I, Aki Tomoya, will not be a simp.

Sending people to remote frontier areas is a common practice used by university hospitals.

The hospital where the deceased was hospitalized was a private general hospital in Shinagawa Ward, Tokyo. After the deceased was admitted to the hospital, it was discovered that he had kidney disease and his urethra was blocked, so he had to undergo a nephrostomy under local anesthesia.

No one expected that the deceased would die in the hospital like this.

"That's right. Mr. Tadokoro's kidney disease was not enough to cause death. The cause of death was not his kidneys, nor was it due to any other organ."

The examination report in Makoto Sakamoto's possession, along with the autopsy record, indicated that the cause of death of Keiichi Tadokoro was not in the kidneys, but was definitely related to this local anesthesia surgery.

"Mr. Tadokoro had a stone in the upper segment of his right ureter and severe hydronephrosis in his right kidney, with multiple stones. However, from a pathological point of view, the kidney disease was not enough to cause death. The problem was in the treatment process."

After showing the tested data to Nakado Kei, Sakamoto Makoto went to Aki Tomoya and explained it to him.

"During the autopsy, we found laryngeal edema, pulmonary edema, and obvious cyanosis of the lips and fingernail beds. Then, the test data showed that the concentration of MCT in the blood was 25.80 ng/mL and the total IgE was 168.12 IU/mL, both of which exceeded the normal value."

Laryngeal edema, pulmonary edema, eosinophilia (not mentioned in Makoto Sakamoto's words), and the allergic indicators in the cardiovascular blood mentioned are all characteristics of an allergic reaction.

The normal value for MCT is less than 13.5 and the normal value for total lgE is less than 100, but both of the deceased's values ​​exceeded the normal values.

Based on the autopsy and three tests, death caused by mechanical injury or kidney disease can be ruled out.

"Dr. Sakamoto, is it a lidocaine allergy or lidocaine poisoning?"

Aki Tomoya looked at the data displayed on the tablet.

The problem arose during the surgical procedure, and given the hospital's explanation that the death was due to anaphylactic shock, the investigation must begin with the medications used in this local anesthesia surgery.

Lidocaine was indeed detected in the poison test.

This type of local anesthetic drug, which is widely used in clinical practice, can also be fatal if used in excess. Drugs are also a type of poison, and they will inevitably have an impact on the body.

"Lidocaine poisoning can be ruled out. Based on the comprehensive analysis, the cause of death is the same as the hospital's explanation: death from an acute allergic reaction, that is, death from anaphylactic shock."

Does this mean the hospital didn't conceal the true cause of the deceased's death?

"Lidocaine allergy, that's really rare. But lidocaine is widely used precisely because allergic reactions are so rare..."

Tokai Rin Yuko sighed.

How should I put it? It's like walking down a main road and a stone falls from the sky and hits you on the head.

"I don't know if the bereaved family will accept our explanation..."

Aki Tomoya smacked his lips, had an allergic reaction, and then died in the hospital. It's something most people wouldn't accept.

Similarly, the word "allergy" may not sound like much, but after witnessing a death firsthand, it becomes terrifying to even think about.

However, UDI is only responsible for the autopsy investigation; medical malpractice cases are between the hospital and the bereaved family, and the investigation results are only for reference.

And now we can start writing the report.

Regardless of whether the bereaved family can accept it, UDI must inform them of the outcome.

Whether they will sue the hospital later is none of their business.

"Dr. Nakado, the attending physician of the deceased, Mr. Tadokoro, wishes to see you. Are you available?"

"what?"

The deceased's attending physician made a special trip to UDI today.

The man came to find out the cause of the deceased's death.

When the three members of the Zhongtang class arrived at the reception room next door, they met a man who looked to be around forty years old and was dressed in a suit.

“Mr. Tadokoro was my patient. He underwent local anesthesia surgery on the afternoon of the 15th. An abnormality occurred during the puncture. After discovering this, we immediately injected him with 2mg of adrenaline and 10mg of dexamethasone. Although Mr. Tadokoro was sent to the ICU for further resuscitation, unfortunately, the resuscitation was unsuccessful. Our conclusion was that he died from lidocaine anaphylactic shock.”

Is the implication that the surgery was performed normally, and that the hospital was not at fault for the subsequent emergency treatment following the abnormality?

"If Mr. Tadokoro's family wants to sue me or the hospital, it will be a waste of their time, given the preoperative consent form and the video recording."

After saying that, the man sighed, as if he wanted the UDI people to pass on the message to the bereaved family.

"We are only responsible for the autopsy investigation; other matters are none of our concern."

Zhongtang replied bluntly.

UDI does indeed occupy a crucial position in this medical dispute, because whether the bereaved family can gain the upper hand in the lawsuit depends entirely on the autopsy report presented by UDI.

However, the truth is that the hospital did not hide anything or cover up the real cause of death. UDI's people were also well aware that this lawsuit would not be easy to win.

"The bereaved family members don't want to hear our hospital's explanations and are quick to sue us, which is a real headache for us."

They tried to get the grief-stricken family members to understand, but it wasn't so easy to gain their forgiveness; otherwise, the body wouldn't have been brought here.

However, the doctor's words sounded somewhat cold.

He came here only to have UDI convey his message not to waste his time, and he didn't know how he felt after his patient's death.

"What hospital could have prevented this tragedy? We doctors aren't gods, and we did our best to save them. People die in hospitals every day. Lidocaine allergies are very rare! Our preoperative consent form also explained this. We hope you can calm those two down. There's no benefit in suing the hospital."

After finishing speaking, the deceased's attending physician bit his lip, his emotions suddenly becoming somewhat agitated.

"Excuse me, I'm sorry to have bothered you today."

The man kept his head down, got up, and left the reception room, seemingly not wanting to stay any longer.

Nakado gave an impatient snort and then left, bored.

In the reception room, Aki Tomoya, Sakamoto Makoto, and the director looked at each other in bewilderment.

"But it's impossible to say that the hospital bears no responsibility at all. The court will probably hear the case, but just like that person said, the chances of winning are too small."

Kamikura Yasuo sighed.

Based on the current investigation findings, it's uncertain whether it's even possible to get the bereaved family to accept the outcome, as they are still in a state of anger over the death of their loved one.

Chapter 198 Whose Responsibility Is It? (2/?)

"Are you in cahoots with those murderers?!"

An angry roar came from the reception room next door, making one frown.

The director had informed the bereaved family of the results of the identification, but was met with their angry rebuke.

"That's true."

Aki Tomoya looked up, having anticipated the commotion next door.

After all, their loved ones died in the hospital.

"Everything went smoothly, including the subsequent resuscitation. The only responsibility is that we didn't discover the patient's allergy to lidocaine."

But because no allergy to lidocaine was found in the patient, the person died there.

It was an oversight, and also because lidoca was not taken seriously due to its rare and low incidence of allergic reactions.

From the hospital's perspective, the preoperative informed consent form, the attending physician's explanation before the operation, and the fact that everything was done according to normal procedures after the patient signed the informed consent form, including emergency measures in case of an allergic reaction, meant that they were not at fault.

But this is cold-hearted. It's only human nature. Can you feel the grief and anger that comes with losing a loved one?

For the bereaved family to pursue legal action, they need to find more effective evidence to attack the hospital, so they are pinning their hopes on UDI.

Unfortunately, the hospital did not conceal the truth: the patient died from anaphylactic shock. After being injected with a normal adult dose of lidocaine, the patient experienced an allergic reaction and ultimately died despite resuscitation efforts.

"He was perfectly fine before being admitted to the hospital. He only died after going there. The hospital killed my husband! They never mentioned that anesthesia would be dangerous!"

The anger from next door can also be felt here.

Hearing this, Aki Tomoya muttered helplessly, "If the person is really fine, there's no need to go to the hospital. But didn't they mention what happens if there's an allergic reaction to lidocaine? Hmm..."

The grief and anger of the bereaved family is understandable, but

"Even so, it's very difficult to win a case because all medications have the potential to cause death. Hospital lawyers usually sever all the plaintiff's defenses. Unless it's a really serious problem, no one will take on a medical malpractice lawsuit. It's a pity!"

Tokai Rin Yuko shook her head and sighed.

Everyone present understood the family's anger, but that was the reality; they were helpless to be accused of being accomplices of the hospital.

"Ultimately, it depends on how the hospital explained things to them afterwards. Judging from yesterday, the attending physician seemed rather indifferent."

The same question remains: how should doctor-patient relationships be handled? Even in Japan, this is a difficult problem.

When someone dies in a hospital, some bereaved families blame the hospital, saying that they caused the death, and may even take them to court.

An initial apology might gain forgiveness and prevent the bereaved family from pursuing the matter further, but an apology cannot bring the deceased back to life. If the hospital's indifference only provokes them more.

"Furthermore, we cannot ignore allergic drug reactions in clinical practice just because they are rare. Procaine used to be tested with a skin test, but lidocaine rarely is. In my paper, there are already 58 cases of death due to allergic drug reactions."

Mikoto Misumi's hands were constantly typing on the laptop keyboard. After obtaining the identification data of Licardo's death due to an allergic reaction, she added another entry to her paper.

Despite her young age, she is also an associate professor of forensic medicine at a university, and one of the reasons she came to UDI was to gain experience.

Being able to become an associate professor at this age may be partly due to the scarcity of forensic scientists, but she is indeed highly skilled in both academic papers and practical techniques.

On the other hand, Nakado is a forensic pathologist with more experience than Misumi Mikoto, but if she doesn't write papers, she's just a forensic pathologist.

"Aki-kun, do you think the bereaved family should file a lawsuit?"

Suddenly, Mikoto Misumi looked up and stared at Tomoya Aki with great interest.

He thought for a moment after hearing this: "Well... if the goal is to raise awareness about this matter and make people more cautious in the clinical application of drugs in the future, then this lawsuit is indeed necessary. However, this matter will put a lot of pressure on the bereaved family, and it seems that they are more angry about the death of their loved ones. To be realistic, it would be best to reach a private settlement with the hospital."

You can choose to have the injection or not. From a practical standpoint, the best outcome would be to reach a private settlement with the hospital.

At the same time, if we were to use this method, we could say it was to raise awareness of this issue. Drugs can save lives, but they can also kill them. Even if the allergy rate for lidocaine is low, it could potentially lead to the next Tadokoro Keiichi.