Abstract
INTRODUCTION: The investigation and reporting of medical accidents are important to prevent medical errors and ensure patient safety. A successful reporting system should be non-punitive, meaning that reporters are free from any reprisals that arise owing to their reporting of a medical incident. METHODS: In this study, we reviewed all lawsuits involving reports in Japan's Medical Accident Investigation System, identified using a Japanese database of lawsuits (https://www.westlawjapan.com/). We examined the basic characteristics of medical accident cases and how these reports were cited in judgments in medical malpractice litigation. RESULTS: A total of 13 cases, including 15 reports, were collected in this study. Two judgments cited two kinds of reports: those conducted in-hospital and reports prepared by the Medical Accident Investigation and Support Center. Twelve reports (80.0%) were provided by the bereaved family, and four reports (26.7%) were entered into evidence as exhibits for the determination of negligence. Nine reports (60.0%) were cited as evidence of negligence; among these, six reports included content establishing negligence among medical professionals. At least three reports provided grounds for the establishment of negligence in the judgment. CONCLUSIONS: We described the basic characteristics of malpractice lawsuits related to the medical accident reporting system established under Japanese law. The current situation of reports provided in medical malpractice lawsuits in Japan indicates discrepancies between their use and the purpose of a non-punitive reporting system. Systems to ensure patient safety should be separate and distinct from those intended to report negligence by medical professionals.