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Regarding Informed Consent

At NTT Medical Center Tokyo, medical care procedures and items are divided into those requiring official written informed consent and verbal explanation and consent. Many of the following medical care items and procedures do not require the presence of a physician, and there is minimal physical and mental stress on patients. In order to ensure the smooth progress of treatment, the following medical care items and procedures are conducted upon verbal explanation and consent. If you have any questions, please ask your physician or nurse.

Items included under comprehensive consent at NTT Medical Center Tokyo

[General Services]

Interview, visual and physical examination; measurement of temperature, height, weight, and blood pressure; rehabilitation; nutritional status evaluation, nutritional guidance, and dietary prescription.

[Laboratory Tests/Monitoring]

Blood tests; urinalysis; microbiological examination of pooled urine, sputum, and other samples; pathological and cytological examination of samples; physiological tests such as electrocardiography (ECG), sphygmography (pulse waves); pulmonary function, echocardiography, electroencephalography, ultrasonography, respirometry, expired gas analysis, electromyography (EMG), and thermography; plain x-ray and x-ray fluoroscopy ; plain CT and MRI; radioisotope (RI) tests; psychological tests; monitoring including ECG, transdermal oxygen saturation levels, arterial blood pressure, respiratory ventilation, bispectral index (BIS), and muscle relaxation; intradermal reaction tests (e.g., patch, intradermal, scratch, and tuberculin reactions and minimal erythema dose); and allergic skin tests. Blood tests to determine the presence or absence of infection of syphilis (Treponema antibody), hepatitis B (HBs antigen), hepatitis C (HCV antibody), HIV antibody (AIDS), which will be necessary for medical treatment such as surgery, dialysis, and angiography.
To help ensure the safety of patients, we use surveillance cameras to monitor patient status, when considered necessary for treatment purposes, in the operating room, ICU, HCU, CCU, Wards 4C, 8A, and 9A, radiotherapy room, Gamma Knife Center, MRI room, CT room, and fluoroscopy room.

[Treatment]

Aspiration of sputum; nasal catheterization; indwelling bladder catheterization; examination and treatment of dental caries (tooth decay), periodontal disease, and dentures; and oral care.

[Medication/Administration]

Routine medication, routine injections, peripheral intravenous cannulation (establishment of an intravenous line), continuous subcutaneous cannulation, and oxygenation.
Even though the above medical treatment are performed by qualified medical personnel with appropriate levels of experience, complications such as bleeding may occur. In such cases, the complication is treated under ordinary health insurance coverage. We would like you to understand this arrangement in advance.

Communication of medication information when performing surgeries/ treatments that involve bleeding
For treatments such as surgery that involve bleeding, depending on the kind of medication you are normally taking, there is a possibility that we cannot perform the surgery/ treatment unless you temporarily stop taking that medication. Please inform the staff in detail about the medication you are taking when you are scheduled for a surgery or treatment involving the possibility of bleeding. If we are not informed about the detailed information of your medication and the surgery or treatment is called off, the patient may be held responsible for the expenses.

[Team Activities]

In order for us to enhance patient’s care, teams such as Infection Control Team, Nutrition Support Team, Palliative Care Team, Preventive Management for Diabetes Dialysis Team, Dementia Care Team, Urinary Continence Care Team, Pressure Ulcer Care Team, Neuropsychiatry Liaison Team, and Heart Care Team may be involved in treatment in addition to a team of clinical department, as needed.

[Medical Coordinator for International Patients and Medical Interpreter]

We accept non-Japanese patients while providing medical information in multiple languages, and accommodating cross-cultural, and religious consideration. We cooperate environmental improvement which Ministry of Health, Labor and Welfare of Japan promote for non-Japanese patients to receive medical treatment at ease. When necessary for smooth and safe medical treatment, a Medical Coordinator for International Patients and/or Medical Interpreter (including on-line interpreter) will support medical treatment at clinical practices. In that case, we ask for your understanding and cooperation. When family members or companions interpret for the International Patient please understand that there is a risk of interpretation errors or ethical problems.

[Participation of Students/Trainees in Treatment/Care]

We are a clinical training designated hospital that meets the designated standards set by the Ministry of Health, Labor and Welfare. Initial clinical residents are involved in medical practice under appropriate guidance. In addition, as our hospital is also a clinical training institution that fosters medical professionals, students and trainees may participate in tours, practices, and trainings under strict supervision. In that case, we ask for your understanding and cooperation.

[Privacy]

At our hospital, it is prohibited to take photos or videos with a camera or smartphone, etc. in order to prevent the breach of privacy to others.

[Providing information to dispensing pharmacies]

For smooth cooperation to improve the safety of medication therapy, we will provide information such as the patient’s medication history profile, history of side effect, laboratory data, and explanations about the medication to dispensing pharmacies and other medical institutions as needed.

[Religion and Culture]

While we will do our best to accommodate different religion and cultures, we may not be able to meet your requests for the gender of medical staffs and your dietary restrictions. We will not be performing any surgery for those patients who do not accept any blood transfusion.

[Jurisdiction of Court]

The Tokyo District Court is the exclusive court of jurisdiction for the first instance for any legal matters or disagreements regarding our clinical practice or interpretation/translation services relating to clinical practices, and/or office procedures.

[Governing Law]

Any matter in our hospital will be interpreted and dealt with according to the Japanese law.

September 11, 2020, NTT Medical Center Tokyo

Medical Treatment that Requires Consent Individually

Medical Treatment
All departments CT-guided biopsy
All departments Central venous (CV [subcutaneously implanted]) port construction
All departments Deep vein thrombosis (DVT) treatment
All departments Stent insertion
All departments Bronchoscopy
All departments Tracheostomy
All departments Endotracheal intubation
All departments Thoracentesis / drainage
All departments Transesophageal echocardiography
All departments Angiography
All departments Anticancer drug therapy
All departments Bone marrow puncture
All departments Continuous epidural anesthesia tube placement
All departments Intravenous sedation for procedures
All departments Endotracheal intubation for artificial respiration management (invasive)
All departments Physical restraint
All departments Pericardiocentesis
All departments Cerebrospinal fluid puncture
All departments Biopsy (except for superficial ones)
All departments Myelography
All departments Aspiration cytology
All departments Contrast enhanced CT scan
All departments Contrast enhanced magnetic resonance imaging (MRI) scan
All departments Central venous catheter placement
All departments Enterostomy / gastrostomy
All departments Discography
All departments Puncture for arterial pressure monitoring
All departments Endoscopy
All departments Abscess incision and drainage (except for superficial ones)
All departments Superficial lymph node biopsy
All departments Abdominocentesis / abdominal cavity drainage
All departments Transfusion / use of blood products
All departments Lumbar spinal puncture
All departments Planned cricothyroid membrane puncture (except for emergencies)
Surgical departments Surgery performed in a surgery room or on an outpatient basis
Anesthesiology, surgical departments General anesthesia, epidural anesthesia, local anesthesia
Cardiovascular Medicine Cardiac resynchronization therapy defibrillator (CRT-D; implantable cardioverter defibrillator with biventricular pacing) implantation
Cardiovascular Medicine Electrophysiology study (EPS)
Cardiovascular Medicine Endovascular therapy (EVT; percutaneous peripheral artery intervention)
Cardiovascular Medicine Intra-aortic balloon pumping (IABP), percutaneous cardiopulmonary support device (PCPS) insertion
Cardiovascular Medicine Implantable cardioverter defibrillator (ICD) implantation
Cardiovascular Medicine Percutaneous coronary intervention (PCI)
Cardiovascular Medicine Catheter ablation
Cardiovascular Medicine Pacemaker implantation (temporary, permanent)
Cardiovascular Medicine Inferior vena cava filter insertion (temporary, permanent)
Cardiovascular Medicine Left heart catheterization (coronary angiogram [CAG], left ventriculogram [LVG], aortogram [AoG]), right heart catheterization
Cardiovascular Medicine Direct current defibrillation therapy
Gastroenterology Endoscopic injection sclerotherapy (EIS)
Gastroenterology Endoscopic variceal ligation (EVL)
Gastroenterology Radiofrequency ablation
Gastroenterology Balloon dilation of stenosis
Gastroenterology Transarterial embolization
Gastroenterology Percutaneous transhepatic biliary drainage (PTBD)
Gastroenterology Endoscopic retrograde cholangiopancreatography (ERCP)
Gastroenterology Endoscopic tumor resection
Gastroenterology Endoscopic submucosal dissection (stomach / large intestine)
Neurology Genetic analysis test
Neurology High-dose gamma globulin therapy
Neurology Plasma exchange therapy including immunoadsorption
Hypertension & Nephrology Vascular access creation
Hypertension & Nephrology Vascular access contrast examination
Hypertension & Nephrology Introduction of dialysis
Hypertension & Nephrology Catheter insertion for dialysis
Hypertension & Nephrology Catheter insertion for peritoneal dialysis
Respiratory medicine / respiratory surgery Ultrasound-guided percutaneous needle biopsy
Endocrinology & Diabetes Endocrine load test
Hematology Bone marrow transplant
Hematology Bone marrow transplantation for aplastic anemia
Hematology Umbilical cord blood transplant
Hematology Autologous peripheral blood stem cell transplant
Hematology Autologous peripheral blood stem cell harvesting
Hematology Intrathecal injection
Hematology Allogeneic peripheral blood stem cell transplant
Hematology Allogeneic peripheral blood stem cell harvesting
Surgery Gastrostomy (performed outside of a surgery room)
Cardiovascular Surgery Intra-aortic balloon pumping (IABP)
Cardiovascular Surgery Percutaneous cardiopulmonary support (PCPS) device insertion
Gynecology & Obstetrics Delivery by cesarean section
Gynecology & Obstetrics Delivery (normal delivery, abnormal delivery, episiotomy)
Gynecology & Obstetrics Induction and stimulation of labor (including cervical dilatation procedures)
Pain Clinic Facet thermo / joint thermo
Pain Clinic Continuous epidural drug infusion with Racz catheter
Pain Clinic Thoracic/lumbar sympathetic ganglion block
Pain Clinic Epidural block / sacral epidural block
Pain Clinic Trigeminal nerve block
Pain Clinic Nerve root block / nerve root thermo
Pain Clinic Stellate ganglion block
Pain Clinic Sacral epidural contrast, sacral epidural irrigation
Pain Clinic Facet joint block
Pain Clinic Discography
Pain Clinic Intercostal nerve block / intercostal nerve block under fluoroscopic guidance
Pain Clinic Brachial plexus block
Gamma Knife Center Gamma knife treatment
Gamma Knife Center Cerebral angiography
Neurosurgery / Cerebrovascular Medicine Carotid endarterectomy (CEA)
Neurosurgery / Cerebrovascular Medicine Tissue plasminogen activator (tPA) treatment (thrombolytic therapy)
Neurosurgery / Cerebrovascular Medicine Vagus nerve stimulation (VNS) therapy
Neurosurgery / Cerebrovascular Medicine Diamox stress SPECT (RI [radioisotope] tomography)
Neurosurgery / Cerebrovascular Medicine Endovascular treatment for acute cerebral infarction
Neurosurgery / Cerebrovascular Medicine Explanation of transesophageal echocardiography (extracerebral)
Neurosurgery / Cerebrovascular Medicine Intravascular thrombolysis (transarterial)
Neurosurgery / Cerebrovascular Medicine Endovascular treatment (coil, stent, percutaneous transluminal angioplasty [PTA])
Neurosurgery / Cerebrovascular Medicine Thrombolytic therapy (intravenous rt-PA therapy)
Neurosurgery / Cerebrovascular Medicine Intraoperative indocyanine green (ICG) angiography
Neurosurgery / Cerebrovascular Medicine Long-term video electroencephalography (EEG)
Neurosurgery / Cerebrovascular Medicine Electrical stimulation mapping
Neurosurgery / Cerebrovascular Medicine Cerebral angiography
Neurosurgery / Cerebrovascular Medicine Wada test
Urology Gonadotropin-releasing hormone (GnRH) antagonist (endocrine therapy [hormone therapy])
Urology Luteinizing hormone-releasing hormone (LHRH) agonist (endocrine therapy [hormone therapy])
Urology Treatment with Zometa
Urology Treatment with Ranmark
Urology Gold marker placement
Urology Endocrine therapy for prostate cancer
Urology Bacillus Calmette-Guerin (BCG) infusion therapy for bladder cancer
Urology Intravesical BCG infusion therapy for bladder cancer
Radiological Center / Radiology CT-guided lung biopsy
Radiological Center / Radiology Transcatheter arterial embolization for endoleak after endovascular stent grafting
Radiological Center / Radiology Transcatheter iliac artery embolization prior to endovascular stent grafting
Radiological Center / Radiology Balloon-occluded retrograde transvenous obliteration
Radiological Center / Radiology Myelography
Radiological Center / Radiology Image-guided biopsy
Radiological Center / Radiology Image-guided abscess drainage
Radiological Center / Radiology Bronchial artery embolization (BAE)
Radiological Center / Radiology Transcatheter internal iliac artery aneurysm embolization
Radiological Center / Radiology Transcatheter pulmonary arteriovenous fistula embolization
Radiological Center / Radiology Transcatheter splenic aneurysm embolization
Radiological Center / Radiology Percutaneous transhepatic portal vein embolization (PTPE)
Radiological Center / Radiology Percutaneous transluminal renal angioplasty (PTRA)
Radiological Center / Radiology Angiography (incision ×)
Radiological Center / Radiology Superior vena cava stent placement
Radiological Center / Radiology Selective arterial secretagogue injection test (SASI test)
Radiological Center / Radiology Contrast enhanced CT scan
Radiological Center / Radiology MRI with contrast (gadolinium)
Radiological Center / Radiology MRI with contrast (Resovist R injection)
Radiological Center / Radiology Preoperative arterial embolization for vertebral body tumors
Radiological Center / Radiology PTA of dialysis shunts
Radiological Center / Radiology Blood sampling from adrenal vein
Anesthesiology Laryngeal mask insertion (consent included in anesthesia management)
Anesthesiology Gastric tube insertion (consent included in anesthesia management)
Anesthesiology Cardiopulmonary resuscitation related procedures (consent included in anesthesia management)
Anesthesiology Arterial catheterization (consent included in anesthesia management)
Anesthesiology Pulmonary artery catheterization (consent included in anesthesia management)
Anesthesiology ALEX laser
Anesthesiology V-beam laser
Anesthesiology Treatment of ingrown nails
Anesthesiology Discontinuation of anticoagulation therapy
Anesthesiology Venous embolism
Anesthesiology Variceal sclerotherapy
Otorhinolaryngology – Head & Neck Surgery Swallowing videofluorography
Otorhinolaryngology – Head & Neck Surgery Myringotomy
Otorhinolaryngology – Head & Neck Surgery Nasal mucous membrane ablation
Ophthalmology Sub-Tenon steroid injection
Ophthalmology Steroid pulse therapy
Ophthalmology Laser iridotomy
Ophthalmology Fundus fluorescein examination
Ophthalmology Anti-vascular endothelial growth factor (VEGF; intravitreal injection) therapy
Ophthalmology Aqueous humor collection
Dentistry & Oral Surgery Oral surgery in patients with bisphosphonates (BPs)
Dentistry & Oral Surgery CDDP (cisplatin) concomitant chemoradiotherapy
Dentistry & Oral Surgery Cmab (cetuximab) + FP (fluorouracil + cisplatin) therapy
Dentistry & Oral Surgery Cmab (cetuximab) concomitant chemoradiotherapy
Dentistry & Oral Surgery FP (fluorouracil + cisplatin) therapy
Dentistry & Oral Surgery TPF (docetaxel + cisplatin + fluorouracil) therapy
Dentistry & Oral Surgery TS-1 therapy (oral antineoplastic agents)
Dentistry & Oral Surgery Anti-inflammatory surgery for osteomyelitis of the jaw
Dentistry & Oral Surgery Open reduction and internal fixation
Dentistry & Oral Surgery Neck dissection
Dentistry & Oral Surgery Torus removal
Dentistry & Oral Surgery Dental implant treatment
Dentistry & Oral Surgery Apicoectomy
Dentistry & Oral Surgery Tumor resection / reconstruction
Dentistry & Oral Surgery Tumor resection / excision
Dentistry & Oral Surgery Maxillary sinus floor augmentation
Dentistry & Oral Surgery Partial glossectomy
Dentistry & Oral Surgery Cystic fenestration / excision
Dentistry & Oral Surgery Tooth extraction
Dentistry & Oral Surgery Tooth replantation / transplantation
Dentistry & Oral Surgery Impacted wisdom tooth extraction
Rehabilitation Swallowing videofluorography
Neuropsychiatry / Psychosomatic Medicine Happiness program
Neuropsychiatry / Psychosomatic Medicine Group cognitive behavioral therapy program
Neuropsychiatry / Psychosomatic Medicine Program to assist a return to the workplace
Neuropsychiatry / Psychosomatic Medicine Administration of therapeutic sedatives
Neuropsychiatry / Psychosomatic Medicine Electric current therapy