Medical and welfare workers across Japan breathed a sigh of relief after a court overturned a conviction in the case of a nursing home resident who choked to death on a doughnut.

The Tokyo High Court on July 28 acquitted an assistant nurse, 60, who had been found guilty of professional negligence resulting in death for providing the doughnut to the 85-year-old woman at a special care home in Azumino, Nagano Prefecture.

“The victim’s risk of choking on a doughnut and the accused’s chances of anticipating the possible death from eating it were both extremely low,” Presiding Judge Kazuyuki Okuma said. “The nurse did not breach her care duties under the Criminal Law.”

The high court decision annulled the ruling by a branch of the Nagano District Court in March 2019 that convicted the nurse and ordered her to pay 200,000 yen ($1,890) in fines.

Kazuhiko Katakura, a doctor at a clinic in Okutama on the outskirts of Tokyo, welcomed the high court decision, saying it would lessen unease in the health care industry.

Katakura, who also works at a nursing home, said care providers had “felt abandoned” by the district court’s ruling. 

The assistant nurse gave the resident a doughnut at the dining hall of the Azumino home after care workers asked for her help in feeding the woman in December 2013. 

The resident temporarily suffered from cardio-respiratory arrest after eating the doughnut. She died about a month later from brain damage caused by a lack of oxygen. 

The care home and the bereaved family of the resident reached a private settlement over the death.

But prosecutors indicted the nurse without arrest in December 2014 on charges of professional negligence resulting in death, stunning those in the medical and welfare sectors.

Problems during meals, such as accidental swallowing, are not rare at care homes for elderly residents.

Plagued by chronic labor shortages, individuals working at nursing homes have regularly faced close calls in the line of duty. 

A survey in fiscal 2018 by the public-interest incorporated Care Work Foundation found that 74 percent of workers at special nursing homes, like the one in Nagano Prefecture, had experienced incidents that could have resulted in accidents over the past year.

The guilty verdict raised concerns among care providers that they would be held criminally responsible for accidents that occur when a resident eats or drinks.

A petition signed by around 730,000 people seeking the nurse’s acquittal was sent to the Nagoya District Court and Tokyo High Court.

After the high court decision, the assistant nurse expressed gratitude to her supporters in the capital. 

“I appreciate you for supporting me over these six and a half long years,” she said in tears.

She also said she fought the legal battle under the belief that “care givers should not be intimidated by the indictment.”

Hideo Kijima, a lawyer who heads her defense team, hailed the “landmark ruling.”

“The court’s recognition of facts and its judgment were appropriate,” he said.

Kijima called on prosecutors to swiftly decide against appealing the case to the Supreme Court. 

The Tokyo High Public Prosecutors Office said in a statement that it will “carefully examine the content of the ruling and take appropriate steps.”

The district court had ruled that the woman’s death resulted from the nurse’s failure to check a document that stated the resident’s snacks were changed to a jellylike food from solid food six days before the accident. 

The high court, however, pointed out that “the document was produced to share information about residents among care workers” and that “the nurse did not need to grasp all the content in it.”

The high court acknowledged that the nurse was not notified by a care worker about the change in snack items for the resident. It also recognized that the resident had experienced no trouble eating doughnuts or bean-jam buns until a week before the choking accident. 

Under these circumstances, it was difficult for the nurse to foresee that the resident could die from eating a doughnut, the court concluded. 

“Giving food is important in terms of not only sustaining residents’ health and physical activities but also their mental satisfaction and comfort,” the ruling said.