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Wednesday, Feb. 13, 2008

Hospital, doctor cleared in chopstick suit

Even if detected, impaled brain would likely have killed boy anyway: court


Staff writer

The Tokyo District Court on Tuesday turned down a damages suit brought by a couple whose 4-year-old son died in 1999 after a doctor overlooked a 7.6-cm broken chopstick section lodged in his brain following a fall.

The court concluded the child would have probably died even if he had been properly checked and operated on.

Shunzo Sugino, who fell at a community summer festival in Suginami Ward, Tokyo, while eating cotton candy off the wooden chopstick, died the following morning after being released from Kyorin University Hospital.

A doctor at the hospital failed to notice a severe gash in his cranium and discharged the boy after only applying an antiseptic to his throat. No X-rays or CT scans were carried out.

In demanding ¥86.2 million from the hospital and Dr. Hideki Nemoto, Sugino's parents alleged that their son's early symptoms suggested a brain injury and that his death stemmed from malpractice.

However, presiding Judge Kenichi Kato ruled that the death was not directly caused by the lack of a medical examination, and that Nemoto and the hospital could not be held liable.

"It cannot be said that the defendants had the obligation" to check the patient for cranial damage, the court said, noting the rare nature of the injuries made it difficult for Nemoto to presume serious brain damage.

The court said Sugino's chances of surviving were extremely low regardless of the doctor's failure to notice the chopstick lodged in his brain.

Sugino's mother, Fumie, was working as a volunteer at the community festival when her son tripped with the chopstick in his mouth.

Nemoto, who was on the night shift July 10, 1999, examined Sugino after he was taken by an ambulance to Kyorin University Hospital in Mitaka, western Tokyo. The boy was barely conscious and vomited continuously but was given only basic treatment and released shortly thereafter. He died the next morning.

Although an autopsy found that the chopstick section had reached Sugino's cerebellum, Nemoto claimed the object was not visible during his cursory examination.

He also suggested the boy would not have survived even if the damage was pinpointed.

In justifying their decision not to carry out a computed-tomography scan, Nemoto and the hospital argued Sugino's death was the result of a rare injury, and the severe brain damage could not have been an easily drawn conclusion.

Nemoto also said the boy responded to his questions and showed no signs of cerebral damage.

Nemoto was found not guilty in 2006 in a criminal trial of negligence by the same court, which ruled that Sugino's death was probably unavoidable regardless of the doctor's treatment or lack thereof.

The court acknowledged that Nemoto failed to provide appropriate medical care but concluded that malpractice was not the direct cause of death. Prosecutors have appealed that ruling.

"(Tuesday's) ruling completely denied any liability on the part of the hospital, which surprised me," Fumie Sugino told reporters. Sugino's father, Masao, said he will appeal the ruling. "The hospital released Shunzo after a five-minute medical examination. My son died because of inappropriate treatment," he said.



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