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Medical Accident Investigation System of Japan in Malpractice Litigation: A Non-Punitive Reporting System?
Masayuki Ohira1,2, Satoru Makita3, Masaki Takao1
1Department of General Internal Medicine and Clinical Laboratory, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan.
JMA Journal
|February 12, 2026
Summary
Medical accident reports in Japan are used in lawsuits, often to determine negligence, contradicting the system's non-punitive goal for patient safety. Separate systems are needed for reporting errors versus negligence.
Area of Science:
- Medical Law
- Patient Safety
- Healthcare Systems
Background:
- Effective medical accident reporting is crucial for preventing errors and enhancing patient safety.
- A non-punitive reporting system ensures reporters are protected from reprisals.
Purpose of the Study:
- To analyze lawsuits involving Japan's Medical Accident Investigation System.
- To examine how medical accident reports are utilized in malpractice litigation.
Main Methods:
- Reviewed lawsuits linked to Japan's Medical Accident Investigation System.
- Identified cases using a Japanese legal database.
- Examined report characteristics and their citation in judgments.
Main Results:
- 13 cases and 15 reports were analyzed.
- Reports were often provided by bereaved families (80.0%) and used as evidence of negligence (26.7%).
- Nine reports (60.0%) were cited as evidence of negligence, with six establishing medical professional negligence.
Conclusions:
- Malpractice lawsuits in Japan reveal a disconnect between accident report usage and the intended non-punitive system.
- Patient safety initiatives require reporting systems distinct from those used to identify medical negligence.
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