Hero Overview

Hitsugi Sayo (柩 小夜, Sayo Hitsugi) is the head nurse at Mochizuki General Hospital as well as one of the members on team Ampule Zero. She's the close combat expert of Black Label and she processes incredible strength and specializes in heavy weaponry, handling mini guns and light machine guns with ease. While usually friendly and casual, on missions however, she wears a devil mask and armored gauntlets and turns berserk, showing her more brutal and sadistic side.


Hitsugi 20

Hitsugi is a slightly tall, lean built beautiful young woman, who has lightly colored skin, with long blue hair and eyes that are violet. Her bangs are shorter and go off to the side of her face. Behind her bangs is a grouping of hair that is longer than her bangs, but not as long as her actual hair. Along with other female members of Ampule Zero, Sayo has a larger than average bust size (94 cm). She tends to wear a nurse's outfit, but is seen wearing other clothes as well. She is usually seen wearing headphones when she is dressed more casually. Hitsugi always wears a mask when completing a black label mission. The mask gives Sayo a demonic appearance, especially when she is carrying heavy weaponry like the MG42s, and minigun.


In the hospital, Hitsugi appears to be just an average, kindly nurse with a timid side. While normally nice and laid back, on a mission, she wears a devil mask and armored gauntlets and turns into a loyal fighter. Also when Sayo fights behind her demon's mask, her personality has a drastic change. She has a brutal and sadistic side that even enjoys the idea of torturing those with the black label on their heads. She's incredibly strong and has 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. Hitsugi is a harsh nurse that also shows no mercy on missions by wielding huge guns. Without any hesitation she pointed a minigun at point blank range and fired at a guy, killing him instantly. Her efficiency in killing is said to be so high that she's makes it as painless in possible. Sayo obeys her orders flawlessly earning respect in the eyes of her comrades. However, she can get a little hotheaded when she is at risk of injury, saying something like, "Maybe you should be a little more careful how you use me. What if I'd gotten hurt?" to Yuuko. Despite the fact that Sayo has her merciless and aggressive side, she also has a kind and thoughtful side, which is shown when she invites Arashi to the bath with the other Ampule One members after their mission was complete. In Episode 8 of the Anime adaption, She passionately kissed Arashi for saving her, hinting she harbors romantic feelings for him, without realizing the difference between their ages. In episode 10 of the anime adaptation, she openly admits that she loves Arashi in front of the rest of the girls of black label.

Major Story Arcs

Case 1: Prescription from Hell

Histugi is first seen as backup per request by Yuuko Sagiri during Arashi Mikami's first mission with Black Label. Wiping out any stranglers that tried to escape with dual wielding MG42 machine guns.

Case 2: Surgical Strike

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

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 and Abilities

Enhanced Strength

The source of Hitsugi's incredible strength has yet to be revealed in the series. She has the physical ability to surpass the average human strength and beyond. 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.

Enhanced Speed

Sayo has the physical ability to surpass the average human speed and beyond.


Due to her father's experiments done to her by the unknown medicine/serum called "D99," that had done unspeakable things to her mentally and physically. Because of this drastic change in her own self being, she has developed a healing factor but not a drastic change compared to humans, but is immune to moat diseases because of this and in drastic situations, she can regenerate limbs, organs, and even her own life.

Berserker Rage

When she enters this rage mode, her abilities enhance ten fold, but at a cost of her sanity while she is in this stage. The only known way to bring her out of this rage is by sincere and genuine compatibility with her and that person, usually emotions or sympathy and understanding, and to remove her Berserker mask.


Though not perfect, Hitsugi 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.


Hitsugi specializes in using heavy weapons. She is able to wield such heavy weaponry because of the massive amount of strength that she possesses. Weapons that Sayo has used include:

  • Dual Wielding MG42 "Buzzsaw" - Sayo has enough strength to hold a light machine gun in each hand. This type of fire power leads to mass slaughter of any enemies in her path.
  • M134 Minigun "The No Pain" - Hitsugi's ability to carry a minigun around makes her job of killing very simple. The fire power from this gun leaves almost no trace of the enemy, simply leaving chunks and fragments of human remains. This weapon is also powerful enough to completely destroy a car.
  • The No Pain Black Label Shield - A shield like piece of equipment that Sayo carries around with her on her back. The shield contains some type of mechanism that locks itself into the ground. This shield is strong enough to with stand the impact of a high power car with little damage.
  • Unbreakable Equipment - Sayo studied how to constantly improve and to better herself for anything she comes across. Therefore, she has made constant changes to her armour, guns, and her No Pain Black Label Shield, making it almost unbreakable, but constant improvements to her gauntlets (which has hidden blades) and body armour making it near impossible to break.


  • The kanji used in Sayo's family name Hitsugi is the same used in the word for coffin 柩 (hitsugi). Which is ironic that her weapon The No Pain Black Label Shield shapes like a coffin.
  • Hitsugi's current age is 24 years old.
  • Her height is 169 cm (5' 6.5") while her BWH measurements are 93-58-84 cm (37-23-33 in.).
  • Hitsugi is the first female of Triage X to kiss Arashi.
  • Her favorite phrase is "aye, aye".
  • Her fetish appeal is large breasts.
  • She is voiced by a Japanese voice actress Ryōko Shiraishi.
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