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Obstacles to Reducing Human Injury and Death Due to Medical Error

As a matter of policy, both the United States and Japan try to reduce occurrences of human injury and death due to medical error. Health officials in both countries realize// that to develop any successful quality-improvement program to address this problem, they must obtain accurate information on the nature, frequency and cause of medical errors.

Robert B Leflar, a law professor at the University of Arkansas, says both nations struggle with this problem because obtaining information about mistakes by health-care providers creates serious tension between the equally important goals of patient safety and public accountability. In the United States, civil malpractice litigation has become so fierce that hospitals regard internal hospital information, obtained for the purposes of quality improvement, as a source of legal liability and thus want to protect it from reaching potential plaintiffs' attorneys.

Leflar, who is also an adjunct professor at the University of Arkansas for Medical Sciences and formerly a visiting professor at the University of Tokyo School of Law, spent the 2005-06 academic year in Tokyo studying how people and institutions in that country deal with medical error. He discovered that the Japanese approach is dramatically different from U.S. methods, and he says both countries have much to learn from each other. Leflar's recently published article on the topic is titled 'Medical Error as Reportable Event, as Tort, as Crime: A Transpacific Comparison.'

Leflar found that a major difference between the two countries is the type of law used when a patient is injured or dies because of a health-care professional's mistake. In the United States, legal action as a result of a medical error is almost always treated as a civil matter, a dispute between two parties. If one has reason to believe that a family member died because of error or negligence, the family hires an attorney who will use tort law, specifically medical
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