शैडोइंग अभ्यास: The Killer Nurse Who Poisoned Patients | Ayumi Kuboki Case - YouTube के साथ अंग्रेजी बोलना सीखें
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Between early July and late September 2016, 48 patients died at Oguchi Hospital in Yokohama, Japan.
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Between early July and late September 2016, 48 patients died at Oguchi Hospital in Yokohama, Japan.
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For a long-term care ward, that's not necessarily alarming.
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There are plenty of elderly and terminally ill patients receiving care there.
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But 48 in around three months, including five in a single day in late August and four in a single day in early September,
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was enough to make some of the staff uneasy.
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But it wasn't enough to call the police.
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Not yet.
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However, it would turn out that not all of these deaths were of natural causes.
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Some of the patients were given a helping hand.
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What finally broke the case open wasn't a tip-off.
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It wasn't a confession.
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It wasn't even a body.
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It was actually a completely accidental discovery.
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This is the case of the Oguchi Hospital murders.
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September 20th, 2016, a nurse on the fourth floor of Oguchi Hospital was tending to a patient whose condition was rapidly deteriorating
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when she noticed that the liquid in his IV bag was half empty, but also foaming off.
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That shouldn't happen.
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The IV solution in question never creates foam.
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She brought it to the doctors.
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They examined it and found the solution had been contaminated with diametol, a disinfectant used throughout the hospital.
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It wasn't a small amount, it was enough to kill.
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This was serious.
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They checked every IV bag on the ward.
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Several others had been pierced through their protective filters with a fine needle, small enough that the hole was almost invisible,
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but large enough to inject disinfectant into the drip.
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The patient who had already received half of the contents of the poisoned drip bag, Nobuo Yamaki, 88 years old, died that same day.
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His 88-year-old roommate, Soso Nishikawa, had died two days earlier.
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Autopsies were performed on both men.
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Both men had traces of disinfectant in their bodies.
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They had been poisoned.
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But who had done this?
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Before we dive into that, you need to understand what was already happening on that ward before the deaths.
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The fourth floor of Oguchi Hospital had been a difficult place to work for some time.
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Nurses were clashing with each other.
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There were complaints of gossiping, arguments over patient care, and instances of staff yelling at patients in front of their families.
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Multiple nurses had resigned over accusations of verbal abuse and neglect.
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The ward had a reputation for having an internal tension that management hadn't resolved.
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Then, starting a few months before the first confirmed murder, a series of strange incidents occurred on the ward.
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Patient records went missing, nurses' uniforms were found torn, items were being stabbed with needles,
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drinks left at the nursing station were spiked with foreign substances, and nobody knew who was behind it.
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The harassment was never resolved.
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It escalated.
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What no one realized at the time was that by July, the poisoning of the IV bags had started.
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In the months before the poisoned IV bags were discovered, the Yokohama City Council had received a series of complaints about these incidents at Oguchi Hospital.
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The city did not investigate them in detail.
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After it was found that patients had been killed, the city set up a third-party verification committee to figure out why.
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The committee's conclusion, delivered in March 2017, was striking.
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Under Japan's Medical Care Act, the hospital had no obligation to report any of this to the city.
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The city had no authority to inspect or instruct the hospital.
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The complaints had into a gap in the system.
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The hospital director admitted he initially believed the problems could be handled internally.
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By the time he contacted the police, three people were already dead.
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The police were called on the same day that the poison ivy bags were discovered.
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What followed was nearly two years of painstaking detective work.
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It was incredibly difficult to discern who was guilty.
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The core problem was the disinfectant.
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It was used all over the hospital and everyone had access to it, so this alone didn't help narrow down the suspect pool at all.
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And the bodies, most of them, were already gone.
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Japan has one of the world's highest cremation rates and families often move quickly from death to cremation.
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Of the 48 deaths that occurred that summer, many of the bodies had been cremated before anyone knew that there was a problem to investigate.
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The police acknowledged publicly
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that they might never be able to establish the cause of every suspicious death that occurred on the ward.
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But still, the investigators went through everything they could.
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They took the hospital's entire disinfectant inventory.
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They analyzed the uniforms of every nurse who had worked on that ward.
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Only one uniform came back positive for traces of the disinfectant that had been used to poison the patients.
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It belonged to a nurse named Ayumi Kuboki, and it was concentrated around her pocket.
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The evidence was weak, very weak, but it was something.
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Then came the camera footage.
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On the nights immediately after the tampered backs were discovered, the police installed security cameras throughout the ward.
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Footage from those cameras showed Kuboki walking through the hospital during a night shift, carrying a drug she had not been assigned to administer.
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She was moving through areas she had no reason to be in.
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And then one of her colleagues came forward with information.
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He told the police he had personally witnessed Kubo-ki enter the room of a patient she wasn't assigned to.
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Within minutes of her leaving, the patient's condition sharply deteriorated, and ultimately, the patient died.
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None of this was enough.
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The disinfectant was everywhere.
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Suspicious behavior wasn't proof.
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The colleague's account was circumstantial.
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Kuboki had quit Oguchi and moved on to a job at a care facility in Kanagawa.
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She had denied any involvement with the killings to every reporter who reached her.
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By late June 2018, almost two years after the deaths, the Kanagawa Prefectural Police decided they had gone as far as the physical evidence would take them.
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They brought her in for voluntary questioning.
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Kuboki, who had spent two years denying everything, broke.
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She confessed to injecting diametrol into the IV bags of at least 20 patients.
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She was arrested on July 7th,
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2018, on suspicion of Sozo Nishikawa's murder and re-arrested over the following weeks for the murders of Nobuo Yamaki and Asai Okitsu.
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But who was Ayumi Kuboki and what drove her to kill so many people?
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Ayumi Kuboki was born in 1987 and grew up in Ibaraki Prefecture.
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She qualified as a nurse in 2008 and worked at another hospital before joining Oguchi in 2015.
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Her early career was difficult in specific ways.
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She was competent at routine work, but struggled when situations required quick improvisation.
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She kicked a hole in her dormitory wall as a result of stress.
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She was rotated through wards, rehabilitation, disabled care, and eventually an affiliated elder care facility,
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where a patient died during her shift and she watched a colleague get shouted at by the grieving family.
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By 2014, she was in psychiatric care for depression, overdosing on sleeping pills and taking leaves of absence.
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But it seems that she was able to keep her mental health struggles hidden from her peers.
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One former co-worker said she was considered competent, but she was the kind of person who was hard to figure out.
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You never really knew what she was thinking.
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After she moved to Oguchi, she also largely flew under the radar.
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She showed up, she did her job.
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She didn't seem to cause any problems at all.
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But on the inside, she was unhappy.
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In June 2016, three months before the first confirmed murder, Kuboki called her mother from the hospital.
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She told her about the slashed aprons, the missing charts.
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She said, it's scary, maybe I should quit.
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Her mother initially agreed.
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Then she said, wait until you get your bonus, then quit.
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Kuboki stayed and that decision would leave at least three people dead.
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Kuboki found something about her job unbearable.
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That something, it turned out, was a specific part of what nurses on that ward were expected to do.
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When a patient died during a nurse's shift,
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it was that nurse's responsibility to sit down with a family to break the news and to be present for their grief.
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Kuboki found this troublesome.
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That's the word she used when police asked her about it.
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Troublesome.
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She told investigators, I hated seeing the rapid deterioration in their condition.
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I did not want them to die during my shift.
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It was troublesome and difficult to explain to their family members.
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So she found a way to make sure she never had to.
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What Kupuki did was draw diametrol into a syringe, then use a fine needle to pierce the protective filter on a patient's IV bag,
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the rubber-sealed stopper designed to keep the fluid sterile and inject the poison into the bag.
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The patient then received it slowly through their IV line, along with whatever medication they were supposed to be receiving.
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The timing was deliberate.
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She told police she administered the disinfectant between 3pm and 4.55pm,
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the shift changeover period when nurses were occupied with handover briefings.
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Her colleagues were busy, and so nobody was watching.
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In the case of Sozo Nishikawa, she is believed to have poisoned his drip when she arrived early for a scheduled night shift.
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He was confirmed dead at 7pm, so the day nurse, not Kuboki, was the one working.
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The day nurse broke the news to his family.
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That was Kuboki's logic, to poison them on her time, let them die on someone else's.
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She told investigators she targeted patients she believed were already near death, patients who she thought would die during her shift anyway.
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Ayumi Kuboki was arrested on July 7th, 2018.
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She was 31 years old.
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After her arrest, she gave interviews to multiple TV stations and newspapers.
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And then, while in custody, she sent handwritten letters to media outlets denying everything.
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She said she was shocked by the crimes.
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She expressed sympathy for the victims and their families.
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She claimed she hadn't noticed anything unusual during her shifts.
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And she called the murders heinous.
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She had confessed her guilt to the police, but outwardly, she played the role of an innocent woman.
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Eventually, she retracted the statements she'd made in the letters.
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She admitted that the confessions she'd made were true.
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Her motive, she said, was exactly what she had first told investigators.
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She didn't want to be on shift when patients died.
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She found explaining deaths to families troublesome.
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But psychiatrist Tamami Katada, who analyzed Koboki's psychology, suggested the motive may have run deeper than an aversion to inconvenience.
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Katada's view was that Koboki's real target was not the patients, but her colleagues and supervisors.
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By engineering patient deaths to fall on other nurses' shifts,
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she could create a series of unexplained deaths that would trigger scandal and bring those around her down.
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The patients, according to that theory, were merely instruments to be used against others.
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Three deaths were confirmed in court.
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Asai Okitsu, 78 years old.
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Koboki contaminated her IV bag on September 15th.
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Okitsu's condition collapsed the following morning, and she died on September 16th, 2016.
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Unlike Kuboki's assertion that she was just targeting terminally ill patients, Okitsu was an orthopedic patient with an infected wound.
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She was not terminally ill.
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She was just someone who tried to leave the hospital early.
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And Kuboki, worried that Okitsu would injure herself and she would receive the blame, decided that Okitsu would have to be poisoned too.
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Sozo Nishikawa, 88 years old.
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He died on September 18, 2016, in the terminal care ward at Ouchi Hospital.
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Police believe he was poisoned between 3 p.m and 4.55 p.m that day, when the disinfectant entered his drip.
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He was dead by 7 p.m., one of the day nurses told his family.
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Nobuo Yamaki, 88 years old.
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He shared a room with Nishikawa.
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He died on September 20th, the same day the foaming IV bag was discovered.
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The same day staff on the ward checked every bag.
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The same day the hospital called the police.
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There was a fourth case that investigators believe she was responsible for.
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An 89-year-old man, whose name has not been publicly disclosed, had also had his IV bag contaminated.
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Kanagawa Prefectural Police referred to a fourth murder charge to prosecutors.
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Prosecutors declined to indict, citing insufficient evidence.
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The prosecution's theory was that Kuboki had intended to poison a different patient sharing the same room
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and that the 89-year-old man's bag was contaminated by mistake.
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So Kuboki had been trying to poison someone else in the same room and the wrong bag was pierced.
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Beyond the three confirmed victims, Kuboki admitted to targeting around 20 patients Police suspected she may
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have been responsible for many of the 48 deaths from that summer.
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But with most of the bodies having been cremated and the forensic evidence gone, the full number will likely never be known.
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Kuboki was formally indicted on December 7th, 2018.
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The Yokohama District Prosecutor's Office charged her with three counts of murder for Okitsu, Nishikawa, and Yamaki,
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and five additional counts of preparation for murder relating to five more IV bags she had already contaminated with diametol,
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but which had not been yet administered to patients.
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Investigators had found those bags during the September 20 ward wide check, the same day Yamaki died.
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Eight counts in total.
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Her trial opened on October 1st, 2021, before the Yokohama District Court, more than five years after the murders.
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At the start of the trial, she pleaded guilty.
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She apologized to the families of the victims.
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She told the court she had been mentally and physically exhausted from nursing, that she had felt she had no choice
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but to accelerate the deaths of the patients in order to temporarily relieve her own anxiety.
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In her final statement, she said she wanted to make amends with her own death.
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The prosecution argued for the death penalty.
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They said she had acted with full awareness, with calculation, and had done so repeatedly.
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The court found the truth was more complicated.
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Kuboki had been assessed during a three-month psychiatric evaluation after her arrest.
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The evaluation found she showed traits consistent with autism spectrum disorder.
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And that was acknowledged as a mitigating factor.
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But she had also been diagnosed with schizophrenia.
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But the court rejected the schizophrenia defense entirely.
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It was determined that she had known what she was doing.
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She had done it on purpose, repeatedly over time.
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She was legally sane.
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On November 9th, 2021, presiding judge Kazunori Karei sentenced her to life imprisonment.
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He stopped short of the death penalty because of the remorse she had shown during the trial.
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He said she understood the gravity of what she had done.
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His reasoning was that it would allow her to face the weight of her guilt for the rest of her life
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and give her the chance to find the right path again.
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The son of Nobu Yamaki responded through his lawyer.
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He said it was strange that she wasn't sentenced to death for killing innocent people due to such selfish motives.
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Neither the prosecution nor the defense was satisfied with the verdict, so both sides appealed.
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The case went to the Tokyo High Court, which upheld the life sentence.
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The ruling stands.
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Kuboki is currently in prison.
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Though the possibility of parole is not completely out of the question, she will most likely spend the rest of her life there.
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Oguchi Hospital no longer exists by that name.
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It was renamed Yokohama Hajime Hospital.
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A new name, the same building.
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And Japan is still sitting with a wider problem that this case brought to the surface.
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It has one of the fastest staging populations in the world, and one of the most severe nursing shortages.
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Hospitals are understaffed, nurses are overworked, and each is handling more than one person should handle alone.
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That doesn't explain or excuse what Kuboki did, but it does explain how someone who was falling apart could
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fall off the deep end without anyone noticing until a dropped bag hit the floor and started to phone.
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What makes this case so difficult to understand isn't the scale of the problem, it isn't the method, it's the frivolity of the motive.
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Asai Okitsu, Sozo Nishikawa, Nobuo Yamaki, possibly more.
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They died because a nurse wanted to avoid some difficult conversations, because she found grief, other people's grief, inconvenient.
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The judge wanted her to live with the weight of that.
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Whether it actually weighs on her, whether any of it is real to her is something only she knows,
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but hopefully her imprisonment brings some solace to some of the bereaved families.
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Let me know your thoughts in the comments and I will see you in the next one.
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Thanks for watching.
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