Lawsuits Associated With Medical Malpractice in Japan: Rate of Lawsuits Was@Very Low in Pediatrics, Although Many Children Visit Emergency Rooms

Akira Ehara
Pediatrics 2005;115;1792-1793

To the Editor..

According to the Supreme Court of Japan, there were 1019 newly accepted lawsuits associated with medical malpractice in 2003[1]. The numbers of lawsuits among clinical-specialty groups were: internal medicine, 258; pediatrics, 21; psychiatry, 42; dermatology, 20; surgery, 214; orthopedics/plastic surgery, 129; urology, 20; obstetrics/gynecology, 137; ophthalmology, 27; and otorhinolaryngology, 25[1]. There were many lawsuits in internal medicine and surgery. Furthermore, the number of lawsuits in each specialty was divided by that of physicians with the specialty[2]. Physicians who had such specialties as surgery and obstetrics/gynecology had higher rates of lawsuits (0.62 and 0.91 per 100 physicians per year, respectively), whereas pediatricians had a lower rate of lawsuits (0.18 lawsuits per 100 physicians per year), as in the United States[3].The proportion of adverse events due to negligence was highest in the emergency department in the United States[3], and in Japan approximately half of the patients who visited emergency departments were below 15 years old; therefore, the rate of lawsuits in pediatrics was expected to be high. However, pediatricians had a very low rate of lawsuits. The reason is unknown. In Japan, there were few serious pediatric patients in the emergency departments, and only about 4% of children who visited emergency departments were transported to secondary and tertiary medical centers[4]. Therefore, there might be so few risky procedures used in pediatric emergency departments that serious consequences due to medical malpractice might not occur as often.

Akira Ehara, MD, PhD

Koala Medical Research
Sapporo, Hokkaido 062-0021 Japan
[Editorfs note: There are very few lawyers in Japan compared with the United States!]


1. Supreme Court of Japan. About the committee of lawsuits associated
with medical malpractice [in Japanese]. Available at: http:// Accessed
April 14, 2005
2. Ministry of Health and Welfare. Survey of physicians, dentists and
pharmacists, 2002 [in Japanese]. Available at: http://
t0089336/k04001.html. Accessed April 14, 2005
3. Leape LL, Brennan TA, Laird N, et al. The nature of adverse events in
hospitalized patients. Results of the Harvard Medical Practice Study II.
N Engl J Med. 1991;324:377.384
4. Tanaka T. Current State and View of Pediatric Emergency Services [in Japanese].
Tokyo, Japan: Shindan To Chiryosha; 2004