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  • Moharekar Case: Parents raise questions about baby’s death to Sapporo’s Tenshi Hospital

    Posted by Dr. ARUDOU, Debito on February 13th, 2008

    (revised February 14, 2008 at the Moharekar’s request)

    Hi Blog. Here’s a sad tale about the death of a baby while in the womb, and the unsatisfactory explanation, as far as the parents are concerned, given by a Sapporo medical care facility named Tenshi Hospital about what happened.

    Dr. Shubhangi MOHAREKAR and her husband Sanjay, Indian citizens who have been doctorate researchers at Hokkaido University for 9.5 years and 6 years respectively, were expecting to have their second child in Sapporo’s Tenshi Hospital (Sapporo-shi Higashi-ku Kita 12 Higashi 3 1-1, phone 011-711-0101).

    Up until 11th July 2007, their attendant doctor at Tenshi Hospital, a Dr, Oh-ishi, did not find any abnormality in the fetus. However, just 5 days later, i.e. on 17th July 2007, another doctor, Dr. Watari found abnormalities–the baby had congenital heart disease. On August 1, 2007, their child died in the womb. It was stillborn, despite repeated reassurances of fetal health from Dr Oh-ishi.

    I’ll let the Moharekars tell their own story in scans below, but they say the basis of their dissatisfaction is: 1) insufficient diagnosis and prenatal care by the Gynecology Department of Tenshi Hospital of their child’s condition from the start, 2) a sudden, unexplained change in the diagnosis of the fetus when the mother detected a change in its life signs, and 3) the ill-treatment from Tenshi Hospital they say they suffered after the stillbirth. Not only did they feel they were rebuffed by the head of the gynecology department of hospital, a Dr Yoshida (who hitherto spoke good English, but allegedly got upset at them and demanded they speak Japanese properly), they were told the hospital would not accept complaints–-and even charged them 210 yen after the death just to get an explanatory meeting with hospital director, a Dr Tsujisaki!

    For the record, the Moharekars are not after money or damages (they would of course prefer their 210 yen got refunded). They just want a full and proper explanation in writing from Tenshi for this apparent misdiagnosis. Not rebuffs and rudeness. They have never been able to meet Dr Oh-ishi again (she has apparently been transferred to another hospital).

    The Moharekars consider Gynecology Department of Tenshi Hospital to be negligent and irresponsible. They want to make sure that what they consider to be mental harassment will not happen to anyone else. The Moharekars are also aware that baby having congenital heart disease is not the hospital’s fault and impossible to change the situation anyhow, but this kind of problem could have been detected earlier using 3D/4D sonography. Early detection could have prepared the family for the emotional strain, expense, and logistical problems of surgery on the newborn.

    I have met them, and they said they may be contacted at their email address, included in page one of their letter below.

    Evidence follows. Arudou Debito in Sapporo

    LETTER OF COMPLAINT TO TENSHI HOSPITAL, DATED OCTOBER 24 2007. PAGE ONE OF TWO.
    moharekar001.jpg
    PAGE TWO OF TWO.
    moharekar002.jpg
    THE LETTER IS SIGNED AT THE BOTTOM BY TENSHI HOSPITAL DIRECTOR, DR TSUJISAKI, CERTIFIED AS WITNESSED.

    HOSPITAL CHARTS INDICATING ALL LIFE SIGNS WERE NORMAL FOR SEVERAL MONTHS UNDER DR. OH-ISHI. NO HEART DEFECT DETECTED.
    moharekar003.jpg

    DOCUMENT FROM TENSHI HOSPITAL WITH DIAGNOSIS OF HEART DEFECT, ACCORDING TO A DIFFERENT DOCTOR, DR WATARI.
    moharekar004.jpg

    LETTER FROM ATTENDANT HOSPITAL IN INDIA WITH RESULTS OF PHYSICAL EXAMINATION, SHORTLY BEFORE FETUS’S DEATH. HEART DEFECT DETECTED.
    moharekar005.jpg

    EXPLANATION FROM DR TSUJISAKI, PAGE ONE OF TWO.
    moharekar006.jpg
    PAGE TWO OF TWO.
    moharekar007.jpg

    BILL FROM THE HOSPITAL OF 210 YEN FOR A POSTMORTEM EXPLANATION FROM HOSPITAL DIRECTOR DR TSUJISAKI:
    moharekar008.jpg
    ENDS

    6 Responses to “Moharekar Case: Parents raise questions about baby’s death to Sapporo’s Tenshi Hospital”

    1. HO Says:

      The letter you labeled postmortem seems to be a letter form Dr. Watari to a doctor in Hokkaido University Hospital, because the date of the letter is July 20, twelve days before the baby’s death, its title is “letter for providing diagnostic information”, and the addressee of the letter is 先生御侍史 which is an address usually used between doctors. (check 侍史 in your dictionary.)

      I wonder what could have been done, if they had detected the disease earlier. If nothing could have been done, no one is to blame.

      –Sorry for overlooking that. Will make correction. Thanks. Debito

    2. icarus Says:

      Since none of us are medical specialists I did the first thing most people will do. I googled the topic of cogenital heart disease.

      From wikipedia:

      Before birth, an obstetric ultrasound scan may be used to screen pregnant women for signs of CHD in their unborn babies. This screening scan is often performed around 20 weeks of pregnancy when the fast moving structures of the fetal heart are large enough to be more easily imaged. If CHD is suspected, a mother will be referred for a fetal echocardiograph, which is a more detailed, diagnostic ultrasound scan by a specialist cardiologist. It is increasingly possible for specialists to screen for CHD as early as 14 weeks, if CHD is suspected from other factors, such as a family history.

      From Marchofdimes.com

      Congenital Heart Defects
      About 40,000 infants (1 out of every 125) are born with heart defects each year in the United States (1). The defect may be so slight that the baby appears healthy for many years after birth, or so severe that its life is in immediate danger.
      Heart defects are among the most common birth defects and are the leading cause of birth defect-related deaths (2). However, advances in diagnosis and surgical treatment have led to dramatic increases in survival for children with serious heart defects.
      …snip…
      What tests are used to diagnose heart defects?
      Babies and children who are suspected of having a heart defect are usually referred to a pediatric cardiologist (children’s heart disease specialist). This doctor will do a physical examination and often recommend one or more tests. These tests often include a chest X-ray, an electrocardiogram (which records heart rate patterns) and an echocardiogram (a special form of ultrasound that uses sound waves to take pictures of the heart).

      I’m not a doctor so I’m not even going to bother making a judgement on what was or wasn’t the proper treatment. According to both of these articles though, referrals to pediatric specialists is normal and that would answer the questions that Mrs. Moharekar had at the end of her letter concerning a transfer to another hospital.

      There is too much information here, in my opinion. There is the very tragic death of a baby and there is the issue of potential mistreatment by administrators in the hospital. These two issues need to be separated as nothing good can come of us probing into the medical treatment this couple received. Perhaps if someone is familiar with local policies they can recommend more official channels to go through to file a complaint about the hospital. As for potential mistreatment, more discussion should occur, but only after a statement has been made by the hospital.

      On a more serious note, I wanted to wish my heartfelt condolences to the Moharekars.

      –But a statement has been made by the hospital, no?

    3. icarus Says:

      –But a statement has been made by the hospital, no?

      I was thinking more in terms of a statement concerning the potential “bad behavior” or mistreatment that was the cause of the mental stress for the family. I’ve re-read the statement given by Dr. Tsujisaki a few times now and he only mentions issues related to the medical treatment of Ms. Moharekar and steps they took to examine the baby. I suppose you could read the last line – I believe the members of our staff at Tenshi Hospital had acted as reponsible doctors – as referring to mistreatment (mental not physical), but since Ms. Hoharekar makes no mention of poor treatment as a result of being a foreigner, I’m pretty sure the hospital is thinking of this in terms of a malpractice suit.

      This is why I feel it’s important to separate the two issues. On one hand we have what could be a very serious legal issue, and on the other hand, we have an issue that might be of interest to NJ when choosing a hospital in the area. Are you saying the two are related?

    4. John k Says:

      Like Icarus, I am no medical expert, my wife is however, and concurs.

      Your article has 3 points referring to this “case”. Noting the difficulty as posted by Icarus above, why is this being raised? I can imagine some local newspaper hack getting a story, but the purpose here escapes me…..it is also not in keeping with your obvious M.O.

      The only reason for the posting should be to offer our condolences to the family and hope it never happens to us.

      Anything else is just procedural and as such occurs all over the world in any hospital.

    5. TJJ Says:

      Tragedies sometimes can’t be helped. My condolences to the Moharekars.

    6. icarus Says:

      I still feel that this situation is extremely volatile and that this needs to be moved to a new location for more precise assistance. Is this situation about being NJ in Japan or dissatisfaction with medical services rendered?!

      The Tenshi Hospital is mentioned on the American and Australia consulate web sites as a reliable English speaking hospital in Sapporo, so my first suggestion is to get in contact with the Indian Embassy to see if they have any suggestions for approaching this.
      Here is the embassy information:

      http://www.embassyofindiajapan.org/

      Address of the Indian Embassy Japan
      2-2-11 Kudan Minami,
      Chiyoda-ku,
      Tokyo – 102-0074
      Japan
      Telephone: 00-81-3-32622391-97
      Fax: 00-81-3-32344866
      Email:indembjp@gol.com

      Also, I found an organization called the Indian JSPS Alumni Association that has links for assistance while living in Japan. Most of the information seems to be Tokyo-centered but I’m sure if you call the hot line you can get some additional information:
      Here is the JSPS homepage:
      http://www.indianjspsalumni.org/index.html

      The life page contains the phone numbers I mentioned:
      http://www.indianjspsalumni.org/life.html#3

      Particularly:
      Japan Helpline (24 hrs, toll free in Japan) 0120-46-1997
      Tokyo Medical Info Service 35285-8181
      Tokyo English Lifeline 5721-4347

      Debito, since you live in Hokkaido perhaps you have some other phone numbers available for Hokkaido?

      If anyone else has information that might help please include it to this list. I was looking for info about filing a formal complaint about a hospital but I was unable to find anything in English.

      Here is the contact information for the Sapporo City Hall Citizen Contact Center:
      Sapporo Citizen Contact Center
      For those with inquiries for City Hall, please feel free to call us. –
      Phone:011-222-4894 (outside of Japan, +81-11-222-4894)
      FAX:011-221-4894 (in Japanese and English)

      The city hall should have more information about what to do in this kind of situation. You might also consult a lawyer because that’s really where this is headed. You need legal advice and not assistance from random people on a blog. Even if this doesn’t involve money, you may need to be aware of your legal options.

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