Japan hospital sued after dementia patient swallows 12cm key

Some have voiced concern that hospitals worried about accountability would stop taking in dementia patients

A hospital in Japan is facing a negligence lawsuit after an elderly patient was discovered to have swallowed a key in the ward and later died, sparking worries about dementia care in the rapidly ageing country.

Kenichi Onishi, 82, was admitted to the Osaka hospital in January 2022 after breaking his chest bone in a fall. A few months later, in September, he complained about throat pain and was diagnosed with Covid-19.

A chest X-ray, however, showed a large shadow in his throat, which was later identified as a 12cm (4.7 inch) key with a keychain attached.

“At first, I imagined it was a small key that he accidentally swallowed,” his 55-year-old son said, according to a Yomiuri TV broadcast on Wednesday. “But when I saw it, I was shocked. It was heavy and oddly shaped, and I could only think how much my father must have suffered.”

The metal key, which was on a goose-shaped chain with sharp edges, was a “clothing key” used to secure a special jumpsuit designed to prevent patients from tampering with medical equipment or diapers, Onishi’s son said. His father, who had been diagnosed with mild dementia, was wearing the suit during his stay.

Onishi, who ran a printing business in Osaka, died a few days after the X-ray was taken and the key was removed.

A year after Onishi’s death, the hospital told the family that the key was likely left on a table near the patient’s bed and he might have accidentally swallowed it.

The family believes that the key directly caused life-threatening complications, including aspiration pneumonia, which ultimately led to his death.

“The death certificate lists Covid-19 as the cause of death, but I believe he could have lived longer had he not swallowed the key,” the son said. “His Covid-19 condition wasn’t that severe, and the hospital’s explanations have kept changing. They need to reconsider the gravity of being entrusted with human lives.”

In April, the family filed a negligence lawsuit with the Osaka District Court against the hospital, demanding 16.5 million yen (US$114,400) in damages for failure to properly manage the key.

While the hospital admitted in the 2023 documentation provided to the family that it mishandled the key, it said there was no connection between the metal key’s ingestion and Onishi’s death. It declined further comment, stating that relevant staff were unavailable.

The family’s legal action has sparked debate over the hospital’s accountability in looking after dementia patients.

“This is basically a death sentence. If we let lawsuits like this succeed, no facility will accept dementia patients any more. And guess who’ll suffer most in the end?” an online comment on Yomiuri’s coverage read.

Government data showed Japan’s elderly population reached a historic peak of 36.25 million last year, with people aged 65 or older making up nearly one-third of the nation’s total population.

In 2015, Japan had nearly five million citizens living with dementia. Projections indicate that by this year, one-fifth of the population will be affected by this condition, growing to one-third by 2060, researchers from Kanagawa University of Human Services wrote in the academic journal Global Health Medicine.

Last year, 18,121 people with dementia went missing, local media reported on June 5. Of them, 491 were found dead and 273 were still missing, raising concerns about dementia care in the country.