I, Aki Tomoya, will not be a simp.

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Aki Tomoya also knew that he absolutely could not change Takagi's decision.

If you really want to help him, now is the time to offer reliable advice.

When it comes to conducting more thorough pathological autopsies, it is crucial to determine who should be entrusted with this task; a neutral and authoritative institution must be selected to carry it out.

And it has to be quick, otherwise, as is known, the bereaved family may choose to cremate the body.

"Are you interested in the forensic institute where I used to work?"

"You mean UDI? Is that okay?"

"It's a nationally recognized research institute, backed by the Ministry of Health, Labour and Welfare and the National Police Agency. Besides, when I was there, I had already dealt with the university hospital during the MERS incident at Toyo University Hospital. There's no need to worry about the university hospital putting pressure on them."

To be fair, Aki Tomoya, who spent time there, knows better than anyone else.

At least during his time, the director of a university hospital was brought down because their investigation by UDI revealed the fact that the MERS virus had leaked.

Similarly, he has experienced many cases of medical disputes and medical malpractice, especially those involving his contemporary Suzuya, whose father was also indirectly affected.

If we hand it over to them, we should be able to get a fair answer.

"But you have to be quick, you have to persuade the bereaved family as soon as possible to allow them to have a more thorough forensic autopsy."

Instead of having a hospital perform the autopsy, a third-party forensic medical institution should conduct a pathological autopsy to determine the cause of death, which would be more convincing.

Did hemoptysis lead to respiratory and cardiac arrest?

This is just the hospital's statement; the affiliated hospital of Southeast University has not provided a clear explanation regarding the true cause and effect.

……

Following Aki Tomoya's advice, Takagi secretly contacted the deceased's family, informing them that there were other hidden circumstances surrounding the death and suggesting that they undergo a more thorough pathological autopsy.

As a semi-collaborator, Aki Tomoya contacted UDI after a long time, explaining in advance what he knew.

A week later, UDI provided Aki Tomoya, who had been concerned about the matter, with an appraisal report that they could disclose to him.

"Male, 45 years old... A blood clot is attached to the left anterior wall of the esophagus 12-17cm below the epiglottis... A hard object can be felt on the corresponding left side of the esophageal wall... Upon dissection of the esophagus, necrosis and erosion of the esophageal wall at the site of the blood clot attachment are observed, and the edges of the remaining esophageal rupture are blunt... On the left wall of the descending aorta, 7cm below the aortic arch, there is a 2.0cm x 1.5cm rupture in the intima, with irregular edges and a hard texture. Within the dissection at the rupture site, there is a 6cm x 3cm x 3cm cystic mass containing a large amount of blood clots..."

During his lunch break, Aki Tomoya stayed in the department and looked at the reports sent to him via email.

He stared intently at the appraisal report, deep in thought.

"Aki-kun, is this an autopsy report?"

Suddenly, a female voice rang in my ears; Maki Nishikino had returned sometime earlier.

"Just randomly picked a report to look at when I have nothing to do..."

"Hmm...did you notice anything?"

She didn't read the report carefully; she just glanced at it and read a little bit.

The report was brief, so Aki Tomoya was left to analyze it based on what he knew.

"Aortic atherosclerosis, aortic dissection, aortitis, subacute aortic dissection rupture, esophagitis, esophageal wall necrosis, post-aortic dissection stent placement..."

He paused for a moment, then continued, "The esophageal wall at the site of the blood clot in the esophagus was necrotic and eroded, with a residual rupture in the esophagus. At the corresponding aortic rupture site, there was a 6xcm x 3cm x 3cm cystic mass within the dissection. Based on the pathological changes, it is considered that the aortic dissection compressed the esophagus for a long time, causing degeneration and necrosis of the esophageal wall, which compressed the recurrent laryngeal nerve, resulting in vocal cord paralysis. Eventually, the tumor continued to enlarge, broke through the degenerated and necrotic esophageal wall, and ruptured, causing bleeding, followed by hematemesis, and finally, massive hemorrhage led to respiratory and circulatory failure and death."

"Cases of treatment failure?"

"You can say that."

"That's a rather ambiguous statement!"

Nishikino Maki, unaware of the hidden story, chuckled.

Aki Tomoya shook his head slightly, then silently deleted the email.

It's not that the treatment failed, but rather that the attending physician simply didn't consider the possibility of aortic dissection recurrence, which led to the patient losing their chance of survival.

Chapter 453 That's pretty bold!

The true cause of death was aortic dissection rupture that pierced the esophagus, causing massive bleeding that led to respiratory and circulatory failure.

The hospital diagnosed the patient with massive hemoptysis followed by respiratory and cardiac arrest.

The former conclusion was drawn from a more thorough pathological autopsy, while the latter was reached after the patient died in the hospital and was attributed to laryngitis, without being linked to aortic dissection.

The Department of Otolaryngology at Southeast University would offer the following explanations: first, a more thorough pathological autopsy was not performed; second, they may have realized the cause of the massive bleeding at the last moment.

The history of aortic dissection that they had been ignoring.

“Even after surgery, there is still a possibility of re-rupture. When it ruptures again, the patient’s left recurrent laryngeal nerve and esophageal wall are compressed. The body has already sent out dangerous signals and chooses to seek medical attention. However, after being informed of the medical history, the patient is only treated for laryngitis and vocal cord paralysis. In the end, the patient suffers massive bleeding and respiratory and circulatory failure. Such a misdiagnosis is terrible, right?”

"Delete the email completely," Aki Tomoya casually said to Nishikino Maki, who was standing next to him.

Whether it was due to the ENT doctor's lack of understanding of aortic dissection, or the doctor's arrogance in thinking they had everything under control, the fact remains that the patient died.

After the bereaved family learns the true cause of death, they will be held accountable for medical malpractice.

This is an obvious development.

When bereaved families learn that the patient had the opportunity to receive proper treatment, but the past medical history was not taken seriously, leading to an irreversible outcome, they may choose to take the attending physician to court simply out of anger.

"That was indeed terrifying..."

What was clearly a tragedy that could have been averted with a little more care and caution has now become irreversible, resulting in the patient's death.

Although she didn't know exactly what had happened, she gleaned some key information from what Aki Tomoya said.

Misdiagnosis or missed diagnosis occurred because the attending physician failed to take the patient's past medical history seriously.

Ultimately, the patient was only diagnosed with laryngitis and vocal cord paralysis, thus missing the best opportunity for treatment.

If the problem can be detected as soon as possible and surgery can be arranged, the patient still has a chance to survive.

But now, that patient is a cold corpse lying on the autopsy table.

At the same time, Nishikino Maki noticed something different about Aki Tomoya's face compared to usual.

It's strange, yet it's hard to pinpoint exactly how strange it is.

At this moment, Aki Tomoya was no longer just thinking about the faults in this medical accident, but also whether his good friend Takagi Sai would really go and act as a witness for the bereaved family, standing against the university hospital if the lawsuit really went on.

Doing so is absolutely the right thing to do, the right thing to do, and it is full of justice.

As the person involved, Takagi had suggested that the attending physician re-examine the aortic dissection, knowing that the attending physician was aware of the patient's medical history.

This point was rejected, and it was quite crucial; it could very well be a fatal flaw for the University of Tokyo Affiliated Hospital.

It's one thing if the attending physician lacks knowledge about aortic dissection, but the key issue is that others have reminded him, yet the attending physician still insisted on going his own way, so there's really nothing more to say.

Takagi's testimony will be a crucial element, likely determining the direction of the verdict.

Therefore, Takagi is indeed a suitable candidate and a necessary part of representing the side of justice.

But if he does that, regardless of who wins the lawsuit, he won't be able to stay in the university hospital any longer.

At least in Tokyo and even throughout the Kanto region, university hospitals would not welcome someone like that.

It is very likely that he will be transferred to the countryside.

Aki Tomoya is worried about Takagi, but not about his future prospects.

Because Takagi's future is none of anyone else's concern.

At worst, this guy will return to Kyoto early to inherit the family business.

His concern was that Takagi would be bullied at the university hospital, because she would be completely isolated after becoming a patient for the bereaved family of a deceased patient.

This outcome was inevitable after Takagi decided to become a witness and testify for those outside.

The incident occurred in the Department of Otolaryngology at the University of Tokyo Affiliated Hospital, but once it is exposed, it will affect the reputation of the entire University of Tokyo Affiliated Hospital.

The university hospital, a famous white tower, represents the authority of the Japanese medical community, and is under the watchful eyes of countless people.

"You must hold on..."

Aki Tomoya already had a prediction in mind.

Takagi will definitely choose to stand against the university hospital. Since he has decided to speak out on this matter, he will definitely not go back on his word.

And he will suffer unwarranted criticism for this decision.

……

A week later, news of the lawsuit against the University of Tokyo Affiliated Hospital appeared on the front page of newspapers and was broadcast on television.

One particularly striking piece of content was something that Aki Tomoya and Mashima couldn't ignore.

Inside the University of Tokyo Hospital, a medical resident will act as a witness to provide testimony for the plaintiff.

In other words, it's about publishing negative content targeting one's alma mater's hospital.

Just like Aki Tomoya thought, after learning the true cause of death, the bereaved family filed a lawsuit demanding a determination of medical malpractice.

The University of Tokyo Affiliated Hospital also took a very tough stance. They had no choice but to be tough because the deceased's family was determined to sue them and had no intention of making any attempt at a private settlement.

The University of Tokyo Affiliated Hospital probably never imagined that someone inside would help someone outside, thus causing trouble for their own people.

"That's Takagi-kun, isn't it!"

Majima said to Aki Tomoya with concern.

The newspapers and television stations have explained the whole incident clearly; it was just a case of aortic dissection re-rupture after surgery being misdiagnosed as acute laryngitis and vocal cord paralysis.