THE HEALTH Service Executive said yesterday it had consulted outside experts before it ruled out a review of all X-rays read at Ennis General Hospital last year.
The call for a widescale review came from the family of Ann Moriarty (53), who died of breast cancer last April, just months after being told her chest X-rays taken at the Ennis hospital were normal, when this was not the case.
The X-rays had been performed in June and August last year after the mother of one, who was in remission from breast cancer after having had a mastectomy at Dublin's St James's Hospital in 2005, presented feeling unwell.
Her husband, Karl Henry, is dissatisfied with two internal HSE reports into what happened and wants an independent inquiry, which would also look at whether other patients might have had X-rays misread.
The HSE said that based on "the wide range of expert opinion, including the [RCSI] faculty of radiology", it had concluded "that a retrospective review is not warranted in this instance".
Prof Peter McCarthy, dean of the RCSI faculty of radiology and a practising radiologist in Galway, said a wider review wasn't felt necessary because there had been no other concerns expressed about the work of the locum consultant radiologist who misread Ms Moriarty's chest X-rays. It was felt to be an isolated incident.
He said the faculty of radiology had engaged with the HSE and the Department of Health over the past six months and agreed a three-step process that could be followed to determine the extent of a review, if any, when concerns were raised. The first step was that the issue would be discussed locally to see if colleagues or others had concerns about the work of the doctor who made an error. If there were no concerns, there was no need for a wider review. If there were concerns, a sample of the radiologist's work would be reviewed and if concerns hadn't been assuaged, a widescale review would be commenced as occurred recently in the northeast, when 6,000 scans were earmarked for review.
Prof McCarthy stressed that, while he understood the devastation felt by Ms Moriarty's family, no test was perfect. "It's been shown in the international literature that there is a 2 to 5 per cent error rate among radiologists."
Furthermore, he said, it is well recognised that up to 20 per cent of lung tumours may not be picked up on a chest X-ray, as happened in Ms Moriarty's case.
However, Mr Henry insists an independent investigation is needed to assess if others have been put at risk at Ennis and to find out why a mammogram on his wife at St James's Hospital in April 2007, reported as normal, is now missing.
He said he found it "incredible" that the HSE could decide no lookback was required in Ennis on the basis that the error in his wife's case was an isolated incident.
"How can they come to that conclusion without doing a review? Quite clearly when somebody as full of cancer as my wife was discharged from Ennis it shows the system there was a shambles."
Co Clare Fine Gael TD Pat Breen backed his call for an independent inquiry. "Public confidence must be restored that other X-rays taken at Ennis have not also been misread," he said.
Meanwhile, a spokesman for Minister for Health, Mary Harney, said she would meet Mr Henry to discuss his concerns.
And a spokesman for the Health Information and Quality Authority (Hiqa), the independent organisation that has carried out a number of investigations into the misdiagnosis of cancer patients, said it would seek a briefing from the HSE on Ms Moriarty's case. "When we receive that [briefing] we will consider it carefully before making any further comment."
Two internal HSE reviews of the care given to Ms Moriarty at the Ennis hospital found she did not receive "optimal care". The HSE said yesterday it had apologised to her husband and son for the distress caused to them and had implemented the recommendations contained in the reviews.