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Sayo Hitsugi is a nurse at the Mochizuki General Hospital, and a part of the secret Black Label organization that is dedicated to eliminating the criminal element that infect the city. She's a member of the Team Ampoule Zero with Yuuko Sagiri and Miki Tsurugi.


Triage X Vol. 1 JPN (Dec 2009)
Triage X Vol. 1 JPN (Dec 2009)

Sayo Hitsugi (柩 小夜, Hitsugi Sayo) is a main character in the Triage X series that was created by Shoji Sato. It began serialization as a bi-monthly series in Fujimi Shobo's Monthly Dragon Age in 2009.

Her first appearance was in Triage X Volume 1 CH. 1 "CASE: 1 Hell's Perscription I - Cross of Fresh Blood".

The kanji used in Sayo's family name Hitsugi is the same used in the word for coffin 柩 (hitsugi).

Character Evolution

Sayo is often described as a "harsh nurse" and member of the Ampoule Zero Team. She is a tall woman with fair-skin and long blue hair. In the hospital, she appears to be just an average, kindly nurse with a timid side. In battle she wears a demon mask and wields huge guns. Her efficiency in killing is said to be so high that she's makes it as painless in possible, meaning instant kills.

Age: 24

Hair: Blue

Eyes: Violet

Height: 169cm (5' 6.5")

Measurements: 93-58-84cm (37-23-33in.)

Sayo is a loyal fighter, but the source of her monstrous strength has yet to be revealed. When she fights behind her demon's mask, her personality has a drastic change. She has a sadist side that even enjoys the idea of torturing those with the black label on their heads. Among her other skills is a keen mind and photographic memory. She can remember the names of all those targets with the black label and the heinous crimes they committed.

Major Story Arcs

CASE 1: Hell's Prescription

Saya worked as backup on Yuuki's request for Arashi Mikami's first mission with Black Label. She wiped out any stranglers that tried to escape with twin two Weilding MG42 machine guns.

CASE 2: Surgical Strike

Sayo deflects Yoroida's car
Sayo deflects Yoroida's car

Team Ampoule One's mission to eliminate Taisei Aranami hit a bump when Jin Masaki escaped them. Masaki arranged for his men to kidnap Miss Fujino when she was released from Mochizuki Hospital, and his man, Yoroida, ran over one of Yuuko's elderly patience.

Team Ampoule Zero joined the mission to take out Masaki after he was located in an abandoned building. Sayo assisted Yuuko in finding Yoroida. She stood in the path of his speeding car, and blocked him with her No Pain shield. This causes the car to deflect backward and fly up in the air for Yuuko to slice both the car and Yoroida in half. While celebrating their victory back at the hospital's bath, Sayo tried inviting Arashi to join Yuuko and Miki.

CASE 3: Midnight Guerrilla

Sayo goes wild
Sayo goes wild

Black Label missions were recently being interrupted by a young woman who was setting criminals on fire. When random bodies were found burned alive in the city, Dr. Mochizuki tasked Sayo to investigate in town by tracking where the lady pyro got the XM25 launcher she uses. Sayo noticed Shinichiro Inunaki, a former member of Team Ampoule Zero who left year ago; and she followed him. She lost Inunaki, and ran across some local drug dealers. She recognized some of them as black labeled criminals and made short work of them after one tried to kill her. The only survivor was the weapons dealer she was looking for, but he was killed by a crossbow bolt to the head before she could interrogate him. She only missed throwing it back at her attacker becasue the bolt defected off their second shot.

Black Label discovered that Mikoto had gone rogue to go after the Kabuto Syndicates new leader, Kunio Ohmichi. Both teams followed to back her up. Sayo was one of the team that killed the snipers hired by Kunio. Mikoto shot the man who fired on Sayo earlier, and the pryo-girl, Chikage, that Mikoto had befriended dropped herself into the burning building below.

Powers & Abilities

Super Strength

The source of Syao's incredible strength has yet to be revealed in the series. She has been seen lifting large machine guns with ease and a large and sturdy shield on her back. She once used this shield and braced herself against it to stop a speeding car. The impact forced her back a few inches and launched the car backward into the air. She only suffered stiff shoulders afterward.

While in a fight with some thugs, one kick from Sayo launched a man into the air with enough force to launch him up and crack the cement ceiling.


Though not perfect, Sayo was able to throw back and crossbow bolt by hand and nearly hit the person who fired it at a great distance. She does frequently use firearms, but these are heavy weapons used an close to medium range and little need for accuracy.

Weapons & Equipment

Due to Sayo's incredible physical strength, she is able to wield massively heavy weaponry with astounding ease.

  • Dual Weilding MG42 "Buzzsaw"
  • M134 Minigun "The No Pain"
  • No Pain Black Label Shield

Other Media


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