-Caveat Lector- Medical Errors Outrage Japan By MARI YAMAGUCHI .c The Associated Press YOKOHAMA, Japan (AP) -- Instead of fixing a 74-year-old man's heart problem, surgeons removed part of his right lung. Then they gave the 84-year-old with the lung problem heart surgery. But that's not all. Eight hours later, as the misidentified patients were receiving post-op transfusions, the hospital staff realized their error. Fortunately, the patients both had the same type blood -- or else the transfusions might have killed them, too. Few cases of medical bungling in Japan have received as much publicity -- or generated so much outrage -- as this one at the Yokohama City University Hospital earlier this year. Many experts, however, say there is little being done to address the underlying problems: overworked doctors and a dangerously cavalier attitude toward the quality of care. ``Patients are treated like machine parts on a conveyer belt. Doctors often don't care about each patient, they don't even remember their faces,'' said Makoto Kondo, a radiologist at Keio University Hospital, one of the best medical facilities in Japan. Since the botched surgeries in this city just south of Tokyo were revealed in January, Japan's media has focused the national spotlight on similar, and at times worse, mistakes around the country: In February, a 58-year-old housewife died after a nurse accidentally injected her with disinfectant instead of blood medication. Also in February, a 61-year-old housewife went into shock after receiving transfusions of the wrong blood type. In March, a 7-year-old boy had to undergo an operation to remove part of a surgical instrument mistakenly left inside his skull. Doctors say fatigue from chronic overwork contributes to such errors. And with advanced technology and the increasingly complex array of medications, a simple mistake like a wrong syringe can easily kill a patient. But critics of the medical status quo in Japan say such problems would not be so bad if more was done to supervise the quality of doctors' performances. Medical records, for example, are usually off-limits to patients. Doctors need not even renew their licenses. And rarely are mistakes made public -- officials at the Yokohama hospital only acknowledged theirs after a national newspaper reported them. Shunya Ito, a member of Medio, a civil group investigating malpractice, said the medical community's treatment of patients reflects its hierarchical structure -- with patients on the lowest rung. ``We patients feel so intimidated that it's even difficult to ask doctors any questions,'' he said. Ito's 72-year-old father died six years ago at a hospital an hour after beginning to receive an intravenous injection containing potassium. Ito sued, and had medical experts saying the injection may have contributed to his father's death. The hospital denied any wrongdoing, and Ito lost the suit. Some members of the medical community say hospitals are often too concerned with protecting their own reputations -- at times resorting to illegal means. Shigemi Oshida, professor of forensic medicine at Nihon University of Medicine, said hospitals routinely destroy evidence of operating room foul-ups. ``Japanese hospitals haven't tried to learn from mistakes,'' he said. ``And by covering up, they fail to share valuable lessons.'' Because of the secrecy and difficulty in obtaining documents, victims of hospital mistakes are rarely able to take legal action. But according to the latest Supreme Court statistics, more are willing to try. Malpractice suits have nearly doubled to 2,700 in 1998 from 1,508 cases 10 years ago. Shamed into action, the government has formed an investigative panel and is expected to announce its recommendations later this month. ``We were shocked,'' said Tatsuya Aoki, an official at the Health and Welfare Ministry's department of health policy. ``The Yokohama case suggested this is a universal problem.'' Staff at the Yokohama hospital, meanwhile, are taking more care to clearly identify their patients and to double-check blood types before giving transfusions. ``We learned an important lesson,'' said hospital spokesman Nobuo Uchida. ``Next time we make a mistake, there will be no future for our hospital.'' DECLARATION & DISCLAIMER ========== CTRL is a discussion and informational exchange list. Proselyzting propagandic screeds are not allowed. Substance—not soapboxing! 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