Medical malpractice litigation related to choking accidents in older people in Japan.

Abstract

To analyse malpractice litigation cases in Japan and identify the factors related to choking accidents in older people. Choking while eating is common in older people and has potentially severe consequences. This study analysed court decisions related to choking accidents occurring in Japan between 2000 and 2015 that involved the death of an older person or permanent severe choking-related injury. A database of court decisions (n=23) was constructed according to patient and caregiver characteristics, and nursing services. An analysis was performed on caregiver liability, and to identify factors related to choking accidents. The court ruled that the caregiver was liable in 10 of the 23 cases. Liability was related to appropriate food choices, failure to monitor of eating or the non-performance of resuscitation after an accident. Prior knowledge of aspiration (P<.001), inappropriate assistance during the meal (P<.001), and inappropriate emergency treatment (P=.028) were more likely to be present in cases in which caregivers were judged liable than in those in which they were not. Lack of appropriate assistance during the meal was the factor most strongly associated with a court ruling of caregiver liability for choking accidents in older people.