Reviewing the Fukushima Prefectural Ohno Hospital Incident（1/2）

Masahiro Kami, M.D., Ph.D. President, Medical Governance Research Institute, Tokyo, Japan

I recently had the opportunity to revisit the 2006 arrest incident of an obstetrician at Fukushima Prefectural Ohno Hospital. This was due to assisting Yuria Iyano, a student from Yokohama City University Medical School, with her report.

Ms. Iyano chose to study under Professor Suzuki at the Graduate School of Public Policy, University of Tokyo, as part of her external training curriculum at the university. Professor Suzuki assigned her the task of interviewing stakeholders in the Fukushima Prefectural Ohno Hospital incident and compiling an oral history.

I was involved in this incident along with Professor Suzuki, who was a member of the House of Councillors at the time, hence the guidance responsibility fell to me.

On April 18, Ms. Iyano first visited the Medical Governance Research Institute. She is a talented young woman who entered Yokohama City University directly from a high school in Gunma Prefecture. She is a serious woman with a lovely smile, who mentioned she was considering specializing in obstetrics and gynecology in the future.

When guiding her, I emphasized the importance of visiting the site, meeting the stakeholders, and studying the history of Fukushima, as understanding the essence of this incident is impossible without knowledge of the local history and regional characteristics.

Ms. Iyano faithfully followed my guidance. Below is a photo from her visit to the site of Fukushima Prefectural Ohno Hospital on May 15.

The hospital is located in Okuma Town, Fukushima, about 5 kilometers from the Fukushima Daiichi Nuclear Power Plant. It suffered significant damage during the Great East Japan Earthquake and the subsequent nuclear disaster, forcing evacuations of doctors, patients, and local residents. The hospital remains closed, and Fukushima Prefecture plans to rebuild and reopen it in the fiscal year 2029.

Ms. Iyano energetically interviewed various stakeholders. The top photo is from her visit to Fukushima Medical University on May 31, where she met with Director Takemoto and Vice Director Hazama. From them, she learned about the severe shortage and maldistribution of doctors within Fukushima Prefecture.

Although I won't go into detail here, the arrest of the Ohno Hospital obstetrician involved rare complications such as placenta previa and adherent placenta, which necessitated a cesarean section during which the patient tragically died.

The Fukushima Prefectural Police arrested the surgeon on suspicion of professional negligence resulting in death. In Japan, the criminal conviction rate is 99.97%. Once charged, a conviction is almost certain. However, this case took an unexpected turn. On August 20, 2008, the Fukushima District Court acquitted the defendant, and the prosecution did not appeal, making the acquittal final.

Criminal cases that conclude with an acquittal are rare, similar only to the 2010 postal fraud case involving Mr. Muraki, a former director-general at the Ministry of Health, Labour and Welfare, where the Osaka District Public Prosecutor's Office dropped the appeal after evidence of fabrication was discovered. The circumstances of the Ohno Hospital case were entirely different.

The reason the Ohno Hospital case ended in acquittal was a shift in public opinion. Initially, public sentiment was critical of the arrested doctor. The image of the doctor being handcuffed and taken away was broadcast on television, and the media condemned it as a "medical error."

However, ultimately, this incident came to be recognized as highlighting the structural issues of medical care in Japan's local cities, where doctors often must perform complex surgeries alone, leading to a consensus on the "collapse of medical care" in the country.

Using Nikkei Telecom, Dr. Morihito Takita (a graduate student at the University of Tokyo Institute of Medical Science at the time) found that articles containing the terms "medical collapse" and "maternity service suspension" surged in major national newspapers from 2006 and 2007 onwards.

A significant program that played a role in this change in public opinion was Fuji TV's "Tokudane!"

Following the Ohno Hospital incident, a volunteer group called "Association to Prevent the Collapse of Perinatal Care" was formed. I served as the secretary, and stakeholders in this association requested that the issue be highlighted on television, particularly on talk shows, as that would influence public opinion.

The only TV contact I knew at the time was Mr. Munakata, who worked on "Tokudane!" and was my senior in the Kendo club at the University of Tokyo.

After a long time, I called him and explained the situation. His initial response was challenging, "It's difficult. There's a victim, so defending the doctor isn't possible." At the time, there wasn't widespread awareness of the doctor shortage; the prevailing image was "doctors = rich," and when medical accidents occurred, the norm was to condemn the doctor for a "medical error."

Originally published in “Japan in depth” in Japanese on Jul 28, 2024.