• 의료법학
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• 제19권2호
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• pp.3-40
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• 2018

예전부터 일본에서 의료사고가 형사사건으로 취급되는 경우는 드물었다. 하지만 요코하마시립대학병원과 같은 중대한 의료과오가 발생한 이후 검사가 의료과오를 기소하는 태도를 보이고 있다. 의료사고는 의료관계자간 역할분담의 형태가 과실 인정에서 중요한 하나의 요소가 된다. 요코하마시립병원사건에서는 환자의 동일성확인에 관하여 의료관계자 사이에 역할분담이 확립되지 않은 경우에는 관계자 전원이 환자의 동일성을 확인하여야 할 의무가 있다고 하였다. 또 사이타마 의과대학병원사건에서는 치료에 신중할 필요가 있는 중대한 증례에 관해서는 그 증례를 담당하는 주치의 뿐 만 아니라 대학병원의 과장도 치료방침에 관하여 확인할 의무가 있다고 하였다. 현립 오오노병원사건에서 무죄판결이 내려진 이후는 형사소추에 신중을 기할 필요가 있다는 목소리가 강해지고 있다. 이러한 상황 속에서 후생노동성은 의료사고방지를 위해 의료사고조사제도를 도입하여 의료사고에 제3자기관에 의한 검증의 강화를 도모하고 있다.

• Safety and Health at Work
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• 제10권3호
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• pp.305-313
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• 2019

Background: The oil and gas industry is one of the riskiest industries for confined space injuries. This study aimed to understand an overall picture of the causal factors of confined space accidents through analyzing accident reports and the use of a qualitative approach. Methods: Twenty-one fatal occupational accidents were analyzed according to the Human Factors Analysis and Classification System approach. Furthermore, thirty-three semistructured interviews were conducted with employees in different roles to capture their experiences regarding the contributory factors. The content analyses of the interview transcripts were conducted using MAXQDA software. Results: Based on accident reports, the largest proportions of causal factors (77%) were attributed to the organizational and supervisory levels, with the predominant influence of the organizational process. We identified 25 contributory factors in confined space accidents that were causal factors outside of the original Human Factors Analysis and Classification System framework. Therefore, modifications were made to deal with factors outside the organization and newly explored causal factors at the organizational level. External Influences as the fifth level considered contributory factors beyond the organization including Laws, Regulations and Standards, Government Policies, Political Influences, and Economic Status categories. Moreover, Contracting/Contract Management and Emergency Management were two extra categories identified at the organizational level. Conclusions: Preventing confined space accidents requires addressing issues from the organizational to operator level and external influences beyond the organization. The recommended modifications provide a basis for accident investigation and risk analysis, which may be applicable across a broad range of industries and accident types.

• 자동차안전학회지
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• 제11권3호
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• pp.43-47
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• 2019

Developed countries are operating an in-depth database in motor vehicle crashes nationwide. They do not rely solely on the police investigation reports that are responsible for motor vehicle crashes in each country but are developing into a useful database by expanding the categories of data through more indicators addition. In Korea, after implementing comprehensive measures to reduce traffic accident deaths in 2013, the medical centers participated in establishing the actual accident investigation system, which was called as the Korean In-Depth Accident Study (hereinafter KIDAS). This KIDAS database included more in-depth indicators as the types of accidents, types of vehicles, the injury severity, adequacy of safety devices, seating position of passengers. Although there are difficulties in establishing an actual accident investigation system including data collection due to various restrictions, if the system can cooperate with each other such as medical centers, insurance companies, police, fire and rescue services, towing companies, and car repair shops in the future, It would be expected to contribute to the development of safer vehicle, treatment system and traffic safety policy that lower the injury severity of occupant in the event of a motor vehicle crashes.

• 수산해양교육연구
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• 제27권5호
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• pp.1211-1220
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• 2015

There exists dead zone from the aspects of health equity and health medical equity for maritime personnel. They could not have been benefited from disease prevention and health promotion in comparison with shore personnel due to the restricted medical accessibility caused by long voyage ship operation. Furthermore, the system of health management and medical assistance for maritime personnel is insufficient, the continuous health monitoring system does not exist, nor health diagnosis system, maritime industrial accidents and occupational disease control systems are adequate. The International Maritime Organization and the International Labour Organization recommend their Member Governments to take necessary measures in the management of seafarers' health and diseases through conducting continuous and systematic investigation. Thus, this study intends to propose action strategy and tasks for introducing marine telemedicine system aiming to provide seafarers with health management service for the years to come. The conclusions of this study can be given as follows. First, it is required that a systematic medical service system needs to be provided to promote seafarers' health. Second it is recommended to establish the marine telemedicine system incorporating U-Health technology. Third, it is necessary to revise the relevant laws and regulations to introduce the marine telemedicine system. Fourth, it is also necessary to provide various assistance system at the national level in the furtherance of global marketing of marine telemedicine system.

• 대한수사과학회지
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• 제3권1호
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• pp.5-24
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• 2008

The necessity for the investigation of death occurred in military services has no differences to the death of civilians. But the death of military service members under the Universal Conscription System in Korea has special considerations because of hard accessibility by the bereaved family and closed environment of the army. The analysis of the death occurred during military service was carried out and the advanced death investigation system to prevent the death was proposed to prevent the declination of fighting spirit and efficiency and also to restore the solid support by the people. The deaths in the period 1995~2006 were 330 persons in 1995, 359 persons in 1996 and were decreased to 135 persons in 2006. The death caused by safety accidents including vehicle accident, drowning, fall were 56% and by military crimes including suicide, arms, homicide were 44%. The numbers of suicides were 108 persons in 1995 and were decreased to 79 persons in 2006. The numbers of suicides were decreased constantly, but the ratio of suicide to death were increased, so the suicide prevention is more important. The autopsy ratio was increased to 51.5% in 2005 and was much higher compared to the ratio for civilians. The main reasons of complaints by the bereaved family were for regaining reputation, death in harness and reinvestigation of death. The proposals for the advanced death investigation system were as follows. The unnatural deaths including the obvious accidental deaths and homicides have to be defined by the rules. The human resources to perform the autopsy can be supported by the forensic pathologists from medical school. The special training and quality assurance programs are needed for the crime scene investigator. To regain the impaired reputation from the suicide and to support the bereaved family has to be discussed by the government.

• 시큐리티연구
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• 제17호
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• pp.255-276
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• 2008

민간조사업의 주체는 다양한 서비스를 제공한다는 측면에서는 자연인, 법인 모두를 허가해야 되지만 공익성을 확보라는 측면위해서는 경비업법과 마찬가지로 법인으로 해야 할 것이며 허가제로 시행해야 할 것이다. 민간조사업 도입범위는 개인과 기업을 대상으로 하는 가출인 미아에 대한 소재 확인 조사, 특정인이나 특정집단의 신원확인, 습관, 행동방식, 동기, 소재파악, 친자확인, 교제, 거래, 명성, 성격 등을 조사, 실종된 자 또는 귀속되거나 포기된 재산의 소유자 및 부동산의 상속인 등의 소재확인 조사, 분실 또는 절취 된 재산의 행방조사, 화재, 명예훼손, 비방, 손해, 사고, 신체장애, 부동산이나 동산에 대한 침해의 원인 조사, 교통사고, 보험사고, 의료사고 등 각종사고에 대한 조사, 저작권침해 등으로 규정할 수 있다. 자격시험에 있어서는 25세 이상이 바람직 할 것이며, 1차 시험 면제자는 타 자격증과의 형평성을 고려하여 관련분야 경력 10년 이상인 자로 해야 할 것이다. 감독기관에 있어서는 민간조사업과 프랑스(경찰), 일본(공안위원회) 등 다수의 국가들이 경찰기관이 감독기관인 점과 민간조사업 업무의 성격이 경찰과의 관련이 높다는 점을 고려하면 경찰청이 감독기관이 되어야 한다. 벌칙에 있어서 특히, 개인정보에 대한 관리를 명확히 하여 고객의 기본권 침해를 방지해야 한다.

• 자동차안전학회지
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• 제8권3호
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• pp.10-15
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• 2016

The purpose of this study is to evaluate the injury mechanism of facial injury related to an air-bag's deployment in occupant motor vehicle accident (MVA) by using Hospital Information System (HIS) and reconstruction program, based on the materials related to motor vehicle accidents. Among patients who visited the emergency department of Wonju Severance Christian Hospital due to motor vehicle accidents from August 2012 to February 2014, we collected data on patients with agreement for taking the damaged vehicle's photos. After obtaining the verbal consent from the patient, we asked about the cause of the accident, information on vehicle involved in the accident, and the location of car repair shop. The photos of the damaged vehicle were taken on the basis of front, rear, left side and right side. Damage to the vehicle was presented using the CDC code by analytical study of photo-images of the damaged vehicle, and a trauma score was used for medical examination of the severity of the patient's injury. Among the 309 patients with agreement for an investigation, thirty five (11.3 %) were the severe who had ISS over 15. And also, sixteen (5.2%) derived from the reconstructed data (maximum collision energy, maximum acceleration, delta V) by PC-Crash. As a result, ISS including the facial injuries was affected by the condition. It was high when the number of crash extent, the safety belt was not fastened, and the seating position of occupant and the direction of collision is same. For accurate analysis of the relationship between occupant injury and vehicle damage in MVAs, build-up of an in-depth database through carrying out various policies for motor vehicle accidents is necessary for sure.

• Journal of Multimedia Information System
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• 제7권2호
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• pp.147-156
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• 2020

The author Nakajima was involved in the field of disaster communications and emergency medical care as guest research scientist at the Fukushima Nuclear Accident Independent Investigation Commission established by the National Diet of Japan and reviewer of the Commission's report, and Kurokawa was the chairman of this Commission. Looking back over a decade, we are on the liability issue of bureaucrats and telecom operators, so it's becoming clear what was hidden at the time. The battery of NTT DoCoMo's mobile phone repeaters had a capacity of only about 24 hours, and communication failures increased after one day. The Government also failed to issue an announcement of "Vent from reactor" under the Telecommunications Act Article No. 129. This mistake lost the opportunity to use the third-party telecommunications (e.g. taxi radios). Furthermore, as a result of LASCOM (telecommunications satellite network for local governments via GEO) and a variety of unexpected communication failures, the evacuation order "Escape!" could not be notified to the general public well. As a result, the general public was exposed to unnecessary radiation exposure. Such bureaucratic slow action in emergencies is common in the response to the 2020 coronavirus.

• 한국산학기술학회논문지
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• 제11권6호
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• pp.2078-2087
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• 2010

본 연구는 수술환자의 타지역 의료이용과 관련된 요인을 규명하기 위하여 2004년부터 2006년도의 퇴원손상 환자조사뿐 아니라, 인구센서스 및 보건의료자원 실태조사자료를 이용하여 교차분석, 로지스틱 회귀분석을 실시한 결과 다음과 같다. 첫째, 수술환자의 의료이용은 수도권 중심으로 집중화 현상이 뚜렷하다. 이를 개선하기 위해서 정부에서는 의료기관 및 병상수를 공급하는 일 뿐만 아니라 의료의 지역화를 위해 지방에서의 의료의 질적 수준을 올리는 정책이 필요하다. 둘째, 눈 및 부속기 질환 및 암환자의 타지역 수술률이 높으므로 질병에 따른 의료의 지역화를 위한 특정 질환의 지역화 정책추진이 요구된다. 셋째, 산재환자 수술환자의 타지역 진료율이 시간이 갈수록 증가하므로 손상환자를 위한 지역화 정책도 필요하다 할 것이다.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.113-118
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• 2007

Purpose: The purpose of this work was to describe the results of treatment for motor vehiclerelated crushing injuries among children and adolescents under sixteen years in Korea. Materials and Methods: A retrospective analysis was conducted of data from children who were under sixteen year and injured foot by motor vehicles. Cases were documented 1) age at the time of injury, 2) injured site, 3) the area of accident, 4) the kind of vehicle, 5) associated injuries, 6) methods of treatment for soft tissue reconstruction and 7) complications. The relationships between the area of accident and associated injuries, and the kind of vehicle and associated injuries were analyzed using Chi-square test and Fisher exact test. Results: There were 97 children who were 15 year and younger. The mean age was 7.4 years, and 65% were boys. The left foot was more dominant side of injury (57%). Seasonal variation was seen with the number of injuries peaking during the summer (43%, p<0.05). Among the vehicles, 78.3% were the large vehicles (bus, truck or van). The where of accident was more frequent at an alley or less than two lanes of traffic. But, the relationships between the place of accident and associated injury or the kind of vehicles and associated injury were not statistically significant. The associated injury were fracture or dislocation (23 cases, 35.9%), injury of tendon (21 cases, 32.8%). There were amputation or disarticulation of foot in 8 cases (8.2%) and post-traumatic deformities such as flatfoot, hindfoot varus or valus deformities by tendon injury in 7 cases (7.2%). Conclusion: More than 50% of crushing or degloving injuries of child's foot by traffic accidents happened in boys between 5 to 9 years old. The associated injury was unrelated with size of vehicles or accident place at the time of accident. But, even though foot injury happened in an alley or one lane by small vehicles, child who hurt feet by car need thorough investigation about associated injury. If a surgeon keep in mind and treat child to associated injury necessarily, can minimize complication. Microsurgical reconstruction for soft tissue defect was prior to other methods.