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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
PubMed
Abstract

Insights

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.
Keywords:
malpractice lawsuitsmedical accident investigation systemnon-punitive reportingpatient safety

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