damaging the hospital’s reputation as a top heart center and prompting the health ministry to strip it of its designation as an advanced treatment center.

Seo headed the 14-member team that operated on Hirayanagi, who was diagnosed with a hole in her heart shortly after she was born.

While the defect was not life-threatening, she was admitted to the hospital in late February 2001 for corrective surgery.

During the operation, Kazuki Sato, the doctor in charge of handling an artificial heart-and-lung machine, altered the machine’s program so that blood was sucked out of the patient when the machine’s internal pressure was lowered instead of raised, the court said.

But Seo was unaware of the change when he ordered Sato to raise the pressure inside the machine, with the intention of sucking blood out, according to the court.

As a result, blood flowed back into her body, accumulating in the girl’s brain and causing brain damage. She fell into a coma and died three days later.

Sato is currently standing trial for professional negligence resulting in death.

According to the court, Seo ordered the falsification of the patient’s medical records and machine data in order to hide the fact that the girl had suffered brain damage. He altered some of the data himself.

Presiding Judge Yuichi Okada said, “Forcing members of the surgical team to falsify operation records and making false explanations to the family of the deceased is an extremely evil act by the accused.”

He added that Seo’s deeds “are abominable, and run totally counter to the ethics of a health-care practitioner.”

Seo had earlier told the court that it was an unwritten rule in the hospital that mistakes would be concealed, adding that he had been given subtle instructions to do so by his former supervisor and head professor, Yasuharu Imai.

But the court ruled that a concrete conspiracy between Imai and Seo could not be established, and that even if Seo had committed the crime as a result of the professor’s wishes or the hospital’s unwritten rule, it did not merit sympathy.

The judge added, however, that his prison sentence was suspended for three years due to Seo’s deep remorse, the fact that he had worked to save lives as a heart surgeon for 20 years, and the fact that he had already been punished by society.

Seo’s lawyer said he would like to appeal the ruling, but added that he would discuss the matter with his client.

Hirayanagi’s parents suspected something was amiss from the way hospital staff had behaved after surgery. They sent a letter to the hospital in May that year, asking for a detailed explanation of what happened during the operation.

Doctors responded by telling them the girl had died of heart failure.

The hospital set up an internal investigation team in June 2001, and owned up to the machine errors and subsequent coverup in October that year.

Hirayanagi’s parents filed a criminal complaint against the hospital staff after receiving a letter from a whistle-blower in December about the malpractice.

During a news conference after Monday’s ruling, Hirayanagi’s parents said the present state of medical care cannot change without a clarification of obscure elements of medical practice in Japan, including internal power structures that call for unconditional obedience toward superiors.

“Although Seo was found guilty, there was a strong tendency in that hospital to conceal mistakes,” Hirayanagi’s father, Toshiaki, said. “Related parties at the hospital may still be thinking that Seo was just unlucky (to have been caught).”

Meanwhile, the Tokyo Women’s Medical University Hospital said in a written statement that it takes Monday’s ruling seriously and will do its utmost to effect hospital reforms.


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