Abstract
Purpose: We have experienced the case in which an attending physician reported an expected death to the police as an unnatural death. In this case, we reconsidered the significance of unnatural deaths occurring in hospital settings and of reporting them to the police, under the operation of the nation’s medical accident investigation system.
Summary of the case: A male patient in his 60s was admitted to our hospital. The patient’s condition stabilized in intensive care. However, on the 35th day of hospitalization, he suddenly bled from the tracheotomy and died of hemorrhagic shock on the same day. The attending physician had previously reported emergency outpatient deaths of unknown causes to the police as unnatural deaths and requested inquests. Accordingly, he reported this death to the police as unnatural, meaning the cause of death was unknown. The police came to the hospital and investigated this case based on the hypothesis that medical malpractice was involved. The police cancelled the scheduled pathological dissection at our hospital and conducted an autopsy based on investigative legislation regarding the cause of death and the person’s identity （a new legal autopsy）. When we asked the police for the results of the autopsy, they refused our requests. After inquiring several times, we finally received the response that “the death was caused by heart failure” , and there was “no obvious bleeding in the trachea” . Then the police investigation was closed, and the cause of bleeding remained unknown. We reconsidered the significance of reporting unnatural deaths to the police, from the perspective of death investigation.
Conclusion: Based on this case, in the viewpoint of the solution of healthcare problems, we could not identify the significance of reporting unnatural deaths, including medical-related deaths, to the police for the criminal investigation, which was defined by the “Guidelines for Notification of Unnatural Deaths”, under the nation’s medical accident investigation system in which appropriate investigation and analysis were performed by medical professional.
