NINE PATIENTS in the northeast had their diagnosis of lung cancer delayed by periods ranging from five weeks to 14 months as a result of errors made by a locum consultant radiologist, a new report has found.
Eight of the patients are now dead. One is receiving ongoing care.
The report, which outlines the findings of a review of the work of the locum who worked at Our Lady of Lourdes Hospital in Drogheda and Our Lady's Hospital in Navan from August 2006 to August 2007, states that "tragically in one case" a major or 60 per cent chance of cure by surgery was denied to a patient as a result of the delayed diagnosis.
In five other cases "the original small chance of cure was lessened by the delayed diagnosis", but in two cases cure was not a realistic prospect at any stage.
The report, published yesterday by the Health Service Executive, states that the delayed diagnosis shortened "by a valuable number of months" the lives of at least six of the nine patients. It also led to a delay in the institution of timely palliative care for eight patients.
"The degree of harm or disadvantage that accrued to individuals involved was considerable and the human cost was clearly very significant," the report says.
Thousands of chest X-rays and CT scans reported on by the elderly locum, who now lives in Scotland, were double-checked since the review began in May.
As a result of the review's findings, he is being referred to the Medical Council of Ireland, the report states. He is also being referred to the General Medical Council in the UK.
The nine patients who had a delayed diagnosis included six men and three women aged between 61 and 84 years. The delayed diagnosis, the report says, led to worry, uncertainty and distress for families, and greatly reduced the time available to them to come to terms with the serious diagnosis and the impending death of their family member.
In each of the cases an assessment of the significance of the delay in diagnosis was carried out by a team led by Prof Muiris Fitzgerald, former dean of the faculty of medicine at UCD, who also met the families of the nine patients.
The review states that the nine cases had been picked up before the look-back actually commenced. Concerns were first expressed about the work of the radiologist in September 2007 but the review did not commence for another eight months.
The report says that from when the first concern was raised "there was consistent activity" within the hospital group "to achieve a consensus as to how best to respond". There were no published guidelines on what to do.
The review also found 270 patients whose X-rays were read by the locum had had findings on their X-rays which went unreported. While these were "unlikely to have any clinical significance", they should nonetheless have been recorded. These included factors such as evidence of old, healed TB.
The report describes these cases as "major misreports without clinical harm" and says detailed clinical analysis of the patient records in all these cases indicated that "harm was averted as a result of the alertness of clinicians, other clinical information or tests, or other factors such as timely intervention with appropriate treatment".
Overall, the review examined 5,835 chest X-rays and 67 CT scans. Some 93 per cent of the patients these related to required no follow-up. The report also says 29 patients' X-rays were missing and could not be reviewed.
The report says 23 barium studies to examine the digestive tract for the presence of ulcers, tumours and other abnormalities were reported on by the locum. Four of these were deemed "incomplete studies" when reviewed and these patients have been referred for further examination. This is ongoing.
The locum, who is not named in the report, is recorded in it as not accepting all the points raised, but he offered his sincere condolences to all the families and wished to convey his apology for the sorrow and anguish that has been caused as a result of the missed diagnoses. He said he was devastated by the report's findings.
The HSE said it too wished to apologise to the families of the patients who were harmed by the delayed diagnoses, and to all patients included in the review.
It said it was now enhancing clinical governance in the radiology service in the region to try to reduce the likelihood of errors occurring, and increase the likelihood of early detection of those errors which do occur.
Minister for Health Mary Harney extended her sympathies to the patients involved.