The British Health Secretary, Mr Alan Milburn, yesterday ordered an independent inquiry into the case of the retired consultant histopathologist, Dr James Elwood (78), who has been accused of misdiagnosing up to 230 tests for cancer and other diseases.
Announcing the inquiry as it emerged that concerns about Dr Elwood's performance were raised three years ago, the Chief Medical Officer, Prof Liam Donaldson, said the independent health inspectorate, the Commission for Health Improvement, would "get to the bottom of why this happened".
More than 10,000 tests carried out by Dr Elwood when he worked at four National Health Service (NHS) trusts in Britain on a temporary basis between July 1994 and January this year have been reviewed. It has emerged that one woman had a breast removed unnecessarily as a result of Dr Elwood's misdiagnosis of her sample.
The Department of Health said yesterday that 10,358 patients' samples had been reviewed across the four NHS trusts to date - Swindon and Malborough, Frimley Park Hospital Trust, Mid Sussex, and Royal United Bath Hospital. As a result it was discovered that seven patients from the Swindon and Malborough NHS Trust were "seriously affected" and "appropriate further care", including surgery, had been ordered. The condition of one of the seven patients is considered life threatening.
In an interview with the BBC yesterday, Dr Elwood said: "I very much regret the anxiety and the stress that my errors have caused patients. Perhaps you would remember that the figures quoted are grossly inaccurate." When she was approached at the couple's home near Farnham, Surrey, this week, Dr Elwood's Irish-born wife told the BBC: "Anyone can make a mistake."
But as the British government announced details of an "early warning system" to detect medical mistakes, it was also revealed that Dr Elwood had ignored repeated demands from the General Medical Council (GMC) to provide details of his employment while an inquiry into his work was being carried out. And in January this year Dr Elwood's application to remove his name from the medical register, a process called voluntary erasure, was granted by the GMC which means that he will not be able to practise, although he can reapply to join the register.
At a press conference at the Princess Margaret Hospital in Swindon, where Dr Elwood was employed on 22 occasions as a locum between February 1995 and February 1999, the chief executive of the Swindon and Malborough NHS Trust, Ms Sonia Mills, said the trust was "deeply sorry" about the mistakes. She said that of the 7,000 tests it had reviewed "a very small number" had serious consequences. Another 215 patients with potentially less serious problems had been contacted, including one person who had a prostate operation and was given the all-clear but was later found to have a small growth, which was eventually removed.
Concerns were also raised about employing a 78-year-old doctor. Ms Jenny Rodgers, the director of nursing at Frimley Park Hospital in Surrey, where Dr Elwood worked in 1994, said doctors usually retired at 65 but could continue working as long as they were considered fit, but she would have doubts about employing a 78-year-old.
The first signs that Dr Elwood was falling below the standards required emerged in March 1997 when his former employers at the Royal United Bath Hospital conducted an internal audit that highlighted concerns about his performance between 1995 and 1997.
At the same time a consultant at the Royal United Bath Hospital warned a colleague at the Princess Margaret Hospital in Swindon, where Dr Elwood was employed in March 1997, that concerns had been raised about his performance.
However, the Princess Margaret Hospital continued to employ Dr Elwood and the Department of Health granted him an extension of his employment as a locum.
