- a number written correctly, a box checked wrong. What happened?
カートのアイテムが多すぎます
ご購入は五十タイトルがカートに入っている場合のみです。
カートに追加できませんでした。
しばらく経ってから再度お試しください。
ウィッシュリストに追加できませんでした。
しばらく経ってから再度お試しください。
ほしい物リストの削除に失敗しました。
しばらく経ってから再度お試しください。
ポッドキャストのフォローに失敗しました
ポッドキャストのフォロー解除に失敗しました
- a number written correctly, a box checked wrong. What happened?
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ナレーター：
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著者：
概要
A single night in Hsinchu turned a five-thousand-case success story into a moral and procedural crisis when a lab value of 56.7 was recorded correctly but the HIV box was checked "negative" twice - and five transplants proceeded. How could one unchecked step let five people receive organs from an HIV-positive donor, and who bears responsibility: the system or its architect?
In this episode, we trace the origins of Taiwan's organ transplant system, the events of August 23-25, 2011, and the missing safeguards that allowed a phone call and a checkbox to determine fate. What did the registry lack, and what price was paid for that omission?
Date: August 23-25, 2011
Location: Hsinchu City, Taiwan
Person: Ko Wen-je
Event: Five organ transplants following a donor with reactive HIV test recorded as negative
Case: Organ Donation and Transplantation Registry Center entry error
- The laboratory reported an HIV test value of 56.7 and described the result as reactive.
- The transplant coordinator wrote "56.7" correctly but checked the HIV box as "negative" and repeated "negative" twice.
- More than 5,000 cases had been processed by Taiwan's system without a catastrophic failure prior to 2011.
- The transplant teams retrieved heart, lungs, liver, and both kidneys and completed five surgeries by the early hours of August 25, 2011.
- The system did not require a mandatory physician review between receiving lab results by phone and entering them into the registry.
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