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Medical, legal, and medical safety analysis of forensic autopsy cases of medical practice-related deaths

Research Project

Project/Area Number 19K19380
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 58010:Medical management and medical sociology-related
Research InstitutionNihon University (2023)
The University of Tokyo (2019-2022)

Principal Investigator

YAMAGUCHI Rutsuko  日本大学, 医学部, 准教授 (90383603)

Project Period (FY) 2019-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2022: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000)
Fiscal Year 2021: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2020: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2019: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000)
Keywords診療関連死 / 法医解剖 / 医療安全 / 医療事故調査制度 / 異状死データベース / 法医学
Outline of Research at the Start

法医解剖となった診療関連死事例について、死亡から法医解剖に至るまでの経緯、法医解剖所見の分析、法的処遇などの追跡調査を含めた疫学的調査・分析を行うことにより、法医解剖の適応となっている診療関連死事例の特徴、第三者機関による死因究明および再発防止策への試みである医療事故調発足前後での事例の傾向の推移、またその理由を明らかにし、法医解剖結果が事例の法的処遇のプロセスにどのように影響を与えているか、 例えば医療訴訟の防止に寄与しえているか、医療事故の死因究明、再発予防にどのように寄与しえているかについて現状を分析し、将来的に望ましい診療関連死調査制度についての考察と提言を行う。

Outline of Final Research Achievements

We compared 147 autopsy cases of medical practice-related deaths at our institution from 2011 to 2017, which were classified into four main categories, before and after the establishment of the autopsy system for cause of death and identity investigation and the launch of the medical accident investigation system, and examined the trends, characteristics, and impacts of these cases. These results were published in a peer-reviewed English-language journal. In addition, we published three papers in English peer-reviewed journals on valuable alarming cases.

Academic Significance and Societal Importance of the Research Achievements

2010年代に制定された死因・身元調査法に基づく新法解剖の施行、また医療事故調査制度の発足という、診療関連死の死因究明における新しい制度の施行前・後の、法医解剖となった診療関連死事例の特徴と傾向、その変化についての調査研究はこれまでに行われていなかった。本研究結果は高齢化・多死社会へと向かう本邦にあって、ますます増加すると思われる診療関連死・病院・施設内死亡の調査において、解剖情報を統合し、医療機関へフィードバックする方法、事故再発予防、システム改善に資するための制度設計についての基礎資料となりうるものである。

Report

(6 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (7 results)

All 2023 2022 2021 2019

All Journal Article (4 results) (of which Peer Reviewed: 4 results) Presentation (3 results) (of which Int'l Joint Research: 1 results)

  • [Journal Article] Ropinirole involved in a fatal case: blood and urinary concentrations2022

    • Author(s)
      Nagasawa Sayaka、Yamaguchi Rutsuko、Saka Kanju、Torimitsu Suguru、Chiba Fumiko、Yajima Daisuke、Inokuchi Go、Motomura Ayumi、Kira Kei、Yamagishi Yoshikazu、Ogra Yasumitsu、Iwase Hirotaro
    • Journal Title

      Forensic Toxicology

      Volume: 40 Issue: 1 Pages: 173-179

    • DOI

      10.1007/s11419-021-00593-8

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Trends and characteristics in health care-related deaths investigated through medico-legal autopsies after system changes in Japan.2022

    • Author(s)
      Rutsuko Yamaguchi, Yohsuke Makino, Go Inokuchi, Kenji Ishihara, Suguru Torimitsu, Fumiko Chiba, Yumi Hoshioka, Syumari Urabe, Yukiko Oya, Ayumi Motomura, Daisuke Yajima, Hirotaro Iwase
    • Journal Title

      Journal of Law and Medicine

      Volume: 29

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Fatal bilateral pneumothoraces after electroacupuncture treatment: A case report and literature review2022

    • Author(s)
      Rutsuko Yamaguchi, Yohsuke Makino, Suguru Torimitsu, Fumiko Chiba, Yuko Kihara, Hirotaro Iwase
    • Journal Title

      Journal of Forensic Sciences

      Volume: 67 Issue: 1 Pages: 377-383

    • DOI

      10.1111/1556-4029.14874

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Fatal airway obstruction due to Ludwig's angina from severe odontogenic infection during antipsychotic medication: A case report and a literature review2021

    • Author(s)
      Rutsuko Yamaguchi, Koichi Sakurada, Hisako Saitoh, Maiko Yoshida, Yohsuke Makino, Suguru Torimitsu, Satomi Mizuno, Hirotaro Iwase
    • Journal Title

      Journal of Forensic Sciences

      Volume: 66 Issue: 5 Pages: 1980-1985

    • DOI

      10.1111/1556-4029.14740

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Presentation] 頚椎骨折による体位性窒息が疑われた2例.2023

    • Author(s)
      山口るつ子, 太田 昂矢,飯酒盃 勇, 鉄 堅,千葉 正悦, 勝又 純俊,奥田 貴久
    • Organizer
      第92回日本法医学会学術関東地方集会
    • Related Report
      2023 Annual Research Report
  • [Presentation] Fatal bilateral pneumothoraces after electroacupuncture treatment: A case report and literature review2022

    • Author(s)
      Rutsuko Yamaguchi, Yohsuke Makino, Suguru Torimitsu, Fumiko Chiba, Maiko Yoshida, Yuko Kihara, Hirotaro Iwase
    • Organizer
      The International Society for Forensic Radiology and Imaging (ISFRI), annual meeting 2022
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] 新法解剖施行および医療事故調査制度発足後の医療関連死の剖検事例の傾向と特徴2019

    • Author(s)
      山口るつ子, 猪口 剛, 槇野陽介, 千葉文子, 鳥光 優, 星岡佑美, 石原憲司, 浦邉朱鞠, 恒矢重毅, 岩瀬博太郎.
    • Organizer
      第103次日本法医学会学術全国集会
    • Related Report
      2019 Research-status Report

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Published: 2019-04-18   Modified: 2025-01-30  

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