A Japanese gangster, known as the "John Gotti of Japan", was flown to the United States for a life-saving liver transplant with the connivance of the FBI.
Tadamasa Goto is head of a major Yakusa, or crime family, with a reputation for brutality. He was operated on at UCLA Medical Centre in Los Angeles by Ronald Busuttil, a world-renowned surgeon and editor of a definitive text on liver transplants. Dr Busuttil is among the highest-paid employees of California's state university system.
It is not known whether UCLA or Dr Busuttil knew at the time that the patient and party were Japanese mobsters. But there is nothing to prevent US hospitals from giving priority to high-paying foreign patients with criminal histories.
Dr Busuttil subsequently flew to Japan for follow-up treatments on Mr Goto and gave medical testimony which helped secure his release from jail there. Mr Goto is still barred from entering the US because of his criminal record.
When an American investigative journalist, Jake Adelstein, began investigating the scandal for a Japanese newspaper, he was soon threatened by mobsters associated with Mr Goto. There was a formal meeting where he was told, "Erase the story or be erased, your family too". He quit his job with the Yomiuri Shimbun, Japan's largest newspaper, and his family now live under police protection in Japan and the US.
The FBI helped Mr Goto hoping he would provide information on the near-impenetrable world of Japanese crime gangs in America. Surgeons operated four times on Japanese criminals between 2000 and 2004 as part of a deal that seems to have yielded little of value.
The FBI confirmed that Mr Goto offered to provide information on front companies in the US as well as gang members in exchange for a new liver. US officials say a crime boss called Susumu Kajiyama, known as "the Emperor of Loan Sharks", has deposited million of dollars in US casino accounts. The yakusa are even reputed to own a Californian bank.
"I don't think Goto gave the bureau anything of significance," said Jim Stern, now retired from the FBI's Asian crime division. Mr Goto "came to the States and got a liver and was laughing back to where he came from. It defies logic."
James Moynihan, the FBI's man in Tokyo who brokered the deal, said: "You can't monitor the activities of the yakuza in the US if you don't know who they are. Goto only gave us a fraction of what he promised, but it was better than nothing." Mr Moynihan has since been replaced.
Mr Goto had his operation at a time of acute shortage of transplant organs. In Los Angeles alone, during that period, more than 100 patients died awaiting transplants. UCLA said it complied with all the rules and regulations for organ-sharing and that last year, the university hospital performed more liver transplants than any other in the US. "UCLA's processes for evaluating a patient – both for mental and physical suitability for organ transplants – are the same regardless of whether the individual is a US citizen or a foreign national."
In Japan, the yakuza number almost 80,000. There are more than 800 yakuza front companies, from construction firms to pastry shops.
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