The HSE was last evening attempting to contact all patients affected by potential misdiagnoses at UHG following reports of discrepancies in the work of a third pathologist who worked as a locum at the hospital in February and March 2004.
The HSE revealed that an investigation had begun into the pathologist’s work following the publication by the Health Information and Quality Authority of a report into diagnostic errors at the hospital arising out of the misdiagnosis of breast cancer in a Co Tipperary woman. The woman, dubbed Mrs A to preserve her anonymity, had been treated at a private hospital in Limerick but biopsy samples had been sent to UHG for analysis.
The third pathologist, who was not involved in the care of Mrs A, had his registration suspended for 18 months by the UK’s General Medical Council last September, a move which prompted the UHG to seek a second opinion on diagnostic tests and reports carried out by the doctor during his time in Galway.
The HIQA this week published its report on discrepancies in the diagnostic work of two unnamed pathologists, Dr B and Dr C, arising out of the misdiagnosis of Mrs A, who was later found to have breast cancer. While Dr B’s misdiagnosis was found to be an isolated incident discrepancies were found in the cases of 49 patients whose samples were examined by Dr C, where there was potential to affect the clinical management and care of these patients.
The HIQA found that the appointment of Dr C, a locum pathologist, was carried out in accordance with guidance at the time, but still raised questions in relation to the lack of objective assessment of technical ability in the recruitment process. The hospital reviewed its recruitment processes last January and has since implemented new national guidelines.
Management at the hospital this week welcomed the publication of the HIQA report and apologised to any patients affected by the review. A hospital spokesperson said it had implemented a number of initiatives to improve the quality of laboratory diagnostic services at the hospital while the HIQA review was under way.
“The hospital accepts the report's recommendations, and we are in the process of implementing its recommendations,” hospital manager Bridget Howley said this week.
Among other measures being undertaken, the hospital has recently implemented a clinical directorate structure and appointed a clinical director within the laboratories. Service level agreements are also being put in place with private hospitals to ensure multidisciplinary team reviews take place for all patients — UHG patients are already subject to these reviews — along with improved patient advocacy systems and improved technical standards and specimen selection, review, and reporting.
“The team in the hospital who have been dealing with this investigation would like to say a very sincere thank you to the many patients and families we have talked to who have shown extraordinary patience, generosity, and understanding for the shortcomings of the service at a time when they were entitled to feel disappointed and hurt,” said Prof Martin Cormican, clinical director of laboratory services at the hospital. “UHG is committed to using the learning from this to drive continuing improvements to services at the hospital for the benefit of patients and their families.”
Cllr Catherine Connolly, vice chairperson of the HSE West regional health forum, said the contents of the HIQA report were “shocking” and “an indictment both of the management of HSE West and also Government policy”.
However she said the hospital has been seriously affected by a lack of funding for several years.
“The HSE West has operated within an environment of cutbacks and an embargo on recruitment for over eight years now which has directly affected how they can operate,” she claimed. “Indeed the report from the HIQA highlights the increased workload of the pathology department over the period in question and the failure to employ permanent staff in the pathology department.
“The report highlights that there was evidence that the growth of the symptomatic breast disease service had run ahead of available capacity in other areas such as radiology and nursing.
“What is also significant is that some of the increase in workload arose directly from samples sent from various private hospitals for analysis with no concomitant increase in staff.”
UHG has set up a helpline for anyone concerned about misdiagnosis, and has said that contact and follow up with appropriate clinicians will be arranged if necessary.
The phone numbers for patient enquiries is 1800 252 016, and this line operates from 9.30am to 5pm Monday to Friday
For general enquiries about HSE services or cancer support services, call the HSE information line at 1850 24 1850, from 8am to 8pm Monday to Saturday.